Sunday, January 30, 2011

my biggest regret

If any of you think you know who I am - please do not read on and rather don't read any of my posts - I am putting too much very personal information here.   But, if I am still just an unidentified blogger - this is the story of why I beat myself up.

Several years ago, I was having mild pain.  Nothing bad, but knowing what I know, I got an ultrasound.   I watched as they were doing it and knew enough to see that there was something odd - something that even to my eye did not look quite right. The reading was a small corpus luteum cyst versus solid mass but they recommended MRI to further evaluate.  Impossible for a corpus luteum I thought, I was on the pill.  You can't have a corpus luteum if you're ovulation is blocked by pills.  So I got worried - really worried.

Then came the MRI.  Definitive diagnosis was dermoid which is a solid ovarian tumor usually with skin tissues, fat, hair and sometimes teeth.  Pretty easy to diagnose, but I never asked to look at the images.  I trusted the radiologist and my surgeon.

So I had a full exploratory laparotomy at her suggestion.  No laparoscopy or mini-lap for me.  Nope - big old incision with great big healing time.  But I trusted her so went through with it.  I knew then that leaving a dermoid alone would probably not be good for future fertility, and if I did need ovulation induction that nobody would want to stimulate an ovary with a dermoid on it.

Problem was, they went in, and nothing was there.  Polycystic ovary, but no dermoid.  So my surgeon did what surgeons do - she went looking for it.  Split open the ovary, dug out some follicles, sent some tissue to path and closed me up.

The recovery was hard and a definite lesson in what I make my patients endure, but it was especially hard to think that it was unnecessary.  I slowly got better and made my peace with it.  Just moved forward with a stomach that doesn't quite look like it used to.

That was until the infertility.  For my baseline sono, my previously operated on ovary is less than half the size as the other and seems to be scarred way up out of its normal placement.  I was frustrated to see this, but didn't worry about it too much - after all, I still had a little stump there and there was a whole other side to get pregnant from!

That was until the HSG.  Only one tube open.  Other could have been spasmed or blocked by scar tissue - but here's the kicker - the open tube is on the side of my gimpy ovary.  I cried when I had the hsg, cried in the car, cried at home and just kept crying.  Days turned into weeks and I was just a little quivering puddle.  Why did I let myself have the surgery?  Why didn't I look at the scan knowing what I know? Why . . . why  . . . why?

My REI just kept telling me that you only need part of one ovary and one tube and that it can work, and maybe after all the other was just spasmed.  I have tried to believe but the reality is I am already working with the PCOS and to have anatomic issues on top is a lot more to overcome than just ovulation.

So of course through all of this it turns out that my normal ovary ovulates a lot better than the gimp, and of course the other day the new single follicle again was on the normal ovary/blocked tube side.  They have offered me another hsg, but I am not sure what it would change.  Its a lot of pain for no change in decision making and it doesn't make the cost of IVF any less prohibitive.

In retrospect I have run the scenario in my head a thousand times, and would have probably made the same decisions faced with the same information.  My biggest regret is that I went looking in the first place.  I should have just ignored it and moved forward but the paranoia got to me first.  Its also difficult to take that as a lesson for the future.  How do you not overanalyze the situation at hand?  Infertility is part medical, part emotional, part luck and is the single item that keeps me from having the life I have envisioned.  How do I not think about that?  How do I not read too much into each scan?  How am I ever supposed to relax about this and let go of the guilt?

I think the answer is that I won't relax and I won't forgive myself until infertility is just a part of my past and not my present.  As much as I want to make peace with this as a process, every ultrasound will always be a reflection of how I screwed up no matter logically that I know I didn't.

And with that - on to the next one tomorrow - go go gimp ovary.

Friday, January 28, 2011


I had a little self-realization moment today shortly after my sono.

For the longest time I have been terrified of multiple pregnancies.  Maybe this just goes back to some very bad experiences with some twins, triplets and quads in med school and residency.  Or maybe I just know the risks, complications and frequencies of bad things that can happen.

At the start of this process, I was worried about the 8% risk of twins with clomid.    All I wanted was to ovulate and get a little single pregnancy out of it.  So when I had to move on to the next step I was a bit . . . . well . . . freaked out.   Knowing fulll well that injectables carry about a 25 % risk of multiple birth, I seriously tried to convince my husband that maybe we should just do IVF with single embryo transfer to avoid the multiples risk.  Given the amazing cost and the invasiveness of it, we chose not to.

