The Elderly Ovary

Frozen Maybes

2010-10-10T22:11:00.000-07:00

So, I don't know. I've been so stuck about how to keep writing here. I wish I could just transition easily to paragraphs about jumpy bouncers and first teeth, but it's been hard for me to recuperate from having every single thing in my life revolve around infertility. For so long it seemed like every vacation plan, every spat with my husband, every decision about my job was really about whether or not I would, could, or should even keep trying to get pregnant. I think I was just so used to thinking about my whole life in terms of cycling that I literally couldn't adjust for a while.

Of course, the sleep deprivation is a kind of eraser. I hadn't been able to actually think about much of anything for a while when I suddenly noticed that old harbinger of possibility, EWCM. It was such a shock that at first I didn't even know what to think. I mean, I actually entertained the idea of trying to jump on the post-pregnancy hormonal rollercoaster and maybe get lucky the old fashioned way. Which is the absolutely ridiculous, both statistically and practically. But still, it was impossible not to think about it.

And then reality really hit hard when my lab called to say that my pre-paid embryo storage was about to expire and did I want to go on a yearly payment plan?

And while it is SO OBVIOUS that we will never use those embryos, I can't help but feel wretched about destroying them. It took me seven years to get those embryos. I will never again even get a chance to have embryos of my own. Those embryos are related to my kids. But of course it is SO OBVIOUS that another pregnancy would not be good for me, that both my husband and I are too old to do this again, that we are worn out and tapped out and emotionally spent and that cycling put such a strain on our marriage that even talking about those embryos caused a gigantic argument. There are a jillion reasons to put an end to this whole thing and move on with our lives and not even think about the frozen maybes anymore.

If I had fifteen fabulous embryos I would donate them and hope that they would make somebody incredibly happy. But I have two semi-good embryos that came from 40 year old eggs. I'm pretty sure isn't what couples who have gone through whatever it takes to get to donor embryos are looking for. I think about my daughter's sunset-colored hair or my son's olive-green eyes, her abnormally high IQ, his impish crinkly grin. They are both long and lean, with delicate features and old-soul eyes. As a mother, it's impossible for me to imagine that somebody wouldn't want these exact traits, even the pale skin and freckles. But as an infertile, I know that nobody chooses embryos that don't maximize their chances of a take-home baby.

So, that leaves research. Which I wholeheartedly support, knowing that research is the only thing that helps anyone have success with IVF. And increasing the chances for success, especially on "old" eggs, is so important to me that I really WANT to be more gung-ho about just signing the donation papers and getting on with things. But it's hard to just give away, give up, something I fought for so desperately.

I have always said that the longer someone struggles with infertility, the more damage it seems to do, and I know that's what this is all about. Seven years of clinging to hope makes it hard to just let go.

Easy-ish

2010-04-16T17:58:00.000-07:00

So, it's just hard to write while you're drastically trying to keep up with the basic laundry/groceries/billpaying/etc., even with an "easy" baby. But you already know that, don't you?

Just so you know, and "easy" baby isn't all that easy. I mean, he does wail inconsolably sometimes. He does want to eat every hour for at least part of the day. He gets fidgety in his car seat and he doesn't like to have his diaper changed. But that all seems kinda normal for a baby, so it's more or less what I expected.

My daughter was colicky and fussy and demanding and sensitive. I remember walking around the house with her for hours at a time, singing and rocking and patting and desperately hoping she'd conk out. Which she would, only to wake about two seconds after I carefully transferred her from my arms to a spot in her crib which had been strategically pre-warmed with a hot-water bottle. The frustration was so aggravating that I would cry at least twice a day.

This little guy is a piece of cake in comparison. He'll sit in his bouncy seat and stare at the light fixtures until he drifts off to sleep. (Sometimes.) He'll wake up and just coo for me instead of screaming his head off if I'm not right there. (Sometimes.) He'll gaze wondrously at the thrill of a warm bath, at the feeling of the water rinsing his head, at the leg massage I give him afterwards while he has some diaper-free time. I am astounded at the sheer amount of time that goes by while he actually looks happy. Which may sound ridiculous, but my daughter was so high-strung as a new baby that she had to be held all the time. One of her first words was "carry-you" since she didn't understand direct pronouns and we were always saying "Okay, I'll carry you" or "Do you want Daddy to carry you?". She said it like one word with a badly pronounced R, "kewwiyew."

Anyway, he's so much more laid back that I can put him in his baby-lounger in the bathroom and take a shower - or cook dinner, whatever has to be done. He wouldn't be happy in there forever, but I can get a half hour or so when he's fed and burped and freshly-diapered. He'll just watch us move around and turn his head to follow the sounds of our voices. He seems fine with just observing and relaxing. Or his eyelids will just get lower and lower and he'll conk out. Then we can have about 90 minutes, which seems like forever. It's kind of unnerving, really - I keep wondering if something's wrong with him, but hopefully he's just a mellow guy.

So, I'm not exactly at my wit's end, but I am trying to get one house ready to sell and organize another. I found a nanny-sharing arrangement, which is great, but I need to get to know her a bit before I decide if it's permanent. I had been telling everyone I knew that I wanted a nanny-share, hoping that something would eventually come of it. I didn't expect it to work out so soon, but it was too good to pass up. The other mother has 3 year old twins, so I think the nanny is happy to have a mellow newborn three days a week. She hangs out with him while I dash between houses - seems like she has the better part of the arrangement, but at least I am almost done moving.

Anyway, that's me these days. Mellow baby, part-time nanny, not working for at least a few more months... and I'm still propping my eyelids open sometimes, moaning about my creaky back and realizing almost every afternoon that I haven't eaten since six in the morning. If I am ever done fixing up the old house, landscaping the new one and figuring out how to get rid of half my husband's old junk without him knowing about it, I might actually worry about some kind of exercise. Meanwhile, elastic waists for me...

Post-Partum Post

2010-04-02T14:20:00.001-07:00

So, the birth. I've tried to write this so many times and it always comes out rambly and bitter and weepy and just too long. I'll try to stick to just the facts, ma'am.

I was on low-dose pitocin overnight and my cervix didn't budge. I had been walking around at about 2 cm and when the doctor checked me at 9:00 am it was still 2 cm. So, my water was broken and the pitocin was turned up and my doctor was supposed to come back around 11:30 to check my cervix again. The nurses told my husband that I'd probably have the baby around 4 or 5 that afternoon, so he left to get some breakfast. My doula had called earlier to find out if she had time to take her kids to school, and was stuck in horrible traffic. I figured the contractions weren't that bad, so I'd be okay for a while.

You see where this is going, don't you? The contractions got steadily stronger and closer together until they were a minute and a half apart and lasted almost a minute each - so, thirty seconds of recovery between each little bout of agony. My husband came back as soon as I called him, but by then I was moaning for the anesthesiologist. My doula didn't even try to talk me out of the epidural - she took one look at me and said that the baby looked great on the monitor and that was all that mattered.

At that point I didn't care about the whole needle in the spine thing anymore. The nurse told me it would be just four more contractions and then I wouldn't feel them. After the fourth contraction the pain was somewhat duller than it had been, but mostly it had just shifted. It was less abdominal and more concentrated right between my legs. I kept saying that it still hurt and the nurse said that it should be getting better. Um, no, actually.

Then they were checking my cervix and telling me not to push yet and asking if I could wiggle my toes (yes) and my husband was putting the swing-tilt lens on his camera (a way of getting only some of the field in focus, which was one of my conditions of being photographed in the delivery room) and then my OB was there and I was having the baby. It was 11:00.

Everybody kept telling me when to push and when to hold my breath. I couldn't feel the contractions at all anymore but I could feel my skin tearing. I was screaming like I was auditioning for a horror movie. I couldn't believe that I had given in and gotten the epidural and I was in excruciating pain anyway. I heard the nurse talking about novacaine and then I could feel the needles and I just hoped I would pass out from the pain.

Maybe I did pass out, because the next thing I knew I could hear non-stop crying and somebody was handing me a baby. My baby. After 13 minutes of Really? This little puffy faced eskimo baby? I was still crying and holding him and my doctor said I had a little tear and needed stitches. No kidding, huh? Then the nurse was asking me to wiggle my toes, asking if I could stand up.

They took me to the postpartum room and gave me percocet. I finally slept for hours while my husband held the baby. When I woke up everything hurt and there was blood all over and I had swelled up so much that I couldn't even put my flip flips on to go into the bathroom. I had to walk with my toes curled under because it hurt so much to put any weight on my giant feet.

I was okay as long as the percocet kept me from feeling to much or thinking too much about anything. But they won't send you home with it, so I had to settle for vicodin, which just makes me feel stupid and constipated. I kept swelling for about a week after the birth - retained IV fluids, supposedly. I only lost about nine pounds after delivery because I was so full of excess fluid - and the baby was 7lbs 4 oz of that.

A few days later I stood up and blood poured down my legs, soaking my jeans. When I tried to wash up, clots the size of dessert plates came out in the shower. I had to go in for a uterine "massage" (external squishing) and a speculum exam, which believe me is NOT a good idea with fresh stitches in that general area. I drew the line at the vaginal ultrasound. Not a chance.

Whoever says there is "no medal" for having a medication-free birth is way off track. Who cares about even the stupid idea of a medal when you can't even hold your new baby because you're zonked out on narcotics? When you're hobbling to the bathroom while blood is soaking through your third pair of pants?

The only reason any of it was worth it was that when the doctor broke my water there really wasn't any in there. The baby had stopped moving much in the day and a half before I was induced, so things were definitely getting more precarious. And of course I would do anything to make sure that this baby was okay. And he is - he's great. More than great - he's a relaxed little guy, a good sleeper, breastfeeding is going well. I mean, it's exhausting but I couldn't really ask for an easier baby unless I was being wildly unrealistic.

I'll always feel sort of bitter about the whole birth experience, just because I felt like nobody cared how I was doing in anything but a technical way. My blood pressure was good and my oxygen was fine, so it didn't matter that I was completely dilated and still getting the maximum pitocin drip. And why bother checking me before the epidural? Just get the drugs into me and maybe I'll stop moaning so annoyingly.

Obviously, the most important thing is that in the long run everything is fine. And the truth is, after that first week, I'm doing pretty well. All the swelling and bleeding and pain is gone and I've lost about 25 pounds now. I'm getting almost eight hours of sleep at night (usually two, two and then four) plus a nap in the afternoon. I'm easing back into life again, going to baby-massage classes once a week and doing some strollering in hopes of someday actually exercising.

In the meanwhile, I will write about my mother's impending visit, the fact that somebody has already offered to buy my baby, and how to buy trees. Plus, maybe another photo or two of the little guy?

All's Well That Ends Well...

2010-03-18T12:16:00.000-07:00

I'm not sure I can even try to describe the birth. I'll try to figure out what actually happened and then write about it, maybe.

But I can absolutely say that the babe is fine. Even though he is apparently an eskimo. Since the rest of us are fair-skinned blue-eyed Gaelic-ish people, there may have been a mix-up at the lab...

Even though he looks kind of eskimo-esque, he has the facial expressions of a three-star chef-de-cuisine touring the kitchens of a junior-high cafeteria. Shock, disdain, repulsion and suspicion are his specialties.

But, he has been a bizarrely easygoing little guy so far, so I can't complain. I'll have to let the clinic know that even though I seem to have been given the wrong baby, I'll probably just keep him.

Ides Of March

2010-03-12T16:48:00.000-08:00

That's the date. Monday, March 15th.

Originally, it was a day of festivity to celebrate the Roman god Mars. Although it this case it may be more fitting to "beware the Ides of March", the dire warning in Julius Caesar. Yep, that's the day I'll be dripped with pitocin and hoping for the best.

At my appt. this morning I was on the monitors for almost an hour and Mister Baby only moved twice. I honestly think he was just sleeping, but my OB decided that it was time to make a move. Not an emergency move, obviously - more of a precaution.

And I agree - I have been so worried that I will have made it this far only to have it all end badly. I feel better knowing that I'll be in a hospital the whole time. Since cord compression and placental abruption are the risks that have had me on bedrest for so long, I've been a little nervous about what might happen when I finally start having serious contractions. I mean, the bedrest was supposed to help by keeping my uterus calm and not disturbing the placenta. Labor is kind of the opposite of that, right?

So, I get the weekend to wrap up any last little things. Not that "everything" will be ready. But things will be ready enough. I went to Targ yesterday, my first and only trip there during this entire pregnancy. It's funny, but after so much online shopping I found the selection incredibly limited. I didn't actually buy much, but it was good to get some of the little things crossed off of my list. Boob cream. A lightweight robe for the hospital. Felt pads for the legs of the new furniture.

The crib and changer and glider were finally delivered yesterday. The nursery will just be my project for the next month or so. For me, it's still better than getting all of that ready months ago and then having to take it all apart if I didn't end up with a baby. There was a time when I wouldn't have considered waiting until the last minute to get things ready, and I suppose I'm not so cautious when it comes to other things. But this one was hard.

In any case, the upside is that I spent so much time figuring it out on paper. It all came together almost exactly as I planned, and I think I'll have fun finishing it up during the nursing-pooping-laundry-exhaustion of the next few weeks.

So, my bag is packed. The car seat is installed. I finally bought diapers. There is an InDesign document on my desktop, all ready for a photo and a few extra bits of information to be added and made into an email announcement. I think I might be ready for this. Yeah, I'm a little worried about the whole pitocin thing, but maybe it won't be that bad?

Dear Baby, Dear Body

2010-03-10T12:19:00.000-08:00

I just want to say thanks for hanging in there these last eight weeks. Way back in the beginning of January, that first L&D nurse told me you'd be lucky to last another few days. Remember that? How you somehow managed to keep what little fluid there was in there from leaking out and a few days later the perinatologist said we could go home? And even though things have been a little rocky since then, you've both really pulled off so much more than any of us expected. 38 1/2 weeks! Woo-hoo!

And, Baby - thanks for making the kick counts so easy, too. It never takes you a whole hour to bust out ten moves. You're quite a little wiggler. And you've passed your non stress tests fabulously, too. I can always see exactly where your heartrate correlates to your movements, which is just what the doctors are looking for. You usually manage to kick exactly on the toco meter, too, which I think is a reflection of your still-developing fetal sense of humor - sometimes on the printout it looks like I'm having crazy spiky contractions, but we all know it's just you.

After trying so hard to just stay in for so long, you might feel hesitant about switching gears and trying to come out now. And I totally understand. But the thing is, you are getting bigger and bigger and your fluid environment is getting smaller and smaller. Things are not going to get better, so you should probably just make a run for it while you still can. Otherwise, the doctor is going to come in and get you. Now, that wouldn't be then end of the world, but it would make things a bit more complicated and let's face it - this has been complicated from before you were even a bunch of cells in a petri dish. How about a nice, natural birth with no emergencies?

As for you, Body - I know it hasn't been easy. You've been poked and stretched and swollen and weakened. I know it hasn't been ideal. I know you didn't really want to do this in the first place. But you've been so good about coping with everything from the stims all the way through the bedrest, and I really, really appreciate it. I know you did your best with the fluid leak. Only about 6% of leaks seal back up and allow the pregnancy to continue without infection - I am so impressed that you managed to do that against such low odds!

The thing is, we don't have to do all this any more. You don't have to lie down all day just hoping to churn out another few drops of fluid. You don't have to let all your muscles keep withering away doing nothing. We can just have the baby now and get this all over with! Think of it - you can hike and do yoga and have wine and cappuccino again! What else is there I can bribe you with? You name it, Body. Anything but a spinning class. How about a spa day?

You've both been fantastic and I so, so appreciate it - let's keep up the good work and get on with things before the doctors come up with some kind of drastic surgical plan. After all, Body, you don't want to be sliced and scarred. And, c'mon Baby - the boobs aren't going to be good for much if they're full of demerol. It's time, you two. Thanks for making it this far, and now it's time to get on with the next phase!

Pricked and Prodded

2010-03-09T20:45:00.000-08:00

I am just so done with bedrest. In the old days, I would have said that anyone who thought they could get anything done with a newborn was just delusional - but now that I have been on bedrest I realize that at least a newborn is portable, if you are allowed to walk around. Yeah, it won't be easy to manage a long to-do- list, but at least it will be possible to do SOMETHING. I am so, so tired of doing nothing.

I've been having mild random contractions, but nothing that feels significant. Yesterday the OB swept my membranes, which is not exactly painful but weirdly uncomfortable. My cervix was about 2 cm dilated, and after the procedure it was almost 3. The actual cervix manipulation didn't hurt at all, but the pressure against the whole nether region was almost unbearable. The process is supposed to get things going by introducing the whole idea to the body and hoping the body takes over and keeps going. Kinda like putting on dance music at a lame party and hoping that everyone starts to boogie down. And, from what I can tell, maybe just as likely to work...

I've had two acupuncture treatments to stimulate my uterus and calm the rest of me, but so far my ute is still reluctant and the rest of me is still antsy. But it is nice to lie down somewhere else for 90 minutes and listen to this CD which supposedly syncs the two hemispheres of the brain. It's kind of hypnotizing. As my OB said, it can't hurt, so I guess I'll keep trying it every few days. Anything to at least give myself the illusion that I'm doing something to get this labor going.

I know that, short of cervadil and pitocin, there isn't that much that can be done. And I know I'm heading towards those things, so I keep telling myself that the goal isn't so much labor as cervix ripening, since pitocin on a rock-hard cervix is supposed to be a recipe for pain. My next OB appointment is Friday (unless I have the baby before that - I mean, I can dream, right?) and she says she won't let me go another week after that. Monitoring low fluid is so random anyway that it just gets riskier and riskier.

Anyway, I have finally made a birth plan. It basically says: do what you have to, but I'd appreciate it if you could support my desire for a non-medicated birth. The main other thing it says is please, please no cheerleading. If somebody starts chanting "Push-push-push-push-push-push!" or "You can do it! You can do it!" I will just scream at them to shut the #@%! up. Last time I tried to just ignore all that and concentrate on maintaining my zoned-out non-awareness of pain. I think I said "Shhhhhh," once or twice. This time I already know that I am starting off with weak muscles and less stamina than I had before. I just can't worry about being polite on top of everything else.

I put the plan in a basket of individually wrapped Newman's Organic cookies. If I wanted to be totally Miss All Natural, I guess I could have made a basket of seasonally appropriate fruit. But who wants to eat fruit in a germy hospital? Anything sealed up is a better bet. Plus, if I was really Miss All Natural, I would probably be planning a home birth instead. I really do want to be in a hospital - things have been risky enough already that I need the reassurance of having a whole staff of emergency specialists there. So, cookies it is. But at least they're not laden with extra chemicals - and I hope I won't be, either!

I Mean, Really...

2010-03-07T23:35:00.000-08:00

I've eeked out the last two months constantly hoping for a few more days before anything else frightening happens, and here I am at 38 weeks, wondering if I will ever just have this baby already.

I've been organizing as much of my new house as I can via the internet. I think I'll have to make about a zillion trips to The Container Store (yes, Brenda! I'm hooked! We will definitely have to make a plan when I am off bedrest!) as soon as I'm allowed to go wander anywhere for a few hours. It was interesting to read about other people's organizing, too. I especially liked the comments everybody's underwear-folding preferences, although I'm pretty sure I won't manage to fold my own. But I'll lay them flat in a nice stack by color* and if my husband and I both die and somebody has to go through my things I hope they are just too bereft to worry about my panty storage.

Speaking of underwear... does it seem that JUST when you've found a really good style of panties they are discontinued? Maybe it's just me, but this has happened to me way too many times. I found a great style last summer and now they are nowhere to be found. Does the market really demand new underwear styles all the time, or is this a fiendish plot to get me to buy a whole new batch of "test" panties and then hope they aren't obsolete by the time I decide which ones I like the best?

* Is it weird to be picky about underwear color? I prefer my undies to be of a similar tone to the pants/skirt I'm wearing. Not the same color, necessarily, but black pants should be worn with black panties, etc. - it always bothers me if I have to end up wearing undies that don't seem like they belong with my outfit. See, that's where I worry about dying and what if somebody finds out that my panties and bra don't look good together (I don't really do sets, because the fit is never right on one piece) or that my underwear has no relation to my clothing?

Holding Pattern (With Extra Questions)

2010-03-02T08:55:00.000-08:00

Yesterday's visit was the same mix of good and bad - everything looks fine, but the fluid is still low, of course. I had a different u/s tech, a younger woman who is only there two days a week. The regular tech also works at a perinatologist's office, and she is very focussed on the medical details. This other person was way more chatty about the baby, showing me his face and his hair and poking around to get good images of his feet and hands. Which was nice - it lightened things up, so it wasn't all about wondering if he was in some dire situation.

So, here I am, poring over organizing-supplies on the internet. If I was allowed up and about I would bribe Brenda with lunch if she would meet me at the Container Store to help!

Here are my organizing questions of the day:

How do you store medicines? In the kitchen? In bins per person? Per type of ailment? Is it okay to leave daily things (vitamins, etc.) out on a tray? Would that be helpful or just contribute to clutter?

Where do you keep screwdrivers? This is a big point of consternation, since my husband keeps all tools in the garage, but I tend to think that a screwdriver (not one of the giant ones) that is used for taking off battery covers, etc. is more useful inside. Should I just get another set? (It might be worth noting that our city ordinances more or less require that our garage be detached from the house.)

Do drawer dividers work? The boxes that fit together? Or the spring-loaded panels that make sections? Everything that looks so neat and tidy in organizing photos seems like it might be hard to maintain in daily life. Like, I don't think I'm going to fold my underwear - but if you all swear that they will last twice as long and make my ass look fabulous if I do, then I'll try it.

Is drawer space or hanging space more useful? We have a smallish walk-in closet in the new house - one side has more drawers (along with more useful surface space) and one side has more rod space. Which should I claim?

And finally - what do you most want when you are a houseguest? Now that we actually have a room that can be used for guests I need to stock up on some guesty things. And I already know that my mom and then my dad and stepmom will be coming soon!

Down

2010-02-27T08:38:00.000-08:00

Yep, still on bedrest. Low fluid (down to 8) is one of the few things that can mean bedrest even when the baby is technically at term. The main problem it can cause is cord compression. No signs, no symptoms, nothing to do but wait and see if it goes down to the point (like, if it was at 2) that requires an emergency C section. Or, if it's going down steadily and gets to about 5 we might try to induce before it gets too low. But that would mean a uterine catheter for amnioinfusion, which puts extra fluid in there to help cushion things as the baby moves around during labor. Which means I would be limited in terms of mobility, and that just makes an unmedicated birth harder.

So, here I am, still on the couch. Frustrated and disheartened and nervous. If I ever hear anyone go on about "enjoying their pregnancy" I'll just roll my eyes as many times as I can before I tell them to get over themselves and shut up already. Enjoying pregnancy is a big ridiculous myth that's built on soft-focus ad campaigns, with gay male models pretending to be doting husbands to winsome actress-wannabes reclining delicately with a fake bump under a linen sundress. It has almost nothing to do with reality, other than the fact that pregnant women do seem to wear a lot of sundresses.

Reality is just being glad you managed to get pregnant at all, and then wondering what dreadful things might go awry as you count down the weeks. And at the end, when it's supposed to be all about folding the tiny outfits and picking out slings that coordinate with the stroller, here I am wondering if my baby is still alive every time I haven't felt him kick for a while. (He just rolled way to one side, by the way, so apparently is not dead!)

If I wanted to have a C section and just get this over with I could probably talk my OB into it - I get the feeling that docs are happy to do it if there is any kind of a good reason at all. It's faster, easier to fit into a busy schedule, they can bill for it - what's not to like? Except that I have to move house now. Recovering from labor is pretty easy. Recovering from a C section while moving into a two story house is probably not a good combination. And - standard disclaimer - of course I'd be fine with the C if it really is necessary. But I'd rather have the one day of pain followed by five days of tenderness than any kind of surgical recovery.

And why the hurry to move, you may ask? Well, if we could afford to maintain two houses in Los Angeles, we would probably have a vacation place in the mountains, or a beach retreat in Malibu...Plus, I have to get an army of plumbers and painters and gutter-fixing handymen in here as soon as possible, and I don't want to be here nursing a baby while their varnishy smells and drooping pants are lingering around.

