Code 83

Today’s mail brought a familiar envelope from our insurance company.  It was one of the many explanation of benefits that we have received from them over the course of this journey to procreate.  They stopped coming for a while, in a direct correlation to our stopping treatment of any kind, with Dr. Uterus or anyone else.  But, with the Clomid Challenge, they’ve started to trickle in again.  Today’s missive was different from its predecessors, though.  There were six little words at the bottom of the page that made my heart sink just a little further into its shell:

Code 83: Maximum Lifetime Benefit Has Been Met.

We have used all of the money that was allocated for us.  It’s all gone. 

I knew this day would come.  What I didn’t anticipate, however, was that I would still have no child in my arms to show for the investment.  All I have is a piece of paper telling me that they will not pay for my office visit on November 12 because, “Maximum Lifetime Benefit Has Been Met.”  It reminds me of the scene in Dangerous Liaisons, when the Vicompte de Valmont intones again and again as he is breaking up with Madame de Tourvel, – a woman he truly loved – “It’s beyond my control. It’s beyond my control.” .  He kept repeating it as she got more and more upset and the letters will keep coming intoing the same six words, “maximum lifetime benefit has been met”.  

I should be grateful that we had this money in the first place. I should not be angry that it is all gone.  I should not feel as if we wasted it because the bedroom in the back is still filled with boxes and my uterus is in no way filled with a child.

But, I’m angry that the money’s gone, I’m angry that we have nothing to show for it and I’m angry that Dr. Uterus spent it all on things that didn’t work. I’m still so angry at all that has happened.

‘Tis the Season

Even though the local radio station started playing Christmas music almost two weeks ago and the tinsel has been up in the stores for almost as long, I don’t get in the holiday spirit until after Thanksgiving.  Call me old-fashioned, but the decorations, tree and other miscellania don’t find their way out of the closet until at least the weekend after Thanksgiving. 

aim-and-shootBut, this reminds me of another holiday tradition: the brag letter.  I know that’s not what it’s called, but damn if that is not what it seems like when I get one.  I have one friend who consistently sends one out, and last year, used it to break the news of her divorce.  For the record, I’ve only ever sent one of these, a few years ago when we had had a particularly action-packed year. 

Now, though, I’m tempted to write another missive to catch up everyone on our ridiculously exciting uninteresting lives and, oh yeah, share all about our infertility.  I will be the first to admit that my motivation is pretty much totally selfish as I’m tired of not telling people that we know what’s going on.  At the same time, it’s not something I want to bring up in conversation when they call me out of the blue.  I’d like to be passive-aggressive that way.

I haven’t broached the idea with Mr. X as I am still trying it on for size.  But, as ladies who are going through the same wringer, I’d like to know your opinion – and get a chance to use the poll option! So, go ahead, vote below!

image: aim and shoot

Trickle Up Economics

While I know intrinsically that my decisions in life invariably affect someone else – the ripple in the water effect – it is not usually very apparent to me that this has happened.  It’s rare that you hear from someone that your actions in turn dictated theirs.  Although, in some cases, feedback is immediate – you stopped and so I crashed into you!

hiddenpowerDespite the Clomid Challenge (and yes, the bombardment), I have still been giving thought to the option of throwing in the proverbial towel and living childfree.  As I have gotten farther down that road, though, I have realized that this sentences not just us to living childfree, but our parents as well.  Which is a little awkward.

For myself, I have to say that my parents have been overwhelmingly supportive of us – regardless of the decision we make. In fact, I think my father believes it is a bit of folly to even consider having children: “they take so much time, so much money and you guys have such a great life together!” is what he would (and has) said.  He is the anti-parent in that respect. There is zero pressure for us to reproduce, in part, I think because they were under the mother of all pressure cookers to have children from my grandmother (my mother’s mother). 

I have no idea what was said, because I wasn’t around, but my understanding is that she made a real stink about not having any grandchildren and my parents resented this for years to come. Not that they had me to placate her.  But, they have often told me that they knew that they would not and could not do that to me because it was so awful for them.  As awful as it sounds, I have to silently thank my grandmother in some respects for being such a harpie in the matter because it has ensured that I don’t have the same treatment.

