Tag Archives: infertility

healed

Last week I brought Cayenne into my office for a visit. My coworkers have been asking about him, so I thought bringing him by might be a good way for me to start getting back into the mental space of work. It was really nice — I honestly enjoy the people I work with, and it was good to chat with them, and of course there was much exclaiming over Cayenne.

People asked me lots of questions: is he sleeping through the night? Are you nursing? Are you excited to come back? How much does he weigh? The one that landed with a thud (or a splat) was: Are you healed?

What a question. I’ve been thinking about it all weekend.

I mean, there’s the obvious sense in which she meant it — am I physically healed from the birth? — and even that is fraught. My incision is closed and it didn’t get infected or anything like that. But the scar has formed with lots of keloiding (which I didn’t even know was a thing, but now I’m all self-conscious about it), and it’s still painful, and I’ve still got serious numbness in the whole ladybits area, and I’m still very weak — a 2-mile walk through my neighborhood or a very gentle yoga class just wrecks me. So, am I healed? I guess.

But there’s other healing to be done.

Infertility has gotten its grubby mitts all over my whole life.

Why didn’t I think I would be able to breastfeed? Because all evidence so far was that my body was a barren waste.

Why can’t I answer the question “When are you going to start trying for #2?” Because … well, duh.

Why don’t I have any friends? Because I spent four years locked in a dark smelly room with just my poisonous thoughts for company. Not that I was, like, a debutante or socialite or whatever before, but my hermitlike tendencies have really gotten out of hand. And now that I’m not depressed* I can look around and see the empty spaces in my life where friends used to be. I don’t have the slightest idea how to reach out to the truly delightful people I shoved away for so long, and since we moved it’s not even as though I can do a casual let’s-meet-for-coffee thing. I guess I also need to start fresh — but the truth is I don’t actually know how to make new friends anymore.**

It’s going to sound insufferable and sanctimonious, but the healing I have done so far is all down to taking care of Cayenne. I can do this, I find, and he is thriving, and holy crap he learned to roll over, and he smiles when I sing to him, and I’m actually his mom.

* Not-depressed is awesome. I had forgotten. It makes me sad for all the time I lost, and for anyone who is still there. I wish I could give you a hand up out of that deep hole.
**Seriously, how pathetic is that?
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miracle, part 4

Later the surgeon told me it was a miracle I ever got pregnant.

Apparently the scarring from the myomectomy had taken over my abdomen, forming adhesions with my tubes and my bowel. It confirms my RE’s suspicions, and it certainly explains why lefty wouldn’t come out.

The adhesions with the bowel were particularly bad, and according to the surgeon he spent some time trying to repair that area. He claims I am now “more anatomically correct.” He wasn’t able to do anything about the scarring on my tubes; I’m not sure if that’s because he had to get out quickly once the anesthesia started to wear off, or if it is actually irreparable.

According to him, it is likely that more adhesions will result from the C-section. He also noted that the appearance of my myomectomy scar should have been a clue that the healing on the inside was not going well. I never knew there was anything wrong with my scar, but apparently they’re not supposed to look like that….I had to ask him to explain “keloiding” to me, and he was really surprised I didn’t know that it was a problem. Live and learn, I guess?

But now we know — because my tubes, while open, were basically pasted to my uterus in inconvenient locations, there is no way those IUIs were ever going to work.

I heard the word “miracle” over and over again while we were in the hospital. Cayenne is truly a miracle and I am so grateful that he is here with us.

wait, what did i just agree to?

Before I say anything else, there is some thanking in order. Thank you, eighteenyears, for nominating me for that lovely award. Thank you, loribeth, for putting this post on Mel’s Friday Blog Roundup. Thank you to whoever put that same post on LFCA. And of course, and with all my heart, thank you to everyone who commented on that one.

We are almost through our “breather” month. (Expecting CD1 any day now — I ovulated a little later than usual so I’m not sure quite when.) We have talked and talked and talked about what to do next. We had a WTF-style appointment with our RE at which for the first time he invoked the Rule of Three.* We talked about doing an IUI cycle with injectibles, but he was of the opinion that the only benefit to that would be to see how I respond to the drugs. Not that it would actually get me pregnant. So what the hell is the point?

The plan he recommends is IVF, with or without ICSI. I asked why on earth we wouldn’t do ICSI, and he made the best argument against it that I’ve heard — apparently, they can’t always tell by looking which sperm have the genetic goods. Seemingly “perfect” sperm can fail to fertilize, and seemingly malformed sperm can result in … wait for it … babies. The whole process of ICSI is based on the clinic’s ability to pick the good ones and get them all up in there, but since they don’t really know which ones are the good ones, sometimes they get better results by just putting the eggs and sperm in a petri dish and letting them fight it out.** So, just like the number of IUIs, he is wanting us to think through the ICSI/no ICSI thing for ourselves. Damned self-determination! Presumably, just like with IUI, after we make a choice he will swoop back in and actually tell us what he thinks.

