Or, if you prefer They Might Be Giants to Alice in Wonderland, “It’s not my birthday, it’s not today!”

Last night was quite a night. I finally understand the contractions that people always talk about; all of my others have been silent or at least painless. This time they were 3-4 minutes apart for hours, and painful. If I consider them painful, that’s saying a lot — the doc estimates that my 5 out of 10 pain rating might be someone else’s 10 out of 10. My bizarrely high pain tolerance is sometimes unhelpful (as when I didn’t feel any contractions at all at 28w), sometimes handy. “Do you want pain medication for the contractions? We can give you the medication we give to women in labor.” Naah, 6 out of 10 pain I can take. The pill pushers (and IV pushers) don’t know what to do with me.

Somehow, despite many hours of full-blown contractions last night, my cervix stayed at 5 cm. And eventually the mag kicked in, and the contractions have stopped.

My reaction to the drugs is also blowing minds around here. With my first mag experience at 28w, I had plenty of side effects, but fewer than average. This time, almost nothing. It’s having the desired effect, but so far not the usual side effects. Vastly preferable to my reaction to fertility medications, where the desired effect was on the low side (except for Infamous IUI #7 in which I had enough follicles to set new world records for higher-order multiples) but I had plenty of bitchy side effects. All of the good and none of the bad on mag? Am I being punked?

The head perinatologist doesn’t think I’ll give birth today, or even tomorrow. I’ll stay on the mag for two more days, long enough for this round of steroids (first was at 28w when I was originally admitted) to take full effect, and then we’ll see what happens. If my cervix resumes dilating during or after the mag, we’ll just deliver.

Know what that means?

October! T minus 4 hours and counting.

In my mind, the plan to stay on mag for a couple of days is the doctors’ secret plot to get me to October. Of course I know it’s not, and DH thinks I’m obsessed with October, but a girl’s gotta have goals.

No matter how long it takes (very likely this week, but maybe at 34w, probably not beyond), I’m definitely having the babies here in this big hospital (>1 hour from home) instead of at the little hospital 15 minutes from the house. Now that I’m this far dilated, they won’t release me, and my regular OB won’t take me back! I feel more confident about the care for myself and especially the babies here, with a proper NICU and high-risk OBs/MFMs on the premises 24/7 for whom my case is no big deal rather than frightening.

As my bloggy friend Carrie (30.5w along with triplets) has been saying since August, “October or Bust!” At the risk of jinxing us, it looks like we made it!

Now I have to come up with a new goal. How about “as long as possible”? Or “any day that’s not today”?

33w: Milestones

September 29, 2009

When I was admitted to the hospital five weeks ago, I had a series of milestones in my mind that I wanted to achieve before giving birth.

Not August? Check.

DH’s birthday? Check.

Autumn? Check.

The Jewish New Year of 5770? Check.

Past the Days of Awe and Yom Kippur? Check. (Bedrest and hospitalization did not allow for Tashlich, so last year’s will have to do).

October? Hmm…

I’m back in the hospital at 33w. 5 cm dilated, having more contractions. Can these babies wait another 26 hours until October? I’ll let you know either way.

I’m not afraid for their health anymore. But I’m a little freaked out that after all these years, I’m finally going to meet my babies.

Put To The Test

September 29, 2009

[Pregnancy update for those who have been concerned due to my silence over the past few days: 33 weeks today. Still at home for now. As of yesterday, cervix dilating a bit more and Baby A’s head apparently can be felt through the cervix, so I have no idea whether birth is imminent, whether I’ll be back in the hospital tomorrow, or whether I’ll be able to come home after I see the perinatologist. I will post something in the evening so that I don’t leave anyone anxious with suspense.]

A year ago I wrote about an old friend of mine, one who is likely to struggle with infertility due to her medical history. I also wrote about how we’re no longer close enough for me to bring up such topics.

Today, after almost a year since our last contact, she emailed me, asking if anything was new.

Obviously, being 33 weeks pregnant with twins qualifies as news.

Here is my chance to practice what infertiles preach: the art of the gentle pregnancy announcement.

