Saturday, January 28, 2012

Mock cycle begins

I am writing up a storm this month. It's my 6th post in January, for goodness' sake.

We started the Dele.strogen injections last night. I'm happy to report that it didn't hurt very much. Just wait for the PIO shots, you say? Oh yeah, those will be coming before I know it. We will do these injections every 3 days, and then I'll go in for b/w an u/s on Feb. 10 to see what has become of my endometrium. We're hoping for thick red fleece, as Oat would say.

Here is an equation I'm having a tough time solving. Calling all mathematically skilled persons out there (yes, that means you, Misfit).
2mgs estra.ce t.i.d., PO +  2mgs est.race, PV + oes.clim patch 5mg every three days < 20cc of Dele.strogen IM, every three days.

I guess you can concentrate a solution significantly, whereas there is only so far to go with packing a tablet and a transdermal patch with estrogen. I'm still wondering why they wouldn't consider the idea of putting estrogen in bubble bath, eye drops, or dark chocolate.  I am curious to see how my lining will respond to this new estrogen regimen. 

I am thinking of Patience and Jess, both awaiting news about potential adoptions, and also for Patience, awaiting to know more about a pregnancy in its early days. I am hoping so much that they will both finally become mothers.

Hope you are having a nice weekend. It snowed all day here, which incidentally, is one thing that truly makes my heart sing. I love snow.

From Bomobob, an artist from my home town, Montréal.

Tuesday, January 24, 2012

Looking ahead to the looking back narrative

Thank you very much for your warm comments on my last post. I feel better: less stuck in that spiral for now, although I know I will revisit my grief. That's just the nature of the process. What I'll muse about today is inherently more positive.

I've observed (however unscientifically) that after harrowing journeys through the inferno of multiple failures at conceiving or gestating a child, a significant proportion of you have found success or are well on your way. A few of you are still in childless land and suffering. I am here with you and like you, doing everything I can to bring our child(ren) home. I've recently been thinking about how infertile women who now have a child or children once felt hopeless, thought it would never happen, suffered through a thousand disappointments and overwhelming anxiety. And then they got pregnant. Or got the call from the adoption agency. And then went though the pregnancy or met the birth family. And at some point brought their child home. It appears from my very naive reading of this bringing-home-of-one's-child that it "draws a line between so far and from now on"* Life will never be the same, they say. From reading your blogs, that's the sense I get, but you will correct me if I'm way off on this one.

So, in writing or talking with some of you recently, I've been wondering about the looking back. As I struggle through this terrible time, I find myself thinking about what I will think and feel about this period of my life once it is over. And how the bringing home of our child will change my sense of these awful years (told you this post was more positive: I am speaking as though I will actually bring a child home!). I have been articulating for myself and some of my close friends that this experience of infertility has changed me at my core. Right now, it doesn't feel like a welcomed change, or one that's made me a better human being. I feel like a diminished version of myself, and have felt this way for 3 years. I have found myself unskilled at compartmentalizing this experience, and have seen my failure at becoming a mother reach into and rattle the foundations of my marriage, my self-concept, my professional identity, my body image, my friendships, my social self and I could go on. Do I really think a baby is going to steady all of those pillars? No. I'm not an idiot. Will it prove to me that earthquakes can shake foundations but not make them crumble? That's one of the questions I ask myself. 

Clearly, having a baby doesn't erase the infertility. It probably changes one's relationship to it though. How will I look back on all of this? I don't know. What will be salvaged of my old self, pre-infertility? I'm not sure. Who the hell will I be once I'm not consumed by thoughts about treatment and time processing all of the emotions relating to this experience? I hope to find out.

In the mean time, CD1 is arriving on Thursday, which will ring in the start of the mock cycle. Dele.strogen IM injections here we come. And with reluctance, I have to do a HPT. I guess if we need to prove that a wheel is round, we will make it roll, but it's been demonstrated time and again. The wheel is round, my friends. Augusta's ovaries are closed for business.

Now, let us see about my uterus. It may be able to do what it needs to for the growing of a fetus. A girl can hope.