For the first few cycles when I saw those multiple follicles I was more than a little worried that more than one would take.  That is until all those little ovulations failed and left me with nothing, twice.

So today I was getting probed only to find out that I have one good 11 mm follicle.  My first thought was not "thank goodness" like it would have been a few months ago.  Nope.  This time my response was "Really?  Only one?  Darn."

So I guess I have now accepted that twins would be okay, and maybe better than just okay.  Maybe an instant family of four would avoid me experiencing this whole thing again in the future.  And as for IVF - there will be no single embryo transfer for me.  If I have to pay that much, I want the 75% live birth rate when transferring two as opposed to the 60% when transferring one.  We just simply don't have the money to keep going on with this forever, and I don't have the resilience to keep having my soul stomped on.

It is a funny thing how this little infertility changes the way you think and the way you view the world.  Something tells me this is the first of many realizations about myself.

Thursday, January 27, 2011

net zero

You know that relief I talked about in the last post - the relief from having one less pregnant person around . . . well its gone.  No sooner than one cute baby was born, another belly popped out.  Ran into another work friend yesterday and she is glowing and pooching.


Also, somehow I got on the mailing list for both carters and osh-kosh on my personal email account.  (thank you email marketing people for rubbing it in - although maybe its just because I am a good supplier of baby gifts - but I am pretty sure I never gave you my email.)

Its a little like ripping the scab off the unhealed festering wound that is my soul.  As soon as there is a little time to repair, something happens to take away the progress only to get it all inflamed again.  

Oh well.  Moving forward.  Maybe I can get the acupuncture today to not only align my Chi but to nourish my soul enough that I don't feel like I need to consume massive amounts of ice cream.

Tuesday, January 25, 2011

showering babies

I threw a double baby shower last month.  Yup not only for one friend, but for two due around the same time - which is now.

This is a kind of embarrassing thing to admit.  I knowingly tortured myself - full on pull out the belt and beat my ego silly over and over again.  When I made the decision to throw it, it was a time of genuine excitement about finding out about my friend's pregnancy.  Sure it only took her two months of trying, but at that time I was only into the infertility treatment thing for a few months.  There was no jealousy yet, I was optimistic about my own chances and I was really excited to throw a party for my friend.  When our mutual friend added her due date to the pool as well we all decided to have one combined shindig.  Little did I know that this act of generosity would drive me completely and totally INSANE!

As it got closer and closer, it became my nemesis.  It was constantly reminding me that not only was I not pregnant and not getting pregnant, but that it would take a seriously long time to have a baby.  (With the whole 40 week bun in the oven thing).  I handmade the decorations, made all the food, and just hated myself the entire time.  My self esteem has never taken such a hit as it did before the shower.  Not only did I feel bad about my inabilities, but I felt bad that I WAS THE ONE making myself feel bad by putting this thing on.

This was actually the inciting event in making me start blogging.  I couldn't even talk about it at the time because I was just too overwhelmed with emotion to deal.  I didn't want to back out on my friends and I thought that they really deserved a shower, so I sucked it up and threw a great party.  In the end the shower was enjoyed by all who attended, the new mommies got lots of wonderful things, and even I had a good time.

So anyway, baby #1 was born today and I am feeling a huge sense of relief.  One less pregnant friend!   Hoorray!  Strangest sensation that I feel relief, but I do.  Maybe its that mom and baby are doing well and I am a worry wart when friends are in labor, but there is also a component of "thank goodness this wave is almost over".  There are several people at work due in the upcoming weeks so maybe time is on my side because in a few weeks there will be a relative dearth of preggo peeps compared to the present time.

So I look forward to delivery of baby #2 in the coming days, hopefully for further relief, and with that thought I am going to the kitchen now to shoot myself up with a little fsh.

Sunday, January 23, 2011

Workin' the system to make it work - a.k.a. saving money

So I decided to publish how much this is costing - which is more money than I have ever spent on me.  I am cheap.  Frugal.  Scrooge-like when it comes to buying things for myself.

