Open House

February 19, 2012

At the nursery school Open House, we discovered that two classmates were born within a week of Burrito and Tamale’s birthday.

One of those dads said, “I guess a lot of us were gettin’ it on around New Year’s!”

What I said to him: “Actually, they were preemies.”

What I thought immediately: “Well, now I know one couple in this room who definitely isn’t infertile.”

What I realized later: “My egg retrieval for IVF #2 was on New Year’s Eve.
I’m pretty sure there was no ‘gettin’ it on’ within a month of New Year’s.”

Thoughtful ThursdayStill in limbo. It has gone from being delicious to excruciating to a chance to practice being patient and back again.

One of the things I’ve been doing while in limbo checking out alternate scenarios in case this job doesn’t happen — how would it play out if we stay here, where else might we move, etc. Mostly, though, I’ve been keeping tabs on our potential new city.

Any new housing listings being posted in the desired areas? An exciting new option might come along, or the owners of the house we’ve already settled on may decide that they can’t stand this limbo any longer and need to rent to someone else.

I already know which organic market I’d shop at. Which farmers markets operate on which days.

I’ve drawn up a short list of preschools — not for this year, and probably not for the next year, but the one after that.

I know what route I’d take to get to work every day.

I know which gym my husband should join, and I know where to find yoga classes for myself and for my little budding yoginis.

I have scoped out every playground within walking distance. I know which museums have reciprocity with my existing museum memberships. I know which pumpkin patch we’d visit for Halloween.

The one thing I don’t yet know, the one thing I haven’t allowed myself to search for? Where I’d do pottery.

For each of the other cities we’ve thought we might move to in the past year, I looked up all of the options and settled on a pottery studio. By drawing this boundary, I’ve simultaneously given myself something to look forward to and kept myself from getting too entrenched in one possible future (as if the farmers market and yoga schedules are not entrenched). The line is arbitrary and artificial and silly, but the existence of a line means that I stay (vaguely) grounded in reality instead of only What Ifs.

Sort of like when I was in infertility limbo. In each city where we lived during IF, I had selected an OB, a prenatal massage therapist, a studio for prenatal yoga, a doula… I’d picked out names, and strollers, and car seats… I literally read a dozen books on pregnancy the first year I was TTC… but I didn’t allow myself to buy a single baby item. In that case, it was already too late to keep myself from getting mired in What Ifs. The boundary was more about waiting for reality to catch up with fantasy. It’s a good thing that I established that particular boundary: if I’d actually bought a car seat when I started TTC, long before I ever got pregnant with Burrito and Tamale that car seat would have passed the expiration date.

Do you ever draw lines for yourself? Do the lines represent real, meaningful boundaries, or are they arbitrary?

Thoughtful ThursdayJumping off from the Dollars and $ense of Family Building (and by the way, if you haven’t checked out the blog hop yet, please do — and if you want to contribute your own post, even better!)…

One theme I’ve seen come up over and over again in the Dollars and $ense posts is money spent on failed cycles and other efforts that didn’t pan out. Some people seem to accept it as a necessary part of the process. Other people seem to lament the waste. I’ve referred to it in my own post and in a blog post years ago as water-under-the-bridge money, and for the most part that’s how I’ve approached it.

Some people are prudent in their approach to sunk costs, cutting their losses and moving on. Others keep going because of the resources already invested, even when it doesn’t make any sense to keep going.

Eating something that tastes horrible?
Halfway through watching a terrible movie?
Paid thousands of dollars in repairs for your crappy car?
Invested a couple of years in a bad relationship?
Spent tens of thousands of dollars and years of your life trying to have a baby?

With the little things, eating something yucky or watching a bad movie, I’m likely to just finish, even though it would be wiser not to. When it really counts — relationships, big ticket items — I think I’ve been good about cutting my losses. With infertility, though, I was in between: I accepted the losses as water under the bridge, but I couldn’t ever bear to cut my losses and move on. The hard part is that during infertility, you don’t know whether you’re showing perseverance necessary for achieving your goal, or whether you’re succumbing to the sunk cost fallacy and throwing good money after bad. Of all of the awful things about infertility, that part — not knowing if you will ultimately succeed if you just keep going or if everything you put in will ultimately be wasted — is, to me, the very worst.

When there are sunk costs, do you move on or try to stick it out? How does your typical sunk cost approach relate to your family building efforts?

Welcome to my contribution to the Dollars and $ense of Family Building blog extravaganza!

I am one of the organizers, along with Lori Lavender Luz of WriteMindOpenHeart. At Lori’s blog you can get the background and overview of the project, as well as add a link to your own post if you’d like to join the fun.

Lori and I wanted to get a variety of bloggers’ perspectives on the role of finances in family building, and you can find a dozen others at the main Dollars and $ense page. There are infertility and adoption bloggers with just about every perspective you can imagine. The perspective I’m bringing is that of a longtime infertile who pursued treatments with no regard to the cost.