The good news is that the biophysical profile always looks great. The little guy does all of the flexing and breathing and swallowing sort of movements that he's supposed to be doing. The cord flow is always good. He's measuring at about 5 1/2 pounds. Most of him is in the 65th percentile, except for his abdomen, which is only in the 10th. BUT, I am not panicking about that yet, since my daughter's pediatrician always measured her in about the 20th percentile for weight but off the end of the chart for length. So, he's probably just following in her long skinny footsteps.

I guess the thing that panics me so much now is that if anything goes wrong I know that I'll never be able to tell myself "it was probably for the best." Which I was always skeptical about anyway, but it gives you something to at least try to cling to, a toehold of understanding. I mean, I'll never know what went wrong with my last pregnancy, but I can at least tell myself that it might have been a terribly unfortunate problem with the baby. I don't really believe that, but I can at least concede that it's a possibility.

I think the bedrest thing is just getting to me, making everything seem worse than it really is. Basically, I should be thrilled that I even have a reason to be stuck on the couch, and I know that. But the grouchiness is getting in anyway.

Yeah, Okay...

2010-02-23T14:46:00.000-08:00

http://newsmomsneed.marchofdimes.com/?p=6731

Last Night

2010-02-20T19:32:00.000-08:00

Not as in the night before last, but the very last night before I can claim to have made it all the way to that goal of 36 weeks. Although I am technically on bedrest until my next OB appointment (on Wednesday) at least I am now at the point where nobody seems especially alarmed about earliness. Now, every few days means more brain development, less chance of any breathing difficulties and increased ability to regulate body temperature. All of which are good, so I do hope the little mister won't pop out the minute I hoist myself of off the couch. Still, having been told back on January 10th that I'd be lucky to keep him in long enough for the betamethasone injections to affect his lungs, I am starting to feel like I have been waiting for a looooong time for this kid to get out of me!

The sweet thing that happened this week is that my cousin-in-law (is that a real thing? My cousin's wife?) announced that she is expecting again. She has had several early miscarriages, although that's about all I know. She hasn't wanted to talk about it, which is fine. But she called me to say that since she is having a girl she would be happy to send me all of her son's baby clothes and various boy-ish things. I'm not sure if she realizes how much of a relief it is to have a big box of newborn things just sent to my door. All of the things I have been dragging my heels about buying, just in case something happens in the next few weeks. I mean, I have a few things but nothing like the amount of clothing and blankets that a spitty, poopy newborn needs. So it was a true gift, not just of things but help of a practical nature.

Today my bassinetty thing also arrived, along with some bra pads and new havaianas. I guess that about sums up my actual needs - somewhere to stash the baby while he sleeps and a way to keep milk from dripping on everything - and flip flops, because even though my hospital is literally brand new, I just can't cope with the idea of showering there in bare feet. So, at this point everything else is extra. And it's not like I don't like the extras, it's just that I feel okay about not having them all right here at once. The good news is, I might actually be able to go out in the world and get those extra things myself. Otherwise, I could be the only finally-pregnant lady who hasn't set foot in a BRU or a Target - kinda weird, right?

In the meantime, get ready for a whole other set of posts - non-baby questions about how you organize your kitchen and what you REALLY keep in your coat closet. Now that I am moving to a house that has more than three cabinets I am flummoxed about how to separate all of the things that are usually stacked precariously on top of each other and behind other things to the extent that only I know where everything is. Like, if someone wants to sew a button on they really would have to know to look behind the stack of dishtowels (in front, because they're in heavy rotation) in the red plaid tin box under the "scratch paper" basket. Because that's where all the thread and needles and those spare buttons that come in the little paper envelopes attached to the side seam of clothes are all kept. I mean, it works for me - maybe having more cabinets will just be incredibly confusing...

One More Week!

2010-02-17T10:10:00.000-08:00

Of bedrest, that is. After that, I'll still be on "light activity" but at least I'll be able to go out without rationing my vertical minutes.

I had my weekly NST- US appointment today and my fluid has gone up even more. Since the baby is bigger (5 1/2 pounds - ish) and taking up even more room, that's a really good sign. The comet-tail of my placenta seems to be slowly disintegrating, but without disturbing anything else. That could mean that the blood supply to the tail is gone, and that it won't irritate the rest of the placenta so much. In any case, it's hard to tell until after delivery - and even though it seems kinds gross, I want to see the placenta almost as much as I want to see the baby! I think that typically the placenta gets whisked away so the new mom doesn't have to look at it, but I am curious. I think I'll put it in my birth plan.

So, I am going to spend my last week on the couch ordering things for the nursery - thanks for all of your comments and encouragement, by the way. I don't actually have any of those things yet, but it helps with the ordering process to have some good feedback.

I am an Ohdeedoh and Apartment Therapy addict, which I guess is obvious to those of you who are, too. Not just for the nursery, but since we are moving and I have so many other things to figure out, AT has been my oracle of decorating advice. There are so many tidbits of good info in there - like the make-your-own-sheet instructions. And really, a sheet is just a rectangle with some elastic corners, it doesn't need complicated tailoring. Although if he is born before I get it done, I will probably be cursing the idea of sewing anything. I don't think of myself as crafty, especially in the Martha tradition, since I am just not dedicated to doing things like that routinely. But after four years of art school and two years of architecture school at least I can usually figure out how to make things. Plus, I have accumulated a lot of the tools, which makes it easier.

I do think the glider will be good for a snooze - I didn't order the ottoman, but I'm hoping that a big firm floor cushion will give me support for my feet, and the back of the chair is high enough for nodding-off against. I was able to find a store that has floor models, so I did try it out. It's the most comfortable one I tried, and my husband liked it too - a big plus. And, yes Mrs. LC, the pillow I thought would look good with it DOES have a drawing of a vespa on it - although technically it is an advertisement for a brand of matches, so maybe it is just vespa-esque?

I'm not sure why that dresser/changer doesn't have the changing pad in the photo. It's one of those case-furniture pieces with the lip around the top to keep a changing pad secure, and then you are supposed to take the pad off and use it as just a dresser. Which could be a bit weird, with that rim. But, maybe it will be good to keep things from falling off? Although things falling off the top of a dresser doesn't seem to be much of a problem for most people, as far as I know.

In other news, I had a lovely visit with Brenda a few days ago. Not only did she come to my half-moved out house (with one chair left for visitors) and chat with me all afternoon, but she brought me bed-rest survival goodies and super-cute baby things. She herself is lovely, too - waaaay more beautiful than the photos she has posted of herself and definitely not what you would think of as the stereotype of a physics-nerd! Since her blog was one of the first that inspired me to start writing my own, it was great to spend some time with her in real live three-dimensional space. It's funny how the whole anonymity thing really only applies to people you already know in real life...

Sneak Preview

2010-02-13T19:45:00.000-08:00

No, no - not a 3D ultrasound, or even some kind of dramatic early labor story. This is all about the nursery. And I absolutely understand if you don't want to look at baby-room stuff - it can be like a Target full of strollers if you're dealing with infertility. I used to skip nursery posts even though I could cope with belly shots. Weird, but true.

Since we are moving, this nursery is mostly hypothetical. Or in transit. Or in boxes. Our moving date is vague, but should be sometime in the next few weeks, so there isn't much point in converting the little office nook we have in our old house into a baby's room. We'll just plop him in his bassinet (that I finally ordered) in our room.

By the way, back when I mentioned that I had emailed another blogger about her bassinet, she did write back right away - and said her daughter was just growing out of it and would I like it! But she was in NY and the whole taking-apart-and-shipping thing got to be complicated, so I just ordered my own. (I'll just try to keep it in really good shape so I can sell it on Somebody's List after six months. Actually, that's my plan for a lot of stuff...) Anyway, it is nice to know that she loved it.

So, the nursery. I am under absolutely no illusions about this being a room that is "for" the baby. This room is for me. I will (mostly) be the one using whatever is in it to contain or amuse or assist me in some way with the little guy. And I know it has to function someday as a toddler room, so it can't be just a mom-lounge. But in any case, I have been trying to put together a semi-boyish, adult-friendly room that might be able to be toddler-y at some point. And so far, this is what I have come up with:

So, this is the problem I mentioned having with the crib sheet. The orange fabric with the little diamond pattern is the only one that is actually made to be a crib sheet. The other options are just possible fabrics that I could sew elastic onto and - voila! - custom crib sheet. And maybe crib skirt-panel thing.

We have display railings that I'll use instead of a bookcase, so that the front of the books face out. It makes the books double as artwork, and it's easier for kids to pick out books when they can see the fronts. And even if he doesn't choose his own books for a while, we do have quite a few left over from my daughter's collection (just waiting, in case there ever was another baby.) I always wanted those rails for my daughter's room, but we already had bookcases so we just used those.

The glider is my most coveted piece of furniture, the only thing that I think I'll really use for years to come. (I ordered the crib and dresser only after figuring out how much I could sell them for on my local Somebody's List.) I'm planning to use a large floor pillow as a pouf instead of one of those matching glider ottomans, since I need something lower for my feet. I still have to find a good reading lamp and a side table, although I may use the large orange stool for that.

I think the carpet could be fun for a young toddler with all of those spots, plus it's washable. And of course the two pieces of art are the details that are supposed to tie it all together. The little plywood rocker is probably completely unnecessary, but just too cute to pass up - at least for the photo board. (It's on sale for half-price, though, so if I think I have room for it I might have to get it.)

So, that's what I've been doing with all this bedrest time. But I would love to hear suggestions, if anyone had something fabulous or knows of something great or has heard fabulous things about such-and-such. I may add decals, or a banner of fabric triangles. I love the idea of a mini-bean-bag chair, maybe instead of the little rocker. Anyway, since I am still figuring it all out, let me know what you think!

Five Pounds (+ Two Cents)

2010-02-12T07:01:00.000-08:00

According to ultrasound, the little guy has made it to five pounds. And even though it's just an estimate, the tech says she's usually fairly accurate - a few ounces either way, not the pound or so that I thought was the normal plus-or-minus range. So, good news, because five pounds is also the weight that seems to be a magical cutoff in terms of how the baby does out in the world. I will hit the 35 week mark on Sunday, then one more week of bedrest and I am free to be up and about and go into labor. Although I won't be doing any step-aerobics or, you know, trapeze work. And I have already decided that my husband might not get to know when I am technically allowed to resume normal activity - he still has plenty of carpooling/grocery shopping/etc. to do if he's going to make up for ignoring me in the hospital.

It was so gratifying to read all of your sympathies about that in the comments, by the way. I've been thinking a lot lately about how blogging works - that you get a self-selected group of people who share something about your experiences or your point of view or your sense of humor - whatever it is, there is something there that establishes a connection. That's why I can't understand the crappy anonymous comment - I mean, why bother reading at all if you

really don't have any common ground with the writer? And of course I don't mean the gentle nudges that some comments offer with the best intentions. Those are given within that sense of connection, and (at least in my case) appreciated. Anyway, what I really mean is that my husband is just lucky I have a good source for understanding and shared feelings - otherwise, things would be much, much worse for him! (And I'm lucky, too, of course.)

In other news, I am finally going to buy a crib mattress. It's just been hard to get these last things wrapped up with the specter of "placental abruption" hanging over me. I had a shower, which made a huge dent in my "to get" list, but the things that are left are kind of important. I am not the sort of person who needs to have every little piece of the nursery ready months in advance. I'll enjoy getting the details together while the baby is (hopefully) cuddled in some kind of baby-holding contraption. Or in a sling. Or whatever - the point is, I have never cared that all of my son's future teddy bears be lined up in rainbow-color order on the second shelf from the top before he is born. But it might be a good idea if I can put him in his crib (on an actual mattress) while I decide if I'm going to put up those Eames decals.

images from blik.com

They come in different colors and sizes, so it's a kind of mix-and-match project. I am definitely not a circus-parade-around-the-top-of-the-room kind of gal, but this could be good. Since we are in earth-quake land, I won't put any framed art near the crib or the glider, so that leaves something like a decal. For years, my daughter has decorated her room with her own drawings and things from friends just double-stick-taped to the wall. It's almost floor-to-ceiling, like a museum installation of kid-art, and it covers years of her favorite things. Occasionally she curates a bit, but mostly just adds the new things in where she can. But this next little guy may not be at that point for a while.

So, mattress. And after that I may try buying a crib sheet. Actually, that's a whole different post, since I may try making a crib sheet. Not because I'm the world's craftiest person, but because I can't find a crib sheet I like. Yes, I realize this may be a psychological block, and I'm working on it, really. See? I'm off to order the mattress right now...

Hospital Jail

2010-02-10T08:10:00.000-08:00

So, it's no surprise that bleeding means another night in the hospital. A few days ago, I woke up from a nice mid-morning nap to find... well... more than "spotting" but less than "flow". I grabbed the doppler, was flooded with relief to hear the little guy's heart banging away, and called my OB.

I am sooo glad I got the doppler back, by the way, since it is really the only thing between me and full-blown panic at this point. I suppose I could just get a stethoscope, but I like the digital readout and the fact that I can compare the sounds to what I'm used to hearing.

Anyway, she did an ultrasound and an hour of monitoring in her office and decided that I was having too many contractions and needed to go for overnight monitoring until they subsided. Which I didn't mind - better safe than sorry and all that.

The contractions were the same sort of tightening that I've had for a while now, so I hadn't thought much of it. But at the hospital they were getting bigger and closer together, so my OB finally ordered terbutaline, which shut them right down. Apparently, it sometimes just takes one dose to calm the muscle and sort of reset things. The theory is that my little tag of placenta gets irritated and then it bleeds and the whole uterus gets irritated and that causes contractions. Obviously, the main problem would be if the placenta gets so irritated that it starts to detach. And of course, the thing that is most likely to irritate it is Mr. Baby himself, mashing it with his (relatively) gigantic feet.

So, a night in the hospital isn't so bad, right? Except that when I called my husband to tell him what was going on and ask him to bring me my computer and my already-packed bag, he said he was "really, really sick" and didn't want to go out in the rain and into a germy hospital and that it was exhausting enough that he had to pick up our daughter and figure out dinner, etc. etc., and that he would just pick me up in the morning.

Um.... really? For one thing, I hadn't eaten anything except oatmeal at about 7:00 am. And even though the hospital looks kind of like a fancy spa, the food is the same old soggy bland stuff that any hospital serves. I pointed this out to him, and he told me to order take-out. Yes, that's right - my husband told his pregnant wife, in the hospital for the third time, that he wasn't going to drive the twelve blocks to see her, much less bring her anything like decent food or a toothbrush.

I am pretty sure I will never forgive him. I mean, I won't hold it against him actively, but it will go into the general understanding of how our relationship works. And the thing is, he's basically a good guy - I am always caught off guard by his detachment from me when I need him the most. I mean, it's not like I was asking for much.

And to make matters worse, the on-call doctor never showed up the next morning. I was supposed to be released if the contractions hadn't come back, but nobody would officially let me go. By lunchtime I told the nurses that I was done, I took off the monitors and got dressed - there was a hep-lock in my arm, but no IV, so at least I could get my sleeve on. I called my husband and told him to come immediately.

I hadn't had any real food (graham crackers the night before, a soggy pancake and old lukewarm coffee for breakfast - the ideal pregnancy diet!) for almost 30 hours. I hadn't brushed my teeth or taken a shower. I felt like I was in jail. The nurses made some half-hearted excuses for the doctor, but it was pretty obvious that if the on-call isn't your own doctor and you're basically fine, there isn't hope for much consideration. I asked if I could just take the hep-lock out myself, so they paged the doctor and I was released over the phone. Why did I have to wait until noon for that?

My husband did at least come to pick me up, but he wouldn't come up to L&D. A wheelchair guy took me down to the lobby - my husband had somehow managed to gather the strength to drag his carcass from the ten-minute parking spots right outside the door to the seating area inside.

I am telling you, I have a lot of sympathy for anyone with a horrible respiratory illness. I've had bronchitis (several times), whooping cough and mycoplasmic pneumonia. I worked on a master plan for the redevelopment of a major respiratory hospital, including interviews with long-term patients and staff. I know how weak and awful you can feel when you can't breathe properly. But I also know that if you're doing that badly you wouldn't be able to go watch basketball with the guys later that day.

I'm just focussing on the fact the baby is doing well, that I am past 34 weeks now, that in another week and a half my OB won't do anything to stop my contractions, and that I may have a chance to raise a boy to be a considerate and compassionate man. The kind who would bring his hospitalized wife a spinach salad with grilled chicken, maybe.

Bedrest, Schmedrest...

2010-02-04T08:34:00.000-08:00

My too-sick-to-move husband has gone to NY. Yep, couldn't manage a trip to the drugstore, but going to the absolutely other side of the country was okay. Hmmm...

To be fair, he didn't want to go - but he didn't even try to get out of it. And, also to be fair, when you are self-employed you are always semi-worried that you may never work again, so you do things you might not do if you had a regular job. It's not like there's someone else to be sent in his place. He's not only the business, he's the product, too. So, while I admire his determination and his commitment...

I am pretty sure things will be worse when he gets back.

Meanwhile, I am allowed up a bit more now, with all kinds of warnings to take it slowly. I waft slowly around the house like someone playing a ghost in bad community theater. It takes me half an hour to fold a load of laundry.

My favorite new item is one of those grabber-things with a handle on one end and pinchers on the other, so I don't have to bend and twist if I need to pick things up from the floor. I ordered it from Amazon, which tracks your orders and suggests other things you might like based on recent purchases. When I signed in this morning, Amazon wanted to know if I'd like a J-shaped handle to hold the toilet paper so that I don't have to twist to reach behind me when I wipe...

Should have just bought the grabber at the hardware store. And paid cash. Am kind of worried about the database associated with my credit card now.

Sick Husband

2010-02-01T12:24:00.000-08:00

My husband is sick. By which I mean he is moaning and whimpering and hacking dramatically and has taken over my spot on the couch.

So, yeah, he's back from his trip, but he's basically of no use to me. The eleven year old is the only reasonably fully-functioning one in the house. Except she's at school all day, so I'm stuck here with Hacky.

At this point, I'm hoping it's the swine flu, because at least my daughter and I have been vaccinated against that.

More Yuck Than You Ever Thought Possible

2010-01-29T16:06:00.000-08:00

Okay, pregnancy is weird. I get it. In fact, I embrace it. Theoretically.

After I peed today there was a gob of yuck in the toilet. A thumb-sized tannish-shredded-something-with-dark-reddish-brown-spots in it. Now, I never lost my mucus plug before my daughter was born, but the phrase "mucus plug" is so yucky that this seemed like it might fit the description.

I called the nurse. She seemed perplexed by the whole description and had me fish it out of the toilet (note - use slotted or perfed pasta spoon, not ladle, to get anything out of the toilet, otherwise you just have to chase it all over the place and it tries to go down the plumbing) and bring it in.

And you know what that means - another hour of toco/fetal monitoring, an ultrasound and a speculum check. Yay! But it's nice to know that things look good in there, even if nobody's quite sure what the yucky thing was.

People actually kept coming into the room to look at the yucky thing. It was like an obstetrical roadside attraction.

I probably should have charged admission.

"Natural"

2010-01-27T12:27:00.000-08:00

First off, I hate that the word "natural" is used to describe a non-medicated birth. It just seems like it's co-opting a universal but often vague word to describe something that is actually very specific. Plus, as someone who had anything but a "natural" conception, it seems silly to start assigning words like that to any part of the process. So, I'll work on a better semantic descriptor, but in the meanwhile, let me tell you about the apprentice doula who was better than drugs.

I had a doula for the birth of my daughter. That was back in the dark ages of the 90s, when it was harder to find people on the internet. I wanted a doula because my husband gets nauseous at the sight of blood - I knew he would be of no use to me. I didn't want my mother there, because, well - I've written about my mother before. I wanted to have someone supportive and knowledgeable and calm by my side, and I figured I'd have to hire someone. But it was hard to find a recommendation - there were some lists at the hospital and a national organization that gave our names in the area. Finally I decided to use the woman that also taught a pre-natal class at the hospital - I figured that at least she had some relationship with the staff.

She was fine. I think she knew what she was doing and her class was informative. I didn't feel an instant connection with her, but I respected her level of experience and she seemed like a caring person. After we hired her, she asked if she could bring a doula trainee with her to my birth. The trainees had to attend a certain number of births as part of their program, and she said it would be to my benefit to have an extra person helping me. I figured it would be to my benefit to have an extra person helping her, so that she could concentrate on me, so I said sure.

It was the best decision I could possibly have made. The apprentice was exactly what I would have wanted in a doula if I could have figured out exactly what all the options were. She was calm, she knew when to distract me from a mild contraction, she knew when to do accupressure massage for a stronger one. She would tell me stories about being a new mother (she had two young children) while we were in the early phase, and then later she would rub my feet while the nurses watched my contractions on the monitor and made a big fuss over how intense they were. Honestly, all I could feel was the best foot rub I had ever had.

I had a long early labor - almost 24 hours at home (easy, very mild contractions - not even as bad as a period) and then about 12 hours at the hospital. The doulas were there for maybe ten hours. I think the first part of the day was fairly easy, some contractions and a lot of walking around the courtyards. I have low blood pressure normally, and lying down for a long time tends to make it even lower so we tried to keep moving. Plus, walking is supposed to help move labor along, and I was obviously on the long, slow plan. After a while the nurses had me stay on the L&D floor because I was so dilated. I remember suddenly feeling like I had to lie down, and the apprentice doula put me on my side and began doing counter-pressure massage on my lower back.

Just as I was thinking, hmmm, this labor thing isn't so bad, the other doula came back with a nurse and said she thought I was ready. The nurse checked, and suddenly there were people flying in and carts being pushed around and they were telling me that the doctor wasn't there yet and I needed to wait. I was fully dilated. The apprentice doula kept rubbing my back and then she whispered that I had gone through "transtition" - the worst part of labor - in 8 minutes, and that if I wanted to push I shouldn't worry about the doctor. She told me that my nurse had been a midwife for 20 years in Australia, and that she was perfectly capable of delivering a baby.

I remember thinking that I was glad for the nurse-midwife, but that I really wasn't worried about waiting for the doctor anyway. I mean, L&D nurses knew what to do, right? I was in this perfect zone from the counter-pressure massage, and I was going to just stay there. Suddenly the nurses were yelling for a resident. I just decided to go with the pushing feeling, and the apprentice was guiding me into a better position and then my doctor showed up and before she could get her gloves on my daughter was born. We have photos of Dr. D waving at the camera with her hands all bloody.

Afterwards, things were so easy. We just got wheeled to our room (now that hospital has labor-delivery-postpartum rooms, but at the time there were separate areas for the before and after). I had never gotten to a point where I desperately needed an epidural. I had felt like I was in charge of my own experience. I could tell that everything was fine. I was so glad that I had the chance to feel what childbirth was like without being in terrifying pain. And I don't know if any of that would have happened without the apprentice doula.

So, that's my experience with "natural" (substitute your own phrase here) childbirth. I would sum it up by saying it's really not bad if you have the right kind of labor - and don't rely on your husband to get you through it, of course.

Afterwards I found out that long slow labors almost always slow down with an epidural, and then need pitocin to pick back up again. Labors that are naturally long and slow suffer the most complications from pitocin, with decreased fetal heartrate, retained placenta and maternal hemorrhage topping the list. Um, yikes!

Some people have drastic, incredibly painful labors and can't imagine going through the whole thing without an epidural. My most "all-natural" friend went into the hospital swearing she would never stoop to anesthesia, and was screaming for medication after a few hours. She had a hard fast labor and it was just too much for her. So, I get it. And if I have a different kind of labor this time I am totally open to needing the drugs. After all, it was less than a month ago that I was willing to kiss the nurse who put morphine into my IV.

Anyway, I figured it would be easier to find a doula today. Anybody who wants to be found has a good internet footprint, and it only makes sense that doulas would make sure they can be googled. So, I typed the name of the apprentice doula into the search bar and - voila! She's a midwife now, but she will work as a hospital doula in high-risk cases. I have high hopes for another great experience with her, and if I have the same kind of labor I'll be glad to go through a little pain to avoid more serious complications. (If I have the hard, fast, incredibly painful kind of labor, I'll be glad that I'm in a hospital with an anesthesiologist right there.)