Mr. X’s parents are equally circumspect when it comes to the question of Grandchildren.  They are very eager to have grandchildren, but they are also very respectful of what we decide, and what we have gone through. 

We are supremely lucky in this respect.

But, with a decision to live child free, I am making a decision for our parents to live grand-child free as well.  What a responsibility.  On the other hand, it would be wrong to have children just for them.  Somehow, though, making the decision to have grandchildren for them seems less selfish than making the decision not to have children and depriving them of that opportunity. 

I know what my parents would say now about this: you are crazy!  But, what will they say 20 years from now?

image: Hiddenpower

Of Course.

My next door neighbor suffers from a bad case of verbal diarrhea.  She has that special knack for asking and saying the absolute wrong things at the wrong times.  Way back in February, when I was fresh from my first full IVF and in the two week wait, she decided to share with me that the neighbors down the street, were going to start ‘trying’ in March.  Why she felt the need to tell me this, I don’t know.  Even then, when I was fresh from a transfer with three beautiful blasts, it took the wind out of my sails. I remembered all over again when we decided to start trying and it was so exciting and it was only going to be a matter of time before we were planning for a new arrival.  Um, no. Didn’t happen that way.  And, I just knew somehow that they were not going to have any problems.

Fate has proven me right.  Darned if she’s not about 5 months pregnant which would put them at the success on just the second month of trying.  I had heard from her husband that she was pregnant, but I didn’t ask for any details.  It wasn’t until this evening that I saw the extent of their success. 

I can’t help but wonder since my neighbor felt no qualms about telling me – who does not know this woman from Eve – the impending plans for her uterus, if she has also shared our story with this woman.  I have a feeling that she did in low conspiratorial whispery tones, after hearing that they were successful right out of the gate.

“Oh, I’m so glad that you guys got pregnant! My poor next door neighbor is just having an awful time and I would hate to see you have to go through all of what she’s gone through.  I think they’ve been trying for years.  And, she had a miscarriage, too.  They even did IVF.”  Quel horreur. 

I’m not the Cautionary Whale. I’m the Cautionary Snail. 

And, I bet she thanked her lucky stars that things worked the way they were supposed to, in the time allotted and she doesn’t have to deal with the ignomity of bitterness and jealousy that is infertility.  I bet they’ve already found out the sex, picked out the name and had the nursery finished.  All that is required now is to prepare the birth plan and pick just the right hospital for the blessed event that will bring the bundle who will be perfect in every way and fulfill all of her dreams. Or something like that.

They were out walking their dogs this evening and there she was in full pregnant glory with a white shirt straining over her belly, all the better to show the size.  Part of me wanted to see a smug little smile on her face as she saw me, the Infertile Girl, so that I could be angry at her for being cruel. 

I can choose not to be bitter. I can choose to accept that the universe is not punishing me nor is it rewarding her.  I can choose not to be angry and sad.  But, frankly, right now I don’t want to.  I want to be bitter because it feels right.  I want to be angry because I still think this sucks.  And, most of all, I want her to know just how amazingly lucky she is because she is the exception, not the rule. 

image: elycefeliz

Redux

Mr. X and I have secured a ‘complimentary’ consultation on October 22 with another RE up the way from Dr. Uterus.  I filled out the release so he could obtain my records from Dr. Uterus ahead of our consultation.  But, I also decided that it was a good idea to fill out the dreaded 10-page patient questionnaire about our history.  This way, he has as much information as possible ahead of time, and I can test whether or not he actually reads what I send in, as not reading the information I provide that has been requested is in my top five peeves of all time.

It seems like I’ve had to fill out alot of these lately – a new one for the gyn I saw for my pap smear (which they didn’t bother to read – hence the surprise that I’ve now had 2 miscarriages), one for a rheumatologist who I saw for unrelated issues, and now this one.  Each time, I had to answer that question:

How many pregnancies have you had? Answer: 2

How many live births? Answer: 0.

So much joy and so much sadness translated into questions with numbers for answers.  And so many experiences broken down into charts, or yes, no, explain.  I found it so trivializing to have to quantify all that we have been through, even though I understand why it is necessary. Just once, though, can I give you a narrative instead of answering your imprecise questions, or having to read the question, “what are the names of your children?”

(For the record, my babies are named Jellybean and Phoenix.  But, I will never, ever write that on your questionnaire.)

