Good riddance, 2009

"Grief turns out to be a place none of know until we reach it."

-Joan Didion, The Year of Magical Thinking

Where things stand today...

After two years of trying to conceive a baby, I visited a Reproductive Endocrinologist in Atlanta, where I was living at the time. She believed I was suffering from endometriosis and scheduled a laparoscopy and hysteroscopy to make sure. Within a week of my diagnosis, my mother was diagnosed with terminal cancer. I flew out to California to bring my mother back to Atlanta with me so I could take care of her. At her urging, I underwent the laparoscopy, and was diagnosed with Stage 4 endometriosis. My RE told my husband Alex and me we had less than a 5% of conceiving without in vitro fertilization. Because my mother hoped to live long enough to see me become pregnant, my husband and I decided to start the fertility treatment. My mom died before we could begin with IVF, but we decided to forge ahead in her memory. I became pregnant after my first round of IVF, only to miscarry weeks later. Alex and I then moved to San Diego. We still have one embryo left in the freezer in Atlanta, but we are filling out adoption applications now.

This Will Be an Everlasting Love, Blah Blah Blah

I recently tried to convince a friend of mine, whom I'll call "Alisa," to find a mate using the Internet. Everyone does it, I told her. (Even though secretly those eHarmony commercials make me want to vomit when ever I see them.) There's no shame in it, I said. But still, she begged off, and seemed a bit hurt by the suggestion.

Cut to a few weeks later. My husband and I have started the process of adopting a baby. The law firm we're probably going to go through posts the profiles of adopting couples on its website to attract birthmothers. I thought it was a great idea, until I checked out said website. Most of the couples were adorable. Possibly cuter than my husband and me. A lot of them were more athletic than we are. Virtually all of them were super-duper Christian. I felt insecure and frustrated looking at these profiles.

But most of all, I felt angry. Why did I have to pimp myself as a parent, when all it seems everyone else just has to do is just think about getting pregnant and they become a parent? Why do I have to beg to become a mother?

So now I get it: Why "Alisa" is hurt at the suggestion of looking for a guy on the Internet. Because why should she have to advertise herself like a car for sale to find a date?

But the brutal truth is, I do have to use the Internet to become a mother. Fair or not, endometriosis has turned my reproductive organs to mush. And Alisa hasn't been able to meet a man worthy of her beauty and charm. Maybe the Internet is God's way of evening things out. If you believe in God. The jury's still out for me.

Sorting through the past

My sister Tara and her husband Mike drove up to my mother's house this past weekend to sort through my mom's personal stuff. It's been four months since my mom died, but it felt like it happened just last week knowing my sister was in my mother's house. Some small part of my brain still believed my mom was there, in that house, and Tara arriving there to report the house was empty was just further proof that my mom is really, truly gone. As weird as that may sound, my sister Sheila was going through the exact same thing. Like, there had been some huge mistake and my mother was still alive, still in her beloved little condo watching Perry Mason re-runs with her giant cat on her lap.

My mom kept everything. Well, everything that pertained to my sisters and me. Every drawing we made in school. Every story I wrote as a child. Our baby clothes. Tara sorted things into boxes to take back to Sheila and me, and some things went into a group box that the three of us will sort through together later.

I always knew my mother loved me. I never once doubted that. But it's only now that she's gone that I realize no one will ever love me like that again.

The Newest Mermaid

When I was a toddler I wanted to be a mermaid so badly that I slept with a can of Chicken of the Sea tuna. My mother never made me feel weird for doing so. I had seen Charo dressed up as a mermaid on some 1970's variety show, thought she was beautiful, and wanted to look just like her.

I believe my obsession with mermaids ended after my mom read "The Little Mermaid" to me. Now, this was not the sanitized 1990's Disney version of the story. In the original, the mermaid must kill the prince or she will die and turn into sea foam. She cannot kill him, and so sea foam she becomes.

The other day I was at Dog Beach in Del Mar, just a few miles down the road from Carlsbad beach, where my sisters and I scattered our mother's ashes. It was the first time I saw the Pacific Ocean since we scattered her ashes in June. I felt so close to her, watching the sea foam lap at my feet.

I looked up the original passage of Hans Christian Andersen's "The Little Mermaid" about the sea foam, and I felt as if the relationship I had with my mother had come full circle:

"The sun rose up from the waters. Its beams fell, warm and kindly, upon the chill sea foam, and the little mermaid did not feel the hand of death. In the bright sunlight overhead, she saw hundreds of fair ethereal beings. They were so transparent that through them she could see the ship's white sails and the red clouds in the sky. Their voices were sheer music, but so spirit-like that no human ear could detect the sound, just as no eye on earth could see their forms. Without wings, they floated as light as the air itself. The little mermaid discovered that she was shaped like them, and that she was gradually rising up out of the foam."

La Quinta, Super 8, and Holiday Inn

My husband and I are driving home to San Diego to start our new life there. I guess it's not that new, considering my sisters, nieces, nephews, and friends all live there. It's quite bittersweet because my mother won't be there to welcome me back. It stings every time I think of it. Sometimes, before I go to sleep, I ask her to visit me in my dreams. It's strange, even though I don't dream of her, I feel like I've spent time with her, and it makes the pain ease up a little bit.

Driving to Abilene, Texas today. I'm looking forward to the scenery changing from lush and green to dry and brown. It's the native Southern Californian in me that craves parched landscapes.

We've got my two twelve-year-old cats and a rambunctious dog along for the ride. Our dog is pretty mellow in the car, but one of the cats meows her complaints about being stuck in the car for hours on end. The other cat waits until we hit the motel, then meows her dissatisfaction throughout the night.

I'm anxious about arriving in San Diego on Wednesday, though. It's my birthday, and it will be the first one without my mother. More on that later.

You're so pretty

The last words my mother ever said to me were, "You're so pretty." She then slipped into a coma and died ten days later. The thing is, when she was alive, she said those very words to me all the time. It would truly hurt her feelings if I ever put myself down in front of her.

