Incident Report

October 29, 2008

We’re home.

Remember how I declared that I wouldn’t be seeing any friends with children nor the newly married about-to-get-pregnant couple during our trip this weekend? It turns out that DH didn’t read my blog nor ask for my opinion before he invited them all out for drinks with us. Oops! The newlyweds and one set of parents joined the singles in welcoming us to town. Luckily, babies aren’t allowed in trendy bars, so it was mostly grownup talk. There was definitely a grass-is-greener moment when we realized that in the time since DH and I travelled to eastern Europe and then to Asia, the mom has spent exactly one evening out with her husband. Since she doesn’t know about our IF, she coveted our life out loud, and we coveted her life silently a little bit — just the baby part; both of us would trade the world travel for babies, but we’re very happy with the other aspects of our lives.

Both couples (parents and non-parents) mentioned that they had to get up early the next day to attend the first birthday party of the child of Mr. Dad and Anti-Mom. Mr. Dad, as in (formerly) one of DH’s closest friends for decades, but less and less so since he got together with and then married the Anti-Mom. If you paid me $10k I wouldn’t go to that baby’s birthday party, but it still annoyed us to be excluded. Mr. Dad had known for a couple of months that we were coming to town. This means that either he (a) made a conscious decision not to invite us, (b) never considered inviting us, (c) wanted to invite us but was overruled by Anti-Mom. Regardless of how it shook out, DH has declared that he no longer expects anything from Mr. Dad in terms of consideration or friendship. I guess that crosses one obligatory visit off of our list for the next visit.

You’ll also recall that I mentioned That Guy and his impulsive attempts to drag married friends all around the world. Guess what? We spent a couple of hours hanging out with That Guy and a different newlywed couple (not really our friends, so not on the list from the other day), and within 24 hours the newlywed husband, That Guy, and DH had all booked plane tickets to Vegas. Oh, That Guy, you never disappoint. At least something in life is predictable.

At one point, they were trying to figure out if another friend would join them in Vegas. That Guy said, “Naaah, he’s married.” I pointed out that DH is married. “You’ve been married so long that it doesn’t count.”

Finally, the incident. In my last post I alluded to an incident that occurred with family. Specifically, DH’s stepmother, who, by the way, dealt with infertility and recurrent miscarriage herself once upon a time.

We were at a big family dinner. As I happened to be excusing myself from the table to go to the bathroom, someone asked where our next big trip will be. I said cheerfully as I walked away from the table, “Nowhere.” What I meant is that we’ve had so many international trips in the past year that we’re a little travelled out. I was barely within earshot when I heard DH’s stepmom ask DH eagerly, “Does that mean I will have a grandchild soon?” When I got back to the table, the subject had been changed.

Later that night, DH told me what had happened. After that question, he shot his stepmom the Look of Death and said with controlled rage, “Don’t do that. Don’t. Ever. Especially in front of Baby Smiling.” Stepmom clammed up. A few minutes later, she caught DH’s eye and mouthed silently, “Sorry.” DH declared to me his certainty that she will never make another little comment again.

That is the whole incident. I bet you thought there would be more to it.

I’m torn about it, really. I immensely appreciate DH sticking up for me, and it would be great if that really means an end to her little comments (which are not constant, nor malicious, nor particularly intrusive, but still unwelcome and hurtful). But I feel like he outed us in a certain way, gave away too much about our real feelings. I suppose if she really isn’t going to bring anything up then it doesn’t matter that much what she conjectures about our childbearing plans or abilities. DH insists that I have nothing to worry about. I maintain that her nosiness cannot be contained for long.

For the rest of the visit, I was on edge whenever I was alone with her, including a Girls’ Day Out the following day that we had already planned. Afraid that she would broach the subject and ask why he’d been so angry, why we’ve waited so long, if anything is wrong, blah blah. But she never mentioned anything about children, reproduction, or the incident. Instead we talked the whole time about some conflict she’s been having with other family members. Fine with me. I can talk about other people’s heartache and drama as long as you’d like, as long as we steer clear of me.

Open-minded, closed-mouthed, closed-hearted; that’s who I’ve become, apparently.