Getting Over the Bump

I would say that I didn’t really start noticing pregnant women until we were about six months into our honeymoon phase of trying to conceive.  And then, they didn’t really bother me – I smugly thought that it would only a matter of time before I too was sporting the Bump.  But, a full year into our journey – after another six months in which I popped Clomid with no results and was told that my referral to the RE was imminent – I began to see them a little more differently. I began to see them as infertile women see them: unwelcome reminders of what I don’t have, can’t do and can’t seem to get.

I met with the RE, who I didn’t like and knew immediately that I was going to find someone else.  I was then referred to Dr. Uterus by a friend who had already been down this ugly path and she raved about him (as I would too).  I don’t remember if she told me that he shared his office with a high risk OB or not.  I’m pretty certain I googled him and found the place’s website which very clearly shows the other doctor and what she does.  But, even then, I didn’t get it. I figured they probably had separate entrances, etc.

Little did I know.

My first visit, I’m sitting in the waiting room and I am surrounded by Bumps. Bumps of all shapes and sizes, some big, some not so big, some threatening to take over an entire corner.  And I was more confused than anything.  It wasn’t until we started treatment that I came to know just how bad it was.  There were always Bumps. Morning, afternoon, it didn’t matter.  And, it bothered me everytime I went there. 

I began to complain about it to Mr. X.  I would moan and wail on the phone when I would call him after my appointments because it was just so painful, and I couldn’t keep it bottled up. Who better to share it with than my partner in crime?  He didn’t see it that way.  He told me, much later, how much he hated getting those phone calls.  I completely understand now. I would hate to get those phone calls, too. 

What I have come to realize, however, is that he feels that I should get over it, move on, greet the waiting room with its Sea of Undulating Bumps with equanimity.  I’m afraid I’m not that strong of a person.  I have tried, dear Lord, have I tried.  But, I would say 90% of the time, I am at least mildly bothered, and sometimes outright upset.  I think part of my being bothered is that I resent the fact that I have to deal with the Bumps in the one place where I had thought I could be free of them, my safe haven from happy couples lovingly gazing at her navel, cheery pregnancy posters and baby magazines.  If not your RE’s office, then where? 

If it was a normal waiting room, I think I would be able to deal.  I would understand that it is expected that on any given day, in the general population, you are going to run into someone who is visibly pregnant at the doctor’s office.  That I can handle.  But, the fact that it is in the place where I thought that my infertility and all of the emotions that go with it would be respected and understood, turns my normal “meh” reaction to the Bump into a full-blown “Get Me Out Of  Here” plea.  

You would think that time, with its healing properties, would have worked some magic on this.  Unfortunately, it’s been the reverse.  Time, with all of its happenings – including five failed IUIs and two breathtakingly awful miscarriages – has made it that much harder to sit in the room with Bumps.  They mock me with their smooth curves and the knowledge that within that bump resides an honest to God infant – you know, the kind that I can’t seem to grow. 

As much as I dislike these feelings and wish that I could look past the Bumps, I know that for now, it’s just not going to happen.  They will still bother me, without any other effort on their part other than just sitting there when I walk in.  And, I will still resent that they are there, in the one place I should not have to see them.  The vicious cycle will continue as long as I continue to walk into that room.    

top left image: SeraphimC; middle right image: Pet_r; bottom left: ToniVC

Inertial

I haven’t given much thought to the Great Do I Find a New RE Debate of 2008 in the last few days. We had company last weekend and of course there is that work thing, so the mind has been preoccupied in other areas.  But, it has been sitting back there, on a shelf, slightly pushed out in front of all of the other back burner items that inhabit that area of the brain, cheekily reminding me that eventually, I’m going to have to deal with it.

During that time, in the vortex of conscious debate and thought, it seems as if inertia has taken over the decision-making process, leading me where my general feelings of dissatisfaction have been taking me.  And, inertia is making a damn fine showing. 

Case in point: the mail last Friday brought a bill from Dr. Uterus’s office.  This is actually a rare occurrence – not because we don’t owe anything, but because they tend to save up their billing for one gargantuan one every six months or so.  And, for some reason that they have yet to satisfactorily explain to me, it always tells me that the bill is overdue and we must! pay! now! to avoid collection.  Seroiusly annoying.