As an example I went shopping the other night and was completely joyed when I found a necklace for $6 that matched the same color as a pair of shoes on sale for $5.  This is all to pair with a dress I got on clearance at target for $15.  I bargain hunt, clip coupons and wait for sales. I rarely splurge, we don't usually go on fancy vacations and I don't put any money into things that add up over time.  (Starbucks habits, mani/pedis, stylists, purses etc.)  This is what I have had to do over time because for so many years of my adult life I have been in school or making minimum wage as a resident.

So of course naturally I find it hard to wrap around the idea that I am injecting myself with medication every night that not only costs more than the outfit above but that adds up to be A LOT of money over time.

But I have come to terms that this process is expensive, and if it works will be worth every penny.  I certainly have more income than I had even a few years ago, but there is a lot of financial things to catch up on as well.  (student loans, no retirement savings etc)

So what I have tried to do over time was to apply that same sense of discounts to the process and here are some of the things that I have had success with so far: (None of this is advice - believe me doctors are horrible with money - these are simply things that have worked for me)

1) FLEXIBLE HEALTH CARE SPENDING - in late 2009 I knew that we would be facing infertility treatments or a pregnancy so I put aside about $200 a month and by the end of the year had a nice little way to pay for follistim.  Can't do this for 2011 because I have NO way to estimate this but I think in 2011 we will be itemizing deductions anyway - but I AM keeping all my receipts because if I go over a certain amount on healthcare I can get it tax-free!

2) ACUPUNCTURE - I get it by a student and go to my local oriental medicine college.  Being a product of hands-on-training I believe in the system and always feel like I get good attention by the student and the instructor.  It comes out to $38 a session plus herbs.

3) INSURANCE - When I signed up for my benefits I specifically looked into infertility coverage and selected the only plan with any type of coverage.  (And I pay a lot extra for it) According to their benefits they cover 50% of medications only.  Interestingly I can get my follistim from a local independent pharmacy for about $250 compared to most chain pharmacies where it is high 300's- low 400s but in order for my insurance to pay anything I need to be preauthorized and go though a "contracted pharmacy".  Once I found a good contracted pharmacy I was getting each vial for $191 (after insurance) but then my insurance changed their mind, cancelled my rx and I was forking over out of pocket for a while.  I have now found that they will let me go though a mail-order pharmacy for about $180 per vial - but I have to order in advance.  Dealing with the artificial roadblocks put up by my insurance company have been a nightmare and I have spent more hours on the phone than I can count but eventually you get a clue from someone on how to get things approved.  Insurance is also paying for part of the ultrasounds currently because no matter how it is coded it is considered a diagnostic procedure which is partially covered as well.  (although I am waiting for them to realize it and reject me).

4) SHOPPING AROUND - I called every major and minor pharmacy in the area and looked into mail-order.  I compared prices on follistim for all the different sized vials.  Let me tell you that there can be a huge difference.  Even if its just $20 savings it adds up to $100 for a cycle.  I still pay for ovridel out of pocket so there was a little savings there.

5) INTRODUCTORY COUPON - I actually used a coupon for a free vial during each cycle for the first 2 cycles through the follistim manufacturer.  They only give it to you for 2 but thats still several hundred buckaroos.  I got it though my RE and a pharmacy that contracts though the company - I would have never found this on my own.

6)  CHEAP PREGNANCY TESTS - and LH kits can be found online by googling.  The are more difficult to use than drugstore brands but WAAAYYY cheaper.  (I found them for about 40 cents each)

7) KEEPING MYSELF THIN - This sounds funny but I lost about 15 lb to get married but knowing that it helps ovulation I didn't allow it to come back on.  With PCOS, weight is important, and keeping mine down is probably allowing me to use less of the follistim than I otherwise would.  So I am on a constant food watch and exercising several times a week. (This also allows me to look decent in $15 dresses. )  I will admit that this is the HARDEST thing I have done, by far.

8) EMPLOYEE DISCOUNT - just kidding.  The hospital I work for is too money grubbing to give me any discount.  They are looking for every penny out of me.  I offered to do my ultrasounds but that didn't fly with my RE.  So other than figuring out what I did as above, there is no benefit to being a gynecologist.

So those are my ideas - I would be interested in hearing anybody else's comments about what has worked for them - and if you work for an insurance company please don't go looking for ways to save money for your company by cutting me off.


Friday, January 21, 2011


Today I put myself back into place.