Who’s Left?

October 25, 2008

Yesterday I told you about all of the people I am currently avoiding during my visit to a city full of friends and family, as well as the few people that I’m still willing to tolerate.

But those aren’t the only friends we still have in life. In other cities, we have:

Several dear friends who range from gently puzzled to sensitive to truly fabulous and understanding on the topic of infertility. Some of them do happen to have children, and although it can be painful to interact with them sometimes, it’s entirely different from the parents that we now avoid because of the respect that these friends show to us.

Dear friends with whom I haven’t discussed IF, many of whom are so much older that their children are grown and having children of their own. Being around these families isn’t painful because my friends themselves are at such a different place in life, and the direct comparisons aren’t made nor are Those Questions asked.

Infertile couples with whom we occasionally commiserate. Generally, DH and I relay information to them since we’re usually further along in the process. Although I would never wish IF on anyone, I feel strangely better when I learn that someone else we know is in the same boat.

Gay friends with whom the topic of children never comes up.

Gay friends with whom the topic of children frequently comes up. We talk about their struggles to build a family rather than my own, which I much prefer. My vast knowledge of reproductive interventions actually comes in handy.

Friends who’ve turned into acquaintances over the past few years, sometimes because of IF and sometimes for other reasons. The casual nature of the relationships and infrequent communication means that children aren’t discussed. Phew.

A whole new set of friends that DH has made recently, who happen to be 7 to 10 years younger than he is. Historically, my friends have tended to be my age or sometimes much older, and his friends have always been exactly his age. DH goes on weekend trips with them, the kind that his married friends aren’t allowed to attend. He’s the only married guy around who is kept on such a long leash (or, rather, no leash at all). I haven’t met most of them. These friends had cell phones in middle school and have a completely different set of cultural references. They are years away from getting married, much less having children. And that means that Those Topics never come up. It is liberating, even by proxy.

Infertility takes you to all sorts of places you never thought you’d go.

Tomorrow, I’ll tell you about how it’s been going to avoid certain people and seek out certain others like That Guy, and I’ll give a report on an incident that happened with family yesterday — but I need to see how it gets resolved first.

Jetsam

October 24, 2008

Right now we are in a city where many of my in-laws and a large number of our friends live. We’re only here for a few days, but if we were diligent and dutiful, there are literally 12 sets of people that we should be visiting at some point. We used to attempt those whirlwinds, driving all over town from one house to the next or gathering several of them together at lunch and then a few others at dinner, but not anymore. Now, it would be just fine with me if I didn’t see some of them for years. Can you guess which ones?

Here’s a hint: Their lifestyle choices don’t sit well with me.

Did you figure it out? No, not our gay friends. I’m actually particularly thrilled to see them (more on that in the next post).

It’s the friends with children.

Never mind that several of them were in our wedding, or that DH was in theirs. Never mind that he’s been friends with some of them since he was 5 years old. He is free to see anyone he wants, but I am not going to another person’s house to “meet the baby.” Especially now that it’s baby #2 for most of them.

By my count, we have 8 sets of friends in this city. Four of them are couples who have children (including Mr. Dad and Anti-Mom, as well as three couples where we can actually tolerate both people) — 7 kids total among them. None of them has been married as long as DH and I.

Another couple very recently got married, and declared specific childbearing intentions repeatedly at their wedding. Having been married for four months, they don’t have a baby yet — emphasis on the yet. I fully expect that if I go to see them in person, I am guaranteed to hear a pregnancy announcement. No thanks.

That leaves three single friends.

One of them is my friend who used to work with me in a different city. Whenever we get together, we talk about careers, mutual friends, and her misadventures in online dating. Easy breezy.

Another one is That Guy, the perpetually single guy. C’mon, every husband has one of those friends, right? That Guy whose sexual conquests number in the thousands. That Guy who randomly calls your husband and says, “Hey, what are you doing this weekend? Do you want to go to Cancun?” That Guy who routinely picks completely absurd girlfriends, and on the rare occasion that he finds a normal girl, very quickly ruins the relationship. That Guy who may never get married — and you kind of hope he never does, for the sake of womankind. He’s also That Guy that most wives can’t stand. I say, bring him on.

