A Bit of Earth

I love flowers and plants, but alas, lack a green thumb.  Growing up, my mother always had plants in the house including the orchids she had owned since college and carried the flowers as her wedding bouquet.  I always figured that plants were pretty easy until I tried my own hand at them after I moved into my first apartment.

The first plants to fall to my attempts were a couple of cyclamens.  “Just water them, but not too much,” people told me.  “They’re easy.”  These lasted a couple of weeks.

Then there was the container garden I attempted on the porch, which had the unauspicious beginning of a severe allergy attack in the garden center as we were picking plants.  I was sneezing, my eyes were swelling, and we wrapped it up about the time the hives started breaking out on my chest.  The tomato plant produced three miniature tomatoes, which I still dub the most expensive produce I’ve ever bought at $1.25 apiece.  The pepper plant shriveled and died.  The basil was the most successful of the bunch but still had a tendency to develop an unhealthy shade of yellow-brown on and off.

When we moved into the house, I realized I was going to have to figure out the care of the landscaping or risk being the house that had the dead/messy plants.  This has been a bit of a mixed bag.  The day lilies in our front bed around the light post are overrun by grass that I haven’t managed to successfully weed out.  My mother took a look at the various plants and explained that a few of them had most likely been put in during the selling process to make the house look nice and weren’t in optimal spots for that kind of plant.  She was right, during the first spring/summer, most of those weren’t healthy and didn’t make it to the fall.

We did, however, have some volunteer tulips and grape hyacinths that came up last year, didn’t flower, and I decided that I’d dig them up in the fall and plant something that would flower and look nice.  Well, I forgot, and sure enough, this spring, the plants came up.

And there were buds.

To my absolute surprise, the flowers all opened.

It’s been quite pleasant to see them on a daily basis.  As someone who can get rather cynical at times, I think it’s probably a good reminder for me as a more overarching lesson about life: sometimes it surprises in beautiful ways.

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The Space

If you have ever spent time in a hospital, you will detect a rhythm.  Under all the bustling of the doctors, the nurses, the respiratory therapists, the entire infrastructure of acronyms that keep the thing running, there is a quality of silence, stopped time as people wait.  Even in the direst moments when everything is moving at full speed, there are pauses – waiting for lab results, specialists, OR rooms to become available, 30 seconds here, a breath there.

I didn’t really understand that rhythm until I became a patient myself, an object of all the bustling as opposed to performing it.  Sitting in the space, waiting, is hard, especially when you know that the result, the consult, the surgery, could change everything.  I often filled the spaces with books and blog posts and articles.  It’s strange how book or words can become a sort of friend in those places, buoying my spirits or just holding the space with me and affirming the mixed emotions in those moments.

Waiting was what I was doing in spring of 2014 after an unexpected result from my FET.  Pregnant but with far too many worrisome signs for confidence, Arthur and I had to decide whether or not to go ahead with a long-planned trip to attend a writer’s festival at our alma mater.  Several authors I admired were on the schedule to speak, we’d shelled out the money for tickets, hotel, and time off.  My RE gave his blessing to go ahead since we’d only be a few hours away and I knew where to go if the symptoms became more concerning.  So we went, hoping for a distraction from the seemingly interminable wait.

It was definitely the right decision, as hard as it was to make at the time.  I listened to lectures by James McBride, Ann Lamott, and so many others.  I went to the English department reception where I smiled, listened, reconnected with people, and shared stories.  All while simultaneously gritting my teeth as I’d feel the blood seeping out and the panic rising, then be blessedly inspired and challenged by new words, new books to read.

That’s how I wound up in a session with an author named Rachel Held Evans, who wrote a blog (and books) on faith, Christianity, and wrestling with (and eventually leaving) evangelicalism – a process both Arthur and I were going through, though in different stages -as well as a heartfelt and surprisingly funny second book on the meaning of “biblical” womanhood.  Arthur and I had read the book and had some good discussions.  After the session, there was a meet and greet and I told her how much I had enjoyed the book and admired her openness writing about faith, life, and menstruation.  I came closer than I want to admit to bursting into tears and confessing that I was really excited to be here but also probably going through a miscarriage and that I was really grateful for some of her writing, that the presence of her and these other authors had made this waiting just a little better.  Thankfully, my sense of manners and decorum kicked in to save me from serious awkwardness and oversharing, but I also suspect she would have been very kind.  The moment ended, we moved on.