I didn’t set out to break the bank. I got into treatments, both financially and medically, little bit by little bit. I started TTC at age 26, and after more than a year of patience I decided that my charts just didn’t look right and I needed some help with my luteal phase. I was a graduate student at the time, so I went to the student health center. The pediatrician who saw me obviously didn’t know how to handle infertility, nor did the gynecologists who spent most of their time preventing girls from getting pregnant. They immediately referred me to a specialist affiliated with the medical school, who just so happens to be a world-famous reproductive endocrinologist (Dr. Fancy Pants, as I’ve called him before on my blog). It doesn’t really make sense to send someone just starting out to a doctor at the very top of his field, but that’s where I was sent.

I expected Dr. Fancy Pants to start slowly with a month or two of assessment, but he preferred to jump right in with Clomid and do the assessment along the way. It was just a little pill, it didn’t seem like a big deal. Then the next cycle we added progesterone. Then the next an HCG trigger. Meanwhile I was paying out of pocket for each ultrasound (performed by the doctors themselves rather than a tech, ooh la la), each blood draw, and everything else. A hundred bucks here, a couple hundred there. Before I knew it we’d spent over $10,000, which was all of the money we had saved in the 6 years we’d been married. We stopped treatments, in part because a miscarriage took the wind out of my sails but also in part because we were out of money.

I needed to stay away from treatments for a couple of years but decided to try acupuncture (which was covered by my student health plan). When I finished my graduate program, acupuncture stopped being covered, but by that point I felt like it was benefitting my cycles enough to be worth the expense. Through two long-distance moves I pursued Eastern rather than Western medicine. Casually at first only every few weeks, then I added herbs, then I started going weekly. All of those treatments added up too. Eventually my (3rd) acupuncturist and I simultaneously came to the realization that I’d given Eastern medicine a full try and it was time to go back to Western medicine. He referred me to Dr. Full Steam Ahead.

By that point I had turned 32 and “you have plenty of time” was starting to become “you’re not getting younger.” Along the way we had sold a house at a large profit (thanks, housing bubble!) and had replenished our savings substantially. We decided to go full steam ahead with Dr. Full Steam Ahead, who within 6 months had put me through a full assessment, two IUI cycles, and my first IVF. DH and I had committed to finally getting pregnant successfully, no matter the physical or financial cost. Adding a second IVF that year, we ended up spending so much money on medical expenses in one year that it recently resulted in an IRS audit.

At that point our ample savings had ceased to be ample, and we wondered how much longer we could keep going. As with Dr. Fancy Pants years earlier, each new cycle brought an additional tweak such that each time it seemed like this must finally be it. Add this drug. Try IVF. Try ICSI. After the second IVF failed, though, we’d been through 10 treatment cycles and the excitement had worn off. We also looked at our finances and realized that our large savings had now become rather small. Along the way I’d taken a new job largely motivated by the need to secure (any) health insurance. The new insurance happened to cover IF – but only assessment and IUI, which we’d already moved beyond. Then I learned about a way that I could get health insurance that would cover IVF. (I was sure I’d blogged all about the trick long ago, but I can’t seem to find the post… hmm. Briefly, it requires starting your own company, and it only works in certain states, but if you can pull it off it’s a fantastic loophole.) In preparation for that, I did one last IUI to satisfy the future insurance company’s requirements for IVF, and from that perfunctory IUI came my twins.

In an alternate universe, if it hadn’t worked, we would have secured the IVF-covering insurance and exhausted the 3 IVFs it would have given us, bringing us to a total of 5 fresh IVFs. If that still hadn’t worked, I just don’t know what we would have done. Presumably by that point some doors would have started to close themselves – maybe the doctor would have declared that egg quality or my body’s response was inadequate, or something about the sperm-egg combo, or who knows. We very well might have gone back to paying out of pocket, and if we’d had to pursue something like donor eggs we definitely would have paid out of pocket. Thankfully we didn’t have to find out, and I was able to end my infertility tally at only $70,000.

Now, answers to specific questions that the participants raised.
1. Consider your now or future children as adults, and consider the fact that you had to spend money to either conceive them or make them part of your family. What effect do you think the latter will have on the former one day? What, do you think, your grown children might feel about the funds it took to create your family?
Honestly I think it’s a huge compliment to them, and a testament to how very much we wanted to bring them into our lives. While they’re slinging burgers to pay for college they might lament the “wasted “ money, but without all of that water-under-the-bridge money spent, they wouldn’t have come into existence.

2. How did/would you handle it if your child asks you, “Mom, how much did I cost?” How would you answer at age 7? At age 18?
At 7: We wanted you so much that we did everything we could to bring you into our lives. It did cost a lot of money, and we had to experience a lot of medical procedures, and it was very hard, but it was all worth it. We love you so much, and we loved you so much even before you ever existed.

At 18: Bringing you into the world cost a lot less than we’re about to spend on your college education.

