Show and Tell: We Have a Winner!
August 30, 2008
At last week’s Show and Tell, inspired by Barren Bitches Book Brigade selection Eat, Pray, Love, I presented a bridge at which I threw a tantrum. Um, that doesn’t really convey the spirit of that post. I explained it a lot better before. Please just go read that post first. I will wait…
(Tall and tan and young and lovely, the girl from Ipanema goes walking, and when she…)
Welcome back! At the end of the post, I invited people to guess the location of the bridge. Several people guessed, and one person got it right:
The esteemed Lori from Weebles Wobblog, All Thumbs Reviews, and Drama 2B Mama! She knew that the bridge was in Budapest. It, in fact, is the Chain Bridge, a cast iron suspension bridge that was once considered one of the wonders of the modern world. Congratulations, Lori!
Here is the prize Lori has won:
I did not make this vase, but I did paint and glaze it. I’m still working on my vase-throwing technique — the skinny neck at the top can be tough, and I end up ruining almost every piece that I try to turn into a vase. I will keep working on my technique until my vases can reliably hold water. In the meantime, a vase that someone else threw is a safer choice.
It turns out that Lori had an advantage in the contest because she has also been to Budapest. She has posted her own infertility-related story about the Chain Bridge for this week’s Show and Tell. Please go enjoy her story and congratulate her.
Thanks to everyone who offered a guess! To keep the guessing fun going, I will offer another prize to the commentor who can guess the height of Lori’s vase. Closest guess before next week’s Show and Tell wins.
Post-Procrastination Report
August 29, 2008
Post-procrastination, and also post-RE visit report.
Today’s theme: If you think you know what will come next, you are forgetting the nature of infertility.
As I mentioned in my last post, I was a bit anxious about this RE visit, but still I thought that I knew what would likely happen. He would tell me what we learned with IVF #1, and what we’d be tweaking for IVF #2 to make our odds even better.
That is called hubris.
Do you know what the universe does with people who exhibit hubris? Smacks them in the face.
There were three key things that occurred at the visit, which I did not expect.
- He insisted that I try to figure out if I can get any insurance coverage for IVF. Now, I can barely get insurance coverage at all (or at least, insurance that will cover maternity if I can ever get pregnant), which is why I am about to start a new job with good benefits. I have looked exhaustively into every possible plan that is available to individuals in my state, and I know for a fact that not only is there no IF coverage for me, there is barely any coverage at all without getting a job that will include insurance, which I have now done. But Dr. Full Steam Ahead insisted that it’s easy to get fertility coverage. Basically he said that he was happy to take my money if I still wanted to pay out of pocket, but that since it might require a couple more tries at IVF, I should try to get coverage. He detailed the many ways in which coverage is so extensively available, and what a dullard I must be to have missed them for so long. Well, DH and I just spent several hours checking and calling every insurance company, and he is totally wrong and I was totally right. Unfortunately. I would love it if insurance would cover my IVF cycles, but it won’t. I have never been so annoyed to be right.
- He wants to add ICSI to the next IVF cycle. We have never had any male factor problems, and it didn’t seem that we had any fertilization problems with IVF #1, so ICSI never entered my mind. We had 50% of the mature eggs fertilize last time, but Dr. Full Steam Ahead wants to get that number higher. Did I mention that his name is Dr. Full Steam Ahead?
- He wants to do a hysteroscopy before the next cycle or during the birth control pill phase. In case there is any endometriosis from M/C #2, and just to really “get in there and look” at my uterus.
The insurance part was totally stressful. You’d think that it wouldn’t be stressful to potentially get tens of thousands of dollars covered, but just raising the possibility meant all sorts of phone calls and research when I knew it would turn up nothing. There are few things in life I hate more than figuring out health insurance, in large part because the situation is so bleak.
ICSI was a shock but actually no big deal once I thought about it. It costs more money ($2000), sure, but it requires no extra work/pain for me or DH. If it will increase the number of embryos, so that we have better embryos to transfer and/or some to freeze, it may save money in the long run, and save us one or more additional IVF cycles. I’m on board.
