today i listened to instrumental swing music on hold with the RE’s office from the cafeteria at work. something about it just seemed off. i had called to ask about assisted hatching. the woman i spoke with said it “sounded familiar” but wanted to check on something. she returned to explain that apparently the procedure is not something “typically performed” but only in certain instances with some diagnoses after PGD. i was close to just complacently saying “sure okay right” but i stopped myself and asked “what is PGD?” i dwell in acronym soup at work. and infertility is filled with it (as are most things) but i think i should probably understand these things as i fork over tens of thousands of dollars. she hesitated. then said “genetic [stumble] testing [stumble] diagnosis…something like that…genetic testing that is done sometimes – did you have another question?” (it’s preimplantation genetic diagnosis – thank you w.ikipedia) she was very nice and i explained that i didn’t have additional questions – i was just wondering about cost since i was piling up the thousands of dollars on the table to fork over to them shortly. she chuckled and asked if i wanted to have my RE call me back. i declined since i will be there monday to depart with thousands invest in our possibilities. and meet with the nurse for my stack of prescriptions and other protocol instructions.
i feel like i have a million questions and i will forget them all. and that none of them really matter. i am varying between super optimistic and ridiculously cautious. i am trying to binge all pangs of negativity. tonight i wrote out the checks with build-a-baby in the subject line – just want to make sure we are all on board here. then i made pancakes for dinner for me and hook. and drank a vodka tonic.
tonight i asked s if he could pick a name for himself what would it be and he said “captain hook” (and even indicated how his finger makes a perfect hook) so that is how i will refer to him from here on out – hook. he is my heart. my smile. from the second we found out m was pregnant with him my entire world shifted. it was almost like suddenly everything made sense in a way it never had before. that was six years ago. and now i have to admit that i am a bit concerned about the impact the impending influx of hormones will have on him. obviously not that he will be taking them but they will impact me and that in turn effects him. he has been a firsthand witness to how hard IF has been. and its almost like he can sense it on a deeper level. there have been innumerable occasions where hook has asked for a sibling. almost begged for one. and i know he would be a wonderful big brother. i have no doubts. never have. when he was two we decided it would be a good time to try for a second with me as the birth mother. lots of pre-tests. a discovery of a hydrosalphyinx and a failed IUI. i can’t say i took it all that well…but i did start running and that is probably the best thing i have ever done for myself. so i waited quite a while and focused on hook. and m. and our life as it was. but it feels like there is something missing. don’t get me wrong i would not change anything but if we have the chance to add to our family then we definitely want to do that. both m and i grew up with siblings. and we both appreciate the love and bickering and support and shared experience that it affords. all that being said i know that ivf may not work. when we finally picked up again i had a salpingectomy to remove the blocked tube. and then a few IUI’s. with varying levels of injectable hormones. some months ended up yielding nothing more than follicles on the wrong side busting to be free. but my sanity and our bank account suffered. so after several attempts at that we had to stop yet again. hook keeps waiting. this past year when he broke the wish bone at thanksgiving he said he wished for a baby. then he quickly looked at me to make sure i was okay with that. it breaks my heart that i can’t seem to give my boy the one thing we all want. and if it doesn’t work we will all be okay. i know that. but if i had my way. and if i could control the outcome i would hope to make hook the great big brother i already know he will be.
i can’t sleep. well right now isn’t really the issue. it’s only 9pm. and i am watching people with freakish athletic abilities fling themselves into the air while attached to little boards (yay winter olympics!) but the past few nights, sleep is just not working out for me. i head off to bed with good intentions – reasonable intentions. but sleep is just not coming. last night i dreamt i was running in a relay race. as the anchor and my team was unhappy because i was not fast. i woke up with the dog nudging me to go out and the room feeling like a sauna. it was 2:30 am. i let the dog out and considered running on the treadmill. then dismissed that as ridiculous. instead i laid in bed for hours. and hours. and thought about assisted hatching. and bills. and the need to sign my boy up for swim lessons. and why the dog was scratching incessantly. and blastocysts. and wondering who was texting m at 3:30am. and if my morning meeting was going to run on time. and what the heck was going on with megan. and did i do the laundry. and did i really mean i was okay with no FET. and on. and on. and on. clearly i should have just run. at least when i do that things start to make sense and none of this was making any sense. especially after a few days of this.i finally fell back asleep for an hour or so punctuated by loud blasts of the alarm. needless to say this was not the best night of sleep ever.