But, with this bill that arrived less than a month after the last procedure (shock in and of itself), we owe him nothing, monetarily speaking.  We also have no embryos left, no sperm banked, nothing of ourselves cryogenically frozen and waiting to be used at the office.

We could leave … today

I’m just not ready to do the deed.

While inertia may be pointing me in that direction, only I can give the signal that it is time to move on.  And, I’m probably 75% of the way there.  There are some lingering feelings, doubts, remorses, general hemming and hawings going on that tie up that last 25%.  The good news is that I am still not ready to jump back into treatment so I have the time to really think things through.  Right now, though, all of the potential obstacles that would have made switching or leaving difficult or pesky are nowhere to be found.  The door is open and we are free to go with no obligations. 

If it were only that easy.

image: Cougar-Studio

Pencils Down!

My current test paranoia got me to reminiscing.  How many tests has Mrs. X taken in her 32.5 years? Let’s see, by my rough approximation here is the breakdown:

Academic tests: at least hundreds, if not thousands (counting pop quizzes)

Standardized tests: Oof. Three shots at the SATs, two shots at the ACTs, the PSATs, a wretched round with the GMAT, those stupid tests named after different states (Iowas, Californias, etc) used to determine placement in elementary and middle school = um, I don’t know, maybe 25?

Vision tests: too numerous to count starting in the third grade, although since I had Lasik in 2004, just one.

Driving tests: 1. Although, wouldn’t you know I woke up that morning with a terrible stiff neck and could barely look over my left shoulder. I still managed to make it through the obstacle course and turned a three point turn into a seven point turn, but hey, I didn’t hit anything!

Blood tests: since embarking on the Hotel California experience that is infertility, I’ve had quite a few blood draws. I don’t keep count, that would depress me, but I would venture to guess several hundred, including lots of beta draws – 7 for procedures and then one per week after each miscarriage (what a parting gift!).

The thing is, with the exception of vision tests, the outcome of each test I took before starting down the road of infertility treatment was solely determined by me.  How I did depended upon how much I prepared, how much I concentrated, how much I cared – and each test reflected that investment and was a statement of who I was a student, an individual, a driver, etc. 

With pregnancy tests, it is hard not to equate the (negative) outcome with some failing, some flaw in yourself or your overall self-worth.  After all, you prepared, you concentrated, you expended untold amounts of energy to affect the outcome and yet, you weren’t able to influence what happened. 

What does that say about you? In reality, absolutely nothing except that you tried and it didn’t work. It’s like buying a lottery ticket. You tried and it didn’t work and it had nothing to do with what color shirt you were wearing when you bought the ticket or whether or not you are a good and deserving person.  We probably don’t think about these things when it comes to the lottery because, let’s face it, who thinks they are actually going to win? In contrast, people everyday get pregnant with little to no effort and it is a natural and expected part of life.  So, when you don’t get that jackpot that so many others claim with little to no effort, it’s hard not to direct the question of why inward to find the reason.

Suffice it to say, I’m working against 30 years of treating tests as a measure and evaluation of my self-worth, intelligence, etc, and it’s going to take a lot to not view this test any differently.  I know, deep down in those dark places that I keep locked away with a key, that this has nothing to do with whether I am a good person, a smart person, a worthy person, a beautiful person, a good friend, a good wife, etc.  All it has to do with is whether two little embryos decided to snuggle in for a nice rest.  But, as I’ve said 50 million different ways before, knowing and feeling are two very different things.

image: dullhunk

Ready or Not?

I think Big Red is beginning to trickle in and so marks the beginning of our For Real FET cycle – as opposed to the mock cycle that we just finished with the Fabulous Parting Gift of an endometrial biopsy.  I was at lunch with Mr. X. this afternoon discussing the upcoming events (SHG, FET, oh my!) and I once again thought: can I handle this if it actually works? Am I ready to begin the rollercoaster of beta numbers and OB scans? Right now, I don’t know.  I really don’t know.

All of this may be academic since there is by no means a certainty that this will work at all, but I wanted to know for myself now if I was ready to handle everything that goes with a month where you have more than a slim chance of getting pregnant.  Am I prepared if this actually works?