And, in case you were wondering, I don't think I'll be going in for an emergency low-fluid C-section any time soon. Since I've been on bedrest my AFI has gone up to 14. I saw my OB this morning and she said that as long as I keep resting and glugging liquids she doesn't think I have any more risk than anybody else of an early birth. So, yay! I am allowed to do a little bit of light activity, but other than that I have to stay horizontal as much as possible. As long as it's working, I won't complain too much!

Kick in the (Maternity) Pants

2010-01-23T20:33:00.000-08:00

I had another round of non-stress test and ultrasound yesterday, which showed that nothing has really changed. My fluid is still hovering just above 10, but the little guy seems to be growing well and doing fine. My official diagnosis is "borderline fluid." All of this leaking and low fluid and bedrest at least gave me a much-needed jump-start as far as getting some of the baby-stuff figured out.

I am basically torn between wanting to just get it all done now and knowing that I don't really need much in those first few weeks anyway. Since I am trapped on the couch, I have been doing oodles of research about every baby product I can find. And it's been interesting - there are so many new baby-contraptions out there! For instance, I had never heard of a Tummy Tub before, and now I simply must have one. Even though it's $40.

Yep, it's a giant expensive bucket. But there are hundreds of reviews raving about how fantastic it is, that bathtime isn't the screaming disaster that it is with the lounger tubs, that babies love to stay in the water when they are upright and mostly submerged. Okay, I guess you could just get a bucket at the hardware store, but this one is phthalate and bisphenol free, blah blah blah. Of course, I'll save my final opinion for after I've actually used it.

I did order a car seat and a stroller chassis, thanks to Gwynn's recommendations. I have my eye on a "light-jogging" (i.e, brisk walking, which is all I'll do anyway) stroller which won't be available until March, but really I doubt I'll have the gumption to do any actual brisk walking in those first few weeks. I still need to get a crib mattress (gah! latex vs. coconut vs. the pristine wool of hand-fed mongolian goats...) and some kind of Other Thing that can be the thing the baby sleeps in next to our bed for a while.

What this Other Thing is, though, is unknown. I am intrigued by the idea of the co-sleeper, but our bed is this upholstered platform thing with wide edges. The mattress sits about five inches in from the edge of the upholstered platform. I think that the edge of the co-sleeper won't be able to scoot all the way over to my mattress, so it's whole raison d'etre will be irrelevant. Other than that, a moses basket on a stand? They are really little, though, so probably only good for a few months. Bassinet? I can't cope with one of those poofy things that looks like a miniature coffin inside Scarlett O'Hara's petticoat. There is one intriguing option, but I have found two reviews of it: one person loved it more than anything, one person thought it was a death trap. Hmmm.

See? It could go either way - organic cotton and FSC wood, all very green and fabulous and yay. Or, flimsy and collapses on your baby. Although I am always suspicious that the person who thinks it's dangerous just put it together backwards. I did find one blogger who got it for her nursery back in November - I emailed her to find out what she thinks, and if the blogosphere is all it's cracked up to be she'll write back with the real scoop.

So, that's it so far. Next time - "natural" childbirth!

Ongoing Whatever

2010-01-18T19:37:00.000-08:00

So, I am still low on fluid, but not super-low. My averaged fluid measurement is 10.4 - they like to see at least 11. I mean, it's close. It's not drastic. The little guy is banging away in there and it seems like he doesn't have any trouble moving around.

But maybe the bumping is just really dramatic because he isn't cushioned by a vat of fluid? I've had two ultrasounds since I left the hospital and I go back on Friday for prolonged monitoring and another scan. I'm at 31 weeks now, and I know that every week until 36 is important, so I'm just hoping to keep things going for a while with bedrest and liquids. I'm not having any contractions, so if my doc decides that this guy would be better off out in the world, I'm guessing that means the dreaded C.

My husband is going out of town for ten days at the end of the week. I think I can pull off the bedrest with the help of friends and carpoolers and delivery guys, but I can't pull off another late-night trip to L&D by myself. I semi-wish he would cancel, but it's a big deal thing that he's doing and he might never get a chance to do it again. I hate to take away something that means so much to him, especially since I have been so demanding in the past few years - IVF, private school for my daughter, a new house. (Sheesh, I'm like a Real Housewife of Somewhere!) So, he's been working more (which for a freelancer sometimes means taking dumb jobs with idiots he can't stand, or not getting any time off after a grueling project) and now FINALLY he gets to do something prestigious and meaningful and important to him.

I'm gonna try to make it work, but I hope he can get back here fast even if he might have to hijack a snowmobile if he ever hopes to make it to an actual airport in an emergency. My little guy better just hang in there until his dad gets back...

Taking It Easy...

2010-01-14T20:52:00.000-08:00

I'm trying not to really do much of anything, but I'm not sure how long I can keep that up. I am just not very good at lounging, unless I am under a pine tree on Kailua beach, and there's not much chance of that for a while.

I have decided that going through boxes while lying on my side on the couch can count as resting. Today I sorted through letter and photos and travel souvenirs, the junk that accumulates while you try to decide if you are sentimental enough to save any of it. I love the idea of keeping these things as a record of our experiences, but the truth is I'm just not very scrapbooky. Still, packing everything and moving makes you think about your stuff in a way that doesn't usually come up. A sense of minimalism is definitely driving me to get rid of anything that seems superfluous in any way, but there is still some sentimental attachment to all these things I know I don't really need.

And at the same time that I am trying to figure out what to get rid of, I am also researching all the stuff I am thinking about accumulating. I've registered, although my list is on the odd side. I have enjoyed finding a kind of scheme for the baby's room, although I'm still not sure how it will work out in the long run. Let's just call it modern and graphic for now - I'll post some pictures if it seems to work out. My registry has pillows from Bodalee and wall art from B ookhou on it.

I love these things, but they are definitely not necessities. It's been hard for me to figure out what I might really need - when my daughter was born I didn't know anyone with a baby, and learning as I went was a hit and miss process. By the time I found things that might work for us she would be on to a new phase, and we tended to try to make due without things that might have been really helpful. So, if anyone has knows or has heard that such-and-such is absolutely essential, let me know!

I guess I should get up the gumption to read some actual parenting blogs. I have been so amazed at how much it has helped me to find other people going through infertility and the fear of loss - it should be the same for infancy, right? It's just that after years of IF, those parenting sites have always been risky territory. It's not as easy to just jump right in as I thought it would be.

Home For Now

2010-01-12T21:15:00.000-08:00

I'm sprung, at least for a while. My amniotic fluid seems to be increasing a little bit, and there is now a new theory about what may have happened.

My placenta isn't a perfect disc shape - it has a comet tail that wraps around towards the back. It looks like the tail may have separated a bit, which led to some bleeding. That blood formed the giant clot, which passed through the cervix - taking with it the chorionic fluid.

Yep, there is also the lesser-considered second sac of fluid around the amniotic sac. The second sac has it's own thin layer of fluid. It's not something that usually ruptures, but it can happen. And it is just a theory - my amniotic fluid measurements are low, but they were never huge anyway. As long as the baby seems to be doing well we are going to just hope for the best.

Meanwhile, I am exhausted. A hospital is no place for sleep, what with the IV fluids being changed at all hours and the monitors going off for the tiniest reasons. I had to have the IV in the back of my hand since it was so freezing when we got there that all my other veins were shrunken. My fingers are now stiff and swollen and my hand is giant and sore. I can't really type with only one good hand, but I just wanted to post an update.

Tomorrow: why to pack a "just in case" bag, even if you think you have lots of time left...

The Crib Curse

2010-01-10T21:59:00.000-08:00

I have been too exhausted to post lately. Having finally begun to think that I might actually really have a viable baby going on in there somewhere I realized that I should probably get all the baby stuff together. Not just a cute outfit and some burp cloths, but all the stuff that normal pregnant people have so much fun buying. So, I went on a spree.

We wanted to be sustainable reusers of whatever baby things we had left from eleven years ago. Really we did. But when we unpacked it all we saw how it hadn't fared so well through several lendings, so we decided to put what we had on Craig's List and start over. My friend L, due 5 weeks after I am, went on an all day research excursion with me to all kinds of shops, fancy and basic. We loaded both of our bags into countless strollers and car seats to find out how heavy they might be with 10 lbs of baby to schlep around in them. We debated zippers vs. snaps. We rocked and glided, with and without ottomans. We wondered why it is that crib bedding sets always seem to include one component that you really don't like.

The I did a lot of internet research for pricing and scheduling and reviews and even made a universal wish list on Amazon so that I could combine items from other vendors in one place. I figured that the discount some stores offer for registering barely covers tax in Los Angeles (9.25%), so getting a no-tax deal on low-cost internet shopping usually turns out to be better anyway. I bought a few items to have on hand and was really congratulating myself on catching up so quickly, and having over two months left to take care of whatever is left.

Then I woke up in a puddle of wetness.

I've been in L&D since last night, had lots of tests, seen my OB. We still don't know exactly what is going on. When I woke up with a soaked pajama seat I was too woozy to panic immediately. I went to the loo and saw pink and red. I thought, hmm, not so good. Then I felt a whoosh and a giant (maybe like the diameter of a soda can) dark clot came out. I vaguely realized that panic might be appropriate, but all I could do was start saying "oh, no!" over and over again until my husband woke up and took over.

Clearly I had a leak. But the nitrizine test was inconclusive by the time they did it, so the leak had stopped. The ferning test was also hard to read. There is still some fluid around the baby, but not as much as they like to see. It's rare but not unheard of that a partial leak will seal over and the fluid will be replenished. I was started on betamethasone injections to mature the baby's lungs, and antibiotics to ward off infection, which is what usually happens when the waters rupture.

But so far, no more leaks and only a very few minor contractions - just the BHs I've been having for a few weeks now. Yesterday we figured it was our son's birthday, but now I may actually be able to go home (on bedrest, of course). Perinatologist tomorrow - I saw her Friday and she got fluid measurements then, so we'll have something fairly recent to compare with.

The thing is, I never thought I'd have this kind of problem. I assumed that my troubles were at the front end - once I had made it this far I thought it was just a matter of waiting it out. I have low blood pressure, no GD, my asthma hasn't acted up, my cervix is like a vault, my placenta is in a good place, my blood flow and clotting times are perfect...

Nobody knows what happened. The little guy looks good on the monitors, so it's just a wait and see at this point. Either I'm glad I got most of that ordering and shopping done, or I am really terribly cursed with the infertility jinx.

Morphine And Julie Andrews

2009-12-28T17:34:00.000-08:00

I was feeling pretty good about this whole pregnancy thing, really. I had passed my glucose test, my anemia was improving and the little guy is so active that I finally decided to send the doppler back. Sure, it's hard to get comfortable sometimes when I'm trying to sleep, and I have been getting a lot of heartburn lately, but all in all things have been going well.

But yesterday I was pretty sure that I was going to have an emergency C section and then possibly die. I had the worst pain I have ever felt in my life, including having given birth without pain medication. And being run into by a school bus and having a pinched piece of nerve stuck between two of my lower vertebrae. This was worse, to the extent that I wondered why the pain scale that doctors use only goes up to 10.

The pain started suddenly, radiating down from my lower ribs. It was so intense that I had to double over on the couch and cry into my pajamas. It didn't feel like contractions - those are somehow familiar pains, a stronger version of monthly cramps that comes in waves. This was a constant, unwavering torture. I went to L&D only because the pain was covering the whole area of the uterus and I wanted to make sure the little guy was okay. I could feel him kicking and wiggling around, but other than that I needed definitive information.

They ran lots of blood and urine tests and the covering doctor (a Sunday, and a holiday weekend of course) ordered a CT. But having read so many articles recently about CT machines being calibrated at up to 1,000 times more radiation that recommended, I wondered about the risks of exposing the baby to what can possible trigger serious cellular problems later. By that time, I was on morphine and felt like my brain was made out of something light and fluffy, like cotton candy. Nice, but useless. Luckily my husband talked with the radiologist who said CT is only used in pregnancy for dire life threatening conditions and converted my orders to US and an MRI.

Which showed nothing. Nothing! By this time a gaggle of doctors were mulling over my reports, telling me they were stumped. Appendicitis would likely show elevated white cells, pancreatitis would show elevated enzymes, kidney stones would show red cells in the urine... but all of my tests came back normal. So, they dosed me up on morphine and I watched The Sound of Music on the giant flat screen TV in my L&D room. I kept dozing off and having dreams about singing nuns and outfits made from curtains, but at least I was beginning to think I might not die.

Here's a little something I learned about MRIs, by the way. I had one once before to diagnose the nerve damage in my back, and the experience was horrendous. I swore I would never again let myself be slid into that glowing tube and assaulted with those space-alien heavy metal sounds that seem to go on forever and fill your whole body with concentrated distress. However, the morphine kind of took the edge off. It still sucked, especially since they had to do a lot of the scans two or three times because the baby was seriously freaking out during the noise, but it was somehow less drastic.

At a certain point, though, I realized that what with waiting for the MR tech, waiting for the radiologist and waiting for the transport guys to wheel me back to L&D, a lot of time had gone by. Even just realizing that made me think that my brain might be functioning properly again, and I asked how long it took for the morphine to wear off. The nurse checked her paperwork and said it was probably time for another dose, But the thing is, the pain was gone. The most horrendous pain I had ever felt in my life seemed to have gone as mysteriously as it had come. We waited another half hour to see if the drug would clear and the pain would come back, but nothing happened.

The doctors were stumped again, gathering around and asking a million questions. Mostly ridiculous questions like "Has this ever happened to you before?" Um, no - pretty sure I would have mentioned that when I got there. They kept me overnight for observation. I was attached to the contraction monitor, which showed very minor uterine irritation that is considered normal at this point. The fetal heartbeat monitor was driving the nurses crazy, since most bigger babies can't move around as much as my little guy did - he was constantly scooting out of range so the alarm kept going off at the nurses station. But he was fine, very active and the US hadn't shown anything unusual.

Weird, eh? In the morning my OB came to check on me. She just confirmed that everything looked normal and wants me to see her weekly from now on. It was the shift change for the nurses, so I was checked out by my third nurse, who hadn't been there when I was writhing in agony. While she was going over my chart she suddenly stopped and asked me if the pain had started right after breakfast. When I told her yes, she asked what I had eaten. Whole wheat waffle, half a pear and a veggie soy-sausage patty.

She said that when she was pregnant the same kind of thing had happened to her. It turned out to be an inflamed gallbladder - not necessarily stones that would show up on an US, but a condition brought on by the hormones of pregnancy combined with a gallbladder, pancreas and small intestines that are squished up by the expanding uterus. The pain works itself out as the bile levels slowly seep into some kind of equilibrium. She had several bouts before a gastroenterologist diagnosed the problem and put her on a very low fat diet and extra calcium. She recommended some diet options and a stool softener (keeping the intestines from being irritated really helps, apparently) and gave me her direct number at the hospital in case it happens again.

Of course, I don't know for sure that that's my problem, but it seems like such random luck that she showed up for the last fifteen minutes of my stay and was the only person with some kind of information that clicked with what I had gone through. I will absolutely put myself on the low fat diet. All fat will be brain-development friendly rather than just basically whatever seems yummy at the time. Believe me, I will do whatever it takes to avoid that pain again, even though the weird yodeling goatherd daydreams were almost worth it, really.

Boxing Day (Literally)

2009-12-26T17:22:00.000-08:00

To celebrate Boxing Day, we are packing boxes. Lots and lots of boxes of what turns out to be the crap of life, basically. Even though at least half of our things are going directly to charity, we have SO MUCH stuff that for one reason or another can't be ditched.

The blanket my mother in law knit, for example. It's an open lacy pattern so it's not exactly cozy for snuggling and watching TV on the couch. Plus, it has to be dry-cleaned. But we can't get rid of it because of sentimental value, so we'll just keep it in it's vacuum-sealed bag and it will move to our new house and languish on a top shelf in the garage storage cabinet.

Also, my daughter's Madeline doll house. It's big, it has a lot of accessories, it was the perfect little-kid dollhouse because the pieces aren't breakable but they are so much nicer than most plastic doll house things. And I am FINE with the idea of a boy playing with a dollhouse, but my husband said it's too big to keep around on the off chance that he'll be really into Madeline. (Which is code for "I hope my son doesn't really want a dollhouse in his room.")

My jam-making supplies. Which I rarely use, but maybe I'll get a second wind of old-fashioned housewifery after my son is born? Maybe...

And I know I've mentioned the nine giant boxes of bubble-wrapped, peanut-protected Limoges china, with delicate violet-flowered borders and gilt edges, complete with tiny consomme bowls and individual butter-holders. This belonged to my husband's great aunt, and apparently none of her direct descendants wanted anything to do with it, so we have it. Still packed up after seven years. If you know me at all you know that this is the antithesis of anything I would ever use. For one thing, I don't use dishes that can't go in the dishwasher, which is why I spring for the All-Clad pots and pans. I refuse to wash fussy dainty china in the sink. I'll do knives and cast iron, but that's it. I can understand being sentimental about your mother's hand-knit lap-blanket, but this china thing is ridiculous.

As for the 900 years of New Yorker magazines, I got the CD version of all the back issues. On the off chance there really IS a dire need to go back and read that tidbit about guerilla theater, it might actually be possible to find it by doing a search. Instead of vaguely remembering that the cover was a parody of something that may have been related to education, and that it was predominantly green, and was possibly from the mid-1990s...

Anyway, my big holiday plans include more boxes, several trips to the Goodwill and lots of recycling. Festive, right?

Hope you are all enjoying the time off and some holiday cheer of your own!

Shopped, Dropped

2009-12-14T22:11:00.000-08:00

Just for the record, a lingering hacking cough is bad enough normally, but with all your internal organs smushed up into your rib cage? Not good. And I say this as someone who actually once broke two ribs from hacking my way through whooping cough. That was bad, but this is worse. It's not even that I've been terribly ill - no fever, nothing too painful - but I'm full of some kind of mediocre virus that won't go away.

Still, staying home in fuzzy pajamas has given me hours to do all of my holiday shopping on the internet. I'm sure I'll still have a few odds and ends left to scrounge at the last minute, but I really did almost all of it from the keyboard. But it still took hours, and I was still exhausted when I was done.

I'll admit that I was also shopping for me - not just self-indulgently, but for the practical needs of a woman who has for the most part not thought about what she might need when she gives birth to an actual baby in a few months. You know, not-counting-chickens-before-they're- full-term, etc. - which is fine, and basically necessary for self-preservation. But at some point an actual baby might show up and then it could possibly be a good idea to have a diaper or two lying around.

I didn't really buy much, but I have a lot of bookmarked sites and a folder full of information. I can't believe how much has changed since my daughter was born. I feel like some relic from the distant past, way back before babies were their own niche market and everything they need is handmade in the Sweden.

ETA: I never even managed to publish this post back when I wrote it - my cough just got worse and worse and I thought I might actually have pneumonia, but it turns out that my airways are just compromised by being so squished up into my chest. Then the coughing makes it worse and now I am stuck in some vicious cycle of lousy breathing problems. No pneumonia, just steroids and inhalers and warm mist humidifiers. I'm basically fine, the little guy is fine, but my ribs and stretched-thin stomach muscles ache like they've been through boot-camp. Blah!

Non-News News

2009-12-01T20:26:00.000-08:00

Not much to report here. I've shifted from doing everything I can to get pregnant to doing everything I can to stay pregnant, but staying pregnant is just not very dramatic for me. I take my blood thinners and my extra folic acid and lots of vitamins and go to acupuncture. Nothing too fascinating, no midnight trips to the ER or lengthy bedrests here. Which is all good because boring is what I want now, but it gives me very little to write about.

Unless, of course, I write about peripheral things, like the fact that we are moving. Yes, we are up and leaving our sweet little two-bedroom/one-office bungalow and heading nine blocks over to a groovy new place with actual closets and - my lifelong dream - a laundry room. Interest rates just made it all too good to pass up.

It is bigger than our current house, although not by much. But it's more about the storage and the closets than the number of rooms or how big they are. We'll have one more room and one more bathroom than we have now, but the layout is so much better that it feels like twice the space. The lot size is exactly the same, but the setbacks in the new neighborhood mean the front yards are shallower so there is more usable backyard. Plus, the fact that everything is scaled to modern humans helps - our current house is neither pre-war nor past-war, but war-contemporary, built in 1941. The kitchen cabinets hold about 8 teacups and a saucepan, and our closets are like coffins turned on end.

If it weren't for the little studio building we have in the back we'd have been doomed a long time ago. That room is floor to ceiling storage on three sides, with two big walk-in closets. We keep most everything out there and just bring what we need into the house depending on the season or the occasion. We're like our NY friends with tiny apartments who keep most of their stuff in storage units (although it is more convenient to have the storage on the property.)

I love our little house. It's a California classic bungalow, very lovingly maintained and cute as a button. But it's also an artifact of our fertility struggles. We've been looking at open houses for years, but somehow we felt that we couldn't justify moving since we didn't "need" more room. We only had one kid, after all. We also try to live fairly sustainably, keep our carbon footprints low and all that - it felt philosophically weird to buy a bigger house if we didn't even have a bigger family. And some of that is fine, because it makes sense to really think about what you need and to make decisions that value our resources, etc. etc.

But infertility becomes such an emotional component of those decisions. We didn't want to jinx ourselves by moving, we didn't want to buy in the crazy market and be stuck with a big house and no money for IVF, we didn't want to wonder what the "spare" room was going to be some day. All of our thoughts about moving started to hinge on whether or not we would ever have another baby. We did some more remodeling and told ourselves we would make it work, but we were never really happy with the idea.

I wonder if it's like that for most people who struggle with infertility for a long time. If whatever big decisions are looming - taking a new job, getting a new car, going back to school - revolve around the theoretical idea that maybe, next month, everything will change?

Rambling Questions, Meaningless Answers

2009-11-23T20:30:00.000-08:00

People assume I'm on a second marriage when they I say that I have an eleven year-old, too. It's not that I even care what strangers think, but I know I'll have to deal with this, so I've been practicing different responses on random people in the checkout line.

1. The straightforward answer: "We kept trying, but I had a lot of miscarriages. This one took $38,000 of high-tech intervention."

The thing is, if you're that point-blank about it, you're pretty much opening yourself up to a lot of follow-up questions. Which could be good, if you feel like being the infertility ambassador and maybe counteract the myths about relaxing, etc. But it's hard to have that information out there amongst, say, the parents of your kid's school. Gossip can be vicious - and if your kid has any kind of quirk there will be rumours about how he was an IVF baby and maybe that explains why he's so (fill in the blank.) Believe me, even people I generally like have accidentally made comments about "only children" in front of me - always followed by a disclaimer that my child was of course an exception.

I've heard other parents mention only children, adopted children and single-parent (as in true single parents, not divorced) children in pitying tones. The thing that sucks is that even if only a few people that would even think of commenting on something like that, it becomes a part of the child's gossip-resume among the other parents. I barely knew one mother but had heard for years that her daughter by a sperm-donor had "identity issues." Another mom was commonly referred to as "one of those older parents with an only child." What does that even mean?

2. The shock-value response: "Yeah, it took us a while - I had to get over my tendency to have spontaneous abortions."

Shock is always good for getting people to just shut up. Most people I know are pro-choice, but the word abortion is a conversation stopper anyway. Good for if you just want to get away. Again, maybe not the best choice for parents at school...

3. The vague explanation: "Well, things don't always work out exactly like you thought they would."

If you can pull this off without adding any platitudes about how things are "meant to be" or whatever, it might let the other person know that prying is often considered rude, and maybe it's time to change the subject. The worst part of the vague answer is that it implies that the pregnancy was an accident, and given the truth about pregnancy after 40, I hate to contribute to that idea.

4. The deflection: "They say things happen for a reason."

Also vague, but buys into the demand for some kind of grand scheme for our happiness. People seem to like that. It's disingenuous, though, because the implication is that the reason has some reflection on our lives or our worth, and I hate that idea even if I'm just saying it to get out of a longer conversation. I can't believe in any kind of "reason" that has put the women I've come to know through the years of heartbreak infertility can cause.