Cut to: not yet three months after her death. I feel like my body has betrayed me, in the most excruciating way. I could not get pregnant naturally, as most women can. I had to undergo a very physically and emotionally grueling cycle of in vitro fertilization. And it worked. I became pregnant. And then my body failed me again. The embryo died inside me. It was like I had planted a rosebush in a pile of sand.

I want to be angry at myself. I want to look in the mirror and say terrible things about how I failed at the most basic human capability. But something is stopping me.

Yesterday, while cleaning out my mother's suitcase, I found one of her lipsticks. It was barely used. I'm pretty sure I bought it for her, because she hated to buy makeup for herself. I put the lipstick in my own makeup bag. And this morning, as I looked in the mirror, I saw my reflection and the face of the person who has kept me from what I want most in the world.

But it is also the face my beloved mother treasured so much she used her last words on this earth to complement it. And so I put on my mother's lipstick, looked at myself in the mirror, and said, "You're so pretty."

Miscarriage

It's over. All those weeks of injections and blood draws and ultrasounds and mood swings--over. Just last week it seemed the tremendous physical and emotional effort of IVF paid off in blissful happiness. I was pregnant. Each time I went in for a blood draw to make sure my numbers were going up, I'd get a call from the nurse reassuring me that "everything looks great." Except last Friday.

The phone rang, and my caller ID identified the caller as my clinic. I answered, looking forward to hearing the words "everything looks great." But instead, my nurse Nancy said, "Unfortunately, I don't have good news for you." My numbers had plummeted. I was told I would miscarry in a few days. "So it's over?" I asked, crying. "It's over," Nancy said.

I have been bleeding, very heavily and with extremely painful cramps, for three days. Every time I look at the pad and see a clot, I wonder if that was my baby.

The week I knew I was pregnant was the happiest of my life.

To tell...or not to tell?

I am pregnant. My nurse Nancy called on Wednesday morning to tell me the unbelievable news. I was in shock, because it's news I never expected to hear.

I almost immediately felt protective of the news. But so many people knew we were doing a cycle of IVF, because my husband had to tell his boss to get time off. Also, both my sisters and their families knew, as did a handful of my closest friends. They all knew Wednesday was the day we would learn if I was pregnant. But it felt weird for SO many people to know I was pregnant, considering how early it is. In fact, one of my husband's (pregnant) coworkers chided him, saying, "You're not supposed to tell people until the second trimester."

I know that's the conventional wisdom. But I think that's something my grief counselor would have a problem with. She would say it's a way of having control over something (miscarrying) that you really don't have control over. Besides, this may be the only time in my life I can say the words, "I'm pregnant."

The longest day

I just returned from the IVF clinic for my pregnancy test. I walked into the lab, the phlebotomist jabbed me with the needle, and it was over. Now I must wait for a call from the nurse, sometime between 1 and 4 p.m., to find out the results of the test.

This gives me plenty of time to think about my cycle, now nearing its end. There is only one thing I think I would do differently. I would get a haircut before I started. I felt so emotional during the cycle, with all the hormones pulsing through my system, that I didn't have the patience to sit still for a trim. And now I have a Carol Brady-like mullet. It's not pretty.

My friend Pam gave me good advice yesterday. She said instead of praying for a certain outcome to the test, ask for peace with the result. Just thinking about the word "peace" calms me down. I know if I'm meant to be pregnant, I will be. And if not, I won't. I just have to have confidence that eventually I'll come to terms with the outcome, and will find peace with it. I believe I learned enough from my final days with my mom to embrace that.

Progesterone problem

My doctor took me off of the progesterone injections last week. I had a reaction that she had never seen before. Nor could I find anyone else with the problem online. The muscles of my rear end were so sore that I couldn't walk or sit down comfortably. And it only got worse as the days progressed. Last Tuesday, I woke up in a lot of pain and had a fever of 101.5. I phoned the on-call nurse, and she told me to come into the office. My doctor was flummoxed. She put me on Augmentin, and antibiotic, just in case I had a staph infection.

Now I use a vaginal progesterone suppository three times a day, with a estrogen patch. Within a day of stopping the injections I could walk again. The pain went away within three days. Big sigh of relief.

Day 5 blastocyst transfer

I was scheduled to have a Day 3 embryo transfer on Friday. The nurse called in the morning and told me all five embryos were still alive and looked healthy, so the doctor wanted to push the transfer until Sunday...a Day 5 transfer. I felt elated and surprised hearing this. From what I've read, it's quite good if it's possible to push the transfer until Day 5, because any blastocyst that survives that long in a Petri dish has a good shot of making it in the womb. And Day 5 is when a blastocyst would be in the uterus during a natural conception, because on Day 3 the little guy is usually still in the fallopian tube. So a Day 5 transfer more closely mirrors natural conception.

There's a chance all five could be dead when they open the incubator tomorrow. But it's my believe that if they'd transferred two into my uterus on Day 3 they probably wouldn't have made it, either, and I can't stand the thought of thinking I'm pregnant for two weeks (again) and then finding out I'm not (yet again.)

The day after egg retrieval

Woo-hoo! The nurse just called and I have five embryos! During the egg retrieval process, they were able to harvest seven eggs. Six were mature, and five fertilized. I know this is no guarantee that the five will continue to develop in the next day or so. I have braced myself for bad news throughout the process, and will continue to do so. But I've also learned to celebrate the small victories, or in this case, the microscopic victories.

The retrieval process wasn't bad at all. The sedation I got was somewhere in between having my wisdom teeth removed and the laparoscopy I had in May. I wasn't nauseated when I woke up, just a little out of it. When I got home I was famished, because you're not allowed to eat after midnight when having surgery. I downed a Cup O Noodles and a Darvocet, because I was experiencing a little cramping. The Darvocet ended up making me nauseated, and I battled that for about an hour before the queasiness subsided.

My first progesterone shot is tonight. A bit nervous, but I feel like I'm in the home stretch.