One of her books kept me company a year or so later in the NICU as I waited beside my daughter’s incubator.  Arthur and I read it aloud as we put our tiny baby on our chests, sleep deprived, and needing healing words.  Her words kept me company in the empty space when my brother died.  Her words again encouraged us when we walked away recently from the denomination that married us and baptized both our children and were there for us during infertility and the NICU after a decision made at the denominational level to further exclude our LGBTQIA+ brothers, sisters, and non-binary in faith that Arthur and I found cruel and wrong.

Rachel Held Evans died on Saturday, May 4 after a sudden illness that led to complications at the age of 37.  It is for the people who actually knew her in her real life to mourn her in that intimate, deep way that comes with relationship and they are the ones that are truly bereft in this moment.  My heart aches for them as they move forward without her daily presence and grieve her great loss.

As simply a reader of her books and not someone who knew her personally, I’m just grateful for her words and quite sad that the lovely and luminous person behind them is gone from this world.  Those words held my hands and abided with me in some awful spaces.  They are and were a source of presence and balm.

While the many articles and obituaries have quoted Rachel’s final blog post on Ash Wednesday that is unexpectedly apt and poignant in the wake of her passing, the words from her book Inspired: Slaying Giants, Walking on Water, and Loving the Bible Again are ones I remember now and as a fellow reader they resonate deeply: “I know I can’t read my way out of this dilemma, but that won’t keep me from trying.”

#BecauseofRHE

Responding to “Stuff People Say”

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Recently, I had the opportunity to go to a lecture by Dr. Alan Wolfelt, a nationally known speaker and author on loss, grief, and mourning.  I picked up the ticket at my suicide loss survivor’s group and played around in my head with the idea of going for a bit, but I’m glad that in the end, I opted to go.

Wolfelt related the story of being at his own mother’s funeral, sobbing, and hearing someone say “well, he’s a nationally known expert on grief, but he’s not holding up so well”.  It can be hard to mourn in a culture that expects an almost immediate resolution of the outward expressions of grief.  A few decorous tears in the days following a loss, but after that, calm, stoic acceptance is far more acceptable.

One of the best parts of the talk was when Wolfelt tackled the topic of “stuff other people say” and got into what he called the “buck up” messages.  These would be statements like “well, you had him for 38 years of marriage” or “at least she lived to be 89 years old”.  I’m sure anyone who has been through infertility/loss can add a few more to that list: “at least you know you can get pregnant”, “hey, you can sleep in/go to a movie/travel since you don’t have kids”, or “you have a good marriage/job/life, focus on that”.

Because I am a bit cranky on the inside at times, particularly when on Lu.pron or other hormone injections, the response in my head to those sorts of statements often ran along the lines of a rude, anatomically improbable suggestion.  My outward response was usually to smile weakly and change the subject.

However, I appreciated Wolfelt’s suggested rejoinder to these sorts of statements: “True, but not helpful.”

It’s very possible to feel gratitude in times of loss or grief for the good things in life.  But having plenty to be grateful for doesn’t necessarily mean that there’s no room to grieve a loss and feel/express the emotions associated with loss.

This post is a part of Microblog Mondays – please go see Stirrup Queens for more or to participate!  Thanks to Mel for originating and hosting.

Ticket In Hand

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We had our RE consult today and it did not take me long to realize that in the fast-moving world of reproductive endocrinology, I’m definitely a blast from the past.

When I did my first FET cycle in early 2014, I used Lup.ron, oral estrogen, PIO, baby aspirin, a short burst of Medrol, and valium for the transfer.  Today, the FET we’ll undertake in September/October will involve injected estrogen every four days, PIO twice a day (!), dexamethasone, baby aspirin, medrol, and predisone.

My response: “I JUST got feeling back in all the areas of my butt and now PIO is TWICE A DAY?!”

Apparently, this protocol results in much higher implantation rates.  Dr. E explained that there’s too much variability with oral estrogen to be comfortable – apparently some women really struggle to get levels high enough even with high doses – but with the injections, it’s been much more consistent.  The steroids lower the immune system a bit to allow the embryo to implant and the different types plus longer dose periods than before seem to really help this process more effectively.  No more valium for transfer either.  Two days of taking it easy, like before.