The last of the singles is a close friend of both of ours. He knows all about our IF, and even insists on regular updates on our treatment progress. We can talk about anything and everything, including the hard stuff. But, most of the time, he and DH talk about cartoons, or we all chit-chat and gossip, or we deliberate about whether to get sucked into the nightclub vortex of That Guy.

You heard me right, folks. I would rather go to a sleazy nightclub and watch That Guy ooze slime onto scores of women than have a cup of tea with perfectly pleasant friends who happen to have a baby or two.

My infantiphobia isn’t based in a fear of babies, nor a fear of binkies nor breast pumps nor childproofed electrical outlets. It’s an avoidance of Those Questions. And not even Those Questions themselves, as much as the potential for Those Questions to be asked. When my single girlfriend blurts out in her bubbly voice, “So, when are you going to have babies?” it’s entirely different. She is asking from the perspective of someone who is not as far along in the Game of Life as I am, who’s looking ahead on the game board to check out the terrain. The people who have already passed me on the board, with their little plastic cars full of teeny plastic pink and blue pegs — those are the ones I don’t want to play with anymore.

Tune in tomorrow to find out what other types of longtime players I am still allowing in the game — and what kind of new players we’ve been recruiting!

Primary Care

October 22, 2008

As part of the sequence of necessary events leading up to IVF #2, I just went to see a new primary care physician. With my new insurance, I had to establish a PCP as well as obtain a referral for infertility treatment and for the hysteroscopy that Dr. Full Steam Ahead is recommending.

My main criteria in choosing a new PCP:

  • not too far from my house
  • will sign off on referrals

Preferences:

  • female
  • knowledgeable about infertility
  • competent

I received separate glowing recommendations from my acupuncturist and from a lady who does pottery with me for a female physician in my town. With two recommendations for this woman, and zero recommendations for anyone else, she seemed like an obvious choice. However, she wasn’t accepting new patients. Neither were any of the other female physicians in the entire town. It’s not a big town, but there are several female physicians from whom to choose (or in my case, from whom I could not choose).

Finally I found a male physician in town who was accepting new patients, who would make an appointment in less than two weeks, and who was on my insurance list of PCPs. Good enough.

With REs, I’ve always gone to the kind of doctors who were in the top of their class at their prestigious medical schools. It turns out that if you do the math, even the most prestigious med school has people at the bottom of the class. Apparently that’s where Dr. Primary must have been. To be fair, I don’t know why someone at the top of his class would work in a small practice in a small town, affiliated with a small non-research hospital. The fact that Dr. Full Steam Ahead is a superstar located within 20 minutes (albeit at a large practice affiliated with two larger research hosptials) is very lucky.

Anyway, here are some highlights from my visit with Dr. Primary:

  • I waited over one hour before being seen — for a morning appointment
  • I did not fill out any paperwork. Even as a child I cannot recall a doctor where I never filled out any paperwork. I even have to fill out paperwork when I get a massage — at the airport. I answered a couple of questions for Dr. Primary’s receptionist, and a few for the nurse and doctor. Dr. Primary conducted the most cursory family history and review of systems I have ever encountered, even compared to places like urgent care and university health clinics.
  • In his questioning about my surgical history, I mentioned IVF. Comment #1: “Oh, in vitro fertilization?” Do the letters IVF stand for anything else? I don’t think so, but I guess it’s good for him to double-check. Comment #2: “It’s not really a surgery. It’s more of a procedure. It’s not that invasive.” My response: I was under general anesthesia, so it seemed worth mentioning. Also, it’s actually kind of invasive. If someone were poking holes in his reproductive organs, he might reconsider.
  • He was full of weird assumptions. When I mentioned needing a hysteroscopy because of M/C #2, he asked, “So did you lose the baby around 12 weeks?” No, actually, not even close. Why would he guess that?
  • At the checkout desk to obtain my referral paperwork and hand over my co-pay, I saw referral paperwork for a different patient to a gynecology and infertility office, with the patient’s name in full view. I don’t know whether she was being referred for gynecology or for infertility, but it made me think that my name will be next to be broadcast for all of my neighbors.
  • After the meeting with the doctor, the nurse came back to administer my flu shot (while I was there, might as well…). She asked me how I liked the doctor — a very loaded question. I said he was nice. “Oh, isn’t he? I just love him. I’m not allowed to go to him because the staff can’t be seen in this practice, but if that rule weren’t there, I would definitely see him. Of course, it might be a little strange for your boss to be your doctor, I don’t know. There’s a gal who works here who says, ‘I don’t want my boss to see my hoo-hah!’ (laughs hysterically) She is a hoot. I told her, ‘The doctor doesn’t usually look at your hoo-hah, you see a different doctor for that.’ But I guess she has a point.” Me: “Mmm-hmm.”