Day eight, nine, ten, eleven, twelve, and thirteen

The last week has been a blur of belly shots (not the good kind) and blood draws and ultrasounds. Thankfully, last night I got the O.K. from my clinic and my husband gave me the trigger shot. I highly recommend icing the fanny with an ice pack before injection. I hardly felt mine.

I'm feeling some of the side effects today of that shot: major bloating, nausea, dizziness, anxiety. Of course, most of those symptoms probably also have to do with the fact I'm having my egg retrieval tomorrow morning. I'm worried about feeling sick when I come out of anesthesia. I'm also more nervous about how many eggs they'll find, and the quality of those eggs. The last time I came out of anesthesia (after my laparoscopy) my husband had bad news...I had stage four endometriosis. I hope he has better news for me this time around.

I'm thinking a lot of my mother today. By thinking of her, I feel closer to her.

Day seven

I have six follicles now. My visit to the clinic today showed my estradiol levels doubled since Sunday, which the nurse was quite happy about. It looks like I'll be given the trigger shot on Saturday, with egg retrieval on Monday. Of course, things could change...but that's how it looks now.

Day six

This is how I look now. But without the smile on my face.

I spent most of the day napping. I didn't even bother to put on a bra.

I didn't have to go into the clinic today for blood work or an ultrasound, which was a plus. But I have to go in tomorrow.

Day five

There's something so empowering--after spending month after month feeling helplessly infertile--about injecting your body with hormones and watching your body respond accordingly.

During my check up this morning, the ultrasound showed that I now have four follicles maturing at a good rate, at least that's what I think the nurse was telling me. I get so nervous when I'm there that a lot of what is said goes in one ear and out the other. The nurse called me later to say my estradiol level is also where it should be. I don't have to come in to the clinic again until Tuesday. Woo-hoo!

My belly is as large as it's ever been. Even larger than right after I had my laparoscopy, and my stomach was filled with carbon dioxide. I'm wearing pants and shorts with drawstrings, and large shirts that won't accentuate my swollen belly.

Not complaining, though. I'm just thrilled that, so far (and knock wood) my body is responding properly to the hormones.

Day four

I think I'm starting to feel the effects of the drugs I'm shooting up. My belly feels bloated and sore. I either feel very happy, or very tearful. And I have an amazing appetite. Not just that...food seems to taste better. I went out to dinner at a Thai restaurant tonight, and I almost cried eating the spring rolls and Pad Thai--it tasted that good. That, and I cry at the drop of a hat these days.

I did all my own injections today. The key is using the frozen bag of blueberries to numb up the area of my belly that gets the injection. Then, I put the tip of the needle right on my skin. I close my eyes, and push the needle in. I open my eyes, push the plunger, and then close my eyes before I take the needle out. As long as I don't look at the needle going in or coming out, I'm O.K.

Tomorrow morning I go in for blood work and an ultrasound. Hope I don't pass out this time...

Day three

I felt so much better today about everything. The injections this morning, performed by my husband, were not painful at all. My spirits were up the whole day, which I found surprising considering how most of what I've read about I.V.F makes it sound like you get very depressed and moody. Not so for me. At least so far.

The exciting part is that tonight I did my first injection on my own. I was very scared, shaking in fact. I practiced a few times on an orange, trying to get used to the sensation of the needle piercing the skin. About twenty minutes before I gave myself the injection, I took a bag of frozen blueberries from the freezer and placed it on my stomach. Once the area was numb, I swabbed it with an alcohol pad, and put the tip of the needle against my stomach. I closed my eyes, and pushed the tip in. Once the tip was in, I opened my eyes and pushed the rest of the needle into my skin. I pushed the plunger down so the medicine would go in. I then pulled it out and cleaned the area with alcohol.

I must say, I felt a bit high afterward. I am terrified of needles, and never believed I would be able to use one on myself. But I did. I looked fear dead in the eyes, and fear blinked. I feel so empowered now. A piece of cake!

Day two

Today is my first full day of shots. My husband gave me an injection of Lupron on one side of my belly, and an injection of Gonal-F on the other side. It's not the pinch that bothers me. It really doesn't hurt that much. It's just the thought of the needle entering my body that troubles me. I have a phobia of needles--I always have. I can't watch medical shows on TV because they always seem to throw a shot without warning of someone getting their blood drawn. It makes my skin crawl.

And in that vein (pun intended) I had to go to the clinic to get my blood drawn. The lab was full of women like me, anxious to get the draw out of the way so they can get on with their day. I sat down, filled out the paperwork, and then stuck out my arm. It hurt! A lot! Getting my blood drawn never hurts, but this time it did. And then when the phlebotomist was finished, I heard her say, "Oh, no." She was supposed to draw two tubes, and only did one. She started digging around in the original vein for more blood, but it had already started to clot. I made the mistake of looking over at my arm during her hunt, and almost blacked out. In fact, after she drew blood using a second vein, I started sweating so profusely that she ran to get wet clothes for me. She told me to put my head down, and started fanning me with her clipboard. I felt like such a baby. But I couldn't help it. All that digging made me faint.

On the upside, my husband is being so very nice to me. He keeps saying, "You're my hero." I think I'm going to try and get a foot rub out of this.

Day one

After a night of horrendous cramps, I finally got my period today. This morning, in fact. It is a doozey. I also had my first injection today, .2 cc of Lupron. I was so nervous, and my hands were shaking so badly, that my husband ended up giving me the shot. It pinched a bit...I definitely felt it going in. But once it was in it didn't hurt, and I didn't feel the medication go in at all. But I don't know how I'm going to be able to do it to myself. Just looking at the needle makes me feel faint.

I'm relieved the first shot is over. For me, the unknown is more frightening than any reality could ever be.

Tomorrow, I have an appointment at the clinic for a blood draw and an ultrasound. I also have to do two injections tomorrow morning, and one at night. Scary, but exciting. And empowering. I feel like I am literally taking a problem that has plagued my husband and me for two years in my own hands, and doing something about it. Very, very empowering.