In general I hate the idea that we aren't to a larger extent masters of our own destiny. I do blame myself for letting years for letting so much time go by without demanding better explanations for why I wasn't getting pregnant. But even women who do get thorough treatment and better options than I did can spend years trying to find success. That's why I don't like the idea of "working hard" to get a baby - it isn't fair to someone who has tried IVF again and again, gone to the best clinics, changed lifestyles, undergone surgeries and still doesn't end up with a baby.

I wish it hadn't taken me so long to figure out what secondary infertility even was, and that it really was a problem for me. I wish my kids weren't going to be growing up in practically different generations. I'm still mad at myself for letting so much time go by before I realized that I needed an aggressive clinic and a heavy-duty treatment. A lack of information and a lot of confusion about infertility is probably why it took me so long to figure it out on my own - so why is it so hard for me to just be honest about it when other people ask?

Gender Neutral

2009-11-19T15:00:00.000-08:00

So. I've been thinking. And it turns out that I'm not as enlightened as I thought I was, I guess.

I am one of those secondary infertiles who meticulously saved most of my first child's things in desperate hopes of someday having another baby. I have a trunk full of clothes in zip-loc bags categorized by size and season. I have all of her wooden toys in bubble wrap and boxed according to age-range. I have a beautiful library of children's books, which I would give to her without the jackets. I would reunite them with their jackets and pack them in small boxes of themed groups, like gift packages for an unknown recipient.

Now, it helps if you know that my daughter was very precise and delicate with her toys. She wasn't the sort of kid who pushed the limits of things - she was tentative and gentle, so much so that I sometimes wondered if she shouldn't be testing out some boundaries a little more aggressively. In any case, some of her things look brand-spanking new.

All of which would be fabulous news if it weren't for the fact that I have just now realized that I don't think I can populate my boy's childhood with Madeline dollhouses and Eloise books. I do have a nice set of those wooden train-track pieces, and some beautiful plain wooden blocks. There are a few things that are truly gender-neutral, but other than that my carefully packed collections are unbelievable feminine. And the crazy thing is, I never realized it. I thought I was raising my girl without those stereotypes. Sure, a lot of her toys and super-girly outfits were gifts, but I obviously contributed heavily to the overall vibe and it is decidedly feminine.

I should also point out that I will be perfectly happy if I have a boy who wants to wear a tutu and play chef all day. I have a very gay-friendly life and in some ways I might be better suited to having a gay son than a macho football kind of child. But, that's not really up to me - it's not the kind of kid I end up with that I'm thinking about now - it's the kind of parent I obviously am, without even knowing it. And yet...

Do I have boxes of rag dolls because I let my child be her own person, and that's the person she turned out to be? I would love to believe that's true. She is sort of dainty and quietish and, well, girly. Not pink-lacy girly, but still. Anyway, the whole thing is just getting to me because I am finally realizing that if I am actually going to have this boy I might have to get some baby stuff together at some point. And I am gravitating to the decidedly "boy" colors and prints. Stripes seem good, maybe an olive green, or a turquoise...

What do you think? Am I just responding to a lifetime of marketing campaigns, or is there something innate about these choices?

Carefully Orchestrated, Yet Unexpected

2009-11-12T12:37:00.000-08:00

I told my mom.

I had agonized for months about this, given how she reacts to just about anything I ever say. And I had gone over every possible option as far as setting up the conversation for the least chance of her saying anything dismissive or judgmental. It took me this long to come up with the one sure-fire way to get her out of her negativity for at least a few seconds while I told her about the baby.

It was simple. It was easy. It was brilliant, if I do say so myself. I used that negativity to my advantage, setting her up against her least-favorite sister in a way that let her be the one who could "win" in the good-news contest. It was so obvious, I can't believe that I didn't think of it before. In any case, it worked, its done, she said most of the right things and now we can get on with it - she has staked a claim in the happiness of this situation, and I know her well enough that she will not deign to reverse that position now.

I just wish I had a mom that I could really share these things with. I'm so wistful about other people's wonderful relationships with their mothers. I don't need any more therapy to see that she is doing her best, that she can't help it and that she has so many other things that get in the way of being the ideal mom that I can't expect anything more that what she does try to give. But I'm still nostalgic for a mother-daughter relationship that I never even had, if that makes sense. I remember reading Little Women for the first time, and being sadder for the fact that I would never have a beloved mother like Marmee than for Beth dying. Completely selfish interpretation of a classic, but it's true.

Still, my mother came through today. Even if she needed a little manipulation to get there, she did seem to be genuinely happy for me. She asked if she could be the one to tell her mother, of course, which was fine with me - why not encourage the mother-daughter relationship where I can? Now that she knows, everything seems less fraught, somehow.

And The Award Goes To...

2009-10-26T22:36:00.000-07:00

And now, for the intriguingly named Kreativ Blogger Award! From the intriguingly named NoodleGirl, no less - many thanks to you for thinking of me!

First, the guidelines:

1. Thank the person who nominated you for this award.

2. Copy the logo and place it on your blog.

3. Link to the person who nominated you for this award.

4. List 7 things about yourself that people may not already know.

5. Nominate 7 new Kreativ Bloggers.

6. Post links to those 7 nominated blogs.

7. Leave a comment on each of those blogs to let the person know they've been nominated.

1. I'm persnickety about cleaning products. I don't like the fake clean smell of most of them, so I usually use the health-food store brands that don't smell like much (no matter what the label claims) or else just diluted white vinegar. I love having a cleaning person, but it drives me crazy when she uses her regular cleaners in my house - I can tell the minute I walk in that some kind of icky chemical is in the air.

Sometimes I have to air out hotel rooms because of the cleaning smell. I have actually told the front desk that I have some kind of terrible lung disease and can't be exposed to chemicals, which is about the only thing that has ever worked at some hotels where I suspect the staff sprays cleaner into the air to give the room that "just cleaned" smell. I try to tip really well to make up for being complainy, though.

2. I've been going gray since college. At first it was just a few strands here and there - through my twenties I didn't really have to worry about covering it since it sort of just blended in with my highlights. But it's been getting more and more obvious for the last ten years. I finally went to a famous colorist known for creating natural tones and told her I'd do whatever she recommended. She said I don't have the right coloring for highlights and that I shouldn't "go blonde" until my hair is almost completely gray. She chose a demi-permanent dye since my hair is a light reddish brown color that doesn't cover well even with permanent color.

The color did fade every few weeks, so after a few appointments she told me that she had perfected the recipe for my color and that I could just order it through the salon and do it myself at home since I didn't need the foils. It was incredibly generous of her - I obviously had to re-dye so frequently to maintain that look, and I think she genuinely just couldn't bring herself to sell me on a less attractive but more permanent dye just to keep booking me. Such a sweetie!

Of course, I haven't dyed in a while now - would rather be grayish than constantly worried that I've caused some kind of irreversible damage. Which I know is overly cautious, but I can't help it.

3. I've been reading my daughter's books lately. Ever since the Harry Potter books we like to read the same things so we can talk about them. Now we're reading the Percy Jackson series, which is HPish, but with Greek mythology instead of witchcraft. So far, we've read a lot of series - Little House, Wrinkle In Time, Unfortunate Events, Benedict Society. I know the Twilight books are looming, but I've read some of them and they're just a little too into the obsessive infatuation of desperate lust for an 11 year old...

I actually like reading middle school literature. I was a voracious reader as a kid, so I would finish whatever I could find - good, bad, great, too young, too old - and so many of those stories are still on the shelves in bookstores. I remember a story about a girl who got sent to boarding school called something like "V is for Victoria" but I can't find it anywhere...

4. I don't really like taking baths. I always feel like I have to take a shower after I get out of a bath.

5. I'm so happy that lawn is going extinct. I never liked lawn, even before it became the water-guzzling, chemical-guzzling, gas-powered-tool polluter that we see it for today. The smell of freshly cut grass makes my nose itch, and I don't like the feeling of cut blades poking my bare feet. If lawn isn't given a good edge condition it almost always has some kind of problem at the sides - adjacent planting cut by weed-whackers or runoff sinkholes in the corners. Since I often actually have to work with lawn - ironic, isn't it? - I have spent a lot of time at sod farms and ag school experimental areas. I have seen soft Kentucky grass lawns, super-tolerant Israeli grass lawns and a new, promising incredibly drought-tolerant lawn - but I still prefer native grasses that are allowed to grow to their full height, to send up their tiny flower stems and sway in the breeze. Mmm, meadow!

6. I don't like to swallow. Sorry, not even on his birthday.

7. Laundry is my favorite chore. Even more than gardening, really. Which is convenient, since we seem to do about a billion loads a week. I sort fairly specifically and then tailor my soap/softener ratio to the particular load. I listen to This American Life podcasts while I fold and iron and hang things up. Dishes, on the other hand... bleh.

So, those are my seven slightly obscure tidbits of info - hope you enjoyed at least one of them!

And now I will pass this onto 7 more bloggers, because I'd like to know what their obscure tidbits are:

Gwynn I have a feeling she has some surprising things to say!

The Babychaser Something unexpected, maybe?

Midlife Mommy Usually so good about editing herself to one subject - how will she do with seven random ones?

Bad Egg Just want to hear from you!

Breeder Beware Makes me laugh out loud and I want more...

Suddenly Old Eggs A little something to do while going into a new cycle?

Clean Slate Wondering what you'll come up with!

In other, more basic news, everything's fine. The anatomy scan was completely uneventful, things look good and I've started telling people our news. My dad and stepmother, as predicted, were delighted. I haven't got the gumption up to tell my mom yet - but only because I've been unexpectedly swamped at work and literally too tired to cope with the idea.

I suppose I'll have to gather my courage and call her this week - that'll definitely be a post of it's own!

Telling

2009-10-20T20:44:00.000-07:00

I have two real-life friends who have been going through IF treatment. One is pregnant and due only a few weeks after me, and one just had surgery for a septum and is ready to start with her next cycle. We tell each other everything and they have known about my pregnancy since I peed on that first stick. As for everyone else...

I've been wearing very carefully designed outfits and carrying extra large bags (easy enough since I usually have a giant tote filled with rolled up permit-drawing sets wherever I go) and sweaters draped strategically over my shoulder. I think my boss is so wrapped up in his own thought process most of the time that he hasn't noticed much beyond the fact that I may be gaining a little weight. But at this point, it's fairly obvious that I'm not just eating too much cheese. If I don't start talking people will make their own assumptions. Plus, my dad is coming to visit, so at least for my family that's the de facto deadline.

I was going to wait until the level 2 u/s to officially announce anything, and I'm sure my dad will keep quiet for an extra ten days or so if I ask him to, but now I wonder if it's really necessary. I'm more optimistic than I thought I would be at this point - all the tests are good, I have the fancy doppler with the digital readout and the heartrate is incredibly consistent, plus I've been feeling little squirmings in there for about a week now. I think I'm going to just take that leap of faith and make the big announcement.

My dad is probably the best person to start with, anyway. I know he'll be really happy for us, say the right things and I won't have to worry about even a hint of a negative comment. My mom will say something like "Aren't you supposed to be planning your retirement instead of raising another child? Have you thought this through?" But my dad will just tell me that he's thrilled, and he will be. So, the first part will be easy. As for my mom - I'll have to do some kind of calculus to figure out how long information takes to get from my dad and his wife to my sister and then to my mother. The proof will be when the aunt who doesn't get along with my mother finally calls me - then I'll know the news has made it all the way through the family gossip mill.

I'm thinking about sending the announcement to all of my aunts and cousins at once - thereby depriving my mother of her precious gossip, but also bypassing her possibly dire spin tactics. For a woman without much in the way of a life, it would certainly ruin what could easily be the highlight of her - week? month? - but I'm sure she'll make up for it with follow-up emails and all kinds of conversations behind my back.

See why I like to keep this blog kinda private?

PS - Thanks for the recent lovely blog awards - I promise to do them after my dad leaves!

Better Than Normal

2009-10-12T21:20:00.000-07:00

The thing is, when the nurse calls you with your second-trimester screening results, it's always good news. If the doctor calls you at home in the evening, you should just grab a few kleenexes before she even starts talking. But when the caller ID is from the office and not the OB's cell phone, and when it's the nurse's no-nonsense voice on the other end of the line instead of the doctor's sing-songy cadence, it's just a routine call to let you know that things are normal.

Normal!!! Although I have no idea what the odds are for any of the tests, because I suddenly realized that I don't care so I didn't bother to ask. Normal is good enough for me! I know there are no guarantees, but at this point a lack of panic is all I really need to be happy. I feel so full of fortune and gratitude. Normal may be just "normal" for most people, but for me it's a cause for celebration and thankfulness.

I am over 40, I have a blood clotting disorder and a tendency to make crappy eggs. Add into that mix the relatively low success rate for IVF in my age range, and the fact that I am having a so-far "normal" pregnancy seems miraculous. I am just so, so grateful that I even have this chance. And I think I wouldn't even have gotten to this point if it hadn't been for the blogs I read which showed me how to be an IVF contestant.

It was from reading blogs that I realized that my first RE, kind-hearted and well-meaning though she was, was probably fine for someone with blocked tubes, but I needed a specialist with more tricks up their sleeves. I learned that if egg quality is an issue, go directly to a big-gun clinic with lots of experience in coaxing decent embryos out of balky ovaries. When I look back at my dainty little protocols from the first few times I tried injectables, I have to laugh. If I hadn't read about other women with secondary infertility, and what the various issues and possible problems could be, I would never have thought of myself as a candidate for a heavy-duty protocol with ICSI and assisted hatching. I thought that having had one child meant it should be fairly easy to have another one - that surely if I was willing to fork over the big bucks for IVF my biggest problem would be worrying about how to raise twins.

I found a research-oriented clinic that had special protocols for egg-quality issues. I found an acupuncturist who was a nurse practitioner for years, who knew how to integrate her practice with my new protocol. And I discovered supportive, encouraging friends when I started writing my own blog, women who helped me through it all and understood everything, even though we had never actually met. And I did all of this from my keyboard.

Maybe I won't get a take-home baby out of all this - I'm not even halfway through this pregnancy, and anything can happen. But for now I am pregnant, for now things are normal, and for now I am just so grateful for everyone who ever wrote the story of their struggle with infertility and sent it out onto the internet, for anyone who really needed it. Once, that was me, and I know I wouldn't be here now without those stories.

Girl Talk

2009-10-07T17:53:00.000-07:00

First, thank you for all the emails and comments regarding my mean mommy moment. I feel so much better about it all after reading about how many of you felt that you were stuck in the role of people-pleaser and struggled to break that habit. I'm not sure I was a people-pleaser so much as a self-underminer, but I am determined to show my daughter that she can look out for her own best interest without being a mean girl. The few women I know who have vowed that their daughters WILL NOT UNDER ANY CIRCUMSTANCES become people-pleasers have been the mothers of the girls who tend to coerce and manipulate the other kids. I just can't believe that that's the only other option.

The one thing my daughter said is something that I think we all know too well - it's so much easier to figure out, afterwards, what would have been the best thing to say. Doing it in the moment is the tricky part. And figuring out who tends to put you in those spots is crucial - it turns out that the sleepover girl tends to be pushy in lots of situations. Which is probably useful, since I can almost certainly rely on her to provide some "learning opportunities". And the other thing is, she's not a bad kid, really - it will probably be good for her to be stood up to, just to know that she can't always have everything her way.

Maybe the expectations of "being a girl" are much broader and less stereotypical than they were when we were kids - but most of the same cliches are still there. The mean girls are still wearing short shorts and lots of lip gloss and flipping their hair around when the boys are watching. The boys still flock to the eyelash-batting queen bees, who make perfect fake MacCaulay Culkin-esque expressions of shock when their bra straps are snapped. But I do think the quieter girls have a better time of it these days - at least when my daughter is teased about being too Hermione Granger-ish, she takes it as a compliment.

By the way, I won't have to worry about girl issues this next time around - today's scan left no doubts about that:

That second image is an upside down baby with knees up and ankles crossed - fetal yoga? Couldn't really ask for a better angle, though.

As far as the other things that this "early structural" scan revealed, all systems look good, there are no soft markers for any of the problems that routinely show up at this phase, and blood flows through the placenta and the cord are fine. The cord has three vessels and the placenta is safely out of the way on my right side. The second trimester screening info should be back next week - and my OB says that the fact that she hasn't heard yet is a good sign. Bad news tends to come back faster, for some reason. The other interesting thing she told me that the first trimester screen - blood plus nuchal scan - is more accurate for Down's than the second - there are less false positives.

I know there are 97,000 other things that can go wrong, but being oooooold means that Down's is more likely, so that's been a concern all along. My daughter said she just hopes the baby's cute. I told her I hope he doesn't have any major problems, and then she said that not being cute IS a major problem. But I'm pretty sure babies are generally cute, so at least that's one thing I'm not too worried about.

I'm really starting to get attached, though. It's just impossible not to, really.

And Now, For Something Completely Different...

2009-10-04T16:06:00.000-07:00

Here's the thing: a situation just came up which was so annoying to me that I have been upset about it all day, even though maybe it's no big deal. So, I figure I'll just tell y'all what happened...

Now, whether or not you have pre-teen kids or stepkids, I can assume you fairly well remember what it was like to be elevenish. And this is an elevenish thing, so think back to those wonder years and tell me if you recognize any of this:

My daughter's friend asked to sleep over last night because her mom had some kind of early appointment Sunday morning and she didn't want to be left alone with her teenage brother. Okay, fine - We were supposed to go to a charity thing but my husband was really happy to get out of it by agreeing to stay home with the two girls. He took them out for pizza, then made popcorn for them while they watched a movie. So far, so good.

I came home from the concert (architects showcasing their musical talents to benefit Habitat for Humanity - not bad, actually) about 11:00 to find my husband fuming. He had just told them it was time to get to sleep and he saw that the friend was in my daughter's bed and my daughter was on the air-bed. The friend had all the blankets - the quilt and small blanket from the bed, and the big fleece blanket that he had brought in with the air-bed sheets. He mentioned that even though our house is warm at the end of the day, it gets cold during the night so the fleece needed to go back on the air-bed. Fifteen minutes later he heard them still talking and said they really had to sleep - my daughter has a workshop on Sundays and really couldn't be up until midnight. He noticed that the friend still had the blankets and my daughter had a little throw blanket from the sofa.

In the morning, I found out that the friend had said she didn't sleep well at home the night before and she needed to sleep in a real bed that night. She also said she gets really cold at night, so she needed all the blankets. (Her pajamas were a tank top with boxer-style shorts.) When we were alone my daughter said she really didn't sleep well since it's kinda weird to sleep in your own room but not in your own bed, plus it was cold with just that little throw so she kept waking up shivering, and that she was too tired to go to the workshop. She hadn't wanted to switch beds with the friend, but she felt bad saying no, so she did it anyway.

I said she had to go to the workshop. I told her that she was manipulated out of her bed and her blankets and that she should have either figured out how to say no or asked her dad for more blankets for her friend. This wasn't even a serious problem and she just allowed things to be bad for her because she wanted to be "nice". She would just have to be tired at the workshop because she had to live with the consequences of not standing up for herself in her own room, and that next time she should think twice before agreeing to let somebody else have whatever of hers they want. If she wants me to trust her in sticky situations, she needs to learn how to find solutions without just giving in to somebody else's wants.

Was I mean? I'm bummed that this friend did this (it turned out she had done it last time she slept over, too, but we just didn't ever find out), but I'm also bummed that my kid let herself be walked all over. If this friend was just horrible, I would put a moratorium on any more sleepovers with her - especially if she invites herself! But this is a generally good kid, although it seems that she has learned too well how to negotiate getting her own way by playing her recently divorced parents against each other.

I'm just worried that I was too hard on my own kid. She isn't very savvy to the kind of manipulations that kids with siblings are used to battling on a daily basis. I think that's one of the big benefits of having siblings - to learn when you need to stand up for yourself. But she doesn't have that tough skin - she doesn't want to say no if she thinks the other person will be upset. And in a few years, if that situation involves drugs or getting into a car with a drunk driver or some unwanted physical attention, I just want her to have the strength to say what she really means, instead of just giving up and muttering "Umm, okay, I guess...".

It was only a sleepover, and maybe I was overly influenced by my husband's bad reaction, but it really bummed me out. Why didn't she just grab one of the blankets back when she woke up shivering? Why didn't she come wake me up if she couldn't find another blanket in the closet? Did she even bother to look for another blanket?

At the same time, I don't want to teach her to be selfish. How do I make sure she can be a good hostess AND take care of herself? And later, how do I tell her that she has to be a good friend AND call the police if something scary is happening? All I know now that this teenager thing is not going to be easy...

Sneaking Through the Danger Zone

2009-09-30T14:32:00.000-07:00

I feel like I'm tiptoeing through this pregnancy, sneaking up on the dreaded 17 weeks (I'm at 15w2d today) and hoping that nothing terrible happens again. And there is such a temptation to think that if I get through the next two weeks I can breathe a giant sigh of relief and start ordering crib sheets. I hope I can get in that groove instead of starting to worry about the other 97 things that can possibly go wrong.

I had a quickie appointment today just for a flu shot, a doppler check (mine hasn't come yet) and the blood draw for the second trimester screening. This is the test that came back all wonky last time, the way we first knew something was terribly wrong. It takes a few weeks to get the results, so I'll just have to be glad that I have an u/s in the interim. It helps to know that the baby is actually alive - problems can be big or little or catastrophic, but being dead doesn't leave a lot of options.

I still haven't decided about the amnio. We talked about it today and figured we would wait until these results come back and go from there. It's not so much that I'm worried about the risks involved, but I know that there are so many other things that can affect the outcome that I'm not sure it would give me much peace of mind. Then again, my husband and I have always said that we don't want to raise a child with severe problems. But some problems can be mild, and that's where it gets confusing.

I have a friend with an adult daughter with Down Syndrome. She is very social, independent and happy. She has had a lot of therapies throughout her life. Her mother is particularly involved in the DS community, traveling with her daughter to DC to speak to congress and throwing yearly fundraisers at her fabulous home. My friend has found a lot of fulfillment in that process, and I think she feels truly that the circumstances turned out to be the best fit for her, in the long run. But it's hard for me to imagine myself in that kind of life, even though I have the best possible role model for what that life could be like. In some ways, I feel like just knowing she's there is such a safety net for me, but in my heart I really dread ever having to use it.

I'm thinking about a leopard print, by the way. For the crib sheets. Or a funky marimekko-ish geometric. Something absolutely not pastel or dainty. No fairies or dragons or tractors or ballerinas, either. If I can find the right fabric I'll sew it myself - a dust ruffle and a sheet being basically squares. I still have my daughter's old crib - it's been lent out a few times but has always come back in good condition. There is also a matching changing table, so at least I won't be out shopping for furniture. The closet in that room/office has some built-in drawers and cubbies, and a dresser probably wouldn't fit in there anyway. But, maybe a leopard-spotted glider chair?

More Relief

2009-09-23T15:16:00.000-07:00

They really had me on tenterhooks yesterday - after I checked in for my appointment I could hear the nurses talking about me in the hall. They were trying to decide if I should go to ultrasound first or in the regular exam room to see the doctor. Should the doc see me first and be there with me while she found the doppler heartbeat, or was it better to be definitive and go straight to ultrasound?

I was hoping for the ultrasound first. The thought of not being able to find a doppler heartbeat and then having to wait for a confirming ultrasound in a room full of giant bellies just seemed too awful. But, they sent me to the exam room first, since they wanted the doctor to be with me in case things didn't look good.

It did take a few seconds for her to find the heartbeat. I could feel my own heart pounding, and could hear it through the doppler, but then it changed - a much faster, smaller rhythm. It was such a relief - I hadn't even known how tense I had been until that moment. I know that just hearing a heartbeat now is no guarantee of a happy ending, but it's the most I could hope for at this point so of course I'm happy about it. Happy while it lasts, can't really do much better than that.

The ultrasound was uneventful, with normal everything. Growth was right on target, the two halves of the brain have the right amount of space around and between them, the femur length is good. I'll have another u/s in two weeks, which is nearing the time that gender might possibly maybe be identifiable if everything is in the right position and etc., etc. Which basically means there's a chance, but don't count on it.