In this era of paperwork paranoia and HIPAA hysteria, it’s quaint to see a small-town practice that isn’t a stickler for documentation nor privacy. Slightly bothersome, but mostly quaint.

In the end, Dr. Primary fulfilled both of my main criteria: referrals for infertility and the hysteroscopy, walking distance from my house. He fulfilled none of my preferences, but those were much less important. It’s just a funny counterpoint when the other doctors I seek out have to be the absolute best or I feel like it’s pointless, to encounter a pleasant but decidely mediocre doctor. Thankfully, my chances of reproductive success have nothing to do with him.

Remembering

October 20, 2008

Once upon a time, I didn’t have an answer to the question, “What was the worst day of your life?” There were several contenders, all of which were very personal but none of which was truly horrible. Since my first miscarriage, I now have a real answer to the question.

The year was 2004. Britney Spears’ Toxic was climbing the charts. Kerry was in the process of clinching the Democratic nomination. During the two week wait of the pregnancy I’m about to describe, Janet Jackson’s boob shocked the nation and renewed American interest in censorship. I had experienced two years of infertility, and after eight months of treatment including Clomid, IUI, trigger shots, and progesterone suppositories, I was finally pregnant.

Pregnant! It was fantastic. I was nauseous — not too much, just enough to feel really pregnant. I had told a few friends, but no family — we didn’t plan to tell them for weeks. DH had a male bonding trip with a bunch of buddies coming up and doubted that he could keep the secret from all of them. I experienced the most blissful moment of my life (more on that sometime in the future). My betas were rising beautifully. Eight days of joy after two years of sorrow.

And then, the betas started falling.

23 DPO, I got a phone call from the RE’s nicest nurse, the one who had experienced and conquered infertility herself long ago. The call came later in the day than usual, which was a little suspicious. I was about to head into a meeting, so I let the call go to voicemail. When I finished the meeting, I called the nurse back.

She said that the beta had gone down. It wasn’t 100%, but it was likely that I was losing the pregnancy.

Okay, thanks. I moved on through my day calmly.

I was headed to the mall in the evening with a friend, along with her 3-year-old daughter and her 8-month-old pregnant belly. This friend had been with me every step of the way, and had experienced almost a year of secondary infertility and an early miscarriage before conceiving her second daughter. She was the first person I’d shown my pee stick to, hours before I showed my husband — just as I’d seen her pee stick a couple of days before she showed her husband. She was with me every step of the way.

As we got in the car, I told my friend about the nurse’s phone call.

“Do you want to skip the mall?”

No, things like this shouldn’t interrupt our plans. Let’s go.

My friend said one of the wisest things I’ve ever heard:
“We can talk about it if you want. Or, if you want, I won’t mention it all night and we can talk about anything else. We’ll do anything you want, and we won’t do anything you don’t want.”

She is always like that, but she was extra-fantastic that day.

We shopped and had dinner. We mostly didn’t talk about it. I was a little off, but it was fine. Strangely, we ran into a friend of DH’s — one that I never particularly liked. It’s not strange to run into someone, it’s just strange that he ended up making his way into the story of my big day. But there he is.

Anyway, we finished our pleasant outing. I dropped off the ladies and drove home. I held it together for the 20 minutes it took to drive home. I held it together for the 90 seconds it took to get from my car to my front door. I held it together while I opened the door and walked through.