I asked how likely the blastocyst we have in storage was to thaw properly and Dr. E told us since it’s frozen with the newer cryopreservation methods, it’s around 98% certain that we’ll have a transfer.

I am…a little overwhelmed, to be honest.  Not so much by the protocol itself (though it certainly is different than any other fertility protocol I’ve undertaken) but simply by the fact that this is it.  As weird and f—ed up as this sounds, the RE’s office and fertility treatments and reproduction (or lack thereof) have been this huge part of my life for about seven years.  Whether or not this FET or anything else results in a pregnancy, my reproductive years are coming to a close.

I won’t miss the worry, the miscarriages, the fertility treatments, the incredible sadness of failed cycles, the two-week wait, or any of that stuff.  Infertility, high-risk pregnancy, loss, and NICU inflicted real wounds that are still healing and scars that still ache at times.

But there were silver linings that I couldn’t appreciate in the trenches.  Dealing with infertility and the associated complications also moved me from being someone who looked over her shoulder for another person when someone asked for an adult to someone who says “here, me, I’m an adult”.  I can battle with a ferocity I didn’t know was possible and also know when it’s time to walk away from a fight.  I know how to talk to an insurance company, how to marshal my resources, and who to call.

It’s more that I’m letting go of something that consumed vast amounts of time, resources, emotions, and despite the fact that this is, inherently, not a bad thing, it’s a change and a door closing.  It’s moving into an entirely different landscape – where I won’t chart my cycle, pee on OPKs, alternately (depending on where I am in an attempt to get pregnant) hope for or dread my period, or take pregnancy tests.  I’ll get rid of the maternity clothes and the baby stuff.  Labor and Delivery will go back to being a department with no more significance to me than Endoscopy or Medical-Surgical.  I’ll change into whatever lies ahead and deal with it, hopefully gracefully.

It’s strange, though, being here.  It’s like waiting in an airport, ticket in hand, and not knowing exactly where I’m going next or how many transfers or bits of lost luggage, but knowing that my flight will depart soon for somewhere.

This post has been a part of Microblog Mondays.  If you want more, please visit Stirrup Queens‘ blog.  Thanks to Mel for originating and hosting.

Good Stuff

Content note: Child-centered post

Yesterday marked the first day in quite awhile that the weather was fine enough for a good walk outdoors.  The temperature was in the mid-40s, which, given cold this winter, felt downright balmy.  The sun shone and we took a short walk to the park down the street.  E rode her trike and collected rocks.  We came home tired and a little muddy (the trike tipped in a puddle) and it was wonderful to finally get outside again.

The girls will turn two and four shortly.  They’re no longer babies, but instead children who are more interested in running ahead, picking out tiny treasures for their various collections, and reading books.  It is, of course, a little bittersweet – after waiting so long for them, it feels like the days have sped up – but it is also marvelous to watch them grow and change and begin to fill in the contours of their personalities in demonstrable ways.

M waited a long time for words but suddenly now in the last few weeks began speaking in full sentences: “I want more milk.” “Don’t go that way.  Go there.”  “It’s time for snack.”  She’s almost discharged from developmental therapy (for the speech) and knows her own mind well.  Books are her favorites, particularly Paul O. Zelinsky’s gorgeously illustrated Rapunzel, along with almost any book that has flaps to open.

E also is doing well.  Every time I think about the tiny 2lb 8oz (1190 gram) baby in the NICU incubator and stare at this child who is still quite petite in stature but huge in personality, it almost makes me want to cry with happiness.  She’s at age level in most skills except for some gross motor that needs to finish catching up.  Her favorite thing is stickers and making cards for people that she happily scribbles all over and explains to me what she “wrote” there.

Together, as much as I dislike the term itself, the girls are the definition of “frenemies”.  A sample interaction: E yanks a toy away from M, who tries to push E but doesn’t quite manage to do more than brush E’s shoulder.  E flops on the floor and starts sobbing loudly.  M goes over and pats E, making soothing noises.  E yells at M and stomps off.  A few minutes later, both girls are cuddled on the couch with E explaining a book to M, who is listening with great attention.