3. When calculating the costs of your family building, what do you include? The direct costs are easy (such as RE fees for a cycle or homestudy fees), but what about fees that didn’t directly lead to your child’s existence in your life, such as cycles that didn’t work, adoption outreach avenues that didn’t work, failed adoptions, avenues that were explored (and that cost something) but not pursued, etc.?
I count everything. Each cycle that didn’t work was a necessary step in bringing us to our children, and each dollar spent was a dollar that we spent.

4. If two children in a family “cost” different amounts, should that have any significance?
My two children happen to cost exactly the same amount because they are twins who were conceived in the same cycle. If we’d had two singletons who came from cycles with different fees, I don’t think that would matter to us. But, if we had one child from treatments and one child naturally (did you know that people have babies without doctors? or maybe it’s just a fairy tale), it would seem significant – though less because of the financial cost and more because one conception was so much “easier” than the other.

5. To what extent have finances determined the family-building decisions you have made? How have you able to balance financial considerations against other factors such as medical, ethical, emotional…?
Finances have determined our decisions far less than they probably should have. As I mentioned above, we stopped treatments for a few years to replenish our savings, and we did opt for our 11th cycle to be an IUI rather than IVF specifically because of insurance requirements. We also opted to start IVF when we did rather than continue with another IUI or two because the IUIs were so expensive with such a low success rate that IVF just made more sense. Otherwise we didn’t pay much attention to money and just kept writing the checks until the account was empty. I don’t know that I recommend that approach, even for those who have the means, but it’s the approach we took.

6. Has institutional and governmental support for certain family-building paths impacted your choices? For example, ART being covered by insurance, tax deductions for adoption expenses, etc.
The fact that ART was not covered by insurance for most of our journey certainly had a huge financial impact. Once we secured insurance that covered treatments, you’d think that it would have been liberating. In fact, in our interactions with the insurance process, I realized how much leeway we had when we were paying out of pocket. For example, in our one covered cycle, the FSH wasn’t approved until it was too late to start the cycle, and I was only able to proceed as scheduled because I had leftover (and presumably spoiled) FSH from a previous cycle. If we’d ended up doing IVFs covered by insurance, I’m sure there would have been a lot of bureaucracy, to the point that it would have interfered with the cycles in terms of timing or even what procedures/drugs could be used. At $15K per cycle saved, though, it would still have been worth the hassle.

7. Have you considered having ART treatments abroad, either due to lower cost or due to certain methods being unavailable or illegal in your own country? In your decision-making, how did you balance the financial savings against issues like the unknowns of the country, perhaps not speaking the language, and medical practices that may differ from those of your home country? If you did travel abroad for treatments, what was your experience? Would you do it again?
The “IVF cycle as extended vacation” idea crossed my mind only because I’d seen others do it, but doing it locally was more practical and there wasn’t anything we could do abroad that we couldn’t do at home. There are other participants who can answer this question differently, though… Speaking of which, it’s time for you to visit the rest of the Dollars and $ense posts! Thanks for stopping by!

Visit Write Mind Open Heart for more perspectives on the Dollars and $ense of Family Building and to add your own link to the blog hop by May 1, should you want to contribute your thoughts.

Thoughtful Thursday: Goal

January 7, 2010

(Intelligentsia coming in next post. There’s a thing.)

Thoughtful ThursdayThis week’s topic follows last week’s on what kind of person you’re trying to be, as well as a post on another blog. Earlier this week, Carrie from Tubeless in Seattle had a beautiful post about the kind of mother she thought she’d be versus the kind of mother she is. I’ll wait while you read it.

Doot doo doot, boop doo dee doo waaaaaaaa

Okay, great, you’re back.

As you just read, Carrie asked:

Are you a different mother than you’d imagined? Are you still trying to become a parent? What is your ideal role? Do you have peace about your mothering?

I commented:

I am much more willing to share them with others, probably in large part because they are multiples. Ultimately that’s a good thing for all of us. I think if I’d had a singleton I might never let anyone else hold the baby.

I am not as doting as I thought I’d be. I just don’t have as much to give as I thought I would. I think that will come with time, and with sleep.

Everyone constantly remarks about how laid back we are as parents. I expected that DH and I would be the way we are, but I didn’t realize how non-laid back everyone else is.

I know that I am doing a great job of mothering, but peace is not the word I’d use. Can you feel peace with one part of life if you don’t feel it in some others?

For Thoughtful Thursday, let’s examine a variation on Carrie’s question.

What kind of parent do you want to be?

This applies both to those who already have children, as well as those who are working on becoming parents for the first time.

As for me, I want to be a mother who loves her children like crazy and expresses that love constantly.

I want to show my children the world, literally. We’re already talking about a trip to Europe in the fall, though DH thinks it’s nuts to go when they’re less than a year old and can’t appreciate it.

I want to teach them and to help them learn for themselves.

I want to be patient.

I want to ignore the crap that comes with American parenting like consumerism and helicoptering and competitions with other parents.

I want to foster their relationships with each other, family, and friends.

I want to make the most of every day.