No Country for Infertile Women

Last night my husband and I watched the movie No Country for Old Men. It was taut, violent, and thrilling to watch. There was not one extraneous scene.

And there was one scene in particular that caught my attention. The homicidal psychopath played by Javier Bardem gets shot in the leg. He can't go to a hospital for treatment, so he breaks into a pharmacy to get the medicine and supplies he needs to treat himself. He treats his wound in a motel room. At one point, he fills a syringe with some sort of drug, and injects himself. My husband and I squirmed as we watched. I then realized that I would be doing that exact same thing, injecting myself with a needle and syringe, three times a day!

It made my skin crawl, to be honest. I know it's not supposed to hurt, blah blah blah. But I have trouble ripping a bandage off my arm. I really don't know how I'm going to inject myself. I really don't. I'm very nervous.

Drugs, drugs, drugs!

My fertility drugs arrived by Fed Ex today. They were in a very large box with ice packs to keep them cool, although they don't need to be refrigerated. I opened the box immediately to make sure the drugs I needed were there. I've got Lupron, and Gonal-F, plus lots of extra syringes and alcohol swabs.

It's kind of a relief. I was worried that my period would start before the drugs could arrive. But now I feel covered, and should be able to start my first IVF cycle without too much trouble.

The weird thing is, the only place I have for everything to fit is on top of the bureau in the guest bedroom. It's the very bedroom where my mother slept when she stayed with us. And the bureau is where I kept all of my mother's medications and nutrition: the syringes, the methadone, the percocet, the pill crusher, the hydrogen peroxide, the Ensure. It's strange to see medications that may help life begin in the very same spot as the medications my mother used at the end of her life.

The $12000 baby

My month of down time before I start my first IVF cycle is about to end. When it ends, the day I get my period, I start with the injections.

Now, my husband and I didn't try to get pregnant this month. But we didn't not try, either. I've been told I can't get pregnant the old-fashioned way, and if I do, it will probably be ectopic. Yet that hasn't stopped me from hoping against hope that I'm pregnant now and won't have to put myself through IVF.

So I looked up some stats online, and it really would be a miracle if I were. Meaning, it's really, really unlikely. I need to not expect it or even act like it's a possibility, because it's really not.

It's kind of a freeing thought, because then on my first day I can be excited to start a process that might end in pregnancy, instead of being disappointed (yet again) that I failed to conceive.

Some light reading

I've been reading a few first-person accounts of what IVF feels like. I'm most concerned about the emotional aspect. I'm afraid I'll go backwards in my grieving process. The two weeks after my mother died were the most emotionally painful I've ever experienced. The grief was so overwhelming that I had trouble functioning.

I'm doing better now, slowing returning to the life I had before my mother got sick. But I worry that the strong hormones I'll be injecting myself with will let all those terrible feelings of loss take over again.

Back to our regularly scheduled program

I am still grieving, but unfortunately my biological clock couldn't care less. Endometriosis doesn't take a break because there's been a death in the family. It's been made clear to me by my infertility doctor that time is of the essence. I don't have the luxury of mourning for six months, then starting IVF. My endometriosis is so severe that it could start to grow back well before then.

So, I went to my doctor yesterday for "sounding" and a lesson on injections. The sounding was kind of like a pelvic exam, but quicker and weirder. A doctor came in to the exam room, saddled me up in the stir-ups, and practiced putting a catheter through my cervix and into my uterus, sort of a dry run for the embryo transfer. The docs wanted to make sure there were no impediments to getting the catheter in, and luckily there were not. It did not hurt.

The injection lesson was quick and a bit confusing. I guess I have the option of doing the pre-egg retrieval shots in my thigh or belly. I talked with a friend of my sister's who had IVF five years ago, and she strongly suggested "pinching an inch" of my belly and jabbing there. Seems doable. She said it really doesn't hurt there. This is a time when it pays to have what the commercials call that "annoying belly fat." More fat means less pain.

As for the post-retrieval progesterone shots, my husband will have to do those. They go in the tushy, and those do smart. But I really don't have a choice. This is what I've decided to do, so it's time to suck it up.

I wish...

I told her everything I wanted her to hear. How much I loved her. How she molded me into someone who was fearless to try something new, even just once. How much I knew she loved me.

I just wish I had the opportunity to tell it to her again, and again, and again.

January 17, 1938 - June 3, 2009

The Bustle in a House (1108)

by Emily Dickinson

The Bustle in a House
The Morning after Death
Is solemnest of industries
Enacted opon Earth –
The Sweeping up the Heart
And putting Love away
We shall not want to use again
Until Eternity –

She had loved them Double

My mother is still alive, despite the fact that several hospice nurses told me with authority that she would be dead by now. She appears to me to be comatose, non-responsive, her pupils fixed and dialated. And yet she still breathes, and the blood vessel in her neck still throbs quickly.

The last book my mother finished reading before she slipped into her coma is called The God of Small Things, by Arundhati Roy. Mom thought it was a strange book, not the normal mysteries or literary classics she's used to tackling. But at one point she took a pen to the book, and circled a passage. She told me to read it. Not now. But later. So I read it last night.

The passage refers to the death of the grandmother (Ammu) of a child named Rahel. Rahel watches Ammu get cremated.

"The steel door of the incinerator went up and the muted hum of the eternal fire became a red roaring. The heat lunched out at them like a famished beast. Then Rahel's Ammu was fed to it. Her hair, her skin, her smile. Her voice. The way she used Kipling to love her children before putting them to bed: We be of one blood, though and I. Her goodnight kiss. The way she held their faces steady with one hand (squashed-cheeked, fish-mouthed) while she parted and combed their hair with the other. The way she held knickers out for Rahel to climb into. Left leg, right leg. All this was fed to the beast, and it was satisfied.
She was their Ammu and their Baba and she had loved them Double."

The Death Rattle

The hardest part of my mother dying, so far, has been the death rattle. Thank God others have written about it, or it would be far too easy to believe that my mother is still suffering.