And then I lost it.

My husband found me in a heap against the front door, sobbing like he’d never seen me in the 10 years we’d been together.

“Oh my G-d! What happened???”

I coughed out between sobs: I-lost-the-baby.

He was so sad too, but brave and sweet for my benefit. I’m sure he felt the loss as much as I did, but he never got a chance to express it.

Until October 20.

While I was pregnant, I had put a little post-it flag in the calendar on the due date, October 20. It was a weekly calendar in which we charted our exercise, so the flag wasn’t apparent until you turned to that page.

On October 20, he turned to that page and saw the flag. “What’s this flag for?”

That was the baby’s due date.

“Oh.” We hadn’t talked about it for months. It went from a mundane moment of charting his workout to a knife in the gut. We cried and hugged.

I remember so many things about that day, and about the moments of sobbing in a heap. I don’t remember the exact date it happened (though I have it written down, so I do know it). But I have never forgetten October 20.

Even though I always know the date, I sometimes forget the year. I just have to think of the age of my friend’s daughter, who was born a few weeks after my miscarriage. She is 4 now. She is starting to read.

I don’t even know the due date of the pregnancy that I lost only a few months ago. After my first loss, I just couldn’t put my heart into the next pregnancy, even four years later. When my next pregnancy happens (not if, but when, dammit) I will try to put my heart into it, but it may take a few milestones to really convince me that this one is here to stay. Several betas, certainly. Ultrasound with heartbeat? Maybe. Past the age of viability? Perhaps. Birth? Possibly. High school graduation? Definitely by then.

I will have many other dates to remember in the future, hopefully mostly good. But no matter how many dates make it into my calendar and my brain, I don’t think I can ever forget October 20. And since I can’t forget, it means that baby will always be remembered.

Thank you for remembering with me today.

Show and Tell: Foliage

October 19, 2008

For Perfect Moment Monday this week, I talked about a bittersweet autumn day. But I didn’t include pictures.

So, for Show and Tell this week, here is a photo of some of the local foliage. In fact, this grove is next to my RE’s office, across from the hospital where he performed IVF #1 and will perform my hysteroscopy and the next IVF in the near future. Seems fitting.

Joy and Trouble

October 15, 2008

Today I will finish off my Jewish New Year train of thought.

The most common Rosh Hashanah greeting I’ve heard is something along the lines of, “May the new year be sweet.” There is a definite focus on sweet foods as a metaphor for good things to come. Apples dipped in honey and honey cake in particular.

The other common greeting that I’ve heard is a wish for nachas. No, not nachos. No chips and salsa in Judaism. Nachas. Pronounced with the gutteral ch sound. Sort of like knock-us, but instead of ck, you sort of clear your throat.

Nachas is yiddish for pride and joy. The opposite is tsuris, meaning trouble, worry, heartache.

Both words can have broad meanings, but typically nachas refers to joy specifically from children or grandchildren.

The entire holiday therefore feels exclusionary, inadvertent though it may be. The well-intentioned e-cards and mass emails mock my infertility.

During the almost 7 years I have been trying to conceive, I have had exactly 8 days of nachas, the 8 days before my first miscarriage. That works out to 0.3% nachas and 99.7% tsuris.

If I conceived during the next IVF cycle, by the time my hypothetical child started kindergarten, my nachas:tsuris ratio wouldn’t even be 50:50. By the time the child graduated from high school, it would be up to 75% nachas and 25% tsuris, assuming that throughout adolescence the child did not give me a single day of tsuris. Fat chance of that, but bear with me. And assuming that the child continues to offer nothing but joy every day thereafter, my nachas:tsuris ratio won’t exceed 90:10 until the child is almost ready to retire. Perhaps the child would be a grandparent by then, and I will have become a great-grandmother. Did I mention that 7 years is a really long time?

I don’t mind the wishes for a sweet year, but maybe people can lay off the nachas wishes for the infertiles and others without children. Instead, next year’s Rosh Hashanah greeting cards can declare:

May the new year be filled with nachos.