I had a long phone conversation with the clinic’s IVF coordinator, who didn’t bat an eye at the fact that I called her on her cell phone when she wasn’t even in the office (it was the number the RE gave me — I assumed it was her office phone).  Once I realized it I apologized four or five times, but she just stopped whatever she was doing and talked with me. I like her already — but I don’t want to take advantage. We are repeating some tests (yet another SA for him, CD3 bloodwork for me) and then we are going to come in for what they call The IVF Meeting. They want us to do this meeting even if we’re not sure we want IVF — apparently walking through the process can help people make a decision. Personally I love this because it means I can feel like I’m doing something without actually having to decide a thing. My usual practice of avoiding the hard things. Not so good in the long run, but it does keep us moving.

But apart from that, in the many many conversations with my husband, I think I may have agreed to do IVF. Once. I am so worried that if it fails he will blame me, resent me, start tallying up all the cups of coffee I’ve had over lo these many years, all the exercise I don’t get, all the fattening food I make,*** everything I’ve ever done wrong, and then I will not only not have a baby, I won’t have a marriage either. And we are back to the Life Plan of Living in My Mother’s Spare Room, which is always the endgame of my pessimistic thought patterns. I know he would never blame me — but still I keep asking him. “Will you still love me if it fails?” “Will you resent me if it fails?” “Will you blame me if it fails?”

So there is that.

But on the positive side, we have even come up with a plan to pay for it. The clinic wants us to pay them in full for the entire cycle up front (about $15,000). Needless to say, although we really are doing OK, we don’t just have that lying around in cash. So my husband told me that his parents had once offered to let us borrow from their HELOC if we needed help getting a down payment together for a house.**** We are thinking that if that offer still stands, we could probably borrow the money from there and make payments on it for a year or so. But that will mean telling his parents what is going on.

My husband has been very uncomfortable telling his family about our infertility. They know I had surgery, and they know the surgery was because we couldn’t get pregnant, and they can use a calendar so they do know that two more years have gone by with no sign of a grandbaby, but they never talk about it. He is going to have to tell them. I think for him, having this conversation with his parents is on the level of difficulty that agreeing to do IVF was for me. I need to let him do it in his own time — but I also need his own time to be kind of soon, since we want to try to do this during the summer (when he’s not in class and will have more time to hold my hand and shuttle me back and forth to the clinic and stick needles in my butt), which means we will need to come up with the money fairly soon, either from his parents’ HELOC or from some other (magic fairyland) source.

So saddle up, ladies*****, it looks like we are doing this. Holy shit.

*As in, if this IUI business hasn’t worked yet, it might be approaching cray-cray to keep beating that horse. Not that he called me a horse. Or crazy.

**The RE didn’t explain it in quite this way, of course, but I think I’m pretty close to his meaning.

***Holy shit, I made some bangin’ risotto last weekend. It’s amazing what lots and lots of olive oil can do.
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****Buying a house? It is to laugh.
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*****What’s with the horse images today?

breather

This BFN hit my husband really hard.  I had already told him I was pretty sure the cycle hadn’t worked, but having a small amount of familiarity with my thought patterns he wrote that off as pessimism.  I got (embarrassingly, violently) sick right in the middle of our Passover seder, and he convinced himself that it was a pregnancy symptom instead of, you know, a microorganism.  I was really a little surprised this weekend when he told me how upset he was.  I wish there was something I could do to make it easier for him.  I wish I could tell him that this is going to have a happy ending.

We are going to take a month off from treatments to recover and to think about what to do next.  Certainly there comes a point at which IUI has to be abandoned — but how do we know when we’ve gotten there?  Is three enough?  Have we tried hard enough?  I feel like I’m nine years old, asking my mom if my room is clean enough yet.  And three IUIs is not the whole story, not by a long shot.  There is the three and a half years before the IUIs, not to be held up as equal but not to be forgotten either.  There is the niece, and the other niece, and the nephew, and the friends’ kids conceived, born, and sent off to preschool since we decided to have a baby.

That’s what we said to each other: Let’s have a baby.  As though you can just … have one.  As though that’s something you can decide.

Have we tried hard enough?  Do we deserve it yet?

My husband is ready to move on to IVF.  Like I said, this BFN really tore him up, and he looks at the odds for IUI and finds he is wholly uninterested in any more of this.  He’s ready to put all the eggs in one petri dish.

Some boring, but necessary, arithmetic: if I keep working at my current job and put all my wages into making payments, it will take me about a year to pay off a $15,000 IVF attempt.  This does not sound unreasonable to me.  Unlike the last time we were looking at IVF, it is a realistic possibility now.  A realistic possibility that I have to deal with as more than a distant thought experiment.  I have to consider this, and come to a rational decision, and then act on it.  Making this decision feels like too much to ask.  (Haven’t we tried hard enough?)

That’s why we’re taking a breather.  We (OK, I) have to think about what’s next, and I need to do it with a clear head and that means not being in the middle of a cycle.  Also I really, really need at least a few weeks in which nobody shoves anything past my cervix.

i’m not here, this isn’t happening*

Ye gods, but I’m depressing.