I want to think through the decisions I make.

I want to enjoy my own non-parenting pursuits like my career and hobbies and, by being away from them sometimes, be a better mother when I’m with them.

I want to share this journey with my husband with laughter and sweetness.

I want to benefit from the years of infertility by appreciating them for the miracles that they are.

Not too tall an order, right?

What kind of parent do you want to be?

Thoughtful Thursday: Far

December 10, 2009

Thoughtful ThursdayHow far would you go?

My husband doesn’t like What If questions. He finds it pointless to dwell on the hypothetical and instead prefers to deal with actual situations as they arise.

Separately, he really really likes tigers. Whenever we hear about the slaughter of tigers for purposes like creating alleged aphrodisiacs with their penises, he gets terribly angry.

So, you can imagine his frustration when I asked him last year:

If you had to kill a tiger for us to have a child, would you do it?

Oh, he did not like that hypothetical question about slaughtering a tiger at all, not for its penis nor any other part. Eventually he grudgingly acknowledged that if there were absolutely no other way, conquering infertility would trump his love of an endangered species.

Thankfully, it never came to that. Also, tiger penis doesn’t really cure infertility.

We did, however, resort to other avenues that we didn’t envision when we started out. Injecting myself with hormones derived from hamsters and from human urine. Draining our savings, then waiting a few years and draining our savings again. Spending the equivalent of a part-time job, for many years, on treatments and on tears. So many other things that, when I started out, I never thought I’d do.

Because really, I would have done nearly anything for a baby. No amount of money, no number of years, no measure of pain would have been too much. Some people are more sensible and less obsessive, and they know their limits. I wouldn’t have hurt any people (or endangered species), but there’s not much else I wouldn’t have done. I honestly don’t know whether that’s good or bad.

How far would you go (or would you have gone) to have a child?

Fertility Massage

December 2, 2009

Wait, what? Is that title right? Yes it is!

A recent post from Gracie in Brooklyn about uterine massage reminded me that I never blogged about the fertility massages I used to get. Gracie’s post is the first blog I’ve ever seen talk about it. I was always surprised that no one in the entire IF blogosphere ever mentioned it.

I had no idea that fertility massage existed until I saw it offered at my acupuncture clinic. So, as a public service, I’ll tell you what I experienced, and you can decide whether to see if you can find a practitioner in your area. There aren’t many, unfortunately. I suppose that if you have a massage therapist that you already like and trust, you could ask him/her to incorporate some of the techniques.

The “fertility” part combined several massage techniques:

  • uterine massage, in which the uterus is massaged very deeply — strangely pleasant, as Gracie describes
  • femoral massage, which fans of Randine Lewis’s book The Infertility Cure may recall, in which the circulation in the femoral artery is temporarily blocked to pool the blood in the uterus
  • reflexology on points specific to the reproductive organs
  • lymphatic drainage, which I’ve never fully understood so can’t really explain to you

These techniques are primarily focused on increasing blood flow to the uterus. Some women do have fertility problems caused by restricted uterine blood flow, and for them, fertility massage would be perfect. Because my fertility problems are unexplained, it’s not clear whether increasing blood flow would do anything, and I can’t say whether fertility massage actually did anything to help me conceive. I can say that I enjoyed fertility massage even more than acupuncture, and infinitely more than anything that involved my RE.

As someone with chronic back problems, it was wonderful to be able to justify spending money on frequent massages. By my skewed logic, I rarely spend money for my own well-being, but with anything that involved TTC, I spent money hand over fist.

Postscript (mentions pregnancy and babies): I had so many fertility massages that the massage therapist and I became friends. I continued to see the same woman for prenatal massage. When I was hospitalized, she drove almost an hour to visit me in the hospital and to massage me for free. I have seen her for massage a couple of times since giving birth, and in addition to the usual, she has been massaging the site of my C-section to reduce scar tissue (which never would have occurred to me; I thought I’d just have a lumpy scar forever). We also brought Burrito and Tamale for a class she taught in infant massage.  At the class I saw a woman from my old infertility support group. Her baby is a month older than B & T, and we traded parenting tricks and massaged our babies. Full circle.

Thoughtful Thursday: Emotion

October 15, 2009

Quick health/baby update before we begin Thoughtful Thursday: I am feeling better and better every day; the percentage of the day in which I feel Human has gone from 0% for several days post-birth to 80% today. The Burrito and The Tamale are developing incredibly well — so well that we’ve been discussing discharge with the NICU team. Looks like just a few days until they come home!

Thoughtful ThursdayToday’s topic follows from a question I submitted (and then subsequently answered myself) for this week’s Barren Bitches Book Brigade on It Sucked and Then I Cried by Heather B. Armstrong of dooce.com. Since only a few people participated in the book club, I’d like to open the topic up for discussion more broadly.

On your blog, how much emotion do you express? Is that more or less emotion than you tend to express in real life?

From my BBBB post:

In real life, I am very guarded with emotional expression. On BabySmiling, I am considerably more expressive.