*Ani DiFranco, 78% H2O

Wednesday, January 18, 2012

grief's recursive movement

I was on a good spell in the last several weeks. Christmas is not at all my favourite time of year, but felt I weathered it well this year. Before that there was the due date, and I felt I also did well with that. The trip to Washington made me feel very alive, a hard-to-come-by feeling for the last while. For the last 2 sessions, my therapist has made a point of skillfully observing that I seem to be doing better.

As things tend to go with matters of working through grief, there is so much to visit, and revisit, and revisit once again...with feeling. At least that's my experience with grief. I'm not that patient with myself (although more patient with others), so it may be that I want to have worked through this already, I want to stop feeling so mind numbingly depressed, and feeling so 'out of life' and holed up in my house where I don't have to deal with anyone. It's the anhedonia that kills me in grief/depression. I hate the rest of it, but it's always the sense of  'losing the capacity of experiencing pleasure in activities previously enjoyed' that pushes me over the edge and makes me angry and wanting to tear my hair out.

It started last Friday. I might be outing myself to some readers here, but our city just recently got a commuter train and Mr. A, the transit aficionado that he is, discovered how I could get to work via transit. He even accompanied me to work that morning because he was so excited about the transit route and wanted to experience it himself. Let's agree on this: my husband is a freak. When we got off the commuter train, we looked at the tracks and determined that I would be waiting on platform X when it was time to return home at the end of the day. In the evening, it had gotten very cold and I waited in a small indoor waiting area on platform X. I didn't see it arrive because I was still indoors, but the train came in on time. Except that it arrived on platform Y. By the time I realized this and tried to take the underground walkway and ran back up the stairs (swimming through commuters) to get to platform Y, well, the train had pulled out already.

Missing the train is not a big deal. I was angry for about 6 minutes, and then, I figured out another plan to get home and sat down and read my book in the warm station, waiting for another train. But the day had brought its challenges already. A co-worker had announced he was going off on sick leave the day before, to fight against a stage 4 cancer. That morning, a female colleague came into my office to debrief this terrible news, and also to announce that she is pregnant. Second baby, perfectly timed. I weathered it well in the moment, as is usual for me. It's always after that it hits. I work in an agency with an over-representation of women, which is wonderful, but also means that I am immersed in pregnant bellies and baby showers.

Anyway, on my walk home from the train station, it hit me that missing the train had the same flavour as this very striking dream I had in June, shortly after the m/c. I have a pretty intense relationship with my dreams. I may be an unhatched Jungian for all I know. The dream went like this. I was on a train, heading home to Pleasantville. In the dream, I am only one or two stops away from our station. I step off the train as it makes a longer stop in a station. When I return, the train's doors close in front of me and the train rolls out of the station. In order to return home, I am told I need to take the train back to a station that is about 600km away from home, and catch another train heading back towards Pleasantville. I felt that this dream really expressed my feelings of dejection around the m/c. The doors closed in front of my face, and the only way back was one that would require an insane detour. I was so close to home, so close to a baby.

So, Friday night sucked really big. I ate my dinner silently and shed tears on my cat, while Mr. A watched and said nothing (what was there to say?). I couldn't really recover after that, and felt very sad and out of it the entire weekend, and all of Monday. Some stuff happened at work on Monday and I had to go into the bathroom and cry. I felt a little pathetic because it wasn't a huge deal what had happened at work. I was just feeling so vulnerable.

I am weary, folks. I feel like it's time to get out of this negative spiral. And I will. But revisiting this place over and over again just tires the hell out of me. It's probably the case that overall, I am emerging from the intense grief I have felt since the m/c, and since October 2009 when I found out that my ovaries were not going to produce eggs. I think these last few days are just an instance of the recursive pattern that grief takes, where one revisits the grief from a slightly different place, multiple times. Does that happen for you as well? I'd be interested in knowing you've also felt this pattern.

As always, thank you for reading and leaving me sweet notes. Or just for reading. You are amazing women and I feel very, very blessed to have your support.

Monday, January 9, 2012

initial migration south a success

I'm happy to report that the visit to SG went very well. I think that all of the good thoughts you sent our way really helped. The weather was on our side, the travel was smooth, the connections in transit were achieved easily, and the hotels were welcoming. Oh, and the plane did not crash. Always a bonus. As a treat, we also got to hang out with Pumpkin and Mr. Pumpkin. It was so wonderful to see them.