Which of course is fine with me - as long as everything else is okay the gender isn't important. I keep imaging a girl, but that's probably just because I have already have a daughter. I'm so much more invested in having a baby that's actually alive that something like gender seems completely incidental.

So, good. I have an appt. next week just for a doppler check and some bloodwork. Plus, the big decision - amnio or not? Thoughts all over the place on that one, so any advice is appreciated!

Pain Relief

2009-09-21T19:43:00.000-07:00

I had a frightening headache for about 48 hours. It lounged across my forehead like a bad toupee, sort of sliding over my eyes. I went to sleep with it and woke up with it two nights in a row. I took tylenol and sequestered myself in a darkened room with a cold washcloth and I started to think that it might not be possible for me to live anymore.

By the time it finally occurred to me to call my doctor I was sure that something was terribly, terribly wrong with me. Aneurysm, tumor, temporal arteritis... you know, the standard google-induced paranoia. But also, the last time I was 13ish weeks pregnant, I had terrible headaches. And that didn't end well, so of course I was thinking the worst. Luckily, my doctor had a magic solution ready that didn't even require a trip to the pharmacy. She told me to take a motrin.

Yes, it turns out that you can actually take motrin during pregnancy. All of that tylenol-only is simply a precaution against something that isn't a problem in early pregnancy. Although that changes in the third trimester - then you really shouldn't take it at all. There is some risk of premature closure of a duct in the heart during a critical time after about 20 weeks. Actually, in some cases if a baby has to be delivered prematurely they give ibuprofen to specifically speed up the closure.

So, who knew? The funny thing is, my progesterone suppositories and the dexamethasone also had long warnings about not taking during pregnancy, but I was so determined to do whatever my doctor said might work that I never worried about it at all. By the time you have jabbed yourself full of nun pee, it's funny that a little motrin can be such a source of anxiety.

Now that my headache is finally gone, I can go back to the anxiety that probably caused it in the first place - worrying about my upcoming ultrasound. I know that I should "be positive" and all that, but it's hard to think about these next scans, the next round of screening, the next few weeks, without remembering that feeling of utter helplessness and loss. Sometimes I feel like my whole sense of this pregnancy is a murky black-and white feeling, a ultra-sound representation of the kind of feelings a pregnant person is supposed to have. The happiness is in there somewhere, you just can't see it from the outside yet.

Officially Whatever

2009-09-18T18:31:00.000-07:00

So, I don't know. According to the calendar, I am officially into my second trimester - past the 13w3d mark. Since I'm not sure if the baby is still alive that doesn't really mean anything to me, but I hate to be morbid...

Last time, I rented a fetal doppler and took it to an OB appt. to be sure I was using it properly. The doctor showed me how to use it (seemed simple, really) and that was that. She cautioned me not to get it out every five minutes and said it was best to think of it as occasional reassurance. Which was fine, right?

Except obviously I got it all wrong. I didn't use it very often and I ended up picking up my own abnormally fast heartbeat (side effect of anemia) and was so determined not to be a panicky pregno-chondriac that I just kept naively reassuring myself that all was well.

I wasn't sure if I would rent one at all this time, but as the days go by I know I need something during the wait between appointments. If there is still a heartbeat at my next appointment I'm going to rush straight home and send in my order. I've picked out a fancy hospital-grade model with a digital display, so it won't be as easy to confuse the heart rates. It's cheaper than paying for extra appointments, plus I think my sanity will be well worth it.

It's funny how my original ideas about pregnancy being a natural process and trying to avoid a lot of medical intervention have been eroded to the point that I have set up an account with a hospital supply company. I used to think that having a baby meant signing up for prenatal yoga classes and buying a body pillow. Now, I'd order an u/s machine if I could afford it!

Hmm? What?

2009-09-15T20:16:00.000-07:00

This has been one crazy month so far, and since it's only halfway over who knows what will happen before October...

I can only assume that there is still a live baby inside of me, although this is mostly based on not thinking about it too much. At my last appointment, my OB cheerfully told me to come back in three weeks and I absolutely freaked out about waiting that long. Here I am, coming up on the weeks that led to the demise of my last pregnancy, and I couldn't imagine why she wouldn't want to monitor me more closely than before. My last ultrasound had been a week before this appointment, and I know that there are a lot of insurance regulations, blah blah blah, but I absolutely cannot wait a month between ultrasounds at this point.

She did agree to see me in two weeks instead of three, but I was hoping for week by week appointments, at least for a while. Maybe that's just not realistic, but I have begun to think about calling in with "pains" of some sort and see if I can get in earlier. The stress alone is bad enough that my insurance will have to pay for more acupuncture and chiropractic appointments if it won't approve extra ultrasounds. Grrr!

In other news, my daughter has started her new fancy private school. This is not the "school for geniuses" here in Los Angeles - that idea just seemed worse and worse the more we found out about it. Neither is it the "hyphenated exclusive prep" school here that was salivating over her test scores. The school we chose is more focused on developing the whole person than creating an academic superstar. Plus, it is close to our house as well as our philosophy. Which is part of our philosophy, actually, in that we didn't want our child on a bus for two hours a day. Part of me is just desperately hoping that I haven't made a giant mistake about this, but my gut feeling was that those other schools would have made us all miserable.

The work itself is just so different from what she's used to that the level of challenge is more about figuring out what the expectations are than just doing the assignments. The homework is posted online, along with the schedules for all of the extracurricular activities and any special events. She has to check rubrics for each assignment to make sure she isn't missing a crucial component. There are honors levels for most classes, and study halls with teachers who take smaller groups of kids and work past the assignments at advanced levels, so I do think she'll be fine as far as being challenged. Far better than last year. Plus, she has to figure out how to change for PE and still make it to science afterwards on the other side of the campus. I think that will be the real challenge, actually.

We're both still trying to figure out how to get to school an hour earlier than we used to. The good news for me is that I don't have to worry about making it to the office on time - now I can even stop at the farmer's market on my way to work. And I'm fine once I'm up and about - but getting out of bed so early is almost impossible. I miss coffee...

Nose News is Good News

2009-09-04T20:57:00.000-07:00

So, today I had the nuchal translucency screening. It can't be done until 11.5 weeks, so of course I scheduled it for the first possible date, at 11 weeks 4 days.

The nuchal fold is a translucent space in the tissues behind the neck, and if the area is expanded (larger) it can mean that fluid is accumulating in that space - not a good sign, since genetic anomalies can create that excess fluid. Checking for the presence of a nasal bone is also part of the screening. So, a thin neck fold and any kind of nose bone are the hoped-for findings. Which, luckily, is what we found today. And even though I know that it's not a definitive test, it is nice to see that things aren't suspect already.

Still, with my last pregnancy, the nuchal translucency scan was also fine. The first trimester blood screening was normal, growth was always right on target. It does weigh me down to think of how much can go wrong between now and birth, and as much as I want to be able to believe that these things are rare, that the odds are always in favor of "fine", it's hard to forget that I've been here before, not so long ago.

It's not that I'm all doom and gloom - I loved seeing the little somebody wiggle around, floating and bobbing like one of those giant balloons in a parade. It's amazing how human-ish the fuzzy combination of blobs and splotches can look. I'm so grateful for each reassurance: the placenta looks good, the organs look fine, we counted two arms with hands and two legs with feet. So, I am happy, but it's mixed with caution. I am relieved, but it's not complete. I suppose maybe I am pleased - a word that always seems more neutral than it ought to be, but I guess that helps it work here.

I think I am going to have to start "telling" - I'm too bellyish to be anything but pregnant, so it's mostly just obvious. Even a solid diet of pastries couldn't make anybody this particular shape, so the idea that I just got fat over the summer might not go over as well as I had planned. The traditional notion of waiting until the first trimester is over coincides with my girth fairly well - and if that means 13.3 weeks, then I will just have to carry strategically placed tote bags for another twelve days. I'll be like an inconveniently pregnant sitcom actress, always holding potted plants and shopping bags and giant manila folders over her midsection. Too bad it's about a million degrees here and I can't just wear an enormous poncho all the time!

Lag Time

2009-09-01T15:50:00.000-07:00

So, maybe it wasn't the best idea to schedule my ultrasound - on the other side of LA - while I'm still eight hours ahead of local time. It might have been okay in the morning (we've all been up since about 4:00), but by this afternoon my eyelids were drooping and I couldn't finish my sentences. I probably should have rescheduled, but my sanity had been pinned to this ultrasound for so long that it didn't occur to me that I might not go.

I had to stop for a 7Up in hopes that the sugar rush would perk me up, and I cranked the oldies station and tried to channel some of that boppy energy. And it worked, to the extent that I did make it to the clinic without actually falling asleep at the wheel. But I had the bizarre wish that there was such a thing as eyelid-propper-uppers, which can't be a good sign.

The nervousness was crazy. There were all sorts of billing issues and it took forever to get into the little room. Then I sat there with the giant napkin over my lap, waiting and waiting for the doctor to finally come in and read the verdict. When he did get the probe in I couldn't even look at the screen. After so many scans I can say that when there is a lot of wand movement and the doctor/tech doesn't say anything for a while it's not a good sign. That was all I could concentrate on - how long would it take him to say something. I think I actually closed my eyes until I heard him start talking.

The first thing he said was that the baby was really moving around a lot. Suddenly, everything else seemed less crucial - the exact beats per minute, the specific crown-rump length - it all just became "everything looks normal". Such a relief! At 11w1d the baby measured 11w3d, but was moving around so much that it can't be particularly accurate. I guess the 7Up did perk things up, after all...

So, alive and well. So far, so good. I even drove home without even thinking about my eyelids. I have another scan on Friday (nuchal translucency) so at least I know I can make it through this week without worrying myself into a frenzy. I'm so relieved that I don't even know what would have happened if it had been bad news. And I know that this isn't the end of worrying, I know that there are no guarantees, but for now, I'll take it. It finally feels good to be home.

Cream and Pudding

2009-08-24T00:32:00.000-07:00

After almost a month of British food - not at all the mush it used to be, we have had fantastic food here - I am so ready for a California diet. I am way too big for ten weeks, and I can't blame it all on the hormones. I have only had fish and chips once (so good, though - the main thing that keeps me from going back is the line out the door) but the butter and cream and oil in everything has surely contributed to this:

The camera doesn't lie, people. I am really that big at ten weeks. At five months, in a cute little maternity top, this might be adorable. Here at "maybe, maybe not", it's just frustrating. If I could take this as a positive sign that things are going well it would be so much easier, but that idea seems polly-anna-ish ridiculous.

I won't say that I'm not happy, in general, about being supposedly pregnant. I've just created such a neutral approach to the whole thing that I actually can't feel much of anything in the way of joy or love or hope. I mean, in the rest of my life, sure. No problem. But this is different. Which is fine - I guess this is what I wanted, really.

Anyway, off to Paris for pastries and whatever cheese I'm allowed - then home! Ultrasounds! What a difference that will make.

Hulloo and Cheerio

2009-08-12T10:11:00.000-07:00

I feel as if I am writing from the wild, wild west and not one of the most urban places on the face of the earth. I am like a pioneer woman, gaging my pregnancy by the tightness of my waistband rather than anything scientific or even semi-reliable.

The thing is, I have never miscarried in any kind of obvious way. No bleeding, no cramps. The last time I kept gaining weight for at least two weeks as my body produced unnecessary amniotic fluid. I want to believe that my tight pants are a good sign, but I'm still wary of anything that might be considered optimism.

I am huge, by the way. Gigantic. The IVF weight-gain - two cycles worth - plus the dexamethasone bloat have added so much to my girth that I can barely fit into anything but yoga pants. Which is fine in LA - yoga pants is what most people wear around anyway - but going out to dinner in London in gym clothes is a bit odd. I've been wearing nice tops and big necklaces in an effort to draw the eye up (as they always say in fashion magazines) (although I myself am never fooled by that tactic and consider it a lame-ass trick) away from my baggy-kneed lower legs.

And, worse than anything that I might wear out to dinner, today I actually put on a swimsuit. Our hotel is one of the few in London with a pool - this city just isn't big on swimming, and most buildings couldn't be easily retrofitted to accommodate the weight of a pool. So, they are few and far between. Our hotel isn't necessarily super-fancy, it just happens to be built next to a spa, with access for hotel guests.

I bought a new suit before we left. Not a maternity suit - too jinxy - but a loose tankini top and the kind of high-rise bottoms that nobody in their right mind would consider wearing under normal circumstances. It was fine when I bought it, two weeks ago. Now it's like a girdle.

In any case, can I just tell you about this pool? It's in the sub-sub basement of a health club, below the workout rooms and the locker area. It smells like a thousand bottles of chlorox spilled everywhere. Children are only allowed in for one hour each day (maybe good for infertiles?) and all swimming must be done in an "anti-clockwise" direction.

For some reason there are four teak lounging chairs at the side of the shallow end. And for some stranger reason there were people actually lounging on them. A fat hairy guy lying on his stomach with a towel over his rear end, and a grandmotherly woman on her back with her eyes closed. They were there the whole time we swam, used the hot-tub (knees-only for me) and showered off. Weird, right? How relaxing can it possibly be to lie on a wooden bench in the chemical aroma of a dark echo-y basement, during the one hour children (about eight screaming splashing whining children) are allowed in?

Magical Thinking

2009-08-06T16:52:00.000-07:00

I am engaging in a willing suspension of disbelief, continuing to imagine that I am pregnant. I am mostly avoiding wine (sampling a bit from my husbands glass) and coffee (just decaf) and taking my jillion medications as if I am sure that I still need them. After all, why not?

It would help if I actually felt pregnant, but I am so conditioned to be cautious that I'm not sure I will notice any symptoms until I lose a mucous plug. I did tell my friend here about it, but only for the selfish reason that she is a resident on her ob/gyn rotation and I am hoping for some ultrasound love, although she has just started a break so it may not be possible. I am still crossing my fingers for some string-pulling, though.

Speaking of string-pulling, I have to say that I have managed to pull the longest strings ever and wrangled an tour of a certain movie set here in the UK which I will not name directly but if I say the the first word starts with H and the second one with P, and that there are six films out so far and another two being filmed at the same time...

Yep, we went to THAT set. It was unbelievable, every stage was enormous, every set so crammed with details that it is mind-boggling to imagine how they will ever dismantle any of it. The design is simply astonishing. The level of detail, the scale, the technical considerations - the degree of craftsmanship alone is worthy of the term "magical".

Of course, for my daughter the highlight was meeting the three young stars. They were so friendly and welcoming and chatty - especially Dan - and for an eleven-year-old nothing could be better. She's not old enough to be too cool to act like she cares, but not so little that she can't hold up her end of a conversation for a few minutes. They talked about being short vs. being tall (my daughter is quite tall for her age - almost as tall as Dan, since he's really short) and why it shouldn't matter even though it does. Then they talked about being eleven, school, books - all good topics, couldn't have been better.

So, all in all, an excellent day. I think the rest of the trip will be denoument for her, but maybe the glee will last at least a few days?

My Friend Flicker

2009-07-31T13:50:00.001-07:00

The ultrasound technician in my OB's office (my RE is on vacation) actually offered to go on my trip with me, and I said yes. I think she might have been joking, but I was absolutely serious. Of course, she'd have to bring her machine along with her...

Things are still looking like they may actually work out. At 6w4d we saw an embryo measuring 6w5d, and a flicker of a heartbeat at 129 bpm. So far, so good. But it's a hollow kind of reassurance. I used to think that those of us who have gone through losses really had to get past the point of the loss before we could begin to relax and believe things might work out. But now I'm not sure even that will be enough for me - I can't imagine losing this feeling of "maybe" and "we'll see". My OB was so excited for me, hugging and kissing me and almost literally jumping up and down. It just seemed like too much, too soon.

The nurses offered me their pre-natal welcome package, which includes lots of samples of vitamins, a copy of WTEWYE, coupons for pregnancy yoga and massages and gift certificates to maternity stores. I got the same package last fall, so I still had most of the things in my big box of IVF leftovers. I just said thanks, I have everything I need. But I was shocked by how naive it seemed - not even 7 weeks and they are already assuming I'm going to need this stuff? Don't they of all people know that these things are not guaranteed?

I'm going to be out of the country for almost a month - my OB said I could come in the day after I get back, but the ultrasound lady suggested I wait just four more days and then we can do the nuchal translucency scan at the same time. So, okay - but my RE will be back by then, and you can bet I'm going to try to get in there for a scan as soon as my plane lands. I guess it's just going to be a tentative time for me, and I'll have to figure out how to be okay with that.

If anyone has a sister (cousin, friend-of-a-friend, etc.) who's an ultrasound tech in London, let me know!

Six Weeks Exactly

2009-07-27T22:16:00.000-07:00

Because my retrieval was on a Monday, we are measuring weeks and days starting on Mondays - which is very convenient. Of course, it doesn't make time go any faster, but it's easy to keep track of as it goes creeping by.

At 6w0d, I feel tired. No nausea, no sore boobs. Maybe my boobs have been pregnant too many times (this is #7, including the probable early miscarriages before I knew enough to recognize that my period wasn't just oddly two weeks late). Maybe they've been plumped up and stretched out enough that it doesn't really matter any more? They seem a teensy bit firmer, but alas, not really anything more in terms of cleavage.

I think my daughter suspects. She hasn't said anything outright, and I'm not going to bring it up, but she has remarked, at separate times, that I'm not drinking coffee, that my clothes are all really floppy, that I'm going to a lot of acupuncture and doctors appointments. It was only five months ago that I was fully pregnant, that all those things were completely well-known to be related to that, and that she was asking a million questions about everything.

When we were in Yosemite in December and had to run from the bear (I know you're not supposed to run from a bear, but it's impossible not to) I had grabbed her hand and pulled her through the woods. Afterwards, she said it was fun and I told her that I wasn't supposed to run so fast, so haphazardly, because of the baby. (Yes, I've wondered if that could have been a factor in the demise - I wonder about everything.) And today when we were taking a walk in the hills, she started running down a grassy slope and calling for me to come after her. I told her that I can't run right now. She turned and looked me in the eye and said "Like that time with the bear?"

The problem with high-IQ kids is, well, they can figure things out for themselves. If it weren't summer, if my husband weren't out of town, if her camp hadn't ended last week, then maybe she wouldn't have noticed? But now, after only a few weeks, I know she knows. There is some unspoken agreement that we aren't really saying it out loud, but I think she's just waiting for me to say something first. I've been weighing the options - being openly truthful, ignoring the topic completely, waiting for her to bring it up - but I have no idea what to do. I know she probably just wants reassurance - I do too! - but I'm not sure I can give her much at this point. What would you do?

Teeny Tiny Someone

2009-07-24T10:34:00.000-07:00

So, one gestational sac with a yolk sac. (It's too early for cardiac activity, but I have an appointment for next week and we should be able to see something then.)

All I could think of was that if there were two I would have had a back-up. It is just such a measure of how much loss and failure and disappointment come into play with infertility treatments that I couldn't even muster up some genuine enthusiasm for what is actually normal. And the crazy thing is, I quite emphatically don't want twins. I can understand why it's so appealing after IVF - two for the price of one! - to get even more of what you were hoping for. But the possibility of added complications, especially at my "advanced" age, seriously frightens me.

Anyway, even though I never wanted two take-home babies, I did like the idea of a spare in there, just in case. Which is horrible, because it assumes that the odds are so bad that one by itself doesn't have much of a chance, that something drastic will happen. And I know (really, I do) that it's enough that there is one, that it seems to be doing well so far, that hoping for a back-up is ridiculous when there is still every reason to just go ahead and hope for one that's successful. As long as I'm just hoping, might as well hope for what I really want, right?

If I weren't so nervewracked by by infertility I would be amazed that I have seen my child at such an early stage. I wish I could blithely assume that this is my baby, that in March I'll get to meet this little whitish circle. Shouldn't it feel incredible to be able to watch these earliest moments of your own child's life, to see and know and verify such a teeny tiny existence?

Instead, I'm bracing myself for the next scan, hoping for a good heartbeat and the idea that this one might actually make it.

Limbo

2009-07-20T16:32:00.000-07:00

My first meeting with the maternal-fetal medicine specialist (which is maybe just the new-fangled thing to call a perinatologist?) was mostly just that - a meeting, in which we met. We chit-chatted about my history and what her general recommendations would be, with a lot of "if and when", since it's obviously so early. I appreciated that she didn't try to placate me with a lot of reassurance.

She reviewed my protein-S deficiencly results and thought we should retest and look at uterine blood-flow doppler before assuming that I need to switch to lovenox. My hematologist has me on low-dose aspirin until 9 weeks, then lovenox and monitoring. I know that he feels it's better to be on the lovenox just in case, and at this point I am leaning that way, too. So, I have a few weeks to think about it, and maybe the next round of bloodwork will reveal something new, but in general I am willing to err on the side of "don't #2@*% this up."

Other than that, I have nothing. I have no symptoms, no hunches, no news - just me waiting for that first ultrasound. The one good thing I found out from the MFM is that I can still go on my August trip, so at least I don't have to cancel our vacation. I do have to wear compression stockings on the plane, but I should probably do that anyway for my spider veins.

I have been tired, but I don't even have the sore progesterone boobs that I usually get regardless of the outcome of a cycle. I have no nausea, no headaches, no vivid dreams. No overwhelming sensitivity to smell, no cravings. My bras still fit, my pants aren't too tight. Although, to be honest, I'm only wearing the "IVF pants" now - regular pants have been at the far end of the closet rod for a loooooong time.

My OB wants to see me on Friday, but I think that will still be too early for any kind of scan. Done with betas and not ready for ultrasounds. Early limbo.

Second Beta

2009-07-16T15:51:00.000-07:00

I'm still not sure how beta numbers really work when multiple embryos are transferred. It seems like any combination of thriving and failing can produce a vast array of results. But, that said, my numbers more than doubled, to 756. Here's the chart:

So, who knows? But for now, things are good and I suddenly have a slew of appointments with a new MFM, my hematologist, my acupuncturist and - of course - a mani/pedi just to celebrate!

Believe me, I of all people KNOW that this is just the beginning. I'm not telling anyone but my husband (and you!) for a good long while. But it's something, and for now I'm so grateful.

Inbox

2009-07-14T15:28:00.000-07:00

It's easy to love your clinic after a positive HPT. But can I just say that they have been so kind to me, so helpful and so understanding. After my late loss a few months ago the RE called me several times in the evenings to discuss my case and gave me great referrals to specialists. The coordinator checks and replies to emails even on the weekends, and has always given me a few samples of Follistim to offset the costs of my heavy-duty stim cycles.

And now, this email from her:

Hi!

I’m not really supposed to give you the final call until we see your second beta level….which is why I’m emailing and not calling (things echo in here so much….).

I was excited for you though…your first beta is 329. So far, so good! Continue your medications and I will call you on Thursday to let you know how things are looking.

Congratulations and I’m sorry about being impersonal with the email!

Sweet, right? Waiting until Thursday would have been torture.

In any case, 329. Which is high, even taking into account the fact that I tested a day late since I was out of town. Not that I'm questioning my decision to transfer three embryos - yet, anyway. There are so many hurdles between now and the possibility of then that I'm not even going to think about any of it yet. First things first - or, in this case, second things (next beta) first.

Thanks for all of your lovely comments, too - it meant so, so much to me. Of course, after my laptop died my dad had offered the use of his computer, but I was too nervous to use it while everyone was around. I would wait until they were all asleep and sneak back into the family room to check my reader. It was so wonderful to feel cheered on and congratulated in the wee small hours!

Shhh

2009-07-11T17:42:00.001-07:00

Am visiting parents, laptop crashed, have no privacy, pee stick postive.

Lab tests Tuesday and Thursday.

Yikes!

Chill, Baby

2009-07-06T11:36:00.000-07:00

Two of my embryos made it to freeze. I have to say, it never occurred to me that I would have anything left over.

I'm also not sure how I feel about it - two lesser-quality embryos sitting there, waiting. If this cycle doesn't work, I would prefer to do another (pre-paid) fresh one than rely on two slow-poke leftovers. I'll have to go back and read my plan to see if I am required to use the frozens first. If so, I am screwed out of another fresh cycle, since my plan runs out in September.