The hysteroscopy really freaks me out though. I am pretty okay with pain, and I have learned to accept all of the different painful aspects of the IVF cycle. But the idea of an additional invasive surgery, an additional couple of days out of commission, and the possibility it raises that he might find something wrong, all scares me shitless. By nature I am pretty calm and very matter-of-fact (even if some of my blog posts don’t give that impression — this blog is my place to be an emotional wreck, so that I can pull it together in real life), but this one is getting to me.
Oh, and remember when I said that it looked like I might have no Procrastination Tax for putting off my RE consultation? Yeah, well now because I need to wait for my new health insurance to kick in (since it should cover the hysteroscopy and maybe some parts of the IVF cycle like meds — fingers crossed) I may need to postpone the cycle a month. I had just updated my About Me page to say that IVF #2 would start in September. By adding that one line of text, I must have jinxed it.
As I have mentioned before: Man plans, G-d laughs.
To reiterate today’s lesson: If you think you know what will come next, you are forgetting the nature of infertility.
Procrastinator
August 28, 2008
Confession time.
I procrastinate. A lot. Sometimes with things that I don’t want to do, and sometimes with things that I want to do very much. Work, leisure, obligations, optional activites. You name it, I’ve put it off.
There are lots of times that I get things done right away, or in a normal time frame. But very often, when I do something, I am procrastinating from something else. “Useful procrastination” is one of my tricks for productivity, but sometimes the things that I am putting off keep not getting done.
There have been a few times that procrastination has cost me big. Paying credit card bills after the due date. Missing deadlines. Failing to file paperwork in grad school and having to pay extra tuition (boy oh boy, neither DH nor I were happy about that!). I like to think of it as a Procrastination Tax. I’ve gotten better over the years about reducing my tax burden, but I still procrastinate plenty when it doesn’t seem like it will cost me any money.
For a long time after IVF #1 didn’t work out, I put off scheduling my follow-up consultation to plan for IVF #2. At first, I put it off because I was waiting for AF. I wanted to know what the timing of the next cycle would be, so that I would have a sense of the scheduling of the IVF cycle. A post-M/C cycle can be so unpredictable that it seemed more prudent to wait.
Then AF came, and I still didn’t make the appointment.
Not because I was avoiding the next step. I’m quite eager to do IVF #2. Especially now that I’m in a race with my sister-in-law.
I’m also eager to get Dr. Full Steam Ahead’s opinion on what we learned from IVF #1 (he promised that we would learn something) so that we can change the protocol the next time around and maximize our odds.
Frankly, I don’t even know why I kept procrastinating. There were definitely some days that I didn’t think to call until after the office had closed. But there were other days that I remembered during office hours and made a conscious choice not to call.
Because it confirmed the failure of the last cycle? Because Dr. Full Steam Ahead is probably going to tell me that M/C #2 was a random genetic anomaly and we didn’t learn anything that will cause us to make changes the next time around? Because I am afraid that I will keep having more “genetic anomalies” until he finally declares that there is something else going on? Because I don’t technically have enough money in the bank right now to pay for IVF #2? Because I’m anxious about what the future holds? Because it was fun having several weeks when I wasn’t giving myself injections or inserting progesterone suppositories? (Pretty sad idea of fun!) Because it’s a relief not to think about it for a while?
Probably.
Finally, when I had waited so long that my procrastination might force me to postpone IVF #2 for an extra month, I made the appointment. Shockingly, for once, he had an open appointment within one week. For once, my procrastination didn’t bite me in the ass.
My appointment is tomorrow.
I’ll let you know what happens.
Don’t bother to wish me luck. I need to save all of the luck for IVF #2.
Clean Sweep
August 26, 2008
They’re coming…
Most of DH’s immediate family is about to arrive at our house for almost a week.
Aside from the planning in terms of my work schedule and figuring out ways to entertain them, there is a serious matter at hand: I need to get rid of all of the TTC/IF evidence.
Normally I don’t go to great lengths when guests come over. Some friends know about our IF history, so I don’t care what they see. Most other guests don’t know, but are too polite to go snooping around.
But it’s different with family. Between parents and several younger siblings, our house will be overflowing. That means there will be prying eyes in every room. One of the younger sibs is a notorious snoop with no concept of privacy or personal responsibility. She may be a sociopath, or she may just be a kid. My husband strongly suspects the former.
Everything must go.