In Logan airport, while changing planes, we met a loquacious man who started up conversation by telling us he was a war Vet on his way to visit his son and grandkids. When he found out we were Canadians, he said the plane couldn't crash because nice Canadians would not be killed in a plane crash. What a thing to say to a woman who is so afraid of flying. It did raise my anxiety, but luckily, he changed the topic. After I dispelled the myth that we all live in igloos and have pet elks tied to a post in the backyard, the man went on to ask about where were all of our children. I didn't say that we were on route to having them created, but instead that we didn't have any yet. He suggested that Thomas would be a good name for a son, in case we were seeking suggestions.

The meeting with the clinic staff was positive. We are different folks who speak English with different accents, but we are all focused on the same goal and that transpired clearly. They welcomed us warmly and made us feel like they were happy we were there. We started the day with the Dr., which brought on the lu.pron discussion nice and early. I won the argument again, despite his warnings that they have seen failed ovaries flare up in a DE cycle. That would be akin to walking on water, as far as I am concerned. I did need to have a saline u/s after the mock transfer, but found that it was much less uncomfortable that the one I had way back in Sept. 2010. There was a question in the morning regarding my arcuate uterus, but the Dr. didn't find it to be arcuate to the point of concern. 'Somewhat' is the descriptor he used to qualify the curve, and he didn't think it would be a problem for growing a fetus from a donated egg.  Looking at the data regarding my lining, he did suggest that we try deles.trogen injections instead of the combo of oral and vaginal estr.ace plus the oesc.lim patch. Deles.trogen is not sold in my Northern Nation, so we did need to purchase it there. Also, Mr. A had to practice giving me a shot in the behind with saline. He was super nervous, but managed beautifully once he gathered his courage and with the nurses's encouragements. The next day when we met up with the Pumpkins, he got some good pointers from Mr. Pumpkin, who is a world-renouned injection guru.

We have two more pieces of info to gather from our end to send to SG before we can proceed. And then we need to do a mock cycle using the estrogen injections, something that can start as soon as AF shows up on Jan 26 (the beauty of artificial cycles is that you can predict down to the hour when your next bleed will be). After that, we are good to go. We will need to select a donor, pay up, and get the cycles synchronized (which is not hard to do for me, again because of the artificial cycles). We are aiming to do share eggs to reduce the costs, so that might be another thing that takes a bit more time. They ballparked that we would be back there in 4 months and that is entirely acceptable to me. Of course, I want a baby now, or last December, but I am more interested in lining up all the ducks so that we can be successful. They didn't promise us the moon, but they were positive and told us there was cause for hope.

After 7 hours at SG, we took the metro into DC and walked around. Neither of us had ever been to the capital of the United States, and we were both wowed. The awe began at the train station and didn't let up until we left the next morning at 6am. We were kicking ourselves for not having scheduled a day to spend in DC and visit at least a museum and are hoping to schedule some time to do that next time.

On the way out of the hotel, the lady at the desk told us to bundle up because it was cold outside. Of course, for people who live in igloos, it wasn't cold at all. All is relative, I guess. Which goes for going to such great lengths to have a child. It seems like a lot of effort to travel 350 miles and pay all that money, but when it's what you really want and you can't make it happen otherwise, it doesn't seem like you are moving mountains. It's just what you do.

Wednesday, January 4, 2012

here we go

I'll be heading to the airport tomorrow at this time. I am feeling pretty nervous overall. I could tell because I was irritable beyond words last night, and that is a clear sign that I feel anxious and overwhelmed. I came close to biting Mr. A's head off when he slurped his soup at supper. STOP SLURPING YOUR SOUP...is what I didn't say. I still made it to my yoga class but was showing signs of irritability there too. Oh geez. I sometimes get tired of living inside my head.

I am trying to line up all the ducks before our Friday consult. I think there will still be documents to run after and tests to repeat once we get back here after the consult, but we've made some headway in terms of gathering what SG requires. I am dreading having to repeat the HSG or the sonohysterogram, but they may ask me to do that since both were done longer than 12 months ago.