I’m starting to feel that familiar drawing away again.  Wanting to stop being present as things happen.  And even as I write this post my stream of consciousness is doing this:

I should write a post about the Smearing of Trayvon Martin and how it relates to the Slut-Shaming of Sandra Fluke (who is, of course, alive while Martin is dead so of course it’s not a comparison that should imply equality of experience) but that wouldn’t really fit in with the usual tenor of this blog and besides, people smarter than I am have already done this so what would I be adding to the conversation?  This post is supposed to be about IUI #3, which was this morning and while we were in the waiting room we heard that someone had won that Mega-Millions jackpot and what would I do if I had all that money?  I could pay down our debts, buy a house, pay for ALL the rounds of IVF (that’s mine and yours, ladies), put my nieces and nephew through college, secure my mom’s retirement, start a new ensemble, and then I get lost in what to do with the rest of it.  Human rights, health care, arts funding, education of women and girls, scientific research.  So much money, so much power, so many people I could help.  But this post is supposed to be about IUI #3, which was this morning and tomorrow I have to finish doing our taxes which are extra complicated this year because of the grant my husband got last fall and I am crossing my fingers that the accounting for the project is good enough even though I know we made a few mistakes with it.  But this post is supposed to be about IUI #3, which was this morning.

I am having trouble focusing on that.  That’s why How to Disappear Completely seemed like a good theme song for today.

I’m not here, this isn’t happening.

Some true facts:  My HSG showed clear tubes and no scarring.  It also showed an arcuate uterus, which was not obvious on the image from 2009 due to all the fibroids.  As usual my Google-fu is lacking (largely because I am not smart enough to read medical research) but it seems to me that people with arcuate uteri can and do make babies in them.

More true facts:  Today’s sperm count was 23 million (holy shit, husband!) with 37.7% motility.  Post-wash numbers:  40 million, 21.7% motile.  With a .5 ml volume used in the insemination, that’s 4.34 million sperm hopefully making their way up my tubes with another 15.66 million just hanging out.

I’m not here, this isn’t happening.

No facts here:  We have started to talk about how many of these we are willing to do.  How many is too many?  How many is enough?  Why is no one looking at the sperm morphology and what difference does it make?  Why have I never been pregnant, not for one minute, in three and a half years?  If we do IVF, how will we pay for it?  When do we tell my in-laws what is going on?  How many of these do we do?

I’m not here, this isn’t happening.

It’s hard for me to focus on this.  I feel like infertility has become a moving target and I’m just too slow.  I don’t know what I think, I don’t know what I want, and I don’t know how many more of these I can do.

i can hear you, you know

I didn’t test at all this last cycle.  I had no expectation that it would work; it felt like we were going through the motions, some kind of very expensive and unpleasant kabuki so that we could look back and say that at least we tried.  There wasn’t much satisfaction in being right — CD1 was as depressing as ever, CD3 was as uncomfortable as ever, what with the wanding and all, and here I am a week later in a hospital waiting room for another HSG.

Whenever my RE looks at me via ultrasound he says things to his medical students like “scarring” and “pelvic adhesions.”  He says “unusual shape” and “difficult positioning.”  But in the consult room he says “no reason to think the worst” and “should be clear.”  But over the past few months it’s become clear that he thinks there is something going on in my uterus as a result of my myomectomy.  He has brought this up in the past but his recommendation has been to just go ahead and do the IUI, but this time he recommended “getting a look at things” before we go any further.  I was planning to ask for this anyway since I am not actually deaf in the exam room and I can hear what says to the med students, so it was nice that we were on the same page.

So here I sit, waiting to find out if there’s yet more wrong with me.  For the privilege I will be paying a cool $1500 out of pocket unless the insurance company decides to pony up.*

* Not bloody likely.

arithmetic

As I’ve mentioned, we are paying out of pocket for our treatments.  The insurance company wouldn’t even pay for the Pap smear my RE did at our consult in December because it was part of an infertility visit.  Since December 13, we have paid a total of $2,046.86 to our RE’s clinic and the pharmacy down the street.  (I’ve been tracking the costs on my TTC page.)

During that same period we paid $872.04 in insurance premiums.*  My husband’s employer kicked in about twice that much, meaning the insurance company has taken in $2,616.12 on our behalf.

They have paid out $0.

I have a full-time job.  I make $9.50 per hour.  This means that before taxes, I make $380 per week.**  After taxes, I take home $331.67.

More than half of my wages go directly to my RE.

And I am in a position of incredible privilege, that we’re able to live on my husband’s salary.  If we needed two incomes to make rent, like most families do, there would be no way we could afford this.  We would have to give up.

But the insurance company would still have its $2,616.12.

* And I thank my lucky stars our premiums are as low as they are.

** That’s on a week when I don’t lose any hours to doctor’s appointments — and even though our appointments are always at 7:15 or 7:30 a.m., the clinic is far enough away that I lose an hour or more of work each time.  Let us not even speak of all the extra gas we consume driving to and from the clinic.