maybe i need to just get back into training for another marathon even if i am not training for it. can i train for ivf? i was focused two weeks ago. and i had a plan. here of course i have a plan too but the stakes are a bit higher since its one and out. not in a “bucket list” kind of way but in a “this is all we can afford since we have a kid and a house and bills and such and no insurance for if” kind of way. things are just different. as much as i want to i can’t turn fertility treatments into marathon training. i don’t have to be doing anything everyday. i am stuck in a holding pattern. right now i just wait. the next thing is our appointment with the nurse in 12 days. and i will start bcp with the start of my cycle…seemingly counter-intuitive but i am willing to sacrifice all logic to science for the sake of a pregnancy. i just need to make it all make sense somehow. i know this is asking too much but i can always hope can’t i?
i tend to be a bit guarded about a lot of things. fertility or perhaps more accurately, infertility has been one of them. i am not sure if that is because i didn’t think some of my friends would get it or because i did not really want to explain it to them. or perhaps it is a little bit of both. i have to admit when all of this started over three years ago i just expected it to happen. i had a faith in science and technology that perhaps was unfounded. but it had brought me my boy. m had not experienced any stumbling blocks. it was like shooting fish in a bucket for her. or so it seemed at the time anyway. so maybe explanations to me make things real. they bring things out into a light where i don’t really want to see them. the light where they are entirely visible to everyone. there has always also been the part of me that doesn’t want to deal with disappointment. if everyone knows you are expecting something and it doesn’t happen it’s almost like there are too many people invested in something that doesn’t necessarily belong to them. if you don’t explain or don’t let them in then it is yours. you own it and you can open up your disappointments when you feel like it or keep them to yourself if you don’t. and that is how things have always been for me.
last year i kept a tight circle around myself. there were very few people privy to what was going on with our attempts to get pregnant. part of it i think was the less people who knew the less who would have to be kept informed. but also it’s a private journey in so many ways (of course i say this now as i am typing a blog. ha!). i was vague in my details for those who did know something was amiss. timing was never really defined. the few friends who were in the loop for the most part were smattered around the country so i didn’t have to see their sympathy when i felt like a failure yet again. but the further i have moved away from the last round of fertility meds and IUI’s and daily doctors appointments the more i see the need to have some source of support. so i am trying to figure out how to include more people in my life. and to find friends who can understand. or at the very least appreciate how these varied experiences shape my days. i am also learning that on many a day i am reminded exactly why i have historically said so little because what comes back at you is fascinating and disappointing and ignorant. but other days the need to have someone understand anything at all is all-consuming as well. most days it’s a fine line that serves as a happy medium and i can usually walk that without too much trouble…
in a break from my usual silence i offered an explanation this week to a friend who cares and wanted to know where we were at it the process. i went into the conversation knowing that she may not really understand what it all means to me and just where this sits in the center of my being or how deeply it affects me. but still i started at the beginning (well as much as being referred to the RE is a new beginning beginning.) and offered a pretty much soup to nuts explanation. here is where we were. here is where we are going type of road map. and she asked a few questions. mostly of the “how do they do that” variety. so i explained that as well. it was odd. and not really cathartic but possibly good all the same. maybe i needed to hear myself explain it all. and then she raised a few questions regarding what if it doesn’t work. and i was clear from the beginning that it might not. so i responded “then i guess i run a lot more marathons”. it sounds cavalier and dismissive and perhaps it is but it’s all i can offer on that front right now. she asked about m having another. or us adopting. and in reality either of those are viable options. but they are outside of my purview right now. past my line of sight. its like i know they exist on the periphery but i don’t want to acknowledge them until i have to. and in the meantime then i will be ready to offer up an explanation.