Our family physician has once again shown herself to be a superstar in terms of supporting us on our journey. When the lab wouldn't take the blood work requisitions from the US, she immediately wrote the orders out for Mr. A while he waited. When the lab refused to fax the results to the US, she had them faxed promptly by her staff. I feel so grateful to have her support.

It's been interesting to read through documents from our file at the fertility clinic. It's really quite dreadful to see what my FSH and LH levels were at when last tested. Both far below one, akin to the levels a child would have. It's information I already had, but it still feels so hard to see in black and white. I realize that it's  part of integrating all the parts of my story, and grieving for what I didn't have/don't have.

The part about working with a new team still makes me uneasy, but I know that will change once I meet them. I found it helpful to hear about your stories of changing clinics and changing REs. And for those who have worked with the team at SG, it's been very helpful to hear about your positive experiences. I think overall, it's just hard to be so exposed (says the girl who writes about her most intimate feelings on a blog for the whole world to see). It's hard to tell the sob story once more. It helps me appreciate my patients experience when they have to retell their stories to me for the nth time. It takes a lot out of a person to hold themselves together while trying to recount the story of a hard journey, trying very hard not to leave any important detail untold. From a brain perspective, so much of the brain's functions are sollicited. And emotion regulation drains the system big time (in my case), leaving less cognitive resources for the telling, the remembering, the formulating of cogent arguments when asked to take lu.pron, etc.

It would be nice to feel hopeful, but as I've discussed here ad nauseum, hope is not something you can order online from J. Cr.ew like a moss-coloured cashmere sweater. What I predominantly feel right now is anxious. Maybe the hope will come later. Maybe it would be putting the horse before the cart at this point to feel very hopeful. I can just keep focusing on the tasks that need to be done to get us there.

Here we go.

Wish us luck.    

Sunday, January 1, 2012

a new year

The holidays are wrapped up and a semi-sense of order is returning to our household. We un-decorated the Christmas plant, put all the wrapping paper where it lives all year in the basement, and will eat the last 2 Christmas cookies in short order (the many chocolates will have to wait to be consumed as there are more of those than there are days in January). The Holidays were not as awful as some of have been in the past, and for that I am thankful. We were able to strike a balance between time at home and time with our families. The best part for me was to spent Christmas eve and Christmas day at home, cooking boeuf bourguignon for the first time in my life. Do you have any idea how satisfying it is to pour a whole bottle of Beaujolais into a dish? Very. I was a vegetarian for close to 15 years and recently decided to eat the occasional piece of meat, and this year's foray into cooking the French beef stew has made me appreciate the change even more (which is nice, since I often consume meat with a side dish of guilt for what I am doing to the planet and the animals. But that's another post).

I did a lot of walking yesterday, which afforded me time to reflect a little on 2011. What I came up with is that I felt a pretty constant sense of being under water. You can't hear or see very well underwater and everything happens in slow motion. This is funny considering all that transpired over the last year. The DE cycle, my PhD defense, the pregnancy, the miscarriage, the hectic job, the new job, the trip to Cuba, etc. There was so much happening in my outside life while on the inside, it seems I felt immersed (drowning at times) in a thick soup and slowed down in my thinking. As someone who wishes to be able to live in the present moment, I achieved that almost never this past year.

I must say at this point that I feel less terrible than I did from May 25 through to November. There is a lot to be thankful for in the past year, despite the hard blows. The support and love from our friends and family has been significant, including your support and friendship. William James told us that 'it is your friends who make your world'. I have wondered often this year how small my world could become as grief kept pulling me towards more isolation and less human contact. It was good to know that here (and with close irl friends), there were women who cared about me no matter what I wrote or didn't write. Even with the long lapses in between my posts, you came back and left me a comment or sent me an email to check in. To all of you, thank you.

I have to work tomorrow, Tuesday and Wednesday, and then we travel to SG for our Friday marathon appointment. When I talk about it, people tell me I seem very low key and wonder if I am feeling hopeful. As you have all experienced, the infertile's relationship to hope is a complex one. I am once again flirting with hope, but certainly not buying what he has to sell. Yet.