In other words, they’re siblings.  But I also know how much they genuinely care for one another.  E worries about M, M searches for E when E’s not in sight, and they play together well a surprising amount of the time.

They’re small children and there are days that don’t look nearly this idyllic, but every day, I’m grateful. 

Luck

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Ever since I called my RE’s office to set up the series of appointments to lead up to the final transfer, it’s been on my mind a lot.

Like, a lot.  As in a truly ridiculous amount.

I think a big part of it is the unknown aspect to the thing.  I’m truly privileged in the infertility world with my kids and can be happy whatever way life takes me, but the not-knowing part bothers me.  The other part that tends to get under my skin is that – other than showing up and taking medications as ordered – I have no real control over the outcome.

On the spectrum between the laid-back people and the iron-fisted control people, I am definitely a control freak.  Some of this stems from anxiety (as in the diagnosed type).  My brain has a not-so-marvelous tendency towards getting stuck and panic attacks.  I like predictability, stability, and known quantities – and privilege has allowed me some insulation from the unpredictability of life in other areas.  This, I suspect, is why infertility in general has messed with my sense of self so much.

Earlier this week, I ran across an article about socioeconomic privilege entitled The Radical Moral Implications of Luck in Human Life: Acknowledging the role of luck is the secular equivalent of a religious awakening.  Author David Roberts states: “It’s not difficult to see why many people take offense when reminded of their luck, especially those who have received the most. Allowing for luck can dent our self-conception. It can diminish our sense of control. It opens up all kinds of uncomfortable questions about obligations to other, less fortunate people.”

Infertility is nothing if not one giant game of luck.  Diagnoses, lack of diagnoses, economic status to pursue treatment or adoption, one partner or both, what doctors/labs one has access to, the quality/growth of embryos, whether or not those embryos implant, miscarriages, emotional resources – none of these are really factors individuals have control over.  Heck, when pursuing treatment, I know I don’t even have control over when I have to be at the clinic during cycles.

Acknowledging how little control I really have over my life circumstances – and how much good luck has played a role – is a bit unnerving.  Roberts points out in his article that “I get why people bridle at this point. They want credit for their achievements and for their better qualities. As Varney said, it can be insulting to be told that one’s success is in large part a lucky roll of the dice.”

It feels like – given the sums of money, emotion, and time that are in play during treatment – the outcome should be more predictable.  That anyone who rolls the dice (or wants to roll the dice) at anything related to infertility should be rewarded commensurately.

This post is a part of Microblog Mondays.  If you want to read more, head on over to Stirrup Queens.  Thanks to Mel for originating and hosting.  

Coffee-Mug Philosophy

In my offline life, I’m in the process of some new stuff at my job that changes my workflow and sort of upends my established routines there.  It’s fine, positive even, and it’s something expected/planned but it’s amazing how much energy goes into change and re-configuring my habits.

The other day, these words fell out of my mouth: “It will be fine!  All this upheaval and hard stuff is going to make us stronger, right?”

Ironic, because I really hate that particular cliché.

~*~

I heard it quite a bit throughout the infertility journey: what doesn’t kill you makes you stronger.  I heard it when Arthur went through job losses.  I heard it in NICU.  I’m grateful no one said it too me after my brother died because suicide pretty much flies in the face of that kind of gritty positivity.  But that statement has hovered in the background of most of the big, tough moments of my life.

I think – as with most “sound bite” or “meme-ready” sorts of statements – the reality is much more complex.  I also think sometimes it’s employed as a quick conversation ender or a way to escape big feelings.

There are hard experiences that I feel have made me stronger, mostly those that are designed to break down before building up.  Nursing school sucked.  It was terribly long hours often (getting up at 4:15 am to drive two hours to a clinical site, being there for 8-10 hours, then going home), the studying was a full-time job, and I have never forgotten my first semester lab where everyone cried at least once except for the two students who had been in the military.  It was also truly worth it and the toughness was incredibly important when I got into real world and took my first assignment on a general medical-surgical/telemetry floor.

Some of the job losses for Arthur fall into this category as well.  It was sort of a surprise to me that after Arthur’s first job loss, the sky didn’t fall and we figured things out.  We were really privileged in many ways, but the experience helped me better hone savings plans and recognize that while it was 100% not optimal, it was survivable.