  1. Do I just tell her about the impending babies, and that’s that?
  2. Do I tell her about the babies with a subtle hint about the length of time we’ve been waiting, leaving the door open for her if she wants to talk about IF?
  3. Do I flat-out tell her how these babies came to be, and extend the hand of infertile friendship?

1 or 2 would be my natural inclination, but I wonder if the situation calls for 3.

What would you do if you were me? That is, what would you do if you were generally secretive and taciturn, but also trying to be caring and helpful to someone who was your close friend more than a decade ago but is now a very casual acquaintance?

Thoughtful ThursdayOver a year ago, Mel wrote a BlogHer post on the topic of purchasing baby items during post-infertility pregnancy. Many fertiles seem to run out and create a registry before the pee stick is dry. A lot of infertiles, on the other hand, are too fearful of something going wrong to make purchases, especially if they’ve experienced prior losses. In the comment section of Mel’s BlogHer post, Lori had a turn of phrase that I particularly liked: “Don’t buy until you see the whites of their eyes.” She didn’t buy anything at all until after the birth of her daughter.

Here is the progression of my thinking about buying baby items during pregnancy.

  • Too early
  • Too early
  • Too early
  • Hmm better start thinking about it; I’ll make a registry but I won’t show it to anyone
  • I’ll get a few things but it’s still too early to make major purchases
  • Let’s see what other people give us
  • Eek! I almost went into labor and we have none of the essentials!
  • I can’t very well buy things when I’m afraid of losing one or both babies
  • We’ve passed the danger zone, I guess we’d better get moving and stock up
  • What am I waiting for?

…which brings me to now. I actually might have put off major purchases even longer, but during the drive home from the hospital on Tuesday, DH declared, “The registry. We need to get going, now.”

I had basically nothing whatsoever for the babies (if you don’t count a couple of things I bought in Spain right after the first BFP like a mobile and a rattle) until the 4th month of pregnancy. I visited a Mothers of Multiples sale (just to scope it out) and bought a few clothes and a few toys at low low prices, but nothing big.

During the 5th month of pregnancy, I visited a close friend who is parenting twins after infertility. She gave me all sorts of hand-me-downs, mostly clothes. Suddenly I had full wardrobes for the babies’ first 6 months and partial wardrobes for the next 6 months.

Then I visited my mother-in-law, who heaped all sorts of garage sale purchases upon us. We rejected about half of what she bought, and we still filled up our entire car trunk and back seat.

Then came a CraigsList phase. I checked the listings many times a day. Via 4 transactions, I filled out the rest of the babies’ wardrobes for their first year, plus a few bigger purchases like swings and slings.

Suddenly the babies’ room, my home office (which essentially serves as a big filing cabinet), and the linen closet were filled with brightly colored plastic and cozy cotton. But still, I didn’t have essential items like cribs or car seats.

It was a little embarrassing when, on the day of my big preterm labor scare, both hospitals asked if I was “prepared” for the babies and I had to say no. Not that embarrassment was my biggest concern that day.

My fear-based procrastination was vindicated somewhat when I met with a neonatologist. He commended us for not having car seats yet, because we don’t know how much the babies will weigh and many seats are too big for preemies to leave the hospital. He told us not to buy car seats until the babies are born. We will probably buy them once the babies’ weights pass the minimum size for those car seats, hopefully in a couple of weeks.

Now, at DH’s insistence, the wheels are in motion. Apparently these babies really are coming, and with (most likely) less than a month to go, I’d better get ready. Family members have started picking items off the registry, and soon the babies’ room will be bursting with paraphernalia. Any procrastination on my part at this point is based on bedrest fatigue, not fear.

Does infertility/loss affect your attitude toward preparing for a baby’s arrival?

Murphy

September 21, 2009

I knew it. I just knew it.

Less than a week after predicting that the eldest of DH’s younger siblings would probably have a baby in 2010, and that I’d win the baby race by only the tiniest margin, I found out she is pregnant after all. I found out one day after she POAS. She got pregnant the first cycle after going off the Pill. The Pill that she’s been on since I first met her, over 15 years ago. And I am the only person she has told about the pregnancy. Now I must counsel her daily on pregnancy symptoms and crib safety and how long her wedding dress will still fit and when she should announce to the family and which hand-me-downs I will be giving her. Did I mention that she is 4 weeks pregnant?