Things are always harder when depressed.  Harder to go to work, harder to relax when home, harder to sleep, harder to wake up.  I have been very easily annoyed lately by all the people in my life that are undergoing the life changes of parenthood.

I try to be a supportive friend.  I reassure as much as I can, but I can't get whole heartedly behind it because frankly I am a bit jealous and even though it is hard on them now, in the end I know they will both be just fine. Then I went to work today . . .

One of my non-medical acquaintances was initially diagnosed with a really aggressive cancer and it just came back.

So I ended my little pity party because I remember that I am healthy and I have a good life no mater if I am unsatisfied with my inability (so-far) to become a parent.  I apologize to the world for being selfish lately and I promise to be better.  Those little things that I thought were so hard are not hard at all . . . maybe I am just a wimp but I have no real excuse to be depressed right now.  So I have jumped up, brushed myself off and am back on the horse.  I will be praying for my friend but will take her example and celebrate what I do have.

Wednesday, January 19, 2011

holding off

Been a little down since the last pregnancy test.  Period has left but my spirits have yet to lift.  Went to my RE last week for the baseline sono for the next cycle.  Asked her a stupid question and broke into tears.  I try very hard to keep up a funny front - its fake, but how I deal.

I have been told I am very good at hiding things.  I cant lie or hide info, but man can I disguise feelings.  Pretend thats its all ok.  Make a joke when someone asks and move on.  Who really wants to know when the answer is yes . . . I am currently unhappy, dissatisfied and depressed.  People who know what I am doing with my free time keep asking - and every time I think they expect me to say I'm pregnant.  But I'm not.  So there.  I think to myself . . . Do you want to see me cry the way my husband has to see? Are you trying to rub it in?  I know they are not malicious in intent, but it stings none the less.

So anyway, after I completely shocked my RE who previously thought I was handling this whole thing well, we had a chat.  I realized I needed a few days to myself.  A few days not to think about it, not to be probed, injected, stimulated or stressed.

I didn't want to take a full month off - that seemed like a waste of time to me - but we agreed that since I am totally anovulatory and a very slow responder, we can delay things by a week and not start the ultrasounds for a longer period of time.

So today (and for the past several days) I have been on a fertility vacation.  Just taking a few days to myself.  (hence the lesser postings).  I will start up the injections and acupuncture again tomorrow, along with the herbs that taste like you are licking the bottom of your shoe.

We talked about the goal and about realistically how long it may take to achieve it.  I have realized that I cannot expect this to work on a cycle by cycle basis.  This is just a new part of my life that I have to do for a while.  Just like exercise there is just something I need to do on an (almost) daily basis and there is not necessarily an end to the process.  The rewards may not be tangible for a while but eventually something will give me the family I desire.

So here we go again.  Not looking at this as the next cycle as much as looking at the next 4 months before we switch gears to another method.  Not very excited, but I guess more accepting of the process.

Saturday, January 15, 2011

The uterine revolution

My uterus is in revolt.  Cut off from its nice little happy relaxing progesterone it is now in the anger phase.  Like a heroin addict in withdrawals – it is pissy and in pain.

 I hate periods.  I had terrible gynecologists in my twenties.  Nobody would tell me what was going on with my stupidly irregular, seriously heavy periods.  Nobody would mention that maybe there was something wrong here they would just offer me birth control pills.

Thing was . . .why did I need birth control pills if I wasn’t needing control of birth?  It never made sense to me.  Maybe because every other college age girl was sleeping around they needed them, and yes they would regulate my cycles, but no doctor ever took the time to let on that I had a bigger problem.

So I would go months without a period, and when it would come I was certainly in for it.  The cramping, the hemorrhaging – it was terrible.  I remember driving a half hour to see my grandmother and in that time going through a tampon, pads, 2 pairs of undies, pants, the towel on the seat ultimately onto the car seat itself.  At this point I realized there was something very wrong, but like most people right out of college I was (gasp) uninsured.  I actually quit my job after college (because I hated it) and I was too tired to work.  I spent a month in bed.  Probably was excessively anemic – but didn’t know anything at that point in my life to realize what was going on.  In retrospect I was dumb and uneducated.