Here's an excerpt from an August 2005 article by Robin Marantz Henig in the New York Times:

"The death rattle is what's so unnerving. People who sit beside someone who is close to death, someone in a stage the experts call ''active dying,'' might hear a sound that's not quite a snore, not quite a gurgle, not quite a rasp. It doesn't hurt; it probably isn't something the dying person is even aware of. But it sounds terrible.

''Once the so-called death rattle starts,'' says Charles G. Meys, a hospice nurse with the Visiting Nurse Service of New York, ''that's usually an indication that the person is not coming back.''
The sound, made with each intake of breath, is merely air moving across phlegm. ''Healthy people can cough it up or spit it out or swallow it,'' Meys says, but a dying person is just not strong enough, so the secretions collect in the upper airways. ''And as they breathe in and out, it makes that sound -- that sound that we have learned to fear.'' To those watching, the person seems to be gasping for breath, asking to be saved.

Meys tells family members that he can offer atropine to dry up the airways and soften the death rattle, and most of them ask for it. ''But it's not for the dying person,'' he says. ''It's for the family.''

Connected

My mother is dying of cancer. Last week she took a sudden turn for the worse, and the hospice nurse told me she thinks Mom has only a few days left.

When she was still lucid and aware of her surroundings, my mom loved to hear my niece Regan sing a song called "Connected" to her. Four-year-old Regan makes the song her own, with lots of "oh, yeahs" and a special dance to go along with it. And now, even when Mom seems so very far away, just humming that tune can bring a smile to her face.

I decided to look up the lyrics to this song, which is actually from some Barbie DVD. But I got a chill reading the lyrics, because they're exactly how I feel about my mom now, and how I'll feel about her always.

CONNECTED

I’m blind-folded on this roller coaster they call life.

Keep trying to make it through the next turn, knuckles white and holdin’ tight.

So here I go, takin’ a curve,

But I know that I’m never alone.

I think of you, I know you’d never let me go.

I feel connected, protected, it’s like you’re sitting right with me all the time.

You hear me, you’re near me,And everything else’s gonna be alright.

‘Cause nothin’ can break this, nothin’ can break this, nothin’ can break this time.

Connected…connected inside.

It’s not an accident, the time we spent apart.

But now we’re so close, I can always find you right here in my heart.

You’ve given me somethin’ I need, and I don’t ever want it to end.

Because of you, I know I’ve found my strength again.

I feel connected, protected, it’s like you’re sitting right with me all the time.

You hear me, you’re near me,

And everything else’s gonna be alright.

‘Cause nothin’ can break this, nothin’ can break this, nothin’ can break this time.

Connected…connected inside.

Everytime that I breathe, I can feel the energy.

Preachin’ out, flowin’ through, you to me and me to you. Find your dream,

Walk or stand, you are everywhere I am.

Separate souls, you to find, touching at the speed of light.

I feel connected, protected, it’s like you’re sitting right with me all the time.

You hear me, you’re near me,

And everything else’s gonna be alright.

Connected, protected, now you’re in my mind, now I’m doin’ fine.

You hear me, you’re near me, and everything else’s gonna be alright.

‘Cause nothin’ can break this, nothin’ can break this, nothin’ can break this time.

Connected…connected inside.

Never say never

My wise, late grandmother Esther was oft quoted saying, "Don't ever say you'll never do something, because you probably will." Ah, how prescient her words have turned out to be.

In this very blog I have, on several occasions, claimed I would never do IVF. The thought creeps me out, I said. And then I had my laparoscopy.

Doctors grade endometriosis on a scale of one to four, one being slight, and four being severe. Turns out, I'm a four. I had polyps, and ovarian cyst, and loads of scar tissue. One of my fallopian tubes had been deformed by the disease. The doctor told my husband after my surgery, whilst I was still in my anesthesia haze, that I had a less than five-percent chance of getting pregnant naturally. But, she said, I was a very good candidate for IVF. And giving birth would actually help me recover from my endometriosis.

At first I resisted, hating the thought of putting my body through so much, with no guarantee of a positive outcome. But it's something my husband wants. Really, REALLY wants. And so because we are partners, I have agreed to try at least one cycle.

Tomorrow we go in for a consult with my doctor to discuss exactly what a journey through IVF-land would entail. Yikes.

Life, meet Wrench

I've been away from the blog for about two weeks, due to a major life change. Not the one I was hoping for, but something that weirdly mirrors it. My mother is sick, and I have moved her from California to Atlanta to take care of her. She requires constant care, with me waking up every four hours to provide her with medication and nutrition through a feeding tube.

Oddly, this has been a sneaky blessing. I am closer to my mother now than I have been in decades. Things that used to drive me crazy about her no longer bother me. And I'm gaining confidence in my ability to be a mother. I find I have patience and stamina that I didn't think I was capable of.

My surgery is still scheduled for Thursday. My MIL is coming to town to help with Mom while I'm recovering. I'm sure many madcap high jinks will ensue...

A definition of minor surgery

My husband told me that minor surgery is surgery that's happening to anyone but you. So I'm undergoing minor surgery to everyone else (a big freakin' deal to me) in two weeks. Dr. Mitchell-Leef believes I have endometriosis, and the only way to confirm this diagnosis is through a laparoscopy. If the good doctor finds something, she will laser it out.

My sister had similar surgery about a year ago. Her doctor said it was the worst case of endometriosis she'd ever seen. And this was after giving birth to two babies (my sister, not the doctor.) OK, maybe I should back up a bit.

About one-third of female infertility is caused by endometriosis. According to the handy-dandy pamphlet my doctor gave me during my visit:

"In endometriosis, tissue similar to the endometrium is found in other areas of the body and acts like tissue in the uterus. It most often appears in places within the pelvis, including the

-ovaries

-fallopian tubes

-bowel

-bladder

-rectum

Endometrial tissue outside the uterus responds to monthly changes in hormones the same way it does inside the uterus. It also breaks down and bleeds. This bleeding can cause pain, especially during your period. The breakdown and bleeding of this tissue each month can cause scar tissue, called adhesions. Sometimes adhesions can bind organs together."

