Cracks in the Sad

All morning I've been wondering why I am in such a good mood. Inauguration? The end of an era? Sure. The fact that I got (and stayed) out of bed before 9:30 a.m. (major milestone, FYI) Yep. That helps. The presence of my co-worker and pal L. in town for a big meeting this week. Bonus. But what is that underlying thing making me smile?

I think I love the train. Yes. Even I don't know what to expect at the end of my journey. I really enjoy the journey. Always have. Back in the day it was my walkman; today its a (much smaller, much more reliable) mp3 player which unlike my old walkman has buttons that I don't have to hold down to get to play. In the wayback, it was text books, essays and a highlighter; nowadays its stacks of journals I never have time to read at the office, my laptop and this book. Which I may or may not crack open on the way home. We'll see. I think I will love this book. I just don't know if I am ready to read it today.

So here I am. On the train. En route to super smart MFMs. Listening to the band we went to see last week. The band that has been on constant rotation in the apartment for a few weeks now. They are really all I want to listen to right now. Their snarkiness soothes me. Their lyrics make me laugh. Out loud sometimes. And laughing feels good. Thank M for introducing them into my listening sphere. The first time I heard them, I somehow knew a ton of the words already just from M. singing out loud. I could type down some lyric snippets here, but they would be out of context and might not seem as clever/funny/ridiculous/great as I think they are. Or maybe you wouldn't find them funny at all. That would be a bummer. What did Dani819 call it? Gallows humor. Yes, there's definitely some of that. But who can resist when it's got a great beat and you can dance to it? Even on one leg.

Oh shit, I can't help it. Here are some of the lyric that M and I have been singing to each other all week:

And we exhale. And we roll our eyes. And we do these things - in unison.
And woe is me....and woe is you....and woe is us...together.
And WOOOOOE is me...and WOOOOE is you...and WOOOOE is us.
Together.

It's funny. It is. I promise.

Way Too Early to Be Blogging

But I haven't decided whether or not I'll be schlepping my computer along with me on the train to my appointment today.

Yes, even though this is a day I've been waiting for for oh, um, 8 years, even though I have a d*mn T-shirt with the date emblazoned across the front, for some reason, when I made the appointment to go see my RE's preferred maternal fetal medicine specialists (who BTW only do consultations on Monday mornings, Tuesday or Friday afternoons - read: every single time that it would be impossible for M to get off work) I somehow FORGOT this was Inauguration Day.

Way to go, Einstein.

So, instead of sharing a great day with my co-workers who I am sure will be circled around a TV at any free moment today, I'll be chug, chugging along, then schlep, schlepping over to a very big hospital and then waiting, waiting, waiting to hear the big city MFMs tell me what dolts and nimrods my little city MFMs are before they give me their assessment of what precautions we should take for our next attempted pregnancy.

That is my prediction for the day.

M's already left for work. He's feeling a little edgy, I can tell. Feeling guilty about not being able to come along. Feeling bad that I have to retell "the birth story" on my own. Feeling frustrated that we can't just rely on the big city doctors and hospitals for everything up to and including (dare I say it, a delivery). But the distance is too much, at least for that last part.

So we'll take what we can get. Much as the drive/train ride can be a drain, we've actually come to enjoy the time together. We know the route. We know how to entertain each other. If anything, those long drives both coming and going have been the setting for probably every major decision we have made on this (almost) 2 year sojourn.

Yes. Two years. I had that realization around 6 a.m. this morning. My two-year blogoversary is just around the corner. In March, it will mark 2 years since our very first visit to the clinic we love.

And for a few minutes, I was totally deflated. Two years? Two fucking years we've been at this? Only to get so close....and then I veer down that very dangerous path of, if everything were ok I would be 28 weeks pregnant now and gosh I bet I would be huge and the girls would be kicking and....

and and and

Sigh.

But then I remember that everything in our lives (our, meaning M and me) seems to work in these fairly compact 2-year cycles. Don't ask me why. It just happens. Me in Poland = just shy of 2 years. Us in Chile = what I told my boss would be a few months' experiment in telecommuting turned into 2 years. Back home = 2 years. Cross-country trip across the U.S. = once again, just shy of 2 years.

TTC (and have a baby we can bring home. That's the critical part)= coming up on 2 years.

So, if I believed in cycles (which I DO) that could lead one to believe that our lives without children might soon be over. It could mean that the cycle we begin in just a month or two could be the one.

Please be the one.

A Plan

I am hesitant to post because I don't want the jokes to stop!