I’ll never forget the day I heard about pcos from a pamphlet I saw on the wall of a gynecology rotation I was doing.  It was what Oprah describes as the “ah ha” moment.  All of a sudden everything became crystal clear.  That hair on my chin – check.  The acne that plagued not only my teens but into adulthood – check.  My stupid menstrual cycles – check.  There I was, it was me in a nutshell so I got the ultrasound and . . . polycystic ovaries – final check.

I felt validated and betrayed.  I finally had a diagnosis but there was no reason I had to go though all those years of suffering to figure all this out.  But I now understood the reason to use birth control pills and why it made sense – so I started.

There has been no better personal discovery to date than my start oral contraceptives.  For me it was a magic pill.  My periods came on time, light without cramps.  My face back and chest cleared up and the hairiness became more manageable.  Finally, I was attractive, predictable and healthy.  I LOVED MY PILLS!

Now, I miss them - terribly.  My face frequently explodes, I have given up tank tops, I have invested in laser hair removal only to find that the areas are being re-stimulated.  But never do I miss them more than days like today.  Days where I am sitting with my heating pad on my lap and my Advil by my side.  I have never missed a day of work for cramps, but I can certainly relate with those that do.  I actually have “take my heating pad to work” days.  A few of my patients have nodded in recognition.  I wish everyone could have such an understanding work environment.

This is all small beans compared to the infertility of course.  If I could get a pregnancy out of it I would happily become a hairy acnefied beast of a woman that can’t get out of bed.  But it is always a little insulting for my period to show up. 

My uterus is the victim of spousal abuse at the hand of my ovaries.  The years of hormonal control by its previous birth control were happy times.  Productive, supportive and predictable.  My uterus was an empty but happy place.   But then with the removal of the pills the uterus fell back into its old habits of listening to my ovaries and now embarks in monthly turmoil.  Its turned on me and is screaming out “ha ha – I am empty and I am going to purge myself to make you suffer even more”.

One day maybe my uterus will find its purpose.  It will find a good temporary relationship with hormones that come from a placenta instead.  It will get what it needs to relax, grow and feel self fulfilled.  I look forward to the lack of bleeding for nine months.  I hope my uterus gains its independence and stops the revolution but for now the battle is raging on.

So for now . . . Advil.

Wednesday, January 12, 2011

Sushi, red wine and fried salami

In my best Alex Trebek voice:
    "what are 3 things I will sorely miss if I get pregnant but that I am enjoying right now?"

I am currently in the "screw you cycle two" mode.  Okay - its not really cycle 2 - but its only confirmed ovulation #2 since 9/09.  I am not sure if this is more of a success or more of a failure.  Have I not conceived because I have only plopped out eggs twice or am I bigger failure because I cant plop them out in the first place?

Silly ploppage.

So as my official end to this cycle (with another negative pregnancy test just to prove it/rub it in) I am going out with a bang.  Last night - BIG glass of wine.  This morning - fried salami (sounds terrible but is the best thing ever - just put it in a pan and cook it like bacon - grease leaches out and ends up crispy and salty).  Tonight - raw mercury filled fish at a fun little sushi spot - maybe with some sake.

Okay so I know I am still not supposed to have the fish because of mercury buildup and blah blah blah . . . but there are way more self destructive things I could be doing.  I love seafood.  3/4 of my family descends from fishing villages - it is ingrained in my DNA.

So I tonight I will absorb a little more mercury into my life as I look back at this cycle and flip it off.  I will be back on a strict regimen of carb control in a matter of days, but for now pure hedonism.  In the past couple of days I have experienced the disappointment, the anger and the sadness.  So I am taking this derailed train and putting it back on a new track.  I must remember that life is not about the destination but enjoying the journey - although I may not be so positive when the bleeding starts.

Sunday, January 9, 2011

I wish I was a baboon . . . .

Okay not literally wish I was a baboon, but did you know they have an 80% fecundity per cycle?  (meaning that there is an 80% chance of baby if 2 baboons have a little fun while ovulating).  For us humans, its a dismal 20%.  For us career women who had to complete a lot of school/training before starting to even try . . . well lets just say it is less . . . more panda-esque.

I tested today, exactly 14 days after ovulation - because I feel some compelling reason to continue following the rules laid forth by my RE.  (Its still that student in me that thinks if I do a good job on this assignment, I can get an A+).