After DH read my Dibs post, he said, “Not 2010! Maybe 2011.” And I corrected him, “No, 2010.”

DH: She’s not even getting married until the summer.
Me: But she’s already pulled the goalie. She’s just gone off the pill.
DH: How do you know?
Me: Don’t ask me why, but she confided in me.
DH: That’s really weird. You’re not close at all.
Me; Yup.
DH: What is her hurry?
Me: It probably has something to do with me being pregnant. Who knows.
DH: But you have no way of knowing that she’ll get pregnant right away. Maybe it will take 7 years like it did for us, and she’ll have a baby in 2017.
Me: No, it will be the first cycle that she tries.
DH: Why?
Me: Murphy’s Law.

At least I saw you coming this time, Murphy, you bastard.

Thoughtful Thursday: Patient

September 17, 2009

Thoughtful ThursdayInfertility has tried my patience, and it has made me more patient, but that’s not the kind of patient I mean.

What kind of patient are you? How has infertility changed that?

In all realms of life, I straddle a line between following directions and thinking for myself. My rejection of directions is usually based on some combination of logic, my own research, my assessment of the validity of the directions, and doing what I feel like.

This certainly applies to health care. For example, after I had my wisdom teeth removed, I followed all of the instructions for cleaning the extraction sites, but I completely ignored the prescription for narcotics. After the day of surgery, I didn’t even take any Advil.

During infertility treatments, I almost always followed directions to the letter, except when I thought they didn’t matter. For instance, when I was told not to eat after midnight prior to IVF #2 retrieval, I bumped back the time on my own because my retrieval was scheduled for late morning. I know the purpose of being NPO, and I also know that the midnight instruction is the same whether the surgery is at 6 a.m. or 11 a.m. If six hours of fasting is enough for an early morning appointment, then it should be enough for a late morning appointment, in which case eating something at 4 a.m. is fine.

My most egregious case of ignoring doctor’s orders occurred during the infamous IUI #7, in which we didn’t bother to have sex in addition to the IUI because in my mind the whole cycle was pointless anyway. Result: currently 31w2d pregnant with twins.

As a pregnant woman, I have been amazingly dutiful. I have followed doctors’ and books’ recommendations as much as possible (as a vegetarian, 100 grams of protein requires a lot of work but is feasible, but 150 or 200 grams just doesn’t happen no matter how hard I try). When advice has conflicted, I’ve evaluated the relative merits and acted on what seemed to be the most prudent course of action.

And then my cervix started shortening and I was put on bedrest. I followed bedrest instructions to the letter (didn’t go anywhere outside the house except the doctor, didn’t sit up for more than 15 minutes at a time for meals, etc.).

And then I went into preterm labor and I was admitted to the hospital.

This whole time, doctors have remarked on what a “good bedrester” I was and continue to be. They tell me how some other patients interpret bedrest as cutting down on housework or being quicker about grocery shopping. When DH said to the head perinatologist that a high-activity day on bedrest for me meant that I went up the stairs once to go to the kitchen, she laughed.

They’ve been pleased, and a little bewildered, at my openness to staying in the hospital as long as they deem medically necessary. They talk about patients fighting to be discharged — particularly those with other children at home, or those whose husbands are incompetent/unwilling with housework. When I told DH about the latter, he got a little defensive and said, “You told them I’m not like that, right? That I’m not one of those husbands?” I certainly couldn’t manage total inactivity without his constant help.

Doctors and nurses have remarked on my cheerfulness, and one doctor makes fun of me for being so cheerful. They applaud my wisdom when I give them my stock explanation for my compliance and good attitude: Better here than in the NICU.

How did I get to the point of winning some sort of Best Patient award? Sure, I try to maintain perspective in everything I do. But in this case, I’m a model preterm labor patient because I dealt with seven years of infertility, and because I read infertility and loss blogs. It took a hell of a lot of time, money, and work to get this far. The stakes are clearly higher for me than they are for the patients down the hall that the nurses roll their eyes about, the ones who are still smoking (WTF?). Because of the heartache of my bloggy friends, I know that not all babies turn out fine, and I know that some babies die. Often there’s nothing that the woman or anyone else could have done — but if there’s anything I can do to help these babies make it into the world safely? You’d better believe I’ll do it.

