Step, Step

We take everything one day at a time these days.  I’ve heard that as advice a lot over the years (and mostly ignored it), but now it’s all but impossible to do anything else.  It’s strange to see our normally bustling calendar stripped bare of notations, just the date in each square. We’ve been listening to the Frozen 2 soundtrack in our house and one of the songs, titled “The Next Right Thing” has a resonance it’s impossible to miss right now:

Take a step, step again

It is all that I can do

The next right thing.

In a moment I’ve been dreading since the news broke about the Life Care home in Seattle back in February and I more fully began to understand what we were dealing with, my grandfather passed away last week, Covid-19 the most likely cause of death.  The staff at his nursing home took great care of him and for him and I am grateful for them and their good work.  We grieve our private loss, but I know we are also grieving in a community that extends from Italy to Spain to China, across the United States, around the entire world as the virus grimly marches forward.  Friends have lost family members or had relatives seriously ill.  Others are laid off or furloughed and worried.  Still others are parted from living loved ones that they desperately miss.  So many unique losses for so many people, so much collective sadness.  I haven’t decorated the plain wreath I hung on our door at the start of Lent or put up flowers to replace the bare branches in my vases.  No matter what the church calendar may say, the light has not burst forth yet in this season.

And with the dawn, what comes then?

When it’s clear that everything will never be the same again…

Yesterday morning, when Arthur got ready to leave for work, the car refused to start.  This was not a total surprise as we knew the battery’s getting old and we’re trying not to do too much with it since we know we’re going to most likely be buying a new vehicle in the fall.  With no time to try to jump it right then, we hustled everyone into the other car and I drove Arthur to work.

It was the most novel, lovely thing, just going out and driving an essential 30-minute round-trip.

The route to Arthur’s work is fairly scenic, which helps.  There was a heron wading in the marsh and the sun shining across the waters.  After weeks of not leaving the house for days at a time other than work and picking up groceries every once in a while, though, it was such a strange, pleasant feeling to drive further than my extremely short commute.

It’s funny how these little events that I barely would have noticed in The Time Before are taking on such significance now.  Sitting on the porch swing as the weather gets nicer has become a welcome break from indoors.  Having a conversation with a neighbor across the yard and safely socially-distant is wonderful.  We watch the birds at our feeders, mostly goldfinches now.  There are also some events that never would have happened in The Time Before: we got to watch our local Air Force wing take the fighter planes for a flyover to salute the hospitals and all the healthcare workers.

We are – like so many others – okay and also not okay.

We stay home.  Go to essential jobs.  So far, all healthy.  Wait.

But break it down to this next breath

This next step

This next choice is one that I can make…

The next right thing.

 

The Odyssey

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Last year, Arthur and I left our long-time church denomination after the worldwide conference voted to make a decision we simply could not abide by.  After we took a couple months off entirely and spent Sundays making waffles, reading, and just being generally lazy in the best possible way, we knew we wanted to work on finding a new church more in line with our values.  Eventually, we landed and started putting down roots.  There’s plenty that churches and denominations have generally in common, and while this is a new tradition to us in many ways, it’s also very familiar.  There are still occasional moments, though.

Listening to the organ play the intro to one of the communion hymns yesterday, both Arthur and I recognized it immediately.  It’s a particular favorite of mine, to the extent that it’s the music I walked down the aisle to when we got married, but as I looked down at the words, I realized they were definitely not the old, familiar ones I know by heart.  The closing hymn was the reverse: I knew all the words, but they were not set to the music I know.  Both of us laughed afterwards – so close, and yet so far!

Such it is right now in this period of transition generally.

I think one of things that is alternately frustrating and comforting is that after everything (waves hand generally at the last seven or eight years) the building blocks of who I am are still the same.  I’m still introverted, stubborn, bookish, prone to wrath, able to laugh most days at the absurdity of life.  The bedrock is there.  The circumstances have changed fairly vastly, the worldview expanded, perspective changed, but I’m still, well, me.  Also, in some big ways, not.  The familiar sitting in such close company with all the new is a little disconcerting.

Perhaps one of the things I expected after the everything was a personality transformation into something entirely different.  Something that overcame my weaknesses.  Something that transfigured my strengths.  Something motivational.  Something fabulous.  And, perhaps, an ending, a there, a destination.