And drumroll please . . . . .

negative, nada, zilcho, nothing, single pink line, game over - thanks for playing - please deposit more money

Ladies and gentleman . . . the only thing I am gettin' out of this cycle is a period. (quite an expensive one at that)

I had a little mental breakdown full of tears, sobs and snot that led to a migraine, but with that behind me it is on to planning the next cycle.  ( at least with the negative pregnancy test I took an imitrex!)

People close to me think only two things about me:
 1) I am worried for no reason and I just need to calm down and forget about it  or
 2) I am handling this quite well

to respond to the #1 people: **** off
to respond to the #2 people:  I am good at hiding things with humor and sarcasm.  It still hurts just as bad.

On a separate note I have really enjoyed all your kind comments and encouragement!   For those of you that have overcome the infertility part and have gone on to pregnancy and kiddos, please don't apologize.  I am genuinely happy when someone with infertility/loss gets another chance and I smile when I read that you have succeeded.  I am thrilled that people can move forward and get to their goal, and I hope to be one of you . . . someday :)

I will be out of town for the next week and will only have patchy wi-fi.   I decided to take a short vacation to spend time getting fed comfort food and lots of wine by my dad and catching up with my best friend.  I am thinking of it as a mental health holiday.  I expect to return after a significant amount of calories and emotional catharsis . . .  so basically fat and happy!

Friday, January 7, 2011

repetitive soul crushing

When I was in high school looking at “what I wanted to be when I grew up” I wasn’t looking to be a doctor.  Sure Math and Science were what came easy to me.  Just made a certain amount of intrinsic sense – you learned the rules of what an atom could do and you could predict the future.   If you had H2 and O2 and applied a little energy in the right way you could make water. Very certain, exacting and sensible.  Little was left to luck.

But as much as people tried to convince me that biology was my “calling”, it was all just mildly interesting to me.  What I LOVED to do, on the other hand, was to perform.  Singing, dancing, acting – sure I could do it all but I can’t say that there was any real god given talent there.  But there was passion.  I spent more practicing my new dance routines at night than I did doing my homework.  There were long hours in musical rehearsals just for a few nights of glorious stage time.  I loved every minute of it.

So when the time came to pick a major in college it was science v. performing arts.  They were both going to be time consuming so there couldn’t be any waffling on this – I had to pick one.

Most teenagers faced with the same decision would either pick the former because science lends itself to a job better or their parents wouldn’t pay their tuition for a theater degree.  Some would throw caution to the wind and go with their hearts because their minds would follow.  I did neither.

I decided I couldn’t give my life to the stage because of one reason – I was not good at handling rejection.  The few times I wasn’t chosen in high school were devastating for my self esteem.  I could only imagine the number of auditions in the real world that I would have to go through to get one call back.  So I became a geek.  A sciency, uncool, study-all-the-time nerd.  In a way I am proud of my decision, but I still never learned how to accept, process and release rejection.  I never had to.  In science you put the pieces together and it works.  In school you study hard, learn the stuff in the books and ace the test.  It all works out like it should.

So now that I have encountered my first real experience without any control, I ask: How do you prepare for the repetitive soul crushing defeat? 

You know what that single pink line feels like.  You’ve been there before – but you think . . . this time will be different.  Same with auditions.  Maybe I’ll get my big break!  Maybe this is the one!  And you go on, and you never get that call from the director and you pass by the theater with the cast list.   You peer longingly and almost imagine your name there but its not. (the same way I stare at the stick trying to will a plus sign). So you move on to the next audition . . . but how long can you fail before you give up.

My 2 chest goosebumps have lost their ability to sense the weather – although logically I am thinking rain with a 99% chance of gloom.  Apparently with the hcg now cleared from my system they have no point to go on – there is nothing to feed their interest and not much to feed my hope.  Maybe its just the preparation message that my good old aunt flow will be stopping by.  I’m not going to test early.   I need a couple days before I get depressed again.  It will be a few days before I post again.  At this point I need to stop thinking about it.   I just don’t want to know.

Thursday, January 6, 2011

what bothers me about pregnant people

For me . . . its not about the bellies.    I can see bellies all day - if fact I do . . . all day every day.  Maybe this has just desensitized me.  But the truth is I don't think that bellies are that cute - it is just the outward sign of a huge change in physiology that can bring upon potential complications in health.   Maybe that's how I get through the day.  Work is work.  I try very hard to just suck it up.  I take care of women and their babies - when they are there at their visit it is their only time to ask the questions they have - its not about me at all.  And the truth is I care about my patients and the health of their pregnancy - and I wish nothing but the best of health for them all.