What kind of patient are you? How has infertility changed that?


Perfect Moment

(Note: Pregnancy mentioned, though the post is ultimately about infertility.)

A year ago, I wrote about the clean sweep I had to make of my house in advance of a visit from DH’s family.

I hid it all. Books on fertility and pregnancy. The few baby items I’d purchased or made over the years. Prenatal vitamins. Basal body thermometer. Stupid piece-of-crap ovulation predictor watch. Syringes. Sharps boxes. RE paperwork. Fertility medications, unrefrigerated and refrigerated. (The latter required a bit of creativity, as I described last year.)

The family is back. Just before they drove up, I made another sweep of the house (a rather cursory sweep, since I’m on bedrest and not supposed to be roaming around the house).

  • Books on pregnancy displayed prominently on bookshelf. Fertility and infertility books scattered among them — I will not hide them anymore.
  • Baby items are everywhere. We did have to move some of the bulkier items to different rooms so that the people sleeping in the babies’ room can actually get through the door, but that was tidying rather than hiding.
  • Prenatal vitamins out in the open.
  • BBT and ovulation predictor still hidden wherever I left them — they were useless to me, so who knows where they are.
  • RE paperwork left in the same pile in the office, under the mounds of OB and MFM paperwork.
  • Syringes, sharps boxes, and meds cleared out of the bathroom cabinet. They filled a grocery bag to overflowing, mostly with unused needles. Hundreds and hundreds of needles. Infertility aside, it would be a little weird to go into anyone’s bathroom and find a giant sharps box and hundreds of unused needles. More an act of courtesy than subterfuge.
  • Refrigerated meds haven’t been in the refrigerator for months (only a few leftover progesterone suppositories remain). I had stuffed them in a drawer somewhere during a prior clean sweep when I was pregnant but not yet telling people. This time, I am leaving them wherever they happen to be. Anyone who goes digging around the deep recesses of drawers deserves to find vaginal suppositories. Too bad they don’t have VAGINAL written in big letters on the package.

The perfect moments?

  1. I don’t have to hide my pregnancy, nor the intention to become pregnant, because I am finally pregnant. My giant belly and I are on bedrest; I couldn’t hide it even if I wanted to.
  2. If someone wants to snoop around and learns about our infertility history, fine. I am okay with that. I’m still not going to advertise it, but after 7 years of secrecy, if someone wants to ask the question, I will tell them the answer.

See what other perfect moments people have to offer on Perfect Moment Monday, hosted by Lori from Weebles Wobblog.

Thoughtful ThursdayFollowing up on this week’s Barren Bitches Book Brigade discussion of Moose, as well as an article I read a few weeks ago

How has infertility improved your life?

A year ago, I made a list of gifts that infertility has given me.

  • Interactions with amazing people, both those dealing with their own infertility and those who have sought to help me with mine.
  • No more anxiety when getting injections, even from myself. A doctor once told me that he has never in his career seen a patient so calm when he stuck a needle in their eyelid.
  • Greater understanding of my body.
  • Awareness of an underlying sub-clinical thyroid condition which is not problematic now but may become an issue in the future.
  • Much more empathy than I had before for everyone who experiences infertility, pregnancy loss, loss of a child, etc.
  • The end to my delusion that I have control over what happens in my life. The Yiddish proverb, “We plan; G-d laughs” makes so much more sense now.

To that list, I would now add:

  • Perspective. When people say how horrible bedrest must be, I know they are wrong — because I know what the alternatives are. Bedrest is downright fun compared to being in the middle of IVF #3 (or more likely, #4 by now). As for the other direction, I have taken the mantra, “Every day on bedrest is a day not spent in the NICU” (or worse) to heart. I whine more often than my husband would like (“But I neeeeeed cake”) but in the grand scheme, I am the opposite of a whiner. I know how good I have it.
  • These particular babies. I have heard many parents after  infertility say it, but I didn’t quite get it before. If I had conceived easily, sure, I would have a kid (about to enter first or second grade!),  but I wouldn’t have these kids. I haven’t even met them yet, and already I love them so much.
  • Seeing the world. During the period of my infertility I have travelled to 20 new countries, some more than once (and seen more of the three that I’d already visited prior). If I’d had a child, I would never have travelled nearly so much — or maybe at all.
  • Encouraging my children to see the world. Because of the prior point, we now have all sorts of plans to show our children the world that we never would’ve had before. And, since we (as long as these babies come into this world okay, knock on wood) won’t have to spend our money on infertility treatments anymore, we may actually be able to afford to take them somewhere.
  • The chance to know, really know, my relationship with my husband, and to keep improving it. We had been married more than four years before we started trying to conceive, and together several years before that, but even so, we have grown together so much since then. I honestly feel sorry for many people I know who have a child early in their relationship/marriage, especially when that relationship later dissolves and I can see ways in which the child stressed a situation that didn’t have a chance to develop a strong foundation. Although infertility has put plenty of stress on us and on our relationship, we and we are ultimately stronger for it. You certainly can never say that we didn’t have a chance to develop a strong foundation — we have had more chances than anyone could possibly need.

Oh, and to revise my answer to the question I asked a year ago:

Would I trade the past six and a half seven years of infertility heartache for a kindergarten-age child first-grader?

I said yes a year ago, but now, no. I don’t think I would anymore. I guess that qualifies as growth.

How has infertility improved your life? There must be something.

If your situation is loss instead of infertility, you may not be able to come up with an answer. If that’s the case, please say so. If you do have an answer, then you must be a truly Thoughtful person.

Barren Bitches Book Brigade Welcome to the Barren Bitches Book Brigade, featuring Moose by Stephanie Klein.

I wasn’t a fat kid; I was a not-skinny kid. The start of puberty was not kind to me (was it kind to anyone?), and my 8th grade yearbook picture crosses the line into chunky territory, but generally others perceived me as “normal.” However, I was often the heaviest girl around, especially because I was involved in all sorts of activities that encourage extreme thinness, like dance, gymnastics, and figure skating. Once, a skating coach said to me, “I think it’s good that you’re healthy, not so skinny like all these other girls.” And that was in the late 80s, when standards for thin were much less emaciated than today.

Still, most girls were skinny, and I was not skinny. So in my mind, I’ve always been a fat girl. I couldn’t trade clothes with other girls. I was self-conscious about wearing shorts. I consumed SlimFast — not as meal replacement shakes, but as raw powder out of the can (just like I ate Nestle Quik, Ovaltine, hot chocolate mix…).

The very first time I ever thought that I might not be a fat girl after all, I was in my mid-20s. My best friend from grad school (who, I must note, is a size 0) was talking about a woman who was a couple years ahead of me in our program. That woman is pear-shaped to the extreme: top half average, bottom half obese. My friend was explaining how the woman’s weight had grown over the past few years and said, “When she started grad school, she was normal. Like me or you.”

What?!? My size 0 friend and I (size 12-ish, consisting mostly of breasts, plus some extra tummy) were not comparable. I was closer to our pear-shaped classmate, wasn’t I? Wasn’t I?

Reading Moose has confirmed that I am closer in spirit to my size 0 friend (who maintained the 0 through Weight Watchers, having been a “heavy” size 4 before) than to the pear-shaped classmates and Mooses of the world. Many of the emotions Klein describes resonate with my adolescent self, but the desperation she describes for food is totally foreign to me. Anyone could be normal-sized with my take-it-or-leave-it desire for food, just like no one would have a drinking problem if they were as nonchalant about alcohol’s effects as I am. But, faced with what she describes as a true addiction to food, overeating and obesity seem almost like destiny.

Aside from the weight issues, I most enjoyed Moose for three things:

  1. The seamless way she integrates the main narrative with older and newer memories.
  2. The description of early adolescent sexuality, solo and partnered. Even if her desire for sex, like her desire for food, was more extreme than my own, it’s the truest depiction of young girls’ unspoken fascination with sex that I’ve ever seen.
  3. The disingenuity of adolescent emotional expressions, particularly when she starts a big fight with Adam then admits that it was all a show. I’ve seen it so many times, mostly in others but occasionally in myself: acting out a script of the way people supposedly act, as depicted in teen movies, sitcoms, books… One of my sisters-in-law, whom I have previously described as a sociopath, has done this throughout her adolescence. She punches DH on the arm because that’s what little sisters do to big brothers. When she’s away, she talks about how much she misses her friends several times a day, because that’s what people with friends are supposed to do. She temporarily breaks up with boys over minor issues because that’s what teenage relationships are right, or so she’s seen on TV. I never know when she’s feeling real emotion and when she’s acting out a scene from an after school special.