I had a vaginal ultrasound at during my doctor's visit (it's as fun as it sounds) and the pictures didn't show anything thing too scary. After the ultrasound, I was handed the pictures to bring back to my doctor in the next room. I have seen ultrasound pictures before, and they've always had a little fetus in them. You see the spine, the nose, and whether the baby's a boy or a girl. My ultrasound picture just looked so EMPTY.

But enough with the self-pity. I am relieved that my doctor diagnosed me with something, so that we at least now have a starting point to fixing this problem.

From Zero to Sixty

About two years ago, a former colleague of mine called me from his new home in New Orleans to say hi. He also wanted to share some good news. His wife was pregnant. They had been trying for almost a year, and because she was nearly forty, they decided to see an infertility specialist. I felt the satisfaction of superiority warm my heart, because I knew I would never have trouble getting pregnant. And also some pity. How desperate do you have to be to see an infertility doctor?

It turned out his wife was ovulating very late in her cycle. Once they figured this out, she almost immediately got pregnant.

This was about six months before I went off the pill. I was quite certain, from the stories my mother told me about how easy it was for her to get pregnant, to watching my sisters have two babies apiece, that I would have no trouble having the baby I wanted, when I wanted.

Another facet of the judgement stemmed from my ignorance of infertility doctors. I assumed, as I've learned many people do, that a visit to an infertility specialist means you are doing IVF. Zero to sixty in five seconds flat. In fact, there are so many options before that major, expensive step.

I hope to discover what a lot of them are tomorrow.

Fertility Massage

There is a place in Atlanta called the Pregnancy Massage Center. I found it while Googling different natural therapies for infertility. I was thrilled to see massage as a possible aid. I always feel so guilty when I get a massage, like it's a waste of money, even though I know it's not. I feel so much better afterward, and I usually get relief from my weekly headaches for a few days.

But an article I've just read has given me pause:
http://www.webmd.com/infertility-and-reproduction/news/20021023/hands-on-approach-for-infertility

Not because it sounds like it doesn't work. But because it involves "internal massage." That just doesn't pass the heebie-geebie factor for me. That might make me immature, but unless it has a 90% percent success rate (it doesn't,) I don't want someone reaching inside my lady business unless it's a doctor.

There are other massage avenues. I was once told by a massage therapist that I desperately need cranial-sacral treatment. I never followed up. Apparently I have blocked passageways (?) in my head and neck. Maybe it's something I should look into.

Close your eyes and think of England

I seem to ovulate at the most inappropriate times. Last month, it was during the visit of my husband's best friend. During the nights Best Friend was there, we'd all be sitting on the couch, watching some awful action movie in HD, and I'd feign sleepiness and say, "I'm off to bed." About twenty minutes later my husband would follow. We'd turn on the air purifier to its loudest setting, and do the deed, trying to forget we were very much not alone in the house.

Well, it was even worse this time around. My mother-in-law was in town for Passover. My bodily fluids led me to believe I was about to ovulate, as did one of those horrible ovulation predictor kits. We had no choice. Once MIL decided it was time to hit the hay, we followed suit. Again, we turned the trusty air purifier to its loudest setting. I gave my husband the same sage advice Victorian women would give their daughters before their wedding nights: "Close your eyes and think of England."

The next morning, I saw that my temperature had risen. I don't know if that means I ovulated, or if there's another reason my body temp is up. I do know that my husband may have to fly to Norfolk, Virginia this weekend for work, and it's a $700 round trip so I can't accompany him. Looks like we may have another month of non-success. I can't look at it as failure, because of the adoption option. I want to be a mother, whether or not that includes a pregnancy.

Time is not on my side

I'm covering all my bases, so I've made an appointment next week with a very well-regarded infertility doctor. This is her bio:

Dr. Dorothy Mitchell-Leef is a partner of Reproductive Biology Associates, which specializes in the area of in vitro fertilization. She is a graduate of the University of Louisville School of Medicine and is an associate clinical professor at Emory University School of Medicine and specializes in the diagnosis and care of infertility, egg cryopresation and donation, and endometriosis.

This is an article she wrote last month:

http://www.atlantawomanmag.com/Articles/2009/Web_Mar/Health_x_Wellnessx_Timexs_NOT_On_Your_Side.html

Open adoption

My husband and I are signed up for a seminar on open adoption next month. It's something I never would have considered a few months ago, but a little research (and desperation) can go a long way towards changing one's mind. There is a non-profit adoption agency in Georgia called the Independent Adoption Center. The agency's literature makes open adoption sound very appealing.

Of course, the initial impulse towards open adoption is fear. Fear that the birth mother, once seeing how adorable and snugly her baby is, will want the child back. Fear that having a regular relationship with his or her birth mother will make our adopted child want to leave our home and live with her. Fear that somehow, our adopted child won't consider us Mom and Dad the way he or she would if the child never met the birth mother.

But if I'm honest with myself, I realize these are all selfish fears. I've got to ask myself, what's in the best interest of our future adopted child? What would I want if I were adopted. I think I'd want to know who my birth mother was as soon as I was told I was adopted. It's just such a huge unknown for a child to handle, and if there were pictures and notes from the woman who gave birth to him or her, perhaps it would be easier to accept in the long run. And there wouldn't be the fantasy of a perfect birth mother out there, waiting to rescue him or her from the daily struggle and troubles of a real, loving, noisy, messy family.

I hope the seminar is as enlightening as I need it to be.

Either Way

Whenever I am trying to figure out which direction to go in life, I always look for signs. And they always appear, and send me in the right direction.