Here's what does bother me . . . people I know socially that have the gift of nonstop complaining.  When I leave work - I am off, yet pregnant people seem to think that I want to hear about their pregnancy in gory detail over nachos.  I can usually deal with the occasional legitimate question like "they found some dilation of the kidney on the ultrasound - is that bad?" - This is the type of question that makes having a gynecologist friend useful.

What I can't take are the barrage of complaints and the constant re-steering of the conversation back to their pregnancy.  I understand that your back hurts, I understand that you have to pee all the time, I understand that you can't sleep at night.  I will GLADLY trade places with you just about now.  No I don't want to hear about your sex life while pregnant.  No I don't want to know how you are designing the nursery.  Please spare me the details of your name choosing.  And please god don't tell me all of the things you saw on some documentary about how hospitals are evil and expect me to try to convince you otherwise.

I just need to keep reminding myself how much I hate this so I won't do it in the future.  (Hold me to that if I ever get there and keep posting here).  So for now . . . I have decided to avoid pregnant people outside of work.  I almost feel like sending a card:

Dear Friend:

Congrats on your pregnancy!  You must be so excited.
Talk to you again in 9 months*

love, me

*actually in 9 months you will be too busy to ever remember we were once friends . . . so I guess this is goodbye.

So there is my current coping method.  Chicken I know - but its a temporary survival tactic.

Tuesday, January 4, 2011

To test or not to test

Trigger day was 12/26 which places the first day to test (according to my RE) 1/9.  Next Tuesday day is a really big day for me (giving the biggest presentation of my life so far).  I plan to continue the progesterone though tuesday morning because I cant exactly be standing up in front of a bunch of people and have to run out to re-tamponize.   So I ask  . . . when to test?

Here are the options:
1) test early and run the risk of getting really excited about a false positive left over from the trigger or really disappointed if there is nothing - even though it may be too early
2) test on Sunday as I planned to do - just take it and move on.  Either it will be good and may relieve the pressure or it will not and at least I can order the meds for the next cycle.
3) put it off - I will be dying to know but this way it wont distract me.  I can pee on a stick Tuesday afternoon in the airport bathroom.  If its good I can daydream the rest of the way home, if not I can get plastered with the nice people in the airport bar.  Problem with this is the husband will not be there with me.

hmmmmmm . . . .

Monday, January 3, 2011

Darwin . . . I can beat your silly little theory

My mom was infertile.

Something I discovered long after she passed away.   I do remember her saying something once about endometriosis – but it wasn’t exactly a topic of conversation when I was a kid.

I knew my parents “waited a long time” to have me, but I never asked why they “waited” when both came from big families and all their married brothers and sisters had a gazillion children themselves.  I knew that they were devout Catholics who married at 21.  The story they gave me was that they wanted to be a little older before kids.  In retrospect I am not sure how much this was true.

I discovered this a few years ago when I was looking through my baby book.  Deep in the recesses of baby shower cards there was a handwritten draft of a letter.  It was addressed to the jury commissioner about 2 yr before I was born asking to be excused from service so she could attend an appointment with an infertility specialist she had been waiting to see.

I’m not sure how much infertility was actually treatable in the 1970s but after what I can now calculate as 7 years of trying . . . I came along.  She was a great mom, but I can now relate all too well to a feeling she had for a long time.  It was 6 years before my sister was born.  I am old enough to remember my relentless wishes and pleas for a sibling – I was probably just making it worse.  I know they wanted more kids but the cancer intervened before they could have had that prized boy they wanted.

I wish I could talk to my mom.  Get the truth.  Maybe we would be able to relate, maybe she would be my confidant.   Its hard to know what our relationship would have been like because she passed when I was still in my rebellious stage.

I tried once to broach the subject with my father but he just dismissed it and said he couldn’t remember.  As much as he does this a lot when it comes to memories of my mom, the difference was, this time, when I asked again he got defensively angry and told me knot to look into it any more.  Period.  End of story . . . there was going to be no further discussion.