But, at the same time, in researching CGH I learned all too well that the best-looking embryos are not always the normal ones. In fact, it seems more often than not that the normals are the medium=good ones. Of course, there are a million reasons that this is not statistically reliable outside of that particular testing. For one thing, many people who choose CGH already have a history of abnormalities.

I would have loved to know for sure that I had a genetically normal embryo. And if I go through this again, I may opt for the testing after all. But there seems to be a lot of stress attached to the process, in terms of the additional wait, the high instance of "no result" reports, surviving the thaw, worrying about mosaicism. We decided to just cross our fingers and hope for the best - not very scientific, but since I still have to worry about whatever it is that happened in my last second trimester, we figured we'd save the money for all the fancy specialists that our insurance won't completely cover.

For now I know that if I DO get pregnant, I am going to do amnio as soon as possible. Once upon a time I was so low-intervention that I didn't even take tylenol unless something drastic happened. Now, just get me as much information as possible. If things go awry, I want answers.

In the meanwhile, I'll be traveling at the end of the week, so I'll have to bring my pee-sticks with me. Do you think anyone has ever POAS in one of those little airplane bathrooms?

0 to 100

2009-07-04T22:29:00.000-07:00

So, this is my 100th post. Which may a cause for celebration, but I have some better 100s today.

100% of my embryos made it to day 5. When the doctor came in to talk about how many to put back he was so excited for the good quality that I actually felt a little zip of hope run through my veins. I asked him if he could surgically remove it, but he seemed to think it was a good thing.

We put back the 3 best ones. The whole time we were deliberating on the number to transfer, I was thinking of Sky and Wombded, the opposite ends of the transfer spectrum. Both made really well-considered choices about the number to transfer for their own circumstances, and I am just hoping that it works out as well for me. It's always scary to think about having a pile of babies, but it's also a matter of being realistic about the chances of even getting pregnant. The doctor and I talked a lot about success rates, twins, and SR. With three embryos, my chances of triplets are about 1.5% and my chances of just one are only about 30%.

Still, the fact is, embryo quality has a lot to do with success. Many clinics use an embryo-rating system of an overall number grade followed by two letters. The number describes the outer shell, cavitation and expansion. The letters describe the inner cell mass (the baby) and the outer cells (the placenta). Which makes it easy to see why a "A" baby cells and "D" placenta cells would be bad.

Of course, my clinic has their own special system which involves an overall number rating (1-6) and a 1-100 score that includes inner and outer cells, some kind of enzyme released into the culture medium and a lot of visual assessments by the embryologist. Anything under 70 doesn't really have a chance. We looked at the low-res images of the embryos and they showed me the blob of inner cells and the rings of outer cells. These weren't nice clear pictures like the ones from IVF websites - they were sort of like security-video images.

Anyway, we put back an 87, a 95 and - believe it or not, from these old-lady ovaries - a 100. Now, how am I supposed to keep from thinking this has a chance?

Hope - 0 to 100, just like that.

Day 3 Update

2009-07-02T13:07:00.000-07:00

First of all, I have been on the "comment-combo" protein/gatorade/bed-rest regime and I feel much better. Thank you all for being my de facto medical advisors. So, maybe some mild OHSS plus the fact that my eggs were all crammed together so there was apparently a lot of maneuvering around in there. The phrase "foot-long needle" was used, and then I pretty much blocked everything else out. I think she said something about a bruised bladder.

In any case, I have been waiting all morning to find out the status of my six "beautifully fertilized" embryos. I know it's usually a numbers game, so I've been trying to calculate my odds of being mildly surprised or at least reasonably resigned to whatever news the lab has for me. I am still strangely removed from the process - I am very curious about the information in a science-project kind of way, but even when I try I cannot bring myself to be hopeful. Experimentally, I wondered how I would feel if it turned out that all six embryos were doing well and things looked great. But it's so hard to make yourself have a meaningful reaction to a theoretical possibility.

But then, I got this email:

You have some beautiful embryos! Even the embryologist says so. All 6 are still growing strong. We’ll see how they look on the day of your transfer and the doctor will discuss it with you then.

See you Saturday!

So, do you think I might break down soon and start to think, just maybe, there's a chance?

Ouch

2009-06-30T22:02:00.000-07:00

For my second post of the day, I have actually gone back and read my own archives to see if I was in this much pain after the last retrieval. The answer is no.

Is this a bad sign? Has anyone ever felt worse after retrieval as time goes on? I am crampy and it hurts to pee or sit down too suddenly. I have to walk in a sort of hunched over way and if I stretch out in any kind of diagonal direction I actually make myself yelp. I had to drive to Topanga today (windy mountain road) and it turns out that you actually use your stomach muscles a lot in twisty driving - I had to keep pulling over to let people with working abs pass me.

I'm not sure what my E2 was, but there was no mention of possible OHSS. I haven't gained any weight or become nauseous. I don't have a fever. All of my googling has turned up a million stories about pain after retrieval, so I'm not super worried. Still, it doesn't seem like a good thing.

Technical Terms

2009-06-30T11:28:00.000-07:00

I got the fert report from the clinic coordinator this morning. She said, and I quote: of the ten eggs, two "died" and two were "broken".

Not sure what that means, but the other 6 fertilized "beautifully", so I'm trying to just be glad that something in there seems to be working. I'll know more Thursday morning - in the meantime, I am still in the "whatever" mindset, so none of this is either getting my hopes up or bringing me down. I'm not even trying to be all zen about it, I just don't have that level of excitement that I used to think was so unavoidable.

I used to take each step as a cleared hurdle - yay, retrieval! yay, fertilization! etc. - but now I know that it's not about making it through each minor part of the process. Anything can happen, and all of those milestones don't really mean as much to me anymore. There are a million light years between where I am now and a sibling for my daughter, and I know that every journey starts with a single step, blah blah blah. But for now I'm looking at the big picture, not "futurizing" (as my daughter's ed. psych. says) and just focussing on the fact that I will be able to know in my heart that I did everything I could, that one way or the other I will be at peace with all of this.

The Get

2009-06-28T13:11:00.001-07:00

So, my husband has the kind of job that absolutely doesn't allow any time off. I suppose if I were in a terrible accident he would be allowed to leave, but being late is just not an option. He works in film production, which means that any lost time has to be covered by production insurance. Which means that a bonding company has to okay anything that may or may not affect production. Plus, my husband can't just have someone cover him because he's contractually obligated to do it himself.

All of which meant that I had to hire a chauffeur to drive me to my retrieval this morning. Yep, I went in style, a big black town-car and a hunky wanna-be at the wheel. Considering how tender things can be "down there" after the procedure, I'm actually glad I wasn't going home in my husband's little gas-miser. There is something to be said for a giant leather back seat, after all.

I won't know much until tomorrow, of course. Of the thirteen, ten seemed mature. Because my husband couldn't be there they will have to use his frozen "specimen", which we have never done before. I've heard that it can actually be better in some cases since the thawing and washing process winnows out the bad ones - but "fresh is best" is the usual recommendation, so I am a little nervous about it. My clinic ICSIs everything, so as long as there are a few good ones in there somewhere it should be okay, but adding one more thing to the list of "what-if"s isn't ideal.

My doctor said something funny just as I was going into the OR. The embryologist grasps the sperm by the tail, which immobilizes it so it can be manipulated. I had a sudden image of some kind of Harry Potter scene, of embryologist-wizard students learning these secrets. Maybe it was the fentanyl, but there is a kind of strange-magic quality to the whole process.

In any case, thanks for the book recommendations. I managed to borrow almost all of them from friends, but I was so out of it for most of the day that I just watched Mad Men and dozed. If all goes well, transfer will be on Saturday - which is perfect for a long weekend of books, with my husband around to fetch me whatever I call for (until Monday, anyway).

Fert report tomorrow morning.

This, That, The Other

2009-06-25T22:39:00.000-07:00

Those follicles are still going strong, all within 14-17 mm. My doctor thinks we'll trigger tomorrow (Friday) for a Sunday retrieval. Which is unbelievably good timing, since it's the only day my husband can be there for his part in the process. We have three vials of his frozen "specimen" as a back-up, though.

I'm still relatively noncommittal about the whole thing. Follicles? Great. Retrieval? Sure. If I get to the point where I need a perinatologist, I'll start to think we may be onto something. Until then? Okay, fine, whatever.

As for bed-rest, my tivo is full of late-night shenannigans, Chelsea Lately and Craig Ferguson. I love that Craig - he's wry and sweet at the same time, which turns out to be charming. And Chelsea is lewd and smart, also a good combo. So, I hope they can amuse me for a few days. I have more or less given up on regular TV - it's not that I don't like anything, but I can't commit to keeping up with a plot line of any kind.

My emergency TV is My So-Called Life. I bought the whole thing on DVD a few years ago, but I never watched it. Somehow, I thought it would be best to save it in case I ever really needed to be distracted. I watched the first three discs earlier this year, after the baby died. It seems silly to rely on TV to help you through a crisis, but I have to say the time-wasting was just what I needed.

Other than that, I need to get a good book. A really good book. I loved The Time Traveler's Wife and there are rumors that the author has another book coming out soon - but not soon enough for any upcoming bed rest. So - any suggestions?

Baker's Dozen

2009-06-24T23:41:00.000-07:00

Four on the left, nine on the right.

Here, Again

2009-06-18T09:26:00.000-07:00

Well, here I am again. Gallons of follistim, desamethasone working it's insomniac magic on me in the wee hours, acupuncture and supplements and meditation and whatever the hell else I can come up with...

But I'm beyond hope this time. It used to be that I was just too nervous to admit that I was hoping much, even secretly. It wasn't so much the genuine disappointment of a failed cycle that I was trying to protect myself from. I wanted to be able to be objective so that failure wouldn't feel personal. I wanted to be able to shrug off a bad cycle so I could gather myself together for the next one. I was trying to be strong and realistic and determined without letting myself care too much - but it doesn't matter how much you tell yourself that you won't hope if deep in your heart you know you're wishing as hard as you can.

I've been stuck for so long in the in-between phase, knowing that hope isn't going to help me but unable to keep it completely at bay. Hope, wish, want. How could I completely separate the process from the goal? Impossible, really - the goal is the only reason for the process. But this time, the goal has changed for me. I just don't want to leave this unfinished. I'm not expecting anything but closure.

And I can write all of that here and know that it makes sense - but you can bet that if I said it to most people the first thing I'd hear would be "It'll probably happen now that you've just relaxed and stopped worrying so much!"

Aaargh!

2009-05-13T21:21:00.001-07:00

I have a project in my office that is eating into all of my blogging time. Not that I ever read or post at work - it would just be too weird if someone happened to walk by while I was writing about my ovaries. My office is very relaxed, but still...

Anyway, here I am putting together a giant presentation on my old-timey laptop at home. Everything is a bit laggy since the files are so big. But, I have a great boss and I am so lucky to work in an office that lets me be incredibly creative. So, I'll have to just catch up on reading when I can and post when my project gets to a less drastic phase. If my comments are lame for a while, don't take it personally...

Nothing to report here anyway, as I am taking (thankfully!) this month off from my reproductive endeavors. Luckily, my drawings should be complete just about in time for me to start stims in June!

Cyst Twist

2009-05-01T16:24:00.000-07:00

Did you ever play Hinky Pinky? That's when you come up with a riddle to describe a rhyming two-word answer. Like, a despondent father is a sad dad. A poetry session is a rhyme time. A current pachyderm is a relevant elephant.

In any case, the cyst twist seems to be going away on it's own. I should get a period soon. I have really wrestled with whether or not to dive right in or to take a month off. I so appreciate your comments, both for and against an immediate cycle, and I've had to really think about the difference between what feels right, what may be best, and what all of my options really are. It's been hard, because I actually agree with everything any of you said.

I had a long email exchange with my RE yesterday, just to weigh the options. He thinks one month doesn't make much difference for a single cycle, but that it takes you out of the running for a while, and in the event of a chemical pregnancy or other miscarriage, the time adds up. He just wanted to make sure I could get my final cycle in by September, which is maybe very considerate, but also not too optimistic...

In any case, I am going to wait until June. I am really, really not ready, emotionally, to be hormonally frantic right now. I have been cycling and pregnant and recuperating and cycling again since October. I need a few weeks of nothing. I really really need a break, and right now I need a break more than I need a baby. Is it crazy that I am actually at that point? That I am not drastically willing to do whatever it takes to maybe possibly get pregnant?

It's not some kind of zen-like calm acceptance of the now - it's just that I wake up tired from ten hours of sleep and I can't function like a real person any more. I'm getting headaches almost every day and my appetite is crappy. I'm pessimistic and grouchy almost all the time. This is just no way to start an IVF cycle.

My acupuncturist says that the liver can get sluggish from filtering all the hormones associated with pregnancy, loss and stimming. She thinks I need to take the month to cleanse my system. And as much as I remain skeptical about the new-aginess of some of the things she talks about, I do feel like I'm bogged down and clogged up. I wish I could go to one of those luxurious spas where they detoxify you with seaweed massages and mud baths. If I'm going to "cleanse", I would like it to feel fabulous, but spas are kind of out of my scope right now. Maybe I'll just take the week-long course of liver-cleansing herbs and see if I feel better. Well, and maybe one of those fancy pedicures with reflexology, too...

Intuition

2009-04-22T05:08:00.000-07:00

Maybe it was some kind of deep womanly knowledge, or whatever - but somehow I knew. The cycle is canceled - I have a giant cyst wringing my left ovary like a dishrag.

And now? My RE wants me to try again right away, as soon as my ovary goes back to normal. I am desperate for a month off - I have that bloated crappy feeling that makes the idea of doing this again incredibly unappealing. But - and, remember, being told that things will probably "be fine" is basically what has screwed me in this all along - he is saying that I really shouldn't waste any time. That ovarian reserve can plummet one month and then that's it. That at my age I can have possibilities one month that can never be matched again.

But I am so tired. Possibly the fact that I have been up all night has something to do with that, but I am also just tired in general. I'm tired of having my life revolve around infertility. I could actually be a fairly happy person if I could just put all this behind me. And yet, it's just hanging over me in this looming, unending way. Two more paid cycles. Between now and September.

Here's the thing: my husband will be working mainly out of town until the end of August. Our plan had been one cycle now, while he's in prep, and - if needed - one in September after he wraps. The thought was that if this cycle didn't work, at least I could have the summer to get my groove back. And my RE is saying of course it's my decision, etc. etc. - but I asked him what he would recommend and he said frozen sperm and go, go, go.

Really?

Stimulation Depression

2009-04-17T01:21:00.000-07:00

When I picked up the stims the pharmacist eyed the order rather dubiously and even said "Wow, that's a lot of follistim..." I tried not to let it shake me, but the truth is this freaks me out.

I remember when I first used injectables. My dose was something like 37.5 units per day. I didn't even do an IUI - it was just a medicated intercourse cycle. Since I actually got pregnant, I somehow ended up thinking that I wasn't even really infertile after all - that I just needed a jump-start because my husband traveled so much that we weren't getting the consecutive attempts that most couples have. When I look back at that cycle, I realize that if it hadn't worked I probably would have moved on to IVF years sooner than I did. Sometimes you think things make sense when they're really just signs of nothing.

I am telling you now, you will be able to knock me over with a feather - even through the internet - if this cycle actually works. I am going through the motions, but somehow my body already knows this is a bust. I can feel it in my bones, in my cells. I am practically pouring follistim into my ovaries, but somehow I can't muster up even a little enthusiasm for hope. I suppose it's better this way - better than the other way around, at least - but it just doesn't seem right. Shouldn't this at least spark that tiny bit of hope that stays hidden in your heart even when you know you shouldn't let yourself dare to allow it at all?

Wonder Woman

2009-04-09T19:27:00.000-07:00

I wonder about everything. All the time. I wonder if this is at all worth it. I wonder if I will have to deal with some kind of repercussions for taking all of these hormones. I wonder if I can keep myself from getting too hopeful this time. I wonder if it matters that I forgot to take the dexamethasone yesterday.

I wonder if it's too soon, if my body isn't ready. I wonder if I've really recovered at all from the loss, if I'll secretly be happier if it doesn't work. The one thing I don't have to wonder about is whether I'm only doing this now because my husband will be working out of town soon and I have a deadline with my clinic.

I wonder if I'll know when I'm ready to be done with this. I'm stuck in this weird place between being unable to look at babies because I ache for the ones I didn't have, but also not actually being all that crazy about babies, lately. I mean, I loved my own baby, and I know I would love another one. But babies in general, eh. Maybe it's just the effect of long-term ganerelix, the forced-menopausal chemical stop sign for reproduction. I sometimes look at stained sticky mothers tethered to strollers matted with wet crumbs and I just wonder why I'm doing this at all.

Secondary infertility is a weird set of contradictions. I don't have that original driving need to have a baby, to be a mother. I'm in it for other reasons now, and maybe those reasons aren't as compelling. I would so love for my daughter to have a sibling, someone to connect her to family in her own generation and the next. I would love to have the experience of raising a kid the second time around, when I kind of know what I'm doing and am not just figuring it out as I go the whole time. I would love to have another child with my husband, because he's turned out to be such a great dad. But I wonder if I wouldn't be better off just enjoying what life has given me.

I wonder if any of this will seem to make more sense tomorrow, after the stims start working their chemical magic?

Cycle Day Whatever

2009-04-04T16:55:00.000-07:00

I did finally get a period, of course. But now I am in pre-cycle limbo, in a sort of antagonist-suspended animation. Instead of BCPs, I am on a quarter-dose (62.5) of ganerelix. I do have CD6 and CD9 wanding appointments, and a CD-2 lab slip for baseline blood work.

My protocol is only a little bit different this time. In about a week I'll go on the half-dose of ganerelix plus the always lovely dexamethasone. When I start the stims I'll be on three days of follistim 600, then step it down to 375 for (hopefully) fewer days than last time. There is a correlation between stim time and quality, so we're hoping for a faster response this cycle. As far as quantity goes, more is always nice, but quality is the focus now. I am a science experiment, at this point. I keep telling myself that it will be so nice to be done with this, to know one way or the other, to be free from always wondering. If this cycle is a bust, I have one more in September and then it's all over. Done.

It's so odd to be back at the clinic. I don't have the visceral loathing that I came to have for my last clinic, the money-sucking-time-waster that I have to drive by on my way to work. In general, I'm happy with my RE and the staff is efficient and helpful. But it's sad to be back there, to know that whatever happens I won't have that same hopeful feeling again. If it works, great. If not, fine. I know I've written this same kind of sentence over and over again - it's my mantra now. Whatever happens, fine. Fine, fine, fine.

But who am I kidding? I know that hope creeps in, that once things look good at all, at any step along the way, hope flings itself into the picture and then that's that. I keep wondering if it will be different this time, if I won't let myself expect too much, if I can keep the process at a distance. And maybe I can. Maybe. But I doubt it.

Points For Presentation

2009-04-02T20:44:00.000-07:00

At the beginning of an IVF cycle, anything is possible. It's like a figure-skating competition - everyone starts with six points and then deductions are taken for flaws in each element. Each segment is judged for it's technical merit. But even though my US was executed perfectly - good symmetry of antral follicles, no cysts or scar tissue - I will automatically have points deducted for advanced maternal age. And, unfortunately, there are no points for artistic merit in this phase - a recent waxing and good fuzzy socks don't count. (Artistry doesn't come into play until the lab portion of the program.)

I tend to be flawless in Lining and Bloodwork, but I have always been uneven in Stimulation and Embryo Quality, so I've added some extra elements to my regime and am hoping that, with a little tweaking of my long program, I can manage to work through my weak spots. I have a really good support team - my acupuncturist and endocrinologist from my last competition as well as a new hematologist and a maternal-fetal medicine specialist who seems to work with all the winners in town. And of course, the RE, who is coaching me to what will hopefully be my best performance yet.

It's early in the program, and as we know, anything can happen. The protocol has been tweaked for optimum results, and we are still aiming for a flawless execution of stimulation. I can say honestly that I'm really doing this for love, not because I desperately want to win. I don't need a gold medal, but it sure would be nice to place in this event and go onto the finals.

I started the ganerelix today - let the games begin!

Girls and Boys

2009-04-01T09:05:00.000-07:00

No, this isn't a gender-selection post. At least, not in the ART sense.

I went to a girls' school for one year in the seventh grade. I honestly didn't even think about not having boys around. Sure, I had a crush on a boy in the sixth grade, but I would have been mortified if he'd actually talked to me. But in the eighth grade (we only left for seventh while my father was on a sabbatical year) the same boy picked me as his square-dancing partner, and I was thrilled to the core. When he do-si-doed me I felt like I was floating on the gym floor.

What - you didn't have square-dancing at your school? In P.E.? We had it right after roping tricks. It was a tie-in to Texas history. Then we all went to the LBJ ranch and watched sausage-making demonstrations, which at least made the square-dancing seem not so bad.

In any case, I just don't know what to think about all-girls education. On the one hand, it would be lovely not to worry about anything romantic while at school. But on the other, is lack of exposure to half of the species a good idea? Is familiarity with boys more of a distraction, or a benefit? And for a skinny, quirky smart girl, is the fact that other girls use the attention of boys as currency reason enough to go to a girls' school?

Have any of you gone to a girls' school? Wish you did? Wouldn't even think of it?

Thanks, But No Thanks

2009-03-29T20:33:00.000-07:00

I was never completely freaked out that my cousin and my sister both announced pregnancies last year. After all, I had a new RE, an aggressive protocol, and then - I was actually pregnant myself. I was able to really be happy for them, to ask how things were going, if they had thought of names, etc. It was, you know - normal.

They were due within a month of each other, but ended up delivering on the same day in January. One was overdue with an extremely large boy, the other a few weeks early with twins. I was still pregnant at the time, happy for them, thinking how great it was that all these kids would be so close in age. They would grow up together the way the the five of us who were all within a few years of each other had. Nice.

Today my mom called happily yammering away about seeing my cousin's twins, visiting my sister for a month, letting me know that my cousin will be here next week and that she wants me to meet her babies...

Is my month up, or something? Was that my window of sadness and now I'm supposed to go back to the way it was when we were all having babies together? Isn't it enough that I will have to have these reminders with me for the REST OF MY LIFE without having to go be all smiley and coochy-coo before I can even manage to get through a diaper commercial?

I love my cousin, and of course my sister. I'm so happy for them, especially because they both had crappy romantic experiences and waited a long time for this. I really want to be a good aunt /whatever your mother's cousin is but do I have to do it next week? I just can't believe my mother didn't even ask if I felt okay about any of this.

This is why I don't discuss any of this with her. It's like, if she has to be told how to be empathetic it doesn't really count.

Cycle Day 165

2009-03-26T10:35:00.001-07:00

Not really. I mean, I haven't had my period since October, but I guess pregnancy will do that to a gal.

I am still waiting for my first period after the D&E. If all goes according to the outpatient instructions, it should be soon. Like, Saturday. But what are the chances of that? And what are the chances that I will be my old regular 28-day self afterwards?

The only reason I care is that my clinic has a late April cycle, and I may be able to get away with no BCPs if my periods cooperate. The antagonist cycle I'll be on starts on CD1, and if I can get in sync with their start dates I can do a "natural" cycle. Which is such a silly thing to call it, of course, but if it means I don't have to take the pill I won't quibble about semantics.

I feel so neutral about cycling again. I'm stuck somewhere between just ending this all and getting on with the rest of my life and knowing that I will always wonder what would have happened if we had tried. None of my feelings are especially related to hope that this will actually work. It's more about closure. Either I get it from actively deciding that I am ready to be done with this or having the point made by BFNs. I think there is a sense of control over the process if the choice to stop is mine, and that it can be meaningful to feel that there is something to control about any of this. But it's hard to weigh that against the sense of regret that might surface, over and over, if I don't pursue this, at least to the extent that I have already paid for two more cycles. I am torn, obviously. There is something so attractive about being the strong, practical woman who realizes that her life is already so good, so lucky in so many other ways.