Fertility and pregnancy books, hidden in a file cabinet.
Prenatal vitamins, removed from the kitchen cabinet and put into my nightstand. DH’s regular vitamins and my omega-3 pills can stay.
Basal body thermometer, already in nightstand. I haven’t used it in so long, I wonder if it still works.
Ovulation predictor watch, already in nightstand. I wonder if all the times it told me I was ovulating, it was accurate, or it was just trying to make me feel better?
Astroglide, already in nightstand. (Okay, so that’s not actually for TTC, but it is something that we don’t want the kids stumbling onto.)
Syringes and sharps boxes… I guess I’ll put them in a file cabinet. Maybe the one that is labeled Taxes. No kid wants to look in there.
Paperwork from RE. Ugh, there is so much of it. Do I have enough file cabinets for all of this stuff? It took over half an hour to track it all down. Between RE instructions, hospital discharge instructions, billing statements, health insurance statements, health insurance denials, pamphlets… there are literally thousands of pieces of paper.
Computer caches cleared. Incriminating files protected.
And now for the conundrum:
Refrigerated meds. The huge bundle in my crisper includes an unopened Gonal-F pen and over 100 progesterone suppositories in two different doses.
As I have detailed before, after IVF #1, I was staying with family and had to keep my refrigerated suppositories in a cooler bag with ice packs for a week, changing out the ice a couple of times a day. This was fine for suppositories, which don’t really need to be at a specific temperature, as long as they’re not so warm that they start to melt. But the instructions, and the nurses, say that the Gonal-F should be refrigerated. I’m not sure if that’s 100% mandatory, but I don’t want to risk ruining $700 worth of meds, or even worse since I wouldn’t realize that they’re ruined, a $10k IVF cycle. So I need to keep them refrigerated, but I can’t keep them in my refrigerator. What to do?
Here is my crazy solution. I will keep the suppositories in my fridge until just before the family arrives, and then I will do the ice pack thing.
As for the Gonal-F, there aren’t many people around here who know about my TTC, so my options are limited. I certainly can’t keep them in the fridge at work!
And so, I have asked someone else to keep the Gonal-F for me for the week in her fridge. The woman that I mentioned wanting to get to know better last week.
My only regret is that I don’t have the prescription for birth control pills for IVF #2 yet. It would be delicious to leave those lying around for the family to find.
Wish I may, wish I might, have this wish I wish tonight
August 25, 2008
A couple of weeks ago Lollipop Goldstein asked for posts about wishes. She asked:
Is there an expiration date to wishes? What is the longest amount of time you’ve ever witnessed between making a wish and having it come true?… But if my four-year-old wishes happened to come true now (will I get that pony?), in the most random, bizarre way (a pony on my doorstep?), would I chalk it up to that old wish? Or was it just a strange coincidence that a pony showed up in my neighbourhood?
I can’t let her question go unanswered. Better late than never.
I’m a one-trick pony (ha ha ha) when it comes to wishes. Prior to age 8 it’s hard to remember what I wished for; I know that I earnestly wished for a Cabbage Patch Doll until I finally received one. I am pretty sure that I also did a lot of wishing that my parents would get un-divorced. Not sure before that.
Through most of my childhood and adolescence, my wishes revolved around boys. Wishes on stars, wishes on birthday candles, wishes on coins in fountains, wishes on wishbones (before I became a vegetarian), all about boys. From ages 8 to 13 one specific boy, on whom I had the biggest and longest-lasting childhood crush ever. Then once I moved on, I either wished about other specific boys, or for love in general. Never once did I wish for a pony.
Then I met DH, and I didn’t need to make any more wishes to find my prince. I instead wished about the longevity of our relationship, that we would be together forever. I don’t recall what else I wished for during the post-meeting-DH/pre-TTC era. I will say that I didn’t have many chances for wishes due to a decrease in the number of birthday cakes with candles, fewer wishing stars, fewer coins in fountains, and a total elimination of wishbones.
A few years later, I started wishing for babies. At first, I simply wished to get pregnant. Then when it wasn’t working, I wished hard to get pregnant. After over 2 years TTC, I finally got pregnant, then miscarried.
Apparently, I was not specific enough.