Instead, as one of the characters says to the protagonist in the novel (This Tender Land  by William Kent Krueger) I’ve been reading and re-reading, “You believe you’ve been looking for home, Odie.  This is where your belief has brought you.  That doesn’t mean it’s the end of your journey.”

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

The Stories We Tell Ourselves

After the FET didn’t take, Arthur and I had the usual picking up of the pieces and trying to reformulate them into something that resembles a whole.  As always, this involves a fair number of discussions.  Most of the time, even when we’ve disagreed on specifics or details, we’ve generally come to a compromise that both of us are reasonably okay with going forward.  If we’re not on the same page, we’re usually in the same book, as it were.

This time, it turned out, we were decidedly in different books.

We both were in wholehearted agreement that we’re done with ART, but beyond that was where things broke down quickly.  I was on team “let’s see where the chips fall for at least a few months and then move on if nothing happens”.  Arthur surprised me by declaring that he was on team “Done.”

Well, there’s really no compromise possible on something like that – either we’re open to the possibility of another child or we’re not.  The odds would not be in our favor on conceiving and/or carrying to live birth at this point, but it’s possible.

After a several skirmishes leading to outright arguments, the short story is the only realistic conclusion for us has been reached: we’re done.

~*~

I’m not going to pretend that I’m at peace with the whole thing or deny that a part of me is still harboring a small hope that Arthur might change his mind in the next month or so, but I also can’t say I don’t see Arthur’s point in this whole mess.  It’s been a long 7+ years and honestly, we’re both exhausted, physically and emotionally.  ART demands an amazing amount of energy.  Beyond that, I’ve been doing what amounts to a rotating shift for 4+ years now which messes up my sleep cycle (2 consecutive night shifts at work, then up during the day the rest of the week) and while 37 is by no means old, it’s also not the same as being in my 20s.  Arthur and I are often like ships passing in the night since he works a more traditional 5-day a week 8-5 job.  E goes to kindergarten in the fall of 2020, heralding a new phase in life.  M will probably start another day in preschool at that point.

Some of it, though, I think, is the narrative of “try harder” still echoes in my head.  Part of me feels like I’m giving up.  Like if I just kept pushing, trying, hoping, I could somehow still the voice that tells me that it’s possible and I have to do just this one more thing.  It’s the d*mn shadow that I’ve battled throughout the whole process – the one that urges scorched earth tactics, that says that until everything is completely destroyed, it’s not enough.

It’s a liar.

I know that.  I know that.  I’ve spilled volumes of word processor “ink” on this myth myself and read plenty of other essays/blog posts/books that urge the setting of boundaries and the importance of maintaining mental, physical, and relationship health.  It would have been enough no matter how the whole thing ended or at what point we stopped.

And yet, it’s surprisingly hard to push back from the table and say “no longer”.

~*~

I can’t change the facts, but I have been working on re-framing the story I tell myself.

In the last few weeks, the story in my head has gone something like this: I could try harder.  We could achieve this, even in spite of my history.  We could overcome the hardships of possible miscarriage, a geriatric pregnancy, and a failed FET cycle if I was tough enough to keep going.

Instead, I’m trying this on for size: Infertility sucks.  We fought incredibly hard to the absolute best of our ability.  We are beyond fortunate in so many ways.  Setting boundaries and respecting limits are good things.  Time to heal the wounds and move forward enjoying life.

I’ve written about this before, but I keep coming back to author Bill Bryson’s ending to A Walk in the Woods: Rediscovering America on the Appalachian Trail.  Near the end, Bryson has a conversation with his companion Katz.  Bryson is a bit disappointed that they didn’t make it as far hiking as he envisioned.  Katz, on the other hand, has an entirely different perspective:

‘“Anyway, we did it,” Katz said at last, looking up. He noted my quizzical expression.
“Hiked Maine, I mean.”
I looked at him. “Stephen, we didn’t even see Mount Katahdin.”
He dismissed this as a petty quibble. “Another mountain,” he said. “How many do you need to see, Bryson?”
I snorted a small laugh. “Well, that’s one way of looking at it.”
“It’s the only way of looking at it,” Katz went on and quite earnestly. “As far as I’m concerned, I hiked the Appalachian Trail. I hiked it in snow and I hiked it in heat. I hiked it in the South and I hiked in the North. I hiked it till my feet bled. I hiked the Appalachian Trail, Bryson.”
“We missed out a lot of it, you know.”
“Details,” Katz sniffed.’

