Current Cycle Status

Content note: Final FET feelings + already present kids mentioned.

Well, this cycle is finally starting to become real.  I’ve been going back and forth with the RE’s office to start pricing out drugs and nail down the slippery little details that I’ve discovered can really derail things quickly.  I confirmed that they still open at the same time they used to, that now they do Sunday appointments in my city (it used to be that they only took Sunday checks about 1.5-2 hours away at the main office), and got copies of all the paperwork.  When my period starts this month, I’ll call, get the prescriptions, and order the drugs in preparation for next month, thus outlaying the first actual cash in this endeavor.

I’ve noticed that I’m starting to have a more reasonable reaction to the prices again.  Maybe it’s that I’ve been out of the ART world long enough or that we’ve spent money on other things in the meantime, but I’m keenly aware that what we are spending on this cycle is going to be right around what we paid for our entire upstairs flooring in a high end, water resistant laminate including installation.  I remember when I paid for the flooring and called Arthur to give him the final bill remarking that while it wasn’t cheap, it was about what we’d paid for FET cycle past and – salient point – we weren’t paying for a chance we’d get a floor, we were actually going to receive a floor.

That last sort of sums up the mixed feelings I have bidding farewell to the RE’s office and ART.  I’m really grateful for the fact that IVF brought us older daughter and also cognizant of the immense emotional and financial costs that went into all the cycles.  One of the things that’s hard about ART and IVF is that beyond picking a doctor/office/lab and following the protocol, there’s really very little I could control in the cycle.  I was at once expecting my first IVF to fail (because I’m a defensive pessimist) and also completely shocked when I miscarried (apparently there’s some underlying optimism there after all).  I’ve known for a long time – working in the medical field – that modern medicine as a whole is extraordinarily powerful in some ways/instances, but also falls badly short far more often than some of the glowing articles and incredible stories would have people realize.  Even knowing this, I found it hard to stack up the hopes I had with the grittier, less successful realities.

It’s the end of ART for us.  One way or the other.  I’m almost 37 and it’s time.  Whether or not we see if something breaks loose on our own if the cycle fails is something we’re very undecided on.  Met.formin really does appear to regulate my cycles but in my late 30s, other concerns such as higher miscarriage rates are starting to tick up (and that’s making the enormous presumption that I’d get pregnant at all – certainly not a given with my history).  I’m not going to lie, I have a little bit of the ache these days at the thought of being done, I’d really love it if the cycle worked out, but I can’t tell if that’s a deep, ongoing thing or if it’s happening because I’m immersed in getting ready to try to get pregnant with the FET and if the beta is negative will dissipate with some time.  Despite the occasional achiness, I’m grateful for where we are now.  I have no doubt that regardless of outcomes, life is going to go on and I believe it’s going to be good.

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Small Steps Forward

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I’ve finally gotten back into a routine of going to the gym in the mornings several times a week.  For awhile I was using our small rebounder trampoline at home, but it just didn’t really feel like I was progressing.  I’m starting to realize that leaving the house – whether going to the gym or running outside – seems to be an integral part of what makes it relaxing to me and worth it.

As I’ve been running on the treadmill, I kept noticing a class going on in the adjacent room.  I checked into it a little and it’s a whole-body interval training with many different stations that was listed on the schedule as “advanced”.  Well, I’m not advanced, I thought and shrugged it off.  I kept thinking, however, that it met at such a good time and I really do want something other than just running.

Today I asked one of the gym workers about the class.  She reassured me that they are happy to work with beginners, I’d just modify some exercises or do shorter intervals.  I was excited until, of course, I started thinking about September (or, more probably right now, early October).  It’s just three months or so until I’d probably have to quit.

I’m tired of thinking this way.  Fertility/infertility/subfertility concerns have been a part of my life for around seven years now.  It’s always a matter of what if, the next cycle, yes or no.  It’s exhausting.  Even when I know this is coming toward the end.

I think I’m going to do it.  A few months is a few months and I could use the motivation/change up in my routine.  If things work out with the cycle, I can always modify and scale back.  If they don’t…well, then I have a new routine and hopefully some new muscles.

If you want more Microblog Mondays posts, check out Stirrup Queens!  Thanks to Mel for originating and hosting.

The Happy Kind of Boring

We’ve been in that pleasant, uneventful in the large sense, busy in the small sense state for the last few weeks.  I find that I tend to sort of overlook these time periods in life because nothing major is happening, but in a lot of ways, they’re really the ones that make up the bulk and reality of life.  As someone who tends towards impatience, I’ve tried to challenge myself to slow down a little and savor the moments that do come.