the past week has been a mix of extremes in a sense. coast to coast. ny to ca. to work and then to relax and run. while i was in new york my OAR report arrived at home. and fair seemed even a little less than fair. essentially the way the report works is it looks at your FSH, your AMH, and a few other hormone levels and then gives you an assessment of what your predicted outcome of egg retrieval is. and as discussed mine was “fair”. the ranges run 0-5 (poor), 6-10 (fair), 11-15 (good), and 16-20 (excellent). now just hearing fair on the message left a bit of leeway in my mind. but the report left little to the imagination. there it was: 6. blah. essentially there is a good chance of retrieving around six follicles. lots of hormones for six follicles. perhaps more. perhaps less. it’s all a bit unsure. but according to science and statistics and stuff these are the chances. i’m a 6. at a minimum i could be an odd number (my own neurosis here). but no i’m a 6. fun stuff. honestly there isn’t much i can do about it. well really there is nothing i can do about it. i have always done everything asked of me. i eat well. i exercise. i take vitamins. i think good thoughts. etc. etc. the point goes back to what i need out of this and that is two. i need two strong viable ready to go follicles that can be fertilized and implanted. while i was in nyc i took the news that was relayed to me from M relatively well. i stored it in the back of my mind and went on with my days. it was tuesday night when when i first heard and i went on my way and met up with my nearly sister in law. we talked as we never have before. and it helped me to stay centered and calm and remember that i just need to keep moving forward. its interesting how sometimes people and conversations come exactly when you need them to.
somewhat tenuously related i had also planned for my cycle to start at some point while i was traveling but not quite as early as it did. day 22. i was initially shocked but it was actually quite helpful for the marathon that was to come in a few days. after finishing up my tour of duty in nyc and interspersing a few fantastic visits with friends and family i headed to LAX. after a brief delay and breaking the zipper of my pants on the plane (because things are always kinda fun in my world) i was picked up by a friend who actually knows what is going on with all of the IF tumultuousness. after my futile attempt to combat the time change i awoke early thursday and called the RE to schedule a diagnostic ultrasound and trial transfer upon my return. i tried to schedule it for later in the week but the only available time was monday – less than 12 hours after my return. so i took it – knowing that it would weigh somewhat in my mind the entire time i was there. LA was great. an underside tour. lunch and dinner in fun places. seeing random tickets for beverages on metro platforms. a great run around a reservoir and conversations with a dear friend who is making carving her own path to start a family.
friday i had the strange opportunity to think for a while. and i thought about running. and trying to have a baby. and how they have been so intertwined. my history of marathons has been so linked in ways i had not though about before. i ran my first marathon after my first failed IUI. i ran portland last year after 2 more failed IUI’s, a surgery to remove a blocked tube to even have those IUI’s, a decent amount of hormones and way more “morning violations” than i care to recount to assess size, number, etc. of follicles to even get to that point. and that brought us to now and surf city. somewhat removed from it all. the marathon i had to finish before i could start ivf. but really things are different right now. i am different. and it feels entirely unlike any other time. so that is a good thing. but it was interesting to reflect upon. and to consider all that is to come in the next few months. i think i am ready in a way that maybe i wasn’t before. i can’t say i am ready to fail because i am not sure anyone is ever really ready for that but perhaps i am better prepared for it than i was before. hopefully it won’t be an issue…
anyhow, friday night we headed to huntington beach. met up with some of M’s family. Amy – my running partner and possibly closest friend. and Nick – the comedian pilot with a sweet heart. and some fun new friends. i was ready to run another marathon. in a new place. a different way to challenge my body and my mind. after some questionable weather on friday and saturday race day rolled around. and sunday was delightful. and i ran. with palm trees. ocean breezes. views of catalina. mountains in the distance. to an end with a surfboard medal. it was pretty much perfect. and then i came home to my family. for a little while i didn’t have to think about what my body can’t do and instead i was able to rely on myself and what i had done and i knew that i would be okay. i knew that i would make it to the finish. and i knew that i could accomplish what i set out to. running reminds me that no matter how hollow and inadequate i feel sometimes i am in control of some things and i am able to make some decisions about how my body functions. after a short reprieve i headed back to mn. where it was cold and snowing. and late. but i was still riding a runners high. and ready to head into the next phase of my fertility treatments.
appointment with the RE yesterday was promising. the dr wanted to make sure i understood what the OAR report meant. i asked about cancellation rates and she was unconcerned. the diagnostic ultrasound showed 12 follicles – 7 on one side, 5 on the other. without hormones. of course quality and quantity are not one in the same but the dr was pleased and said things looked great. trial transfer was quick and easy. all is on schedule for the next few months. what looked horrible on paper seems okay after talking with the dr. she said my AMH of 1.14 is really good. indicated that we shouldn’t wait on IVF but that she thinks things are alright and from what she has seen she is happy. that makes me happy. and i can run. in fact i should run. at least up to day seven of stimulation medications. that sounds about right to me. now i just need to figure out where all the money is coming from…