Ladies, thank you. Thank you so much for sharing your worst. Wow. You didn't hold back did you? I think I need to print these all out right now and just have them. In my pocket. For when I need them. Like a talis(wo)man.

So what's next? Well, I let my body purge itself of these ungrateful b*stards (that's our pet name for them, you see), I walk around in my undies admiring my new lunapads, and get ready to start my next cycle. I should say mock cycle. One ending in a endometrial biopsy and a hysteroscopy to boot.

Yes, yes, I said it. I gave in. Because frankly, it does make sense now, doesn't it? Eggs were great (I can say that; They weren't mine). Fertilized great. Lining beefed up. Transfer was flawless. We didn't even need to tug on the stitch. So what's left but to "evaluate the uterine cavity"? That's how Nurse phrased it.

So what does one learn from an endometrial biopsy? It seems that we learn whether or not my uterus is to blame for all of this and whether or not she is just a little naughty and will be forced into compliance with a little more progesterone, or progesterone given a little differently, or if "childfree" will be one of the words that defines us. Adoption is not an option that we will explore and my ears practically shut themselves off when Nurse mentions the idea of a "carrier" for our remaining embryos should my uterus decide she'd rather act like Carrie with a capital C and keep on bleeding all over the place. I am just not there yet.

But I do appreciate the idea of hearing 1.) yes, you have a fair shot. Let's give this another go, or 2.) lady, we could pump you with more drugs than Jimi Hendrix and you are still not gonna flower into a pregnant goddess. I think I would appreciate knowing.

So, birth control pills begin soon, then lupron, then estrace....you all know the routine. And then I get scopes and swabs. I asked Nurse to tell me more about the hysteroscopy and she said that most women do fine with just a numbing shot in the cervix (uncontrollable twinge). I reminded her that most women didn't pass the F out during their HSG.

Pause.

"Oh yeah. That's right. Hmmm....I think I'll remind the docs of that and see what they want to do."

Oh hell yes. To be sedated for all of that scraping and scoping would be grand. Thanks, yes, please. See what you can do.

Milestones Galore

Two days ago marked 20 years cancer free for me, and I wrote about it a little bit here.

But what isn't apparent in that pretty upbeat post was the deep, deep sadness that consumed me for the entire day. It started creeping up on me as I was writing the post, then just kind of got worse and worse until hubby found me in my office a weepy mess. What the f%^& is wrong with me?? I asked that question, he didn't. I didn't think I had an answer. I just assumed it was a typical malaise that we all encounter every now and again. I was surprised by the words that came out.

20 years later and what do I have to show for it? What have I done with the life that was given to me? How have I helped anyone else besides myself? Who have I lived for beyond me? My life could have ended 20 years ago but it didn't. How have I shown my gratitude?

That was part of it. The other part of was based much more soundly in self-pity. 20 years later and I still have a drawer full of meds I can't afford. What's changed?? 20 years later and I am trying to undo what's been done to pieces of me that were never diseased in the first place.

But hang on a second. That's awfully presumptuous of me. What makes me think that hubby and I would have zero problems conceiving if cancer weren't in the picture? What makes me so sure that we wouldn't be in the same boat as so many of our real and blogging friends - testing, trying, testing again, trying to figure out why what should be so easy sometimes isn't? Cancer is an easy, easy (and deserving) scapegoat for us. But it has saved us from the months and months of diagnostic hells that so many of you go through - Do not pass Go, go directly to Egg Donor Program. We didn't have the unknowns, the unexplained, the maybe this, maybe that diagnoses that I know would have driven me crazy. So, I'm thinking for that I should be thankful.

Yesterday marked the one year anniversary of our first consultation with the RE. One year. That's a long time, but then again, it isn't. One year later and what do we have to show for it? Well, we now have our families and most of our friends fully invested in (and thankfully supportive of) our desire to have a family. It's no longer a secret, something whispered wistfully between us. I have this blog and this one which have turned into vehicles for empowerment, advocacy, and most importantly, have put me in touch with some kick *ss amazing, phenomenal women.

I have two little embryos that I hope are growing inside me as I type. Tune in Thursday for the first Beta.

And for that, I am thankful.

I said no, no, no.....

Not to going to rehab, but to an endometrial biopsy. Here's how it went down:

Nurse called last week, I thought to start scheduling our next cycle. She was actually calling to relay the advice of a new doctor who has apparently joined the practice. This doctor decided that what we really needed was to do a mock cycle and then an endometrial biopsy to see whether or not I needed to add any additional progesterone to our routine. That means, go through an entire cycle, including weeks of PIO injections, ending not in a transfer, but in this new doc taking a swab of my uterine lining. Based on the results of those weeks of hormones, headaches, shots and that swab we would either: a.) know that the protocol was just fine and start a new cycle or b.) add a little more progesterone to it.