 

We hiked the darned trail through infertility.  We hiked it through snow and heat (especially not fun when a cycle demanded being at the RE’s office, then an hour away over icy roads).  We hiked it through cancelled cycles and miscarriages and negative pregnancy tests.  We hiked it through bills and insurance fights.  We hiked it through joy and devastation.  We hiked it through an allergic reaction and Lupron and injection after injection.  We hiked it through ER visits and SCHs and c-sections and a long hospital stay and NICU.  We were enough all along, both seven years ago and now, no matter how this thing ended.

That’s the story I’m going to work to keep telling.

 

Rising to the Occasion

I sat down after the cycle failure last night and took inventory of all the myriad emotions swirling through my head.  There was one discordant note that stuck with me: that this ending had come with no final input from the RE that really has been excellent through so much of this process.  It seemed so out of character.  I was so jarred by it that two o’clock in the morning found me awake, staring at the ceiling, aching and angry.

Most of the overall situation is fairly inevitable and unfixable – I cannot change the outcome of the cycle, I cannot change the past seven years, and I cannot change the fact that big decisions lie ahead.  Infertility yanked the illusion of control out of my hands when it comes to reproduction and really, most of life.

But I could hunt down this one small loose end and try to tie it up.  I could express my feelings – bewilderment, sadness, shock that this final phone call with the nurse was the end of the relationship with the clinic and doctor who had really seen me through so much.  I called, spoke to the office manager, and (surprisingly calmly) used my words.

I’m very glad I did.  My RE called me back this evening and we had the discussion that I wanted to have, needed to have at the end of this part of the story.  I’m grateful to him for being open and honest about the various reasons things went down the way they did yesterday and getting the chance to close things on a truly good note.  It was the compassion I deeply needed to hear.

I would be lying if I said I don’t tend towards cynicism far too often in life.  I’m not great at faith or hope or trust in anything from medicine to science to churches to myself to other people to G-d Themselves.  Every now and again, though, I’m surprised and I get a small glimpse of something good.

This is one time where, I’m happy to say, my hope was rewarded and my RE rose to the occasion wonderfully.

I don’t really believe in “closure”.  Like so many other griefs, resolving infertility will be an ongoing process.  Even when we’ve finalized the last of the decisions, I suspect there will be pangs that pierce me at the most strange and random moments for many years to come.  Infertility will no longer be one of the major, ongoing parts of my life, but it will always be a part of my story.

That being said, on this one part, I was able to have a moment of genuine resolution.

Right now, for me, that is a victory.

‘Bittersweet’ Isn’t Quite The Right Word, But It’s The Closest Thing I’ve Got

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We had a marvelous trip for a family wedding recently to New Mexico.  The whole thing went remarkably smoothly, the airline staff was lovely, and seeing all my aunts/uncles/cousins was a great deal of fun.

One of my cousins has a strange sort of resemblance to my brother.  I say “strange” because my cousin and my brother have/had completely different coloring (one’s a blue-eyed strawberry blonde, the other dark hair/eyes) and completely different heights.  However, there’s something, because I’m not the first to notice it.  My grandmother used to mix them up at times and multiple family members have remarked on the resemblance over the years.

At the reception, my cousin was dancing with my younger daughter, who was just loving it.  Watching him swing her around as she giggled loudly and yelled “more” was incredibly precious and absolutely wonderful.  He’s really good with kids as well as a lovely person and it was fantastic – I’m truly glad to have him (as well as my other cousins) in the family.  As the oldest by a decent margin, it’s great fun to watch as they grow, find careers, get married, and embark on their adult lives.

I also had this incredible stab of sadness.  Just for a split second, my brain played a trick and saw my brother there.  The memories that I usually keep firmly stowed came flying out so fast that I had to look away for a second, take that deep breath.

I know I’m not the only one with these moments – the ones that are so very wonderful that you’d never give them up, that you’re so grateful to have, but that also pierce you right to the core because they’re such powerful reminders of what you’ve lost.

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

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.

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.

“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.  

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.