In the current Barren Bitches Book Brigade selection, Eat Pray Love, Richard from Texas tells Liz about his long-standing prayer, “Please, please, please open my heart.” He is rewarded with open-heart surgery. He cautions, “Be careful what you pray for, Groceries, cuz you just might get it.” Richard was not specific enough about what kind of heart-opening he sought, and I was not specific enough about what should happen after the pregnancy occurred.
So now, I wish to not only get pregnant, but also for it to result in a healthy live baby. Is that specific enough, Wish Fairy?
As for Lolly’s question about expiration dates and wish lags, I consider my wishes for non-DH boys to have expired. If my long-time childhood crush suddenly tracked me down and professed his undying love, I would laugh heartily and then let him down gently. Anyway, I’ve seen his picture as an adult, and he was way cuter as a little boy.
I don’t foresee an expiration date on the baby wish. I will keep going until it is fulfilled.
Now, let’s tally the wishes with their durations and outcomes.
- Wish for Cabbage Patch Kid: a few months, fulfilled
- Wish for parents to un-divorce: a few years, fulfilled then unfulfilled, now expired
- Wish for specific boy from elementary school to like me: 5 years, expired
- Wish for other boys to like me: 1 day to 1 year, all expired
- Wish for love: 5 to 10 years depending on how you count; fulfilled
- Wish to be with DH forever: so far so good
- Wish for pregnancy: 2 years, fulfilled very temporarily in a cruelly literal fashion
- Wish for baby: total 6.5 years and counting, still wishing
Don’t Get a Get
August 22, 2008
Our anniversary is coming up soon, the anniversary of the day that (among other things) we signed our ketubah. Traditionally in Judaism, the ketubah is a marriage contract, not unlike the modern-day prenup, listing the material goods that the husband vows to provide the wife, and the settlement that will occur in case of divorce. Relative to other practices a couple thousand years ago, it was very progressive in terms of offering rights to women, but at the same time, there was an overtone of the bride as property, something to be acquired.
Because DH and I are not traditional people, our ketubah says nothing about contractual obligations. Instead, we made beautiful promises such as cherishing each other’s uniqueness; creating a home filled with reverence for learning, loving, and generosity; and my favorite, doing everything within our power to permit each of us to become the persons we are yet to be. Surrounding these heartfelt words is a vibrant painting. It is a joy to look at our ketubah on the wall every day. It reminds me to help my husband to become the person he is yet to be, and to strive to develop myself. It reminds me of how much we loved each other on that day, and how much more we love each other now.
Recently, I had a different experience with a ketubah. DH and I were in a marvelous European city, in a Jewish museum attached to one of the most remarkable synagogues in the world, and the tour guide was showing us different artifacts. When we got to the ketubah section, the guide told us about the nature of the Jewish marriage contract. It was all information that we’ve heard dozens, maybe hundreds, of times. Then she said something that neither DH nor I had ever heard before.
Even though the ketubah theoretically offered the option for divorce, it was very difficult to obtain a get, or rabbinically-approved divorce. The husband always had the advantage; he was the one to initiate the divorce, and he was the one with the choices. Unlike today, you couldn’t get divorced just because you were unhappy. It would have to be a situation like infidelity. Or a couple who hadn’t had any children after being married for a really long time, like 10 or 15 years.
Her matter-of-fact little piece of information knocked the wind out of me. DH later told me that he had a similar reaction.
We have been married for over 10 years, and obviously we have no children. According to ancient law, our marriage is a failure.
There are so many ways in which I place no stake in Jewish law, but this one really got to me.
After my initial visceral reaction to our own situation, I thought of all of the infertile couples over the millenia (and some of the highly observant Jews today). The expectation to have kids, and lots of them, right after the wedding. The questions, and looks, and disapproval when the kids kept not materializing. The blame (probably directed at the wife, regardless of the actual cause). The endless trips to the mikvah after every failed cycle. The desperate prayers. Finally, the official decree that the failure to produce children meant that the marriage must end. Maybe the husband could have a chance to try again with a new wife. After 10 or 15 years, the original wife’s clock might have run out (even if the original IF cause had been male factor). After 10 or 15 years, with future children unlikely, who else would want her? Being a divorced woman meant something different in that world than it does here. It meant that it was all over.