For years I have enjoyed Dooce’s monthly newsletters about her daughter. They combine snapshots of Leta’s growth, snarky humor, and pure love. I think that I will be comfortable expressing emotion directly to my children, but it feels strange to think of writing emotional public newsletters under my real name for friends and family (and strangers) to read. Do I save the emotion for BabySmiling, even though it goes against the mandate of the blog as an infertility blog? Do I write the letters privately? Do I remain guarded and let the emotions go undocumented? Probably not the latter, but I’m still figuring this one out.

To elaborate on what I wrote earlier this week…

I have never felt more emotion than in the past couple of weeks. Part of it is attributable to fluctuating hormones, sure. Some is attributable to having babies, the same as anyone. But a big part has to do with the realization of 7 years of infertility plus months of more-difficult-than-usual pregnancy. I am so filled with love, but there’s also a good measure of disbelief, overwhelming retrospective sorrow, hope, worry, wonder… And there you go. I am expressing emotion here on this blog. Emotions which most likely will never be expressed anywhere else, certainly not in writing.

I just don’t see myself writing gushy love letters to my babies under real name for my friends and — gah — family to see. But I am feeling that gushy love, so where do I put it? Here, where I never set out to mommyblog? Some sort of BabySmiling annex? Privately, for only my babies to see someday? I didn’t have an answer on Tuesday during BBBB, and I don’t have one today.

On your blog, how much emotion do you express? Is that more or less emotion than you tend to express in real life?

Note: Here is the birth story people have been requesting. It also involves a major infertility turning point. And, it is very long — you may want to grab a snack and get comfortable.

So it looks like the magnesium did its job.

Recap: A week ago Tuesday, rehospitalized at 33w0d due to further cervical dilation (5cm). Given another course of steroid shots for the babies’ lungs, and put on mag to hold off labor until the steroids could take effect. Tuesday night, had lots of very strong contractions (up to 7/10 pain level, which is almost unheard of for me) 4 minutes apart, but cervix didn’t change further.

Wednesday, contractions slowed then stopped. No notable contractions or cervical change through Friday morning when mag was discontinued.

Friday morning, mag is stopped. Friday morning and afternoon, no contractions. Lower back, which has been hurting steadily for quite a while, starts hurting more.

Friday early evening, contractions resume. Not wanting to be deprived of food and drink for no reason, as I had been on Tuesday night for half a day, I decide to eat my dinner first then report contractions. The model patient rebels a bit. Hungry + thirsty + contractions = crankier than I intend to be.

I ate dinner, then reported the contractions. Monitor showed contractions 4 minutes apart. They weren’t as painful as those on Tuesday (more like 5/10 pain), but I definitely felt them. Cervix still at 5cm.

Throughout the past month+, DH had slept in my hospital room only the first night of each hospitalization, then visited during the day every 2 or 3 days. Most recently, he’d slept over on Tuesday night, left on Wednesday, then hadn’t returned until Friday night. He thought that the discontinuation of mag was as good a time to stay over as any, because I was at higher risk of delivering. This would be the first time he’d voluntarily slept in the hospital with me. He worked late on Friday and arrived well after dinner and the start of contractions. Because my cervix was unchanged, “contractions! come here right now” became “finish your work, see you later.”

He arrived, we hung out for a few hours, and we decided to go to bed around midnight. We wanted to watch a bit of TV before going to sleep. Halfway through the show, I had to pee.

I peed.

Then something else started coming out. Something pink. Something that was not urine.

The nurse and resident quickly concluded that it was amniotic fluid. Baby A’s water had broken. Fluid continued to trickle then flow then pause then trickle then flow over several hours — such a bizarre feeling. How much fluid could there possibly be in one amniotic sac?

Previously, the perinatologist had told me that further cervical dilation would buy me a quick c-section, but that breaking my water at 5cm dilation would buy me an even quicker c-section. Once my water had broken, urgent could become emergency very quickly. (Remember this part.)

DH packed up my room and we were whisked away to Labor and Delivery.

They said that the resident and attending were occupied with another birth, but that we’d deliver soon.

We waited.

My contractions got stronger and closer together.

We waited.

Stronger and closer together.

We waited. What the hell?

A second vaginal birth jumped the queue. Hmm, remember how my water breaking was supposed to constitute a near-emergency?

We waited. Both very sleepy, but it was no time to sleep.

Finally, with my contractions 2 minutes apart and extremely painful (no pain meds on board, some combination of my being a trooper and it being “any minute now”), the nurse announced that both births were finished. I didn’t get to the pushing part, but no one can ever say that my c-section didn’t involve full-blown labor. When contractions are 2 minutes apart, that means that it’s 2 minutes between the peak of each contraction. The respite between the end of one contraction and the start of the next was less than a minute. The limits of my iron pain tolerance were being tested and pushed to the limit.