But as far as some of the infertility experiences go?  Being told there was no heartbeat?  Sitting in a hospital bed being told that I was ruptured and going to lose our very wanted baby?  Waiting in NICU for test results to come back to see if E had NEC?  Losing my brother?  No.

That sh*t broke me to the very core.

I mean, there’s a way in which all these experiences have given me a lot of perspective.  Going through all that reminds me on the days where all the little ridiculous stuff is piling up and it’s frustrating that I’ve survived so much worse.  That I will make it through that day.  I’m much better now at differentiating my small life stuff from what constitutes my bigger life stuff and reacting accordingly.  It’s also made me more able to take some forms of tension or frustration in stride, because, well, I can manage.  In that sense, the adage is correct.  Perspective is valuable in life, absolutely.

What the saying doesn’t reflect, however, is that there are some really ugly broken, jagged edges that are still in the process of being smoothed.  It doesn’t reflect the big ways in which these events changed the course, not always for the better.

I started out in elder care as a nursing assistant when I was 19 years old.  I loved it.  I always envisioned myself as a hospice nurse eventually.  I did some clinical time with hospice and felt confirmed in that calling.  Even when I started in the “real world”, I took assignments that would give me experience.

Then infertility hit and I was just so sad.  Conflicted.  Too many emotions running rampant to step back and be in a high-emotion field like hospice.  I put the dream on hold, mentally, and moved forward with a different path hoping to eventually move back that direction.  Then all the losses happened, NICU happened, and my brother died.

Now, I work in an area where I come in contact with the “hard stuff”, but in far more limited doses than a field like hospice.  It’s a good balance, I’m good at it, and I’m happy.

But I still mourn, a bit, that I had to admit that infertility, miscarriage, prematurity, and suicide loss limited me.  Maybe someday, but it will be years and a lot of therapy if hospice is ever back in my path.  I won’t do it unless I know my stuff is fully handled and integrated.

Empathy is another sort of mixed bag in life after everything.  On the one hand, I know these experiences have made me more empathetic in many ways.  I definitely can identify with people’s struggles and have a better ability to be present in those moments.

But it’s also made it far easier – especially when I’m tired, stressed, overwhelmed, or overstimulated – to fall into a pain Olympics sort of mentality or get really jealous.  I don’t think this is true for everyone by any means, but it’s definitely an issue for me.  I’m ashamed to admit that even while I was very happy for my BIL and SIL when they got pregnant, I was positively green with envy that they had gotten pregnant with twins on their first fertility treatment.  It threw me back mentally into every f*cking failed cycle and miscarrying twins on that first hopeful IVF.  I was happy for them but absolutely overwhelmed also at how sad and angry I was for my own losses.  This resolved with time and things are fine in that set of relationships at this point, but it’s not a great quality and one I’m on close guard against.

All the grief has also exposed the fault lines in some relationships and the Awful Things People Say.  After my brother died, it’s been a revelation how much stigma suicide really carries and also how uncomfortable some people are with grief and strong emotions.  Those secondary losses were really unexpected and the reshuffling of boundaries has been painful.

The fall-out also shows up with everything related to pregnancy or conception.  I’m afraid to embrace the idea of this final embryo transfer – even when I know, no matter how things fall out, I will be okay – because the whole thing activates all the panic responses and pushes me back to thinking on all the other memories.  When I was pregnant with M, my OB wound up allowing me to have appointments weekly through the first trimester, until both the risk of pregnancy loss had gone down and I could pick up the heartbeat on my home fetal doppler.  I was having panic attacks I couldn’t get under control, despite knowing I would manage no matter what the outcome.  It was awful and I’m really grateful that my OB was so kind.

And perhaps that’s one other little silver lining to the tough stuff: I’ve had the opportunity to see people step up to the plate as well.  People who have gone above and beyond and helped so much.  It gives me faith in humanity, in the idea that there is goodness out there.  It helps me better identify where I can be that goodness for others.

All this to say: it’s a mixed bag.  What doesn’t kill me has made me stronger and weaker…and panic attacks…and exposed my limitations along with my less than awesome qualities…and brought out some of my good ones.  But I guess that doesn’t fit as nicely on a coffee mug.