When we first started down the IUI road, I was so fixated on getting that phone call that the test was positive.  That was the hardest part, right?  I was blissfully unaware that that was just the beginning of a very, very long windy road.  We took the Wrong Turn of Miscarriage on my 11-week appointment and our ride was over.  It was over even faster this last time.

As I posted before, I can no longer visualize myself getting past the 12-week mark.  It is literally inconceivable to me.  So, there is the temptation to see this as the beginning of yet another sad chapter.  The challenge is not so much getting pregnant now, as it is staying pregnant.  Of course, it was getting to the point where I thought I would never get pregnant and I did.  Now, it is where I don’t think I will have a live baby.

Who knows? Maybe it’s a matter of setting the bar a little farther.

image: windy_sydney

The Good, The Bad and The Ugly

First, thanks to everyone for your good wishes on my biopsy today! Here’s the rundown:

The Good: the biopsy itself took maybe a minute.  For some reason, Dr. Uterus thought I had had one before, so I politely informed him that while I had partook of the panolpy of infertility abbreviated procedures (HSG, SHG, IVF, IUI), I had not had the pleasure of an endometrial biopsy (which I don’t think has an abbreviation). But, I’m always one for a new challenge!

The other good: NO MORE BUTT SHOTS!!! Can you tell how excited I am?  My tush may never forgive me – my glutes were still sore from the shots in March. Yes, March. But, truth be told, they were only sore when I poked.  Which I don’t do often in polite company.

 The Bad: As with most things in life, there are more bad than good things to report. First bad thing: we won’t know for almost TWO FREAKING WEEKS if the hoodwinking worked, during which time I will already be popping the Estrace pills.  Thankfully, the butt shots will not start up until some time after that.

Second bad thing: I need another SHG (insert collective ‘boo’ here).  My first SHG last December before our IVF this spring didn’t go so well.  In fact, of all of the procedures I have had where I was not sedated, this one by far sucked the most in terms of sheer agony.  In other words, I put the hysterical in sonohysterogram.  I reminded Dr. Uterus of what a nasty time I had of it last time and he offered to use a different catheter this time.  I’ll take it!

Third bad thing: it feels really, really weird to have the inside of your uterus scrapped.  I don’t think I need to elaborate.

Fourth bad thing: CRAMPS!  Luckily, they heeded the smack down of the Advil I took when I got home. 

And, finally.

The Ugly: I have mentioned before that Dr. Uterus – for some imperceptible reason likely only known to him – shares his office space with a high risk OB.  If I didn’t seriously think he was the second coming, I would find me an RE who did not appear to be so insensitive.  On any given day, there are very pregnant ladies in the waiting area with their husbands watching as the infertile girls come in and sign in.  We are so easy to pick out – looking straight ahead so our gaze doesn’t bounce from belly to belly to belly.  No tell-tale bump, and no escort.  Most of us go it alone except for those important visits (like the first baby ultrasound or the IUI).  It can be so demoralizing when the room is filled with unborn children and their mothers and you walk in, alone and barren as a field after a harvest.  The Infertile Freak. I imagine it’s what the perp walk feels like. 

What is so frustrating is that you are surrounded not only when you go in – I usually run into them when they are going on the elevator and I. Just. Know. that they are going to this office.  Today was particularly bad because I was waylaid behind a very pregnant woman and her husband (who frankly looked like he couldn’t even figure out how she came to be pregnant, let alone which direction down the hall to go).  I have to walk behind them down that Long Corridor to his office and then wait behind her while she signs in and then stands there, with her huge belly mocking me.  Finally, she realized that I needed to sign in too and moved out of the way.  I wanted to run as far away as possible from those bellies.  It was like a horror movie.

But, I didn’t.  I walked with as much grace as I could muster to a seat that was not connected to any others so one of those bellies could not park itself next to me.  I knew that they were all looking my flat stomach and thinking to themselves, “Oh, poor thing, she’s here for the infertility doctor.” And, simultaneoulsy thinking themselves to be so lucky to have a living infant growing inside of them.

I sat down and promptly opened my book, while willing Dr. Uterus’s nurse to come get me so I wouldn’t have to fight the urge to look at what I was missing. 

thumbs up: joeltelling, thumbs down: striatic