Finally, it was time. I headed to the OR first for anesthesia while DH was asked to wait. The anesthesiology resident attempted to place the spinal in the midst of my almost constant contractions. Just sitting up in the right position was reeeeally difficult. I got seriously pissed when I heard the anesthesiology attending tell the resident, “You blew the space.” I remembered reading that nowadays, the dreaded spinal headaches are rare and usually only happen if they keep blowing the space and have to do multiple sticks. Luckily, the second try worked. If he had blown it a second time, I was prepared to tell the resident he was incompetent and should step aside. I was also prepared to tell him that I liked the other two anesthesia residents I’d met before much better, and that he was ugly.

With the spinal in place, they started to prep me, and I lost track of the dozen people in the room. I’d never met the OB attending before, but I knew the OB/MFM resident well.

Eventually DH joined us in his gown, shower cap, and mask. He is not the type to peek behind the curtain, but he could still see plenty.

More than 3 hours after my water broke, the babies emerged quite quickly. A, the boy, Burrito, came first. He had the most fabulous loud cry. They showed him to us, and he looked big and perfect. A real baby. A real baby! The neonatologists went to work on him, but not much was needed. From the first moment he was breathing room air and was just perfect.

B, the girl, Tamale, came two minutes later. Her cry was weaker. They bagged her, but she seemed to be doing okay. Also a real baby. We had two babies! All of my Dead Baby Thoughts had been unfounded, and all of the fears of severe prematurity at 26w and 28w had not come to fruition. They were alive, and apparently healthy, and so beautiful.

From my vantage point, I could see Burrito’s station very well, but couldn’t see Tamale. DH was able to see Tamale quite well, as well as some of what the doctors were doing to me. As the doctors started to work on putting me back together, I was so grateful to be distracted with views of Burrito and DH’s reports about Tamale. When I met with the neonatologist at 29w, he’d said that they might immediately whisk the babies away. The fact that the babies were still in the room seemed like a very good sign. It exquisitely seemed like forever, but was about 10 minutes, that I just watched the hustle and bustle and caught glimpses of my baby. DH, despite declaring years ahead of time that he wouldn’t feel comfortable, cut both of their cords. I was proud of him.

According to the time stamp on the photos, 13 minutes after Burrito’s birth, they brought him over to me to look at and touch for a few moments — longer than I was expecting. Was this really my baby? I knew they hadn’t smuggled any babies into the OR, and there were witnesses who saw these babies come out of me, so they must be mine. After I touched and kissed Burrito, DH held him for a minute. They said that Tamale wasn’t ready to be held, but that we could see her soon in the NICU.

Meanwhile DH could see the activity level around my abdomen growing.

Here comes the part relevant to infertility.

The babies were still in the room and I was still wonderfully distracted when the OB attending interrupted. In a very calm but clear voice (thereby telling me that the situation was serious but that he was trying not to freak me out), he said:

BabySmiling, we need to talk about what’s going on. We’re trying to finish up, but it’s not going as planned. B’s placenta was what’s called accreta. Her placenta is attached very deeply to your uterus, and it is so deep that it even goes beyond the uterus. This is very rare, but it is more common with multiples. We have been trying to remove the placenta and control the bleeding, but it’s not working. We may need to do a hysterectomy. This would mean that you couldn’t have any more children. We will try everything we can, but right now it’s looking like we will need to remove your uterus. You will still have your ovaries, so you won’t go into menopause, but you won’t be able to have more children. You have also lost a lot of blood, so we will need to transfuse you.

Here is the golden moment when 7 years of infertility came to a head.

DH and I looked at each other. In one split second it felt like three things occurred as we made eye contact: taking in what the doctor said, asking the other’s opinion, and simultaneous agreement. It felt like we both shrugged with our eyes. Here is what went through my head.

  • Oh. Wow.
  • Hey, it’s like Abby on ER. She lost her uterus during childbirth too.
  • I guess this settles the conversation about having more babies.
  • It’s fine, I can live with that. At least we don’t have to use contraception, and I never have to wonder or take a pregnancy test or cry over a BFN.
  • This will make a really good blog post.
  • Huh, I bet most people would be really upset right now. Abby on ER was really upset, even though she didn’t want that baby in the first place. I’m fine with it.
  • DH looks fine with it.
  • Those pesky placentas! First A’s was previa, and now B’s is accreta.
  • Technically I could have more children via surrogacy, but I know what the doctor means.
  • No surrogacy, these two are enough.
  • Thank G-d the babies are okay. They both seem to be doing so well!
  • Little does he know, even if I have a uterus I probably can’t have more children.
  • I’m so glad the babies are still in the room for me to have something to watch while this goes on.
  • The doctor probably wants an answer.

The way it looked to everyone else: Doctor finishes speaking, DH and I look at each other, and we both say something to the effect of, “Whatever you need to do.”

The doctor said, “Thank you.” In my mind, the unspoken full sentence was, “Thank you for not freaking out like most people do, thank you for not making my job harder while I’m trying to do this, and thank you for not requiring me to convince you that this is the only way to save your life.”