I hung up with nurse, slightly stunned. Thinking first of all, "Who the F*ck is Dr. ____ and what does he/she know about me?" Second thought was, "Yes, my lining was slightly under 8 this time around but THEY CHOSE not to increase my estrace. It was less than 8 the first cancelled cycle and we upped the estrace, which seemed the do the trick. It was less than 8 the second cancelled cycle because I was only on estrace for a few days before the first stripe test...."

The more I thought about things, the angrier I got. I turned to hubby for some reason and rational thought. Perhaps I was overreacting or still upset from the BFN. His anger and indignity only added to mine. He broke it down like this: If an endometrial biopsy was what they wanted to do, they had 2 cancelled cycles which they could have continued to that end, AND the several months we were sitting around doing nothing while we were waiting for our donor to be available. Now, they want to waste our time, money, emotions? Now??

I felt slightly better knowing we were on the same page. From my perspective, I simply couldn't imagine going through the stress of a cycle knowing it was a mock one. Shooting up is hard for me as it is. Would I really go forward with that day after day knowing that all I had to look forward to was a cotton swab up my noonie? It would be different if I or they suspected some serious abnormality. It would be different if increasing estrace hadn't already been proven to work. It would be different if we only had 1 or 2 embies left. It would be different if we had a few thousand dollars to throw around on meds and medical tests that serve our clinic's purposes and stats more so than ours. It would be different if Dr. ___ was the person who had taken us through the process up to this point. It would be different if there weren't ample time and opportunity to address this perceived issues without the pain of additional and fake cycle.

But none of this is the case.

So, confident that hubby had my back, I called nurse the next morning. And we talked about all of this. And much more. We talked about how bothered we were that of the 4 people present for our transfer, we knew none of them (nurse had CPR training and had already told us she couldn't be present). We talked about how upset we were that this new and unknown person (Dr. ___) seemed to be calling the shots on our cycles. We talked about how it felt when we felt the (well-respected and university-affiliated) clinic was more interested in keeping their stats above the national average than they were with us as patients. It was a long and hard conversation.

And it was so worth it.

She totally understood and sympathized and made it seem like she, too, was bothered by the message she had to relay. She explained that the clinic was expanding and that a number of doctors had joined the team, hence Dr. ___, hence the unknown faces between my legs at transfer. She explained who the new docs were and which aspects of the clinic they would be in charge of. We told her that we considered her our lifeline and the one real and human point of contact there. We didn't know what we would do without her. Long pause. She said, "then I am going to keep your file. I'm supposed to turn it over to another nurse now that you are doing FET but I won't and I am going to use this conversation as my justification."

And we told her we were so grateful for that. She has been with us since the day I called almost a year ago and set up an appointment for a consult. She was the one that hugged me when I cried during the needle training. She was the one that held my hand when I got my stitch put in before the first transfer. She was the one that had to call and tell me about the BFN. To go through this without her would be rough.

So, it's day 5 of lupron. So far, so good. I need to get back in the habit of good breakfasts and healthy days. But we are looking forward to our first FET, scheduled tentatively for early March, with nurse by our side.

News and Next Steps

The good news is I didn't have to jump out of bed this morning and give myself a shot.

The bad news is, you guessed it, this attempt is officially canceled.

After a day spent consulting with our doctor and nurse at the clinic and lots of soul searching we have decided that we are going to try again in a month or so with our chosen donor. That is, of course, if she agrees.

She did begin to slowly respond to higher doses of her meds but our doctor felt that at this rate, she would have 3-5 eggs tops to use. Could this be a fluke? Could she be the one out of twenty women that simply don't respond to artificial stimulation? Would starting at a higher dosage of estrace and then Gonal F solve the problem?

We'll see, won't we?

But why not just choose another donor? You ask. And here is my response.

Back in March, when we had our first consult with this clinic, it was strictly an exploratory visit. We wanted to see what our options were. If they felt good and we we happened to find a donor that knocked our socks off, we would proceed. If not, we would go home, mull it over and decide on next steps after a few glasses of wine.

Well, we found that woman. She knocked our socks off. We knew from the bottom of our hearts we wanted to proceed. With that donor. With this clinic. So we did. We read and reread her profile and felt as if either of us could have written it. We laughed at her responses; we appreciated the time she she took to be so thoughtful in her answers. We felt like she could be one of our coolest friends. She was the reason we went down the egg donor path.