Apparently this gene line was not supposed to continue even to me let alone beyond.  But I have something she didn’t . . . thirty something years of research in infertility to help me out.  I miss my mom frequently and will probably miss her more when I am one too.

On a happier note, thank you for all of your comments.  Its really nice to not feel so unique anymore!

Sunday, January 2, 2011

The other half of my family

My husband is a good sport and just a genuinely good man.

This is so not his fault.  The man has the most perfectly textbook semen analysis I have ever seen.  (I wasn't surprised at all since I think he is perfect in my eyes.)  I feel a lot of guilt that that he has to go through this as part of our otherwise happy marriage.  At first he was just obliging my biological clock by agreeing to go for it - I knew he would be ready if it happened but mentally he wasn’t there yet.  But as we have kept trying and failing and trying some more – I have realized he wants it just as much as I do.  He is super supportive, really relaxed and positive about the whole thing.  He dutifully gives me my shots and is there for a big bear hug and sympathy with every little single pink line.  Sometimes though he lets on how much it affects him . . . that always leaves me feeling terrible.  I know he is an awesome pediatrician, but he can be as tortured by his job as much as I am.  For every time my patients ask me if I have kids, he gets that question 10 times over.  He could have had someone else and had a family by now, but picked me anyway.

I told him about my pcos about a month after we met.  Kind of a weird conversation to have:

Me: um . . . so I have something to tell you
He: yes?
Me: You know how I am hairy and covered in pimples?
He: Um  . . . I don’t know what you are talking about! (he has an uncanny ability for always saying the correct response)
Me:  Well . . . I may have some trouble getting pregnant one day.
He: Okay.  Don’t worry . . . it will be fine.

And that was that!

Of course my husband understood what this meant at the time, but he never let it phase him.  It was like he just shrugged his shoulders said “whatever” and moved on.  Maybe he was happy at the time that there wouldn’t be an “oops” in his early 20’s, maybe he was in denial, or maybe he just never thought about it.

We’ve been together quite a while, and I never thought I would be this happy with someone.  I acknowledge that I got very lucky to find him but I find it tragic that I may not be able to give him the gift of a child.  More than being pregnant, more than having a child with my genes, I want to raise HIS child.  I love him so much and can think of no better outcome than to have a little him running around.

I hope that we can have that one day. . .  I pray that I will be able to do it myself.

Saturday, January 1, 2011

NYE and EtOH

So there I am last night, enjoying a party of close friends, drinking my vodka cranberry (minus the vodka of course because I am post-ovulation) and having a nice time.  Apparently my friends like getting a glass of wine in me . . . they say I am much more talkative after I loosen up a bit.  (they are correct in their assessment and I do enjoy a good glass of grape juice)  Needless to say they all think it is their duty to hand me drinks. This makes for a bit of an awkward moment when inevitably I need to come up with an excuse - a good socially acceptable excuse.

Now even though it is the reason, I can't use the "we're trying for a baby" thing because most of them don't know that I am off birth control pills let alone on some crazy regimen of fsh, metformin, prometrium, chinese herbs and disgusting tonics.  I think many of them have maybe caught on that we might be thinking about becoming parents at this point knowing how long ago my biological clock went off, but they are all polite enough not to pry.  I love this group of friends and I thank them for their understanding and their continual use of contraception themselves.

The worst people to try to avoid however . . . . are the in-laws.  They are simply hungry for grandchildren.  I love my parent-in-laws but they get almost giddy when we go over for dinner and I turn down a glass of wine.  Even if I just didn't feel like it they would ask me a couple of times, raise their eyebrows and smile sheepishly as if they were in on a secret.  One particular night after I was getting over some little hospital acquired gastroenteritis while having one of my post-provera hemorrhages I made the mistake of saying I wasn't feeling well as an excuse.  My mom-in-law got so cutely excited I thought she would burst.  I felt like I was crushing their collective souls when I told them I was menstruating.

So I've developed the most socially acceptable excuse ever and I will say for once my job is really coming in handy.  I just say that I am "on call" and therefore glued to my pager.  (This is in fact a partially true statement because I don't drink a thing on nights I may get called in).  If anybody ever does the math they may start to realize that I am "on call" the first two weeks of every month - which even for my job is a little to much . . . but I'm hoping nobody catches on to my little fib!

I may have missed out on actual dom perignon last night, but I was the safest driver out there!

happy 1-1-11!