My little distractions weren’t in the room long, and they soon went upstairs to the NICU.

The doctors kept working, and the anesthesiologists started getting really busy.

DH made a joke/offer about the transfusion being convenient because he is a universal donor, and rolled up his sleeve.

I asked him to tell me everything he remembered about the babies to keep me busy, and to show me the photos he’d taken.

DH, normally rather squeamish, was quite fascinated as the surgeons worked and told them as much. “This is so cool!” “From a medical standpoint, this is so interesting.” Usually I would be the one filled with intellectual curiosity for my own surgery. We weren’t entirely ourselves that day, in lots of ways.

DH didn’t tell me at the time because he didn’t want to alarm me, but there was a lot of blood. He later said that it seemed like an awful lot of blood, between the huge tub of suctioned blood and the giant puddle of blood on the floor that everyone kept having to step around. No one ever mentioned the word hemorrhage.

Later, DH asked how much blood I’d lost, because he thought he’d heard an amount mentioned but it couldn’t possibly be that much. They confirmed that he’d heard correctly. I had lost more than 6 units. My loss was 2/3 of the normal human blood volume, though because blood volume increases during pregnancy and even moreso during twin pregnancy my percentage was lower, closer to half of my total blood. That is still really a lot.

With a spinal, you don’t feel pain but you do feel “pressure.” The pressure got stronger. The way they were throwing my body parts around felt a lot like Thai massage.

Eventually the doctor said, “The bleeding is slowing down. We tried [a drug whose name I don’t remember] and it worked. We aren’t going to transfuse you right now, and it looks like we won’t need to do a hysterectomy.”

DH asked, “Is that drug commonly used for placenta accreta, or did you just try that drug on a whim?”

Everyone laughed.

As the doctors continued to work, they started talking to us more. Several times, DH or I made them laugh quite a bit. I don’t think either of us was trying to be funny.

The OB attending said that it was lucky that B had been breech and required a c-section. If I’d had a vaginal delivery, the bleeding would have been harder to control, they might not have had time to open me up, and I might have died.

After a while, they were done. With all the genuineness I could convey, as they were wheeling me to recovery, I told the doctor, “Thank you so much.” Thank you for saving an organ that I probably have no use for but would have missed, thank you for doing such an incredible job, thank you for saving my life.

As they wheeled me out of the OR, I started feeling pins and needles in my legs. This meant that the spinal was wearing off and they had finished surgery just in time. If it had taken longer or if they had needed to do the hysterectomy, they would have switched to general anesthesia.

Recovery did not go so well. It was supposed to be “an hour or two” but ended up being more than 3 hours — among other things, we had to wait for a shift change in the NICU then in the mother-baby unit. In my altered state, I had it in my mind that I shouldn’t go to sleep because I needed to be alert when they wheeled me to the NICU to glance at the babies. I really should have gone to sleep. I dozed off here and there, but mostly I lay there being agitated.

The nurse appeared periodically to tell me it wouldn’t be long (sound familiar?) then would disappear for far too long. During that time, they had a post-op conference to discuss my case. A Morbidity and Mortality meeting, without the morbidity or mortality. A “here is what went right with this crazy case” meeting.

I was also terribly thirsty even though I was hooked to an IV for hydration.

And I was itchy, so itchy, from the anesthesia.

Unprecedented sleepiness + agitation + impatience to see my babies + thirst + watching DH eat and drink + itchiness + not knowing how much longer + severe nausea + almost dying = a bad combination.

I remember so much about the birth, but the NICU trip is pretty hazy. I thought I’d just get wheeled by each isolette momentarily, the way that a tour bus pauses to look at a monument, but we stayed in each room longer than I’d expected. They told us that the babies were doing wonderfully. Tamale had disagreed with their recommendation for breathing assistance and had pulled out her tubes, so she was breathing room air like her brother by the time we saw them.

The next days were a weird combination of highs and lows. I’ve already talked about the contrast at Show and Tell earlier this week.

To preempt an inevitable question: They didn’t transfuse me because the preference in that hospital on that service is to avoid transfusion below a certain very high limit. I was actually kind of glad that they didn’t, because even screened blood carries a certain amount of risk, but dealing with that level of blood loss has made the recovery much more difficult.

My next post will have pictures of both babies, as well as some processing of the events I’ve just told you about. This post is long enough.

Birth details (in metric or disguised to reduce Google-ability):
Born one week ago exactly (on Sat.) around 3:30 a.m. at 33w4d
Burrito weighed 2.15 kg, Tamale weighed 2.25 kg
Burrito was 47 cm long, Tamale was 44 cm
APGARs 8 and 9 for both
Off the charts in terms of being loved

Thoughtful ThursdayHappy October. No, really, I mean it.

Happy October! OctobeBabies!!!!