In the first chapter, Klein talks about her reluctance to gain weight during her twin pregnancy as a result of her childhood obesity. How have body image issues affected you during infertility? Pregnancy? Post-pregnancy?
During infertility treatments, FSH injections made my tummy, which has always been out of proportion with the rest of my body, bigger. The scale didn’t reflect it, but my pants were tighter and there was clearly more padding in my lower abdomen. Because I started out not-skinny, no one ever said anything and I don’t know if anyone even noticed, but I didn’t appreciate the side effect — especially when no babies were resulting from the treatments.

But, when I would pass myself in a mirror or the reflection on a window, I’d often pause and imagine my midsection much bigger from pregnancy. Finally I would have an excuse to have a big tummy! I was ready to embrace having an enormous belly, if it came with a baby inside.

Since being pregnant with twins, I’ve actually struggled to gain more weight — not a problem I ever fathomed having. Heartily convinced by the twin books that weight gain is key to preventing premature birth, I have been eating the most fattening foods I can, every couple of hours, for months — and I can barely keep up. Between being a vegetarian and having strong food aversions in the first four months to anything that might help me gain weight (particularly sweets and fatty foods), it has required enormous effort to keep up with the babies’ nutritional needs and put on the amount of weight recommended for a healthy twin pregnancy.

I haven’t stopped catching my reflection in mirrors and windows — in fact, I do it constantly now. It’s vain, really. I am so enamored with my growing belly, stretch marks and all, just as I am enamored with all that’s going on inside. Part of my joy comes from the years of infertility and finally achieving what eluded me for so long. But really, part of it is that I’ve never looked better. Later, I’ll go back to having a big blah tummy, but for now I have a big beautiful tummy!

Stephanie describes how she would picture herself slim, and how that image did not look like her at all. Did you/do you picture yourself slim and if so who do you model yourself on? Are you realistic when you imagine the slim you or do you picture someone you could never be like?
The imaginary slim Me isn’t that different from the normal version of Me wearing the right clothes, such as tailored suits. I don’t think I’ve ever, since puberty, been as slim as the imaginary Me (nor as slim as the BMI charts say I should… but BMI is bogus anyway), but ultimately I don’t know if that imaginary Me is something I even want. There was a point in my early 20s when I thought seriously about how I should approach my weight. I could work out more and watch what I ate, or I could do what I wanted and be satisfied with myself. I have chose and have stuck to the latter, in large part as a conscious feminist decision not to accept poor self-esteem as a way of life.

Stephanie Klein writes “Years later I’d feel slightly superior because I’d once been fat. That’s the thing…when asked if I’d change my past if I could, I think for a moment and always answer no. There’s something…that just makes it mildly worth it. Because a sensitivity is tattooed on a part of you no one else can see but can somehow guess is there. It’s always with you.” How do you relate to this with regards to infertility?

I do feel secretly superior for having gone through this long journey, as if I will truly love my children more than those who conceived easily. I can’t judge whether that’s really accurate (and I know that lots of fertile women — but not all — love their children plenty). I do know that infertility has made me more sensitive to all sorts of difficulties that others encounter, in family-building and in other aspects of life. I can’t say whether I’m a better person than anyone else, but I’m a better person than I was before.

Hop along to another stop on this blog tour by visiting the main list at Stirrup Queens. You can also sign up for the next book on this online book club: It Sucked, And Then I Cried by Heather Armstrong (aka Dooce).

I wondered what the next super-higher-order multiple birth might be. Would someone top 8? Ever get to 9? 10? Would anyone ever be “eating for 12” as DH and I joked when my own betas were sky-high? Now I have an answer.

At least the woman pregnant with 12 babies is in Tunisia and the media coverage might not be as crazy as it has been for Octomom (or Octomum as the Brits apparently call her).

Stop giving the rest of us a bad name!