  • Since we moved, because of various issues, it’s been a bit of a challenge to develop community. At this point, we’ve bought a house and plan to stay for a while, so I’ve been looking for some opportunities to find and hang out with people.  This, as you might imagine, is not the easiest thing – for a world that is hyper-connected by the internet, it’s surprisingly hard to meet people in real life.  Especially since we’re also searching for a new church community.  So I took a cue from Loribeth at The Road Less Travelled and checked into the local library offerings.  Happily, they have an adult book club that meets near my house on a weeknight that I can attend!  First meeting is next week and we’re reading The Nightingale by Kristin Hannah.
  • We’ve been watching “Big Dreams, Small Spaces”, a British show about gardening/landscaping. It’s pretty soothing and I like the fact that people are realistic about the labor and financial costs of putting in a dream garden.  Budgets range from “almost nothing” to “over $25K in US dollars”.  What’s most fascinating are the things people find when they start digging – usually some form of concrete or stone, but in the most extreme instance, a live, unexploded WWII hand grenade (the bomb squad and then military ordnance disposal had to be called).
  • Having watched too much gardening, we decided, in a rash of wild overconfidence, to dig in a couple of mulched beds around our patio area where the grass looked horrible and patchy. It’s mostly shady, so the lovely garden/wildflower meadow/herb garden I had in mind was quickly shot down by my (botany minor) mother.  Instead, we’ve got a couple of mulched beds with coral bells and hostas (also known as plantain lilies).  It’s not real gardening but I’m happy to report that so far, the plants are alive and thriving and the area looks much better.  In true “Big Dreams, Small Spaces” fashion, we found seven large pavers buried in the area, along with a bunch of gross plastic.  Probably explains why the grass refused to grow there…
  • Nice as the back now looks, the front needs work. We have two bushes next to the house that we neglected to prune properly and have metastasized into oversized disasters.  There’s probably no saving them, unfortunately, we’ll probably have to go ahead and take them out.  This gives us through the fall and winter to plan (and save) to replant the bed in the spring.
  • As final item in the plant department, I am also happy to report that I bought two hanging baskets for the porch a few weeks ago and both are still alive (no one is more surprised than me). They look lovely and give me a little pop of happiness every time I see them.
  • Currently doing swim lessons with the kids, thankfully in an indoor pool. We are not having a warm summer so far – last week we had a day in the 50s-low 60s.  It’s also rained a ton.  I am so ready for nice weather!
  • I really can’t believe it, but we’re starting to talk about kindergarten and working on settling a pre-K plan with daycare. E won’t go this fall but the plan is for fall of 2020.  It’s a little wild, mostly because I still have a tendency to think of her as 2lb 8oz (1190 g) baby, but in reality, she’s actually a pretty typical 4-year-old with lots of opinions who loves “Frozen” and “Moana”.  She’s progressing in literal leaps and bounds with riding her balance bike, climbing on stuff, and doing somersaults off the couch.  I’m often torn between pointing out that we don’t do somersaults off the couch and wanting to cheer because it’s obvious how far her stamina, balance, and strength have come.  M loves climbing as well.
  • Saline infusion sonogram at the RE’s office on Monday.

“And”

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Content note: pregnancy, children, loss – none recent

This weekend, we tore up some of the scrotty grass that’s never grown well next to our patio in the back and put in hostas.  I pulled out the dead hydrangeas from the back bed and planted shade loving coral bells.  We went to visit college friends and as we sat, I had one of those moments that might be called transcendent or even holy, where for just a second, everything was right with the world and good.

The new life, both literal and figurative, was all around us.

I came home, checked my calendar, and realized that it’s not all that much longer until my saline infusion sonogram for this final transfer.  And before I knew it, this morning I was ugly crying, the one that isn’t a couple of crystal tears decorously sliding down the cheeks, but the red-faced, sobbing, snotty Kleenex filled kind.

That’s life, though, isn’t it?  At least after a certain point?  Where the most extraordinary exists among the prosaic of every day and the deepest, darkest muck that can be dragged up?

I am so incredibly, amazingly thankful for my girls.  And I am so terribly sad that I never got to meet the three that died and were miscarried early, long before they truly lived.

I honor the truly ordinary, uneventful pregnancy I got the immense privilege of experiencing.  And I grieve the long weeks of waiting, of fertility treatments and IVF, of hope mingled with sadness, of ultimately having three others over far too early.

I get the loveliness of watching my older daughter survive and now thrive.  And I mourn that she lost the last weeks in pregnancy that she should have had, that she went through so many painful procedures, that we were separated by plexiglass walls and nights apart at the beginning of her life.

I can’t even express how much gratitude I have to see the girls treasuring each other and also fighting – as siblings do.  And I can feel my heart breaking again and again and again that my sibling is gone, that a person I held as he came into the world left it long before me in such a terrible, senseless way.

I hold my dear ones close, their precious selves tangible and messy and wonderful and alive.  And I cry remembering the unnatural coldness of my brother’s still face, the benediction of viewing him in death, the slight smear of blood that transferred to my hand when I put it on his cheek.

I am fiercely glad for my marriage and the love my husband and I get to share every day.  And I mourn the things we have both broken over the years, some of which are still being repaired.

I am grateful for the chance to complete this final cycle, to close out this particular road, to know that no matter the outcome, I am truly fortunate and ready to live this good life I have.  And I am anxious, struggling with the months of waiting in the lead-up, dreading some painful procedures, and worried about the potential for more hurt.

For the last several months, I’ve been veering back and forth between the extremes, saying how I’m fine (true) and FINE – F*cked Up, Insecure, Neurotic, and Egotistical * – (also true).   It doesn’t sum up neatly, the pros and cons on the paper don’t cancel each other out.  They’re all true, all a part of what poet Mary Oliver termed “your one wild and precious life”.

I am, without a doubt, in today’s parlance, a hot mess these days.

And…it’s an absolutely beautiful mess as well.

*credit to Louise Penny

This post is a part of Microblog Monday.  If you want to read more or add your own, please head over to Stirrup Queens’ blog.  Thanks to Mel for originating and hosting.  

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.

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.