My daughter says, "Aren't I enough?" and of course she is. No other child could be as perfect for me as she has been. Any new child would never be able to have those ten early years with me, often just the two of us because my husband traveled so much for work. Even when we would join him in the more appealing locations, we were mostly alone together in a strange place while he worked all day. We would make our way through foreign cities, trying to figure out menus and public transit and where the best ice cream/gelato/glace could be found. No matter how much I could love another child, it would be impossible to have that kind of experience together.

So, what is it that draws me back in, that makes the idea of jabbing myself with hormones and taking steroids for months seem like the right thing to do? Is it just some biological imperative - Reproduce! - that keeps me going, hoping, trying for something that is most likely to crush me emotionally? I keep thinking that trying again but maintaining an "expect nothing" frame of mind is the way to go.

But - it just doesn't work that way, does it?

Big Envelopes

2009-03-21T14:31:00.000-07:00

Yep - all three schools accepted her. Now we just have to choose...

It's been so much like IVF that I can't help the comparisons. You do what you can, cast your luck out to the discretion of whatever kind of fate you believe in, and hope for the best. And, too often, there is nothing but disappointment and bad news at the end.

I guess I really needed this more than I thought. It's just affirmation that the process of working towards something and being as prepared as possible and knowing that all the variables are covered actually can amount to a positive outcome. Somehow, infertility has undermined my confidence that things can actually work out well. Not a good mindset, even if it does protect you from Too Much Hope Syndrome.

Acceptance

2009-03-19T21:45:00.000-07:00

No, silly. I'm not talking about some kind of Oprah-esque realization that even when bad things happen they teach us something about ourselves, blah blah blah. Although I agree with that idea in theory, I am just not able to get to that point in less than a month.

What I'm talking about does sometimes seem a lot like an IVF cycle. You do everything you can, you go through all kinds of tests, you interview at all the places with the best reputations, you decide you're willing to spend an enormous amount of money in hopes that you'll get what you want in the end. It's a roll of the dice, and sometimes it seems like it only works out for people who don't even really care that much in the first place...

The private school admissions letters come out tomorrow.

So, Hmm...

2009-03-16T21:38:00.000-07:00

I've had all kinds of appointments, and although I'm waiting for the next round of blood testing, it seems like I'm good to go. If I want to go.

Do I, though? Really? Does it make sense to put myself through all of this again when I could just be happy that I have my daughter, that the three of us have a really great relationship, that this could so easily be enough for anyone? We take our bikes to the beach, knit lots of lumpy scarves, play ping-pong outside after dark, cook together every day, read gofugyourself together... why would I want to throw poopy diapers into that mix?

Ten is my favorite year yet. I do tend to say that every year, but the point is, I am not looking back on those early years longingly, wishing that my daughter was "little" again. It's not that I didn't like those years, it's just that now things are less exhausting. I know that the teenage years are looming, but she is so affectionate and thoughtful and smart, it just seems impossible that things will deteriorate too drastically. (I know, I know - famous last words.)

I've been thinking about this all weekend, wondering why I am so determined to keep trying, to keep hoping the next IVF will actually work, to keep going when the chances are so slim and the expenses are so huge. And maybe it doesn't make any sense. Even though I still have two tries left with my 3-for-2 contract, the cost of the stims and possibly doing CGH this time mean it will still be a lot. Really a lot, since stimming on my protocol is like plunging car payments into my belly fat. Not to mention that if I do somehow get pregnant I'll probably be a nervous wreck most of the time. And yet...

I still want it. So, I'm tentatively on for the end-of-April cycle, mulling over the idea of doing CGH and starting acupuncture this week. Wheatgrass, CoQ-10, Cheyzn, extra zinc, 2 mgs folic acid (helps with the Protein S) and extra Bs. Am I leaving anything out?

Lab Results

2009-03-10T10:46:00.000-07:00

Somehow, I knew there would be an explanation.

I think the little rehearsed condolence that my OB presented me with at that horrible ultrasound appointment was just something that she learned in medical school. It was too standard, just a clueless assurance that this child must have had some terrible problem and how hard it would have been to deal with those kinds of difficulties after birth, and that I shouldn't worry that it was because of anything I had done. And maybe most people really need that, just a blanket of semi-medical sympathy and a sense that it was "for the best".

Except that in my case, it wasn't.

My labs came back with extremely low levels of a protein that inhibits clotting, and high levels of anticardiolipin antibodies. The protein is "S", which decreases throughout pregnancy anyway, so if the levels are already low you may be perfectly fine until the second trimester, when they really begin to plummet. The anticardiolipins indicate an immune response disorder. The crazy thing is, I've been tested for both of these things twice before since they are part of the standard "recurrent miscarriage" workup. Apparently, you can acquire some of these blood disorders at any time, including....when taking IVF medications.

They don't know for sure that IVF triggered this change. They don't even know for sure if clotting is what ended this pregnancy. They also don't know if my S levels will go back to normal in a few weeks (typically they are very low at delivery and go back up to normal within six weeks). They'll retest for the ACA, too, as well as a jillion other things, but the bottom line is that even if my S is normal next month, it could be that it just gets too low when I'm pregnant.

All clotting problems are worse as people age, so the fact that I had an easy pregnancy almost eleven years ago doesn't really have anything to do with this. Plus, at the time I was on baby aspirin because I supposedly had a mitral valve prolapse (a floppy valve in the heart). I had partially lost my vision one night and was told that the floppy valve can push clots to the optic nerve. Later it turned out that because MVP was overdiagnosed for a long time, my doctor had me rescanned with better equipment and there wasn't even a suggestion of prolapse, so I've been off the aspirin for years. (I have lost my vision again since then, but it turns out to be a precursor to incredibly bad migraines.)

Of course, it just wrecks me to think that a baby aspirin could have changed all this. I had even asked if there was any benefit to aspirin during my IVF cycle, and was told that because I have reflux problems and was not taking any of the acid-blocking medications I should forego all aspirin. Which made sense at the time. Reflux makes my asthma worse, and breathing seemed like an important part of pregnancy.

Okay, when I look back at what I have just typed I feel like I am such a collection of medical problems. Lung, stomach, blood, vision - no wonder evolution doesn't want me to procreate. But I swear I am not some kind of semi-invalid just trying to survive day to day. I feel really healthy most of the time. As long as I don't eat too many tomatoes or sniff a cat I am basically fine. Unless I try to have a baby.

Appointment With Dr. Google

2009-03-04T12:38:00.000-08:00

As you can imagine, I have racked up quite a few hours googling anything related to second-trimester miscarriage, loss, cause and the like. I have a pubmed password and a research-librarian friend who can get me almost anything else that needs a subscription. I have slogged through countless articles, not because I'm looking for some magic aha! nugget of information that will somehow explain my loss, but hoping for a better understanding of what to ask about, test for, or consider in the vaguely possible scenario that I actually get pregnant again.

I have found THE SITE, the holy grail of actual useful medical information when considering recurrent miscarriage or a fetal demise. And, it's not even password protected! Plus, the writing is lively and the categories are well-organized. So, here it is: Early Path - a reproductive pathologist's understanding of the various things that can go awry in a pregnancy. This may not be useful for most of you, but it so perfectly encapsulates so much of what I have had to dig through, I just had to link to it, if for no other reason than to be sure I can find it later.

I am not a sentimental girl. I am emotional, sure, maybe even overly teary at times - but in the end I am practical above all else. I am happy to have actual reasons to test for things, wait a certain amount of time, and try new therapies on the off-chance that they may work. This site gives specific reasons to wait a few cycles before trying again - reasons having to do with the uterine vessels cleaning themselves out of the debris from a miscarriage - which is so different from what you usually hear. People talk about getting your "schedule" back to normal, which seems to have more to do with ovulation, or checking E2, which is more about the lining. The idea that the vessels may need to repair themselves is a whole new consideration. But I can tell you, if there is the chance that my vessels may not be sufficiently recovered, I am not going to risk another IVF cycle.

I have an appointment (pants on) with my RE tomorrow, just to go over my last cycle and discuss what we might do differently. I figure the chances of actually getting pregnant again are fairly slim. But the chances of a late miscarriage are <5%, and excluding cervical problems are more like <1%. So, I'm already operating in the realm of the very few. At this point, another round of stims doesn't even seem like a big deal. And, if I wait two more periods before starting the dreaded BCPs, not only will my vessels be ready, but I should even be able to fit back into my regular pants again. And at least that seems like an attainable goal, regardless of whatever else may or may not happen.

Moving On

2009-03-02T13:36:00.000-08:00

Thanks for all of your kind comments while I have been trying to get myself through these last few weeks. I can't imagine how it would be to feel that nobody has the least idea what this has been like. It's sad that anybody has to know, but in the absence of a solution for that problem, it's comforting to have such empathy and understanding from others.

That, plus a massage therapist, a chiropractor, a facialist, a hairdresser and a trainer - enough experts and I might somehow emerge from this experience relatively unscathed. If I add all of these expenses to the total IF tab, though, I may actually faint dead away. Luckily, our trip to Hawaii was booked on credit card miles and the very convenient fact that my husband's brothers run hotels on two of the islands. (Needless to say, it is our standard getaway.) Still, the financial toll of infertility is just ridiculous at a certain point. The emotional toll is impossible to measure, but I think we all know that it's steep even if you do eventually get the happy ending.

I had my post-op OB appointment today. This is the first time I've ever felt really confident that all of my online research actually gave me a complete understanding of my options - that scouring pubmed articles wasn't just a random and spotty education. I had researched each component of every article that even slightly pertained to my experience, and I had figured out how to filter for my age and for my first trimester test results. Suffice it to say, I had ten vials of blood drawn, I will be tested for everything I asked to be tested for and I have an appointment with a genetic counselor on Friday.

Other than that, I am starting to feel a little bit sort of normalish again. Maybe it's just that the supplemental estrogen is out of my system, but I feel like I might be able to function like a human being again. My OB thinks I will probably get a period in about two weeks, which is a good sign - sometimes it takes the body a while to readjust, but she thinks I am about to ovulate, so maybe feeling somewhat back to normal is just a side effect of actually being somewhat back to normal?

No Answers, and One Big Question

2009-02-26T21:51:00.001-08:00

The post-op visit was so basic I could have done it myself. The ultrasound looked perfectly normal, no weird dark spots anywhere and my lining is fine. The premarin apparently did it's job, which was to kick-start the lining growth so no scar tissue could form, and I am officially "fine". Well, as far as my uterus goes.

I didn't get much in the way of answers. I understand completely that this doctor's main concern is that the procedure went well and there are no lingering complications, but a little more information would have been helpful. I can only imagine that it isn't pleasant to discuss too much of the procedure with the patient, and she had certainly perfected her evasive tactics. Basically, I got the "every situation is different" story, and other assorted non-committal answers.

I have to have another post-op visit with my regular OB on Monday, which means I have to sit in a waiting room full of pregnant people. I can't imagine she'll tell me anything new, either. And so much of what I have found by googling "second trimester IUFD" are professional practice guidelines to guard against lawsuits, so I can imagine that part of her concern isn't really about me. I know she wants me to see this as ultimately a good thing, that the baby would have had problems, blah blah blah. But I've done enough research to know that it is impossible to make the assumption that this was a genetic abnormality. The screening could just as easily show an abruption (increased AFP) and demise (increased hCG). I really just need a copy of the actual report and an appointment with a genetic counselor.

Of course, the reason I really want to know if there was something other than a terrible genetic abnormality is that everyone keeps asking me the same thing: are you going to try again? Don't people realize that there is probably a reason I have a ten-year old with no siblings? If it was that easy to just have another, then surely I would have a slew of kids by now, right? So, if some other issue contributed to this, I definitely want to suss it out before risking this again.

I did buy the three-for-two package at my IVF clinic. The contract is good for one year, so we may still have time for two more tries. Right now our inclination is to start right away. I am too old to wait six months, grieve and recuperate and get my groove back. It's not "now or never" so much as "maybe or never." I can't imagine having any kind of hope at all even if I do manage to get pregnant again, but maybe that makes it easier, somehow?

Afterwards

2009-02-25T13:27:00.000-08:00

It's been two weeks since that impossible moment, that sudden silence when things went from breezy and chatty to some kind of weird library hush, just the clacking of keys and a few rustling noises as the u/s tech moved the probe against the paper drape. No staticky swish from the doppler. I could see the plain black nothingness where the heartbeat was supposed to be, but then the silence collapsed while nobody said anything. I think I was just desperate for some kind of explanation, some reason - I knew, I knew beyond any kind of doubt, but I couldn't say anything.

Tomorrow I have my post-op visit at the clinic. I suppose every city must have a place like this - hidden behind an ivy-covered wall, with buzz gates and security cameras. It had a zen-garden kind of feeling, very spa-like and calming. The doctor is committed to making sure that these services are available with the best possible quality of care, and I suppose I'm grateful that she left super-prestigious Ced.ar.s - S.i.nai (how's that for dots, Sky?) to run this place full-time. My own OB doesn't do second trimester d&e procedures because the hospital she is affiliated with just doesn't allow them. (Too closely related to second-trimester terminations.) They would have induced labor and had me deliver, which just sounds horrifying.

The people at the clinic couldn't have been nicer, although after a certain point I have no idea what really happened or how it all went. I was completely out for a long time, longer than I have ever been before. Hours. Although I don't know for sure. The anesthesia made everything so incomprehensible and meaningless that I have only the vaguest recollections of anything they said to me afterwards. I remember getting there at 11:00 and not leaving until after 5:00. At some point they hooked me up to the pulse-ox and the heart monitor, and then a valium IV, which didn't really seem to help, but possibly it might have been worse without it. Then the anesthesiologist introduced himself, and that's the last thing I remember.

So, I'll ask a lot of questions tomorrow, although I'm sure I won't get the sort of answers I'm hoping for. And I should stress that I'm not even looking for philosophical answers or anything profound. I just want the facts, but I suspect the facts are lost forever.

My So-Called Luck

2009-02-14T06:44:00.000-08:00

The thing is, I'm an idiot.

I mean, of course in retrospect, it's easy to see what happened. But how could I have become so willing to believe things were fine when all the evidence was right there? The thyroid specialist said my levels were consistent with post-partum thyroiditis. My iron levels dropped like crazy, really seriously in a short amount of time. And the quad-screen results were too wacky, showing too many different possibilities. Down syndrome shows up as low AFP and uE3 with high hCG. Trisomy 18 shows low levels of all markers. SLOS is indicated by extremely low uE3. Demise shows as high AFP and hCG and low uE3. See? It doesn't make any sense.

And yet my OB looked genuiniely shocked to hear that there was no heartbeat. As shocked as I was, really. I honestly don't think she would have proceeded as confidently as she did if she had thought there was even a chance of this. And, looking back, I guess I wouldn't have, either.

I never really got the hang of the doing my own doppler. I only got it after my last appointment with the OB, when we heard a great fetal heartbeat of 150. I never heard anything over 142, but that's within the normal range of 120 - 175, and actually 140 is dead-on average for a 17 week fetus. It's also pretty average for a nervous woman with no iron in her blood. It was my own heart-rate I was picking up. I had my last appointment with my OB at 14w5d, which is pretty much what the ultrasound measured. So I probably never even had the chance to find the real fetal heartbeat - a few days later it was most likely not even there, but my own blind confidence never ever let me consider that as an option.

I was so attached to the idea of staying calm and not freaking out over everything that I didn't even notice the obvious signs. Like my own post about how much my body didn't want to be pregnent. I just hung onto the fact that second trimester miscarriages are rare. I thought the NT scan results and the good heartbeat were enought to hang my hopes on. NT and first trimester screening tests are much more accurate than the second trimester tests for Down syndrome, and a strong hearbeat and appropriate growth are pretty good indicators of viability. I let myself stop being a nervous wreck. And although I KNOW that being more hypervigilant wouldn't have saved this baby, it might have helped me figure it out sooner, so that at least I might have had a chance to know what really happened.

I don't know much about the d&e. The doctor came to talk to me afterwards and said it would be almost impossible to do genetic testing on the tissues because of the length of time since the demise. They will analyze the placenta, but it had detiorated significantly. I never knew what really made this pregnancy happen in the first place, so I had to accept "luck" as the reason. And now I'll probably never know what happened to end it, so "luck" will have to take the blame, too.

No Possible Title

2009-02-11T14:59:00.000-08:00

It turns out that positive quad screen results can also be indicative of fetal demise. The fact that the test screened positive for three different anomalies means that probably none of them were the actual problem.

At 17w3d the u/s only measured 14w5d, just after my last appointment. So, D&E tomorrow and then my husband is taking me to Hawaii next week for some kind of tropical recuperation.

I will probably write about this more later, just to process everything for myself, but right at this moment I can barely manage to type. I am just going to go out for a real espresso now and get a fabulous bottle of wine for later, and try to figure out how to tell my daughter about this.

It Was Only A Matter of Time

2009-02-09T18:41:00.001-08:00

It's probably never a good thing when your OB calls at 7:00 at night to talk to you about your test results. Good results are calls from a nurse and can even be left as a message. The doctor only calls when something is obviously going to involve lots of questions and medical decisions and unfortunate consequences.

My screening test results came back positive for Down's, Trisomy 18 and Smith-Lemli-Opitz Syndrome. While I'm sure most people have heard that the testing for Down's carries a high false positive rate, the SLOS has an almost non-existent false positive history. SLOS is a combination of severe mental retardation and congenital malformations. Basically, it sucks. So does Trisomy 18, with less than 10% of babies who manage to be born surviving to their first birthdays.

The fact is, I'm old. My eggs are old. My husband is old. This baby was old even before conception. And the thing is, old is not good in the world of reproduction. I thought I just had to actually get pregnant, that if I could just manage to have an ultrasound with a normal heartbeat everything would be fine. But at forty years old it's just a fact that things are likely to go awry. I thought I was lucky to get one embryo that made it, but the odds are the others tanked because of chromosomal issues, and this one just happened to have the kind of anomalies that don't cause immediate demise.

We'll do the amnio Wednesday. I don't even know how long it takes to get results after that, but I suspect it will be longer than I would like. Meanwhile, constipation seems like the least of my problems.

ETA - Thank goodness for bloggers like Amber, who has been through this and tried to sort out all of the info about these various results for those of us who are desperately googling "SLOS screen positive" and reading nothing but dire pub med articles. Basically, she had almost the same kind of quad screen results I have, and her amnio was normal. I may not end up with the good news she got, but at least I have a little bit of hope now!

Movement? Or Bowel Movement?

2009-02-08T21:41:00.000-08:00

I can definitely feel some kind of flickery something going on, especially when I lie down. It's usually a little bit to one side or the other, a skittery fluttery something that almost tickles. I've tried to coordinate the feeling with the doppler, but it's not as easy as it seems - it takes me too long to get the doppler going and the little scrambly feeling doesn't last very long.

I have to admit that it's more likely to be related to the odd digestive side effects of Repliva, the iron supplement. I have had either diarrhea or constipation every day since starting these. The crampiness just pisses me off now because I still run for the doppler just to reassure myself even though I know it's bad digestion. Plus, I hate to have digestive problems at work. I know it's some kind of uptight prissy thing that I should try to overcome so I can Be Comfortable With The Human Body or whatever, but I think solid waste is really a home-based activity.

I know, I know - the body should be allowed to function freely as it needs, blah, blah, blah. But personally my own body is somehow adjusted to a daily rhythm that pretty much avoids ever crapping in a public toilet. For one thing, the bathroom at my office is just not the best place for anything discreet. The building is a 1929 art deco tower, and the bathrooms are wedged into little spaces between stairways. The walls are thin, there is no ventilation and some guy's office is right across the hall. There is a window, but it opens onto the fire escape, and usually the across-the-hall guy is out there smoking. Basically, it's fine if you have to pee. Kind of.

So, as much as I would love to think that little bubbling feeling is the tiny whoever* in there, I also kind of dread a day at the office with too much abdominal activity. Luckily I'll be out at some new sites tomorrow, so I may be able to pop home if need be and at least avoid smoker-guy.

* Ultrasound Friday - and we are definitely finder-outers. I can't decide if I even wish for one or the other - I so desperately wanted a girl the first time I was pregnant. I thought that this time I would either really want another since my daughter and I have such a close relationship, or that I would really want to have a boy so I could experience that instead. But I can honestly say I will be thrilled with either and it's all about seeing a healthy little somebody in there. It's just another difference between a naive easy pregnancy and one that was such a long time coming.

Hmmm...

2009-02-07T10:20:00.000-08:00

It's just a hunch, but something does not ring true with this octuplet story. Until someone can explain how an unemployed woman on disability can afford to do IVF six times (at least) I am not buying it.

I haven't seen the interviews (and won't) but the LA Times seems to be covering the whole thing to death. All I can say is that even if six embryos were transferred and two split to become two sets of identical twins, I am still skeptical. I mean, really?

Bad Blood

2009-02-04T20:32:00.000-08:00

It's always something in this fight my body and I have about pregnancy. I can imagine my body in a one-woman (what else?) show, played by an unknown red-head with her best "My Cousin Vinny" accent, chewing gum and wearing too much mascara.

"Look, it's not like a big surprise or anything. I toldja all along that this pregnancy thing just itn't for me, right? Didn't I? Didn't I tell ya like a hundred different freakin' times? So don't go cryin' now that it itn't a bed a roses or somethin'.

"Oh, ya think so? Ya think it's easy to keep this rickety skeleton togetha, to make sure all those organs are workin' in a basically kinda normal way? To get that hair to keep growing? It's a full time job already and now ya I gotta buildja a whole otha human bein' ? Are you kiddin' me?"

I'm pretty sure my body's persona is basically a pain in the ass. No matter how much blackstrap molasses and spinach I eat, plus whatever is in the prenatals, I am severely anemic. I do tend to be mildly anemic sometimes anyway, but this time it's a dramatic drop. So, onto the giant iron supplements.

I keep reminding myself that I am perfectly happy to deal with a jillion little problems along the way as long as I can avoid any major ones in the long run. I just hope my body can stop complaining so much - it's not like I don't try to be good to this rickety skeleton and all of it's various bits.

Tomorrow, a massage - just to show that I do still care.

Thyroid

2009-01-31T20:53:00.000-08:00

Well, I had my thyroid appointment and the doctor - a really thoughtful, helpful man with a great bedside manner - thought at first that I was four months postpartum. My bloodwork shows a classic case of postpartum thyroiditis.

I can understand the confusion. The numbers make sense for that diagnosis, and I wasn't wearing a tight shirt. Sitting down in a long floppy top, I could easily be a new mother. It took a while to sort it all out, partly because he had a lot of paperwork from my OB, so I assumed he had all the facts. Also, part of his exam turns out to be just talking for a bit and trying to see if he picks up on any overt lethargy or jitters. So, the conversation was a little weird.

"Any problems with breastfeeding?"

"Not that I remember..."

"Concerns about post-partum depression?"

"Not really - I haven't really gotten around to worrying about anything like that yet..."

"And when did you deliver?"

"Ummm....1998."

The look on his face was absolute confusion. And I'm sure I had the same look. When we started all over again, he was wonderful. He drew pictures to show how the thyroid worked, what happened to the T3 and T4 and how the TSH was regulated. He was very specific and scientific, which I always appreciate, but with a kindly sense of humor and a great vocabulary. At one point he said my numbers were "not too bad, but nothing to be sanguine about".

He decided to retest everything at a high-spectrum lab. My TSH is .43, with normal being >.5 - he felt this was not too worrisome since my actual hormone levels are fine. So, it's wait-and-see, and least until the lab results are back.

The one interesting thing he did say is that steroids can affect the thyroid. Since I was on dexamethasone for this IVF cycle maybe that has something to do with it. Although the dose is tiny compared to the amount used to treat chronically inflamed tissues, but who knows? I always turned a blind eye to the possibilities of long-term side effects from everything necessary for IVF - if I thought about it too much I would never have been able to go through with any of it.

Obviously, this is not a giant disaster. I feel like I'm in good hands and as long as the baby is fine I can cope with just about anything. But it is like another little message from my body, like it's saying "Listen, lady, wasn't it kinda obvious that I didn't want to get pregnant again? Then you go and do IVF and somehow it works. Great. Well, you can't say I didn't try to warn you."

I wish there was a way to argue reasonably with this grumpy body - but I guess if that were possible I wouldn't have had to go through IVF in the first place...