I spent most of yesterday doing online research on adoption. As I was immersed in my cyberspace studies yesterday morning, I had my I-pod playing some tunes to keep me company. There is one song on my list that I have not been able to listen to since I moved from San Diego to Atlanta one year ago. It's called "Either Way" by Wilco. Before I left, it was my four-year-old niece's favorite song. Every time we drove somewhere together, she'd implore "Play Either Way! Play it loud!" And so I would, over and over again. I would look in the rearview mirror, and see her singing along to the words she knew by heart, as if she were performing for an audience. After I left San Diego, it was simply too painful to listen to the song and not have her there to sing along with it.

But yesterday, when the first few guitar licks of the song played, I didn't fast forward it. I just sat there, to see how long I could take it. I made it through the whole song. I think the belief that I might soon have a little person of my own to sing songs with helped ease the pain I have about living so far away from my niece.

Then, about a half-hour later, my cell phone rang. My sister's name appeared, so I eagerly answered. The voice on the other end was my niece's. I think she has called me three times since I moved, because she doesn't like talking on the phone. But she chatted away, as if I were just across town. "I want you to take me to school one day. I wish you lived closer. I love you. Do you have volcanoes where you live?"

Here are some of the lyrics to "Either Way":

Maybe the sun will shine today
The clouds will roll away
Maybe I won’t be so afraid
I will understand everything has its plan
Either way

New direction

I got a wicked case of something resembling food poisoning, and then got my period, so I don't have much energy to write. But I read something beautiful this weekend in the Styles section of the New York Times. Margaret Gunther wrote in the Modern Love column about the adoption of her eldest son:

"Sure enough, as if it were meant to be all along, we waited not the usual six months to a year for our first child. Instead he came almost immediately, ahead of the crib and already named. A newborn whose birth mother chose us, he flew into our lives like a tiny tornado, washing away my sins and assuming, as babies do, that I was as perfect and blameless as he was."

So lovely.

Ugh

I discovered spotting this morning. On day 23. My first thought was, "Oh, shit. Not again." And then I rushed to the Internet to Google "implantation bleeding." I go through this process every month. Implantation bleeding, according to the trusty Mayo Clinic website, can happen 10-14 days after fertilization. It is usually pink or brown. It lasts one day, maybe two.

Thus, part of me is depressed, realizing I'm getting my period early. The delusional part of me wants to believe it is implantation bleeding, and a symptom of early pregnancy. I also feel nauseated (alas, a side effect of Prometrium) and I have a headache (probably due to allergies.) Unfortunately, I can't take my ibuprofen/Benedryl/caffeine cocktail that would knock the thing out, because I don't have solid proof yet that I'm not pregnant. Oh, how I long for a Benedryl, if only to allow myself to sleep all day so I wouldn't have to feel the sting of disappointment yet again.

On the upside, when my husband saw me crying this morning, he vowed to contact his sister's friend about adoption. And one of my best girlfriends informed me that her close friend recently adopted a baby boy. So, hopefully she'll connect me with her friend, and when Aunt Flo parks her Winnebago in my driveway, it won't be so hard.

Offline test

Yesterday I was walking through Target, and I started to feel queasy. I, of course, immediately attributed the queasiness to pregnancy. I made sure to buy some sparkling water and graham crackers to settle my stomach, and I headed home. Then I started to get angry. I was doing it again! I'm sure before I started my quest to get pregnant, I felt queasy at various times during the month without thinking too much about it. But now just a touch of nausea makes me deliriously happy. It's getting ridiculous.

I decided I needed a reality check. I took a pregnancy test. Now, it's a week before I'm due to get my period. And the test instructions always say to use first morning pee. But I needed to see a negative pregnancy test, just to remind myself not to get my hopes up.

Then I got very sad, because some part of me believes if I were pregnant, it would somehow show up on a test. Or maybe it's become a Pavlovian response by now: see a negative pregnancy test...become devastated.

I'm feeling better today, trying to keep busy. Counting the days until I can take a test again.

Online pregnancy tests

I just wasted twenty minutes I'll never get back taking an online pregnancy test. It's a stupid thing to do. I take them every month, in the week before my period starts, and they always say the same thing: you are probably pregnant. So we know how accurate they are. Add on the fact that the side effects of Prometrium mirror early pregnancy symptoms, and it's easy to see what a colossal waste of time these tests are. The one I just took actually contained this sentence in my results: "Pregnant women have similar symptoms, but many women who are not pregnant also experience similar symptoms." Genius!

My younger sister has urged me to stay off of the Internet during this sensitive week. There are too many websites and chat rooms with misinformation and urban legends. According to some of the sites I've visited: you should wait until the day you missed your period to take a pregnancy test, but you could also take it a week before; brown blood is definitely a sign of implantation bleeding, but also a sign of infertility; and you need to "relax" to get pregnant, but you should also take your temperature daily, check your cervical mucus, take a ovulation predictor test five days out of the month, stop drinking, don't get a massage, don't take hot baths, and be sure to shut one eye and hop on your left foot during a full moon.

Baby from another mother

Last weekend my husband and I travelled to West Palm Beach to visit my in-laws. I hadn't seen my sister-in-law in more than a year, and the last time we talked my husband and I were just starting to "try." So, it was quite obvious we were having trouble with the "succeeding" part. I told her of my adventures with Prometrium, blood tests, ovulation kits, and a hysterosalpingogram. I also told her I wasn't crazy about the idea of IVF.

She mentioned a close friend of hers who had just successfully adopted a newborn from Virginia. The process took about a year, a timeline that shocked me. I assumed it took about five years. The parents were in their mid-forties, and only married for a few months, and still were able to adopt a baby. The realization that I, too, could become a mother soon despite my difficulty in conceiving made me feel hopeful for the first time in a long, long time.

In an ideal world, I would give birth to my own child. But I also know, through my years of babysitting and volunteering, that I can love a child that is not mine genetically. I believe there's a little soul out there, waiting to become my child. It may just have to travel through another woman's body before he or she gets to me.

Prometrium

My doctor put me on Prometrium in November. I'm supposed to start taking it after I ovulate, or at least two days after an ovulation predictor kit "turns." Blood tests showed I had low levels of progesterone, meaning even if I conceived, my uterus wouldn't have what it takes to nourish and keep alive the embryo. When I first learned this, my husband and I had been trying for almost a year to have a baby. I wondered how many times we may have succeeded in conception, only to fail at pregnancy because of my body's low levels of progesterone.