Not that this situation was fair for the men. Imagine spending 10 or 15 years with a woman, loving her very much, but being forced by your family, your community, your society, to divorce her because together you had failed to produce children. The men were able to remarry, but it might not have been so easy to find a second wife when people questioned your ability to do your duty and give her children.
I was pissed. Pissed at the religion, pissed at the power structure, pissed at the close-mindedness, pissed at the judgment, pissed at what these poor people had to endure.
And I’ve been pissed for months, right up until writing this post. Now, suddenly, I am grateful.
As much as IF has been incredibly awful for me, I am so grateful to have so many choices. I could opt not to have children for years after my wedding, and it was acceptable. I could choose to devote my life to something other than raising a family, so that during the years of IF I had purpose (and, sometimes, distraction). I could choose from an array of medical technologies to raise our odds. I could choose to step away from those technologies when it all became too much. I could choose several other avenues to bring a child into the family, if it comes to that. Though I hope I never have to, I could even choose to step away forever, and live without children but with my marvelous husband who treats me as an equal and shoulders these burdens equally. I would get plenty of flack for some of these choices (and I already have, sometimes), but I still have the power to choose.
Whoever would have imagined that a thoughtless tour guide and someone else’s ketubah could make me feel good about my infertility?
Coin Flip
August 20, 2008
Murgdan from Conceive This! recently posted about TTC as a game of dice. She quoted her GYN, who told her:
Remember that each cycle, even if you have perfect timing, perfect mucous, a perfect egg, you still only have a 20% chance of getting pregnant. It’s kind of like dice. One person may roll a dice and get a 6 on the first try. The next person may roll the same dice 12 times and never get a 6.
I have been thinking about my current efforts to conceive as a coin flip rather than a roll of the dice. Regular TTC odds are closer to the 1 out of 6 you get with dice, but my current odds with each IVF cycle are 50/50, just like a coin.
After IVF #1 resulted in BFP followed by BFN, DH was understandably disappointed. I told him how I was thinking about the situation, with some help from my old friend binomial probability.
With a single coin flip the odds are 50/50. But it’s possible that you can flip several times and still not get Tails. Sometimes you get Tails the first try. Usually you will get it the first few tries. But sometimes it takes a bunch of flips before you finally get Tails. Some doctors stop doing IVF after 3 or so tries because your odds are low if you’ve failed three tries, but based on probability, there’s a 1 in 8 chance that all 3 IVFs would fail. Those odds aren’t bad — those odds aren’t far off from the odds of conceiving that we had during the IUI cycles. If the odds of each IVF cycle really are 50/50, it’s likely that you’ll have success if you keep flipping a few more times. By the time you get to 7 tries, it’s less than 1% that you’ll have all 7 fail. You just have to keep flipping the coin.
It seemed to really help DH. Hooray for me, for using math to solve non-math problems. Hooray!
Not so fast. I did leave a couple of things out.
First, it’s $10,000 every time. That’s no chump change.
Second, this all assumes that the true probability is 50/50. My RE says that it is 50/50 for me, but that doesn’t mean that it’s the true probability. If a coin is loaded, the probability can change drastically. If you have a two-headed coin (yes yes, I know, like Two-Face in Batman — I can be more than one kind of geek in the same post!) you can flip a thousand times (or whatever the number of cycles would be if you did IVF every cycle for the rest of your life) and you will never ever hit Tails.
Here’s the thing. It takes a lot of flips before you start to realize that the coin may be two-headed. Harvey Dent flipped his coin many times before anyone ever figured out that it would always turn out heads, that he “made his own luck.” It took me an awful lot of unassisted cycles to finally say, this isn’t working. And then, after my first M/C and the hiatus and then subsequently letting nature take its course, it again took an awful lot of cycles before I finally said, this isn’t ever going to work without some major intervention. I’m slow to catch on sometimes, because I get so wrapped up in each coin flip (or roll of the die, or roll of the D&D 20-sided die — that’s three forms of geekiness in one post, if you’re keeping track) that I fail to see the whole picture.
For now, I’ll keep flipping the coin, assuming that it’s a fair coin. Though, if infertility has taught me anything, it’s that you can’t count on anything to be fair. But, if I keep trying, the odds are in my favor. Is Lady Luck?