Just When I Thought It Was Safe...

2009-01-28T20:27:00.000-08:00

I have never had a thyroid problem. I have been tested who knows how many times during these last years of bloodwork, and always the results are normal. My tests from September are completely normal. Sure, I have all kinds of other problems. My anti-trypsin numbers are too high and my hematocrit is too low. But thyroid has never been an issue.

Until now, of course. My very borderline, nothing-to-worry-about low TSH has been getting worse instead of better. Because my free T3 and T4 numbers were fine, the low TSH didn't really mean anything in the first trimester. Apparently the hCG can affect the thyroid hormone levels as it increases in the first months. But here I am in the second trimester and it's getting worse, so I'm off to the endocrinologist (a regular one, not a reproductive one.)

I keep thinking that clearing the hurdle of actually getting pregnant should be enough. All those years of trying to solve that problem have left me less prepared to handle new ones as they crop up. It should be the opposite - I know how to read journals and figure out what questions to ask - but instead I'm just useless. I googled "hypothyroidism + pregnancy" and there were just too many upsetting results so I quit. My medical-issue resolve has been exhausted. I have an appointment with the endocrinologist in two days, and until then I just want to think about something else.

......................

The most interesting thing I can distract myself with now is the middle school search. It is fascinating to see what amazing opportunities there are at some of these schools. Kids on the debate team go downtown to argue their points before real judges. Science classes take four-day trips to the Channel Islands and the Mojave. For spring break there are (optional - and expensive) trips to Vietnam and Peru to build schools and bridges and clean up wetlands. Seniors are matched with internships in any field they choose. Even the lunches are amazing - one school is catered by one of our favorite restaurants!

My junior high was more like pre-teen jail. The halls smelled like grease and the bathrooms were always out of order. A lot of the boys were left back a few years on purpose, so they could be bigger for high school football. They would cut class and go across the street to get donuts, so there were always smears of jelly filling and whatever that yellow creamy stuff is all over the desks. Those guys would push girls against their lockers and grab their crotches - it was repulsive, but nothing ever happened to them because they were going to be football stars. In high school, one of them was in a bad accident (driving drunk) and his leg was crushed. He wouldn't be able to play football again and I remember being glad. I specifically remember thinking that it was kind of horrible of me to feel that way, but that I was glad anyway. He had grabbed me once, and I had never told anyone.

I know school is still school. Even if my daughter goes to the fanciest private school with the most exclusive everything, there will still be cliques and parties and mean girls and drugs and boy problems. Maybe worse, who knows? But these schools have "life skills" classes and advisory groups that encourage kids to talk about issues and rumors and problems. They have counselors and peer support councils and incredible small student-teacher ratios. If my friends and I had had anything like that, things might have been so much easier to deal with. If we had even thought there was a chance that somebody would really listen to us instead of just telling us what to do, things might not have been so out of control.

Even while I hope to be a new parent again, safe in those early years when conflicts are generally small even if they're noisy, I can't avoid the fact that I am also heading into the pre-teen years.

Relief, Retrospect

2009-01-25T11:16:00.000-08:00

I had an OB appointment on Friday, just in the nick of time. I was about to drive myself crazy with irrational anxiety. Even though my doctor is sweet enough to say that I can come in for a listen any time, I'm going to rent the doppler. If I went in as often as I wanted to there would surely be unflattering notes in my chart - plus the parking for her building is ridiculous.

That said, everything looks fine. I had to laugh when she looked so pleased that I had gained a perfect two pounds so far. Ha! She took my "baseline" weight after I was released from the RE, by which time I had already gained nine pounds. When she flipped back to my last yearly appointment weight she noticeably flinched. But I have to give her credit for regaining her composure so quickly and just telling me not to worry about it!

Other than that, I've been thinking a lot about how I actually got here. Since I never had a firm diagnosis of anything in particular in the first place, it's hard to know what the solution really was. Going to an aggressive clinic was definitely a big part of it - but even within everything they changed as far as my protocol and lab interventions, I wonder if there was one deciding factor that tipped the odds in our favor? Was this just a lucky month, just random chance that one of the few viable eggs in there was coaxed out this time? Were my eggs just "tough", so that they needed ICSI even though my husbands sperm assay was relatively normal? Or did the AH make all the difference? What if they hadn't let me transfer all three embryos? What if I hadn't done all that acupuncture? Would it really have made any difference if I had that glass of wine after all?

All the same questions that I had after my unsuccessful cycles are still there, even though I guess it doesn't matter so much if I get the answers. Still, after all those years of wondering, it's strange that I never really got to find out what the problem was. This cycle really did throw the whole kit and caboodle at me and hope something would work, and I suppose that's the best anyone can ask for... But the part of me that read through so many scientific journals and infertility publications still wishes I had an actual explanation for my seven years of disappointments.

It's not as if I can't just be happy and stop worrying about it - I am honestly thrilled to pieces now. But I can still remember the sting of a failed cycle, and the frustration of never knowing what might have made the difference. Now that I'm on the other side, I have only this to say: When it comes to unexplained infertility, you can either first try one thing, and then another, and then something else and try to pinpoint the exact problem. (I probably wasted years on the tentative possibilities of the "maybe this, maybe that" approach.) Or you can throw everything at it and hope something sticks. I may never know what made this cycle work, but I'll always be amazed an unbelievably grateful that somehow, it did.

Time Not Flying

2009-01-20T21:31:00.000-08:00

It seems like it's been about a billion years since my last scan. It's peculiar that I myself was once a blissfully unaware pregnant lady, nonchalantly assuming that all would be well, and yet after seven years of infertility I am in need of regular reassurance.

Not that I have any particular reasons to worry. No unusual symptoms, no threatening conditions. It's just a tendency to believe that things aren't going to work out, because they so often haven't. And now that I'm really invested in this pregnancy - literally, in that I am having a wall built in my house to make an open room into something that might be able to be called a third bedroom - I am more anxious. The calm I feel after an appointment seems to wear off over time, and I am starting to think that I should rent one of those doppler devices after all. I hoped to be able to overcome the fear that years of disappointing treatment left me with, but it's harder to shake than I thought.

......................

My daughter has gotten over the initial shock of finding out that I'm pregnant. She bought a baby name book with her own money and is busy crossing out the absolutely not acceptable names (Snowdrop, Horst) and highlighting the ones she likes (Jillian, Daniel). She says she is going to read Shakespeare to my stomach once she can feel the baby kicking, so she can tell if it likes the comedies or the tragedies. And she is excited about the idea of taking walks with the dog and the baby.

Our dog research continues. We met an adorable yorkshire-pekingese mix, which is supposed to be low-shedding and very friendly. And my daughter has been googling images of little maltese puppies almost every day. But poodles shed less than any other dog, so maybe a poodle rescue dog is our best bet. In any case, we have put the final decision off until the end of February, since we will be dealing with the construction and it just seems unfair to bring a new dog into a carpentry mess. I think the right dog will find us.

Private school interviews start next week! We got the test scores back and the information is actually fascinating - there are two scores each for verbal and mathematical abilities. The first measures comprehension and the second measures application. If there are wide discrepancies between the two it's a sign that there may be a problem - it could be just a concentration problem or a learning disability.

Luckily my daughter's scores came in exactly the same for each category - 9s for verbal and 7s for math (on a scale of 1-9 - with a true bell curve, anything above a 5 considered good.). Which I think is really accurate, given the flap about standardized testing. Even though her Wechsler IV scores put her in the top 99.9% across the board, IQ tests don't really measure practical abilities so much as cognitive agility. I think that in terms of school experience, the ISEE gives a better picture of her as a student than the IQ test does. Anyone who has taught her would say that her strengths are in the humanities, although she is certainly a perfectly good math and science student. So, that's my take on standardized testing - for this one particular girl, anyway.

So Far, So Good

2009-01-13T20:20:00.000-08:00

I finally got the official results of the first round of testing - the nuchal translucency and the blood test for a specific protein - and the report is: "it's all fine." Huh?

It seems that most people get some kind of statistical probability report, some kind of one-in-however-many that allows them to make a decision about whether or not to do an amnio. I just got a sentence fragment, although it's a certainly a nice one. I'll call the nurse back, of course - I've had enough experience with lost charts and forgotten memos that I like to double-check whenever anything is vague. But for now, at least, all is well.

The real reason I'm not too worried is that the ultrasound tech showed me exactly what she was doing, what she was measuring and how the measurements related to the statistics. She said that anything over a 3.5 could signal a problem, and Little Whoever has a 1.3 lucency. She seemed very confident that there wouldn't be a problem - she did point out that this is only one test, etc., but she said this measurement was very thin, which is always good. She also said that if the measurement is thick she calls upstairs to the doctor, and they usually do CVS right then and there. Wow!

It's strange to be here. It's like all those years of trial and error just disappeared. It just feels normal, and right. I thought I would be overcome with gratitude and celebration, but the truth is, life goes on. My office has a new big amazing project, my husband may be going to of town for months, my daughter is getting ready for her interviews at new schools... The world is more or less the same place it always was, and I guess I wasn't prepared for that. After years of measuring each month in two week waits and injection schedules, I'm just dumped back here into normal everyday life. If my pants weren't all so gigantic, I might not be sure this is all happening...

Other than that, I am going to start a yoga-for-invalids class this week. It's really a class for people who are recovering from an injury or have some kind of chronic condition, but it's super-easy and I think I need that now. I have been so tentative about anything strenuous that I'm not sure I could survive in my old level 2 class. There are all kinds of prenatal yoga classes around, but I can't quite work up to that yet - I think you might need an actual bump for those sessions.

We are also going to figure out how to get a dog. Although I have never really been an animal person (allergies), my daughter has been asking for a dog for a long time. And it's not that I don't like dogs, I just never let myself get attached to the idea of having one. But the idea of a hypoallergenic dog is what really made me give in - although I'm not sure how hypo-allergenic they really are.

In any case, when we told her about the baby, the only thing she said (at first) was "Can we still get a dog?" To which there is really only one reply. So, off we go on the great hypoallergenic dog search. We all agree that we just want a sweet, easy-going dog - a good personality is definitely the most important thing. And it doesn't necessarily have to be a puppy. I keep hoping that you just know the right dog when you see it, kind of like husbands. Anyway, any advice?

Fat and Happy

2009-01-06T12:52:00.000-08:00

Ah, 2009! Even the sound of it, with it's long-vowel and final ringing consonant, seems so much nicer than the sharp little noises of 2008. So nice to be in a brand-spanking new year, full of hope and waiting for it's history to be made.

I am entering this year with my own new hope, less anxious and not quite so nerve-wracked. I think the (almost) weekly ultrasounds have made it so much easier - I can't imagine going a month between scans! I think the fear of early miscarriage is so fraught for those of us who are afraid that's all we'll ever have that any possible concern about frequent ultrasounds is easily outweighed by the relief of knowing things are going well. I know that at a certain point I'll have to learn to live without them - but my OB is very understanding, says I can come in for a quick doppler any time. Maybe I can even get by without buying one of my own?

Of course, tomorrow's scan is the nuchal translucency test, and that has it's own set of fears and worries, but for some reason I'm not too wound up about it. It is what it is, and there's nothing I can do about it between now and tomorrow afternoon.

As for being a forty-year-old pregnant lady, I can only say that it is very different than being a twenty-nine-year-old one. While I know that a second pregnancy - okay, with infertility taken into account, it may not technically be the second actual pregnancy, but whatever - tends to "show" sooner, I am shocked at how pregnant I already look. When I was pregnant with my daughter I wore regular clothes until about five months. Then I wore floppy things and didn't even buy maternity clothes until seven months. Now all I can fit into are floppy things, although one of the advantages to being older is that I can afford nicer floppy things than I could have back then.

Although I don't have strong pregnancy symptoms (like nausea or sore boobs, although I think nursing for 14 months took so much out of my boobs nothing can really affect them any more) I seem to be starting in on the pregnancy-related consequences. The veins on one of my legs are snaking into prominence, and the skin on my stomach is insanely itchy. I am as burpy as a frat boy and as achy as a great-great-grandma. (Yep, my husband is one lucky guy!)

Of course, it's all nothing. I don't care, I'll wear the thick stockings or whatever. It's amazing to even think that I am twelve weeks (and one day!), that I am almost out of my first trimester already and that I feel pretty good most of the time. I thought I would be wracked with worry day in and out, but somehow things just feel right. Even though I know that anything can happen at any time, it just isn't something that haunts me. I think a lot of it has to do with getting past my own personal fertility disaster zone - the early weeks. I can only imagine that it would be harder if my losses had been later.

At this point, I think of those possibilities on the same level as the getting-hit-by-a-bus scenarios. Yes, terrible things can happen, can and do. But, somehow, the Abstract Terrible Thing That Probably Won't Happen just can't wreak as much emotional havoc as the Terrible Thing That Actually Happened and May Happen Again.

Of course, I'll let you know if I still feel that way after I get the results of the nuchal scan.

Vacation!

2008-12-27T09:33:00.000-08:00

We're off to Yosemite! I'll have to do without my weekly scan, but I think it will be worth it...

I still don't feel much of anything, physically. Maybe a little teeny bit of stomach blah, definitely more tired than usual (but also busier than usual). Somehow, I look four months pregnant already. And, somehow, it doesn't help - I just feel awkward and lumpy.

So, I'll be the slow lumpy one on the snowshoes. Or maybe just the lumpy one by the fire with a big fat book! 2008 has been fraught with hope and change in so many ways for me - I am looking forward to a year which holds so many happy new possibilities! A truly Happy New Year, this time. And I wish the same for all of you.

Labs and Other Tests

2008-12-18T22:08:00.000-08:00

Luckily, I've managed to get an ultrasound once a week so far - this one with my regular OB, who called me on Sunday after she got my message so we could schedule an appointment as soon as possible. She completely understands the IVF-pregnancy panic, so I'll get to see her more often at first. Between her office and the last few visits to my RE, I'll be able to stay on the weekly u/s until the nuchal translucency scan!

The only bad news is that my thyroid levels are off - and the nurse who left the message didn't even tell me in which direction. And googling anything like this just leads to disaster - the first three things I read were dire reports of lost motor skills and lowered IQ. I am (for now) assuming that my levels can't be too bad since the nurse said they just want to retest in a few weeks and it should be fine...

...........................................

Meanwhile, maybe I shouldn't worry too much about lowered IQ. Since my daughter is so unhappy at school, we began to wonder if it wasn't more than just feeling alone and disregarded that was the problem. Because she'll be in the sixth grade next year, we have a lot of options as far as school choice - there are so many charters, magnets, private schools and permit-entry public middle schools that start in sixth that we thought it would be good to look into moving her early.

As we researched, we found out that most of the charters and magnets are LA Unified schools, and since we don't live in LA proper she can't even apply to those. There are some state charters open to anyone, and we found one we like. It is on a lottery system, though, so you have to just cross your fingers and hope to get in. The other options are magnet-charters that she may be able to get into at the discretion of the district at the start of the school year (depending on enrollment) - yikes! The local middle school seems mostly fine - not much gang activity, good music program, great theater program. But there are no gifted classes. Since my kid's whole problem is that she has a hard time really finding friends who have "interesting things to talk about and are really smart and funny" I am not sure about the no-gifted program arrangement. I'm sure those kids can somehow find each other, but at her current school finding those kids isn't the problem - the fact that they're not in the same class is what really ruins it.

All of that is a long backstory to this: we are looking at private schools. Which means that we have had to study for the ISEE (a sort of mini-SAT) which is required for the admissions process. And she has been IQ tested, the results of which were unattainable. Yep - the modern IQ test apparently doesn't go high enough to measure my kid's IQ. Which just serves to infuriate me even more when her current school says that they feel gifted is an arbitrary designation, and it doesn't really have any bearing on the classroom situation.

Anyway, I always knew my daughter was bright. But she is not one of those kids who knows everything there is to know about micro-organisms or Greek mythology or whatever. I knew that she was happier when she was in class with her three friends who are also really bright, but I hadn't fully put it together that it isn't just social. She just misses having someone to talk to about whatever they are doing in class. I thought it was more about having a friend to chat with in the "in-between" times, but maybe I was missing the bigger picture.

I think that the ISEE prep is actually great - it's more homework than she gets from school, and she seems to love it. I've also been carving up my work schedule into little ribbons of time just so I can manage ultrasound appointments and playdates with the kids she likes, and it does seem to be making a big difference. She has two semi-friends in her class, but doesn't want to see them outside of school. (She has known them for years and always liked them peripherally, but the few playdates us moms arranged were never really great for any of them.) So, I just make sure to have as many kids over as she wants, lots of sleepovers and lots of cookie-baking.

Anyway, that's my long update on my daughter - private school interviews in January, charter lottery in April, magnet-charter maybes in late August, if we can hold out that long. All I know is, any school is probably better than one that thinks gifted (and, by the way, I hate the word gifted - there should be some better term that denotes specifically cognitive/associative/comprehensive agility) kids don't need any specific consideration at all.

July 20th

2008-12-12T18:05:00.000-08:00

I had another ultrasound yesterday, and the RE told me I could stop worrying about an early miscarriage. He hastily added that there are no guarantees, etc., etc. - but of the few things they look for (heartbeat, growth, condition of yolk sack, no hemorrhaging behind the placenta) all are just fine.

I could see the head vs. body differentiation, and even a little twisty movement and head bopping. Of course, on the little picture it all just looks like a blob, but I swear I saw that blob shrug, as if to say "It is what it is, lady. Just chill." So, okay, I get the message.

Here's the blob, with the head at the top, in profile. The round thing by its (eventual) feet is the yolk sac.

I did go on a drawstring-pants shopping spree, and also got some drapey tops. One of my best friends is getting married Christmas Eve, so I have to find some kind of fancy loose outfit. And I'm thinking of actually telling her that I'm pregnant, instead of making up some kind of reason for not drinking the champagne. How's that for throwing caution to the wind?

Meanwhile, I made my first OB appointment. My RE likes to have an overlap of care, just a week or two. Then, the nuchal translucency scan in the first week of January. Suddenly, it all seems real. It's impossible to remain detached and neutral through all of this, anyway. I can't be invested enough to eat really well and avoid all the bad things and generally try to be a good pregnant lady while also trying not to get too invested in the pregnancy. I am just not that psychologically complicated.

I think the real story now is all about being pregnant and old. I know that over women over 40 may have increased risks for growth problems, preterm labor, preeclampsia, high blood pressure & gestational diabetes. But I'm just not up for worrying about all that too much. It's not that I'm putting my head in the sand - I'll make sure to exercise (at least a little bit) and have any weird symptom checked immediately - but somehow making it past your own personal infertility hurdles is exhausting enough. Fretting about hypothetical problems is just too much - I'll cross those bridges when and if I come to them.

Of course, I'll still be nervous for the nuchal scan, the triple screen, the big anatomy ultrasound. But it seems somehow like normal-person worry, not desperate-infertile-worry-which-
mourns-the-wretched-injustice-of-it-all. I might even buy a bib or something, if it's on sale. (Although I do have pre-planned escape routes for any early purchases - pregnant sister, pregnant cousin, pregnant dear friend. One boy, one set of boy-girl twins, one unknown. I figure I can re-gift pretty much anything.)

Stomach Problems

2008-12-06T20:16:00.000-08:00

I am possibly feeling the teensiest bit of nausea, which I am taking as a good sign. Although maybe I just ate something funny, because one day of stomach weirdness could be anything, really.

Mostly my stomach feels bad because it is uncomfortably squeezed into my pants. As anyone who has gone through a medicated cycle can tell you, there is some kind of bloat that has nothing to do with anything that may or may not be growing inside you. The bloat is some kind of fat-collecting, fluid-retaining, muscle-slackening deterioration that makes fitted pants a very unfortunate fashion choice. I can only imagine what might happen in back-to-back cycles, but maybe there is some kind of bloat threshold.

Part of it is the lack of vigorous exercise, because of course the hormones make you feel terrible and then the taking-it-easy is such a good excuse to skip the gym. Plus, the steroid I'm still taking does tend to cause puffiness. I know I need to get myself back into some kind of regimen. But I think the IVF bloat, added to the fact that I am not some young thing at this point, means that I am just not going to be swanning around in cigarette pants and a halter anytime soon. (Which is fine, because honestly, I don't swan much anyway...)

Floppy pants are not really a problem - I'm happy to need them, happy to be in this situation at all. But it's funny how many little things are different with a pregnancy after infertility. There's just a lingering sense of doubt and failure that's hard to shake, a habit of not expecting too much. I keep thinking it will ease up as time goes by, but maybe I haven't given it enough time.

I did, however, order two pairs of fancy stretchy pants and one of those wrap-around sweater contraptions. I may look like I'm getting fat, but at least I'll be able to bend over.

Hooked

2008-12-04T22:46:00.000-08:00

Thanks to Nikki for the lovely compliment of this award! It is especially pertinent to me because of the tiny houses in the picture - since I am a landscape architect, I am more or less always thinking about houses (unless I am thinking about getting pregnant...)

In the tradition of passing it on to two more blogs, I can only say that I am not somebody who reads a jillion blogs - I really love all the ones that I keep in my reader. But there is a special place in my heart for the stories of my fellow 40 +ers, so I will pass this on to Sky and Egged. Along with my continued best wishes, of course.

............................................

Anyway, today I started allowing myself to think I might actually be pregnant. Just briefly. I am not ordering any crib sheets for a long while, but I may buy another pair of stretchy pants this weekend.

Other than that, I haven't really thought about anything like when to tell and what to worry about. For me, the heartbeat has been such the focus of my anxiety that anything past that is uncharted territory. I guess I should concentrate on the normal things like eating well and getting some kind of exercise, but it seems so odd to stop worrying about death and start thinking about calcium deficiency.

Alive and Well

2008-12-03T14:47:00.000-08:00

By which I mean myself, and one little embryo.

We saw a good heartbeat, about 149 bpm. The little blob is one centimeter long, which is exactly on target for 7w2d. I am so relieved I don't even know what else to write. I'm sure I'll have nine hundred other things to add to this later (when I'm not at work, for example), but for now I will just say that I am extremely relieved and full of gratitude and hope.

Wimp

2008-11-24T19:15:00.000-08:00

It wasn't so much the actual stabbing or any kind of fear of needles or even the welts and bruises. But when I began waking up so many times every night in pain - whenever I rolled over, or my husband flopped his arm against me - I decided I just couldn't take it any more.

So, against my superstitious better judgment, I am switching from the PIO to progesterone suppository. I know there is a sort of hard-core IVF badge-of-honor tradition to the agony of the PIO injections. And sure, I get that after all it takes to even make it to this point, I should be willing to do whatever I have to in order to support a positive outcome. But waking up whimpering in pain six nights in a row has done me in.

It really wasn't so bad at first. Even though that needle is long, you don't feel anything past the surface nerves anyway. It's the swelling - and possibly a mild allergic reaction - that was my undoing. I could massage with a hot washcloth until I was sure there were no lumps of oil coagulating in my muscle, but there wasn't much to be done about the general swelling. I rotated sides, of course, and used different spots each time. But after a few weeks there just isn't any undamaged tissue left to puncture. The last few days I have had large pink spots on each hip, swollen tissue that is so sensitive that I have to wear soft elastic-waist pants and pretend I am just on my way to a yoga class all the time.

I know the suppositories have a bad rap - they leak, they itch, they ruin your panties. They can cause irritation that can lead to bleeding - and, thus, panic - and progesterone levels can't be reliably measured with a blood test since the effect is so localized. I was hoping to talk to my doctor about Claudia's secret sub-Q progesterone alternative, but since my appointment was canceled I decided I just couldn't go another week without a switch.

I've read a lot of studies that show no difference at all between intramuscular and intravaginal progesterone. Then there are studies showing that one is better, and studies proving that the other is better. There are even studies suggesting that no supplementation at all (past a positive beta) is just dandy. It's ultimately impossible to make the right decision based on all this vague information. Even though I used to be paranoid about changing anything or doing anything that might possibly cause some kind of disaster, I've been worn down by exhaustion and worry and the business of trying to stave off hope. So, I don't know. But I'm damn glad that I'm not icing my ass while I type this.