Here are the Intelligentsia (people who have commented on every Thoughtful Thursday post for the month of September). September was a busy month for Thoughtful Thursday, and it was an extra-busy month for several members. There are quite a few mothers of multiples this time around, including some who gave birth in the past month. Given my own current status, it seems appropriate to point those out (but kudos to all, including parents of singletons achieved through any means as well as those without children). This says to me that people with all sorts of similar experiences gather together, and it also says that you can’t keep some people away from blogs no matter what.

Wiseguy from Woman Anyone? continues her remarkable streak with 9 Intelligentsia appearances.

Ernessa from Fierce and Nerdy and Kristen from Dragondreamer’s Lair are both back for the 7th time; in the middle of Ernessa’s June Intelligentsia participation she gave birth to her daughter.

Jill from All Aboard the Pity Boat and Photogrl from Not the Path I Chose return for the 5th time.

Making her fourth appearance is Cat, non-blogger but mother of triplets.

Jules from Just Multiply by 2 is a twin mom, and Lost In Translation from We Say IVF, They Say FIV is a singleton mom who first achieved Intelligentsia status at 41 weeks pregnant.

Heather from Joys In My Life took time out from her twins and singleton for Intelligentsia appearance #2.

There are lots of new members. Long-time commenter, first-time Intelligentsia member Lori, a.k.a. Lavender Luz, from Weebles Wobblog; twin mothers Elana from Elana’s Musings and Stacie from Heeeeere Storkey Storkey; Jamie from Sticky Feet and Michele from My Life After Loss, who both gave birth to twins this month while also achieving Intelligentsia Status, and Carrie from Tubeless in Seattle, expecting to deliver triplets sometime in October (the later the better!).

Thoughtful ThursdayNow for this week’s Thoughtful Thursday topic. Skrambled recently had an interesting post about the reasons she writes her blog.

In my comment on her post, I wrote:

In addition to those, I’d say that I blog to connect to others with the benefit of a cohesive story and set of people. In earlier IF days I often read and considered message boards, but usually unless people are following a board closely, each post ultimately stands alone (plus the little signature at the bottom with all of the details of your cycles etc.).

One thing that really appealed to me about blogging is that you don’t have to retell your story over and over, that instead people follow along with you over an extended period (and I them). When I have read someone’s blog for a long time and feel like I know them as a person, their highs and lows are much more meaningful to me.

Sometimes this involves feedback/comments and sometimes none at all. Of course I love my regular commenters and I enjoy it when my lurkers show themselves, but I’m also happy to have lurkers who continue to lurk. Whether or not they’d get more out of the experience if they started participating in the conversation (which varies by person and is not for me to judge), if they’re getting something out of one-sided reading, mission accomplished.

This leads us now to another blogging-about-blogging topic, but one that we haven’t addressed on Thoughtful Thursday before: Lurkers.

As a blogger, how do you feel about lurkers? As a reader, when and why do you lurk? When and why do you delurk?

One feature that causes ALI blogs to accrue lurkers more than other types of blogs is the secrecy that often accompanies these topics. Many of us create pseudonyms with associated email addresses for our ALI life, but even so, people can find it difficult to comment on a blog and therefore out themselves (even if anonymously) as adopting, dealing with loss, or infertile — or some combination of those.

On the other hand, ALI blogging seems to engender more commenting than any other corner of the blogosphere that I’ve seen. Much of this is due to Mel’s efforts to encourage commenting through ICLW, LFCA, and the general atmosphere. Other types of blogs, even very widely read blogs, often receive few or no comments (except perhaps during National Delurking Week), but in the ALI blogosphere, the ratio of readers to commenters seems vastly higher than usual.

Which, therefore, means that the people who don’t comment can stand out in a way they wouldn’t for blogs on other topics.

To answer my own questions, as I said above, I am personally in favor of lurkers if that’s what they need to do. I also enjoy seeing them delurk when they think it’s time. Part of why I chose this topic now, aside from the related post on Skrambled, is that I have already experienced some delurking here recently, and expect to see more soon — perhaps when I have a birth announcement to make.

As a reader of others’ blogs, I am the opposite of a lurker. On many blogs I comment on just about every post, and on quite a few others others I comment on a fair number of posts. There are some blogs I follow where I comment less often, typically because the person is in a different place and I want to be sensitive to the fact that they may not want sympathy on a failed cycle from a pregnant woman (though if I’ve been commenting on the blog for a while, I often comment anyway). My commenting has gone down lately due to logistic constraints of horizontal typing during bedrest, but I don’t think there are any blogs that I read regularly (and there are a lot of them) where I’d consider myself a lurker. I do follow some as a Clicker for which I comment rarely but post news often, but that seems to be a different situation from regular blog reading.

And so, I can’t really answer the delurking question because I don’t lurk in the first place. I guess I used to lurk before I had a blog, but once I started my own, I tried to fully join the community, and I’ve never looked back.

As a blogger, how do you feel about lurkers? As a reader, when and why do you lurk? When and why do you delurk?

Pssst… hey, lurkers: now would be a perfectly fine time to delurk. Are you really going to lurk on a post about lurking? C’mon! Say hi!