This is the fourth cycle I've been on Prometrium, and it's making me fat. That may sound shallow, but I've spent most of my life as a skinny girl. To see rolls of chub develop around my midsection takes my breath away at times. I know if I become pregnant (knock wood) I would have to adjust to my body growing in strange places, and I'd welcome that. It's just gaining the weight with nothing really to show for it that troubles me. I've started to exercise more, and decrease my drive-thru visits. Hopefully that will firm up the chub a bit.

Five infertility factoids

This was in today's US News & World Report:

5 Things You May Not Know About Infertility

Men and women are equally likely to be infertile, and other facts to know about fertility problems
By Michelle Andrews
Posted March 17, 2009
1. Infertility affects roughly 12 percent of people of reproductive age in the United States, or about 7.3 million women and their partners.
2. Infertility is gender blind: It affects men and women in equal numbers. The most common problem in men is low or no sperm count; for women, it's problems with ovulation.
3. Nearly all cases of infertility—85 to 90 percent—can be resolved through traditional medical treatments like drugs or surgery that repairs reproductive organs.
4. In vitro fertilization and similar procedures account for under 3 percent of infertility treatments.
5. The average live delivery rate for IVF in 2005 was nearly 32 percent per egg retrieval, slightly better than the 20 percent odds that a reproductively healthy couple in any given month will get pregnant and carry a baby to term.
Source: American Society for Reproductive Medicine

That time of the month

OK, well not that time. I'm at day 13. I believe I've already ovulated, if two ovulation predictor kits, testing of cervical mucus, and feeling mittelschmertz are any indication. My temperature doesn't seem to have spiked, but a nurse at my doctor's office told me a few months back that sometimes the rise in temperature can be very subtle.

This is also the time of the month where I start to wonder if I've conceived. I start to feel psychosomatic pregnancy symptoms, symptoms I couldn't possible feel yet because even if I had conceived, I wouldn't be pregnant yet. I start to play with the idea of how completely wonderful it would be if it FINALLY happened. I imagine how I would tell certain people the news. And then I realize how far ahead of myself I am, and that I need to reign in my overactive imagination until I get a little more evidence.

Is it right?

At least ten killed in a shooting rampage in Alabama. At least eleven dead in Germany, also killed by a deranged gunman. It's a day like this that makes me wonder about bringing a child into a world like this. I know that's a trite sentiment. But listening to the Sheriff's deputy whose wife and baby were killed in Alabama sickened me. At my core, I'm faced with the knowledge that creating a new life in these circumstances is a purely selfish act. Society views couples who choose not to procreate as selfish. But how could they be?

I guess it's an evolutionary thing. The desire to have a child of my own, to carry on my gene pool (and my husband's) overrides any intellectual argument against having kids. More later.

Maternity Avatar

I'm a superstitious person. I've tried to shake myself of this, which of course makes me think I'm bringing bad luck upon myself just for doing so. Anyhoo, a few weeks ago I changed an avatar of myself connected to one of my email accounts to be pregnant. My avatar is still at a disco with R2-D2, but now I'm wearing a black sequined top that's obviously covering a very pregnant belly. Not that if I ever became pregnant (knock wood) I would start wearing sequins and visiting 70s-era discos. But I like the thought that somewhere out there, even if it's only in cyberspace, there's a pregnant version of me.

But here's the weird part. I also gave my avatar short hair. Right now, I have long hair. Every five years or so, I chop off all my hair, and it makes me feel really good for some reason. Maybe it's something weird like, even if I don't have control over my life, I still have control over my hair? Wacky, I know. But in order to create a self-fulfilling prophecy (or self-fulfilling avatar?) I'm getting my hair cut today. Short. Not just because of the avatar...it was something I was thinking of doing anyway. But it can't hurt, can it?

Woman Tea

Sometimes I feel like I'm being tested, like if I jump through enough hoops I'll finally get pregnant. Case in point, woman tea. It's not actually called that. It's a herbal tea made of raspberry leaf or bark or something, and according to the box (and the American Pregnancy Association) it's been used for "millenia" to help regulate a woman's cycle and keep her woman parts healthy. OK. It's not disgusting, not too sweet, so I've started drinking it. The trouble is, The Directions On The Box order me to drink it at least three times a day. And I must steep it between 10-15 minutes before drinking. So that's a good hour of my day devoted to the woman tea. But if I miss a dose, that will be just one more thing I can blame myself for not doing during my cycle to get pregnant when Aunt Flo parks her Winnebago in my driveway. So, pardon me, I must get to brewing...

Oh, but here's a link to some tea info: http://www.americanpregnancy.org/pregnancyhealth/herbaltea.html

I've become one of Them

I had an epiphany when I was 27-years-old and working as a TV reporter and living in Reno. As I drove to work, I listened as some author on NPR whose name I can't remember talk about the decision to have children. The writer said she feared many women (and men) end up having children because they reached a point in their lives where they hadn't really accomplished anything they'd set out to. Their lives had no purpose. So, they create a new human being just to give their lives meaning.

I vowed to myself that I would never become one of those people. Someone who got pregnant because nothing else was working out in her life. And frankly, I couldn't imagine any other reason to have a kid. I had spent my high school weekends and college mornings babysitting for other people's kids. It was fun for a while, but ultimately exhausting. I wanted to be someone in my own right, instead of staking my claim to fame on being someone else's mother.

But then Skyler came along. My niece was born in 2004, about six weeks after I met the man who would one day become my husband. The overwhelming, instant love I felt for her as a wiggly, colicky infant has grown exponentially as she's developed into a witty, brave, strong, and compassionate four-year-old. I am never as happy as I am when I'm with her. Those unexpected feelings, along with marriage to a man I knew would make an outstanding father, turned my world upside down. I wanted to become a mother.