The Left Overs

microblog_mondays

Last week I finally bit the bullet and made what I plan to be the first in the final series of appointments with my RE, hopefully culminating in a final embryo transfer around early-mid October 2019.  I mean, my RE is a good doctor and I like him, but I truly won’t be sorry to see the end of treatments and the clinic and all the attendant stuff.  I’m looking forward to moving on and coming to end of the infertility journey.

One part of infertility, however, isn’t going to be over anytime soon.  The reason I wound up at a fertility clinic in the first place, PCOS, still factors into my life, health, and daily living.

This is one of the parts of infertility that I really hadn’t considered much when I was in the trenches, mostly because in the trenches, it’s a day-to-day, minute-to-minute battle.  At this point, however, I’ve got a bit of breathing room to consider the future and that future continues to include PCOS.

And PCOS…sucks.

Mostly, it raises my risk of diabetes along with a number of other conditions, which means monitoring and care to ensure that I remain as healthy as possible.  For me, this means a daily dose of met.formin.  While it doesn’t work for all PCOS women, for me, it’s a miracle drug.  When my second RE put me on it prior to my second fresh IVF cycle because at that point, we were throwing everything reasonably possible at the infertility, I noticed my cycles regulated a bit and we got better egg retrieval and embryos.  After I gave birth to my first daughter, I went back on it to attempt to control the PCOS and boost my milk production, then continued on it and was surprised when, over several months, my acne abated and my cycles regulated.  Because PCOS is one of the big wild card conditions of infertility (some PCOS women have a terrible time conceiving while others, surprisingly, don’t have much issue at all), we were overjoyed when this led to our second daughter.

I