Our doc gave us the info and what he called the "traditional wisdom" that others had followed when faced with our decision. That would be to select another comparable donor, decrease the risk of another cancellation and increase the odds of getting a higher number of eggs. He said he wanted to remove as many uncertainties and "what ifs" from the process as possible. Fair enough.

Our chosen donor already has two children of her own. Which is another reason that we are inclined to think that a.) this cycle was a bit of a fluke and b.) she has some quality eggs, perhaps just not as many as the average person.

Who wants average?

When our doc said he wanted to remove as many "what ifs" as possible, both hubby and I immediately felt that there would always and forever be a "what if" if we settled for a donor that we felt was inferior to the one we have now. Looking through the big book of donor profiles confirmed that. We compared timelines and additional financial obligations with our doc and they are both pretty much a wash. It comes down to, do we want to take a 30% chance of success with someone we feel 100% about or do we want much higher odds with someone that we feel about 30% ok with?

If our donor declines, then we'll reassess the situation. We'll have a look at new donors that have come in. Maybe we'll even pay a visit to another clinic. Maybe we'll wait. We refuse to feel rushed or desperate. There is no reason to be. As far as having a baby, it doesn't have to be right now, it just has to be right.

Call Me, Dammit

While I am sitting here waiting, waiting, waiting to hear if our donor has started to respond to her hormone cocktails (1 in 20 do not), I can fill you in on our yesterday.

First of all, why didn't any of you tell me the "ultrasound" was not at all the put-the-gel-on-her-belly-and move-a-little-scanner-over it ultrasound that I was thinking of? No! It is just a big ole dildo-looking contraption. Its a good thing my inhibitions have left long ago. I had no idea.

Friendly reminder: this whole trying to get pregnant thing is all new to me.

The ultrasound went fine. My lining is just a wee thinner (7.9) than they would like (8.0). Nothing that an increase in estradiol won't sort out.

During my mock transfer (mapping the course to my heart, well, at least my uterus, with the help of a thin catheter), we learned that my inside is just as curvaceous as my outside. With the help of a small clamp to pull my cervix on down (yowch!), doc had a clear path. Smooth sailing he said.

We are scheduled to return on Tuesday for another ultrasound and to place a small stitch into my cervix so doc can pull it into a preferable position for the transfer. That way, no trauma of a clamp or anything so intrusive on the day of the real deal. I appreciate that.

Give me a minute while I consider that someone is actually going to reposition my insides like a puppeteer with a marionette in order to insert embryos inside of me. Is that not amazing?

All of this, of course, hinges on the phone call that I am waiting to receive. Right about now. Any minute now.

If my donor has not responded to an increase in her meds, odds of calling off this attempt are high. If the clinic sees even an inkling that she has started to spark, we will continue down this path a little longer, only slightly delaying retrieval, transfer, all that good stuff.

My doctor was much more optimistic than we were yesterday. He reminded us that all women are variable and that it was unfair to use pie charts or lab percentiles to try and gauge how a woman would or wouldn't react. Just because our donor didn't have the average response doesn't mean that she won't respond at all. He suggested we wait a little longer before calling the whole thing off. At least until Tuesday.

Happy Birthday, Ruth

So, you’re probably wondering how it went. The Consultation.

We are still wondering out loud if it actually happened.

My guardian angel charms, rosaries and novena cards my mother smothered me with during treatment are long since discarded or lost. Neither myself nor my husband even subscribe to a religion. But we can’t help feeling that the day was charmed; that someone or something somewhere was watching us and guiding us through the beginning of what seems like it’s going to be one hell of an adventure.

We sat in a small, cozy room all afternoon as the doctor, the shrink, the nurse, and others paraded through with new pieces of information and new papers to add to our folders. Every single person was patient and kind and didn’t leave the room until we were finished probing them with questions and scenarios. The psychiatrist successfully eased my husband’s biggest anxiety of the day when she mapped out an alternative driving route home which avoided rush hour traffic.

They told us we are perfect candidates for the egg donation program; The program was made for people in situations like ours. Our youth works in our favor. As does the fact that we have made a conscious effort to get fit.

Music to our ears.

At the end of the day, we began looking through donor profiles and found the perfect match. The very first profile we saw. It felt right. It is right. I really can’t describe how elated we are. And that’s all I’m going to say, until she is contacted, says yes, the meds are ordered and the process begins. No jinx. No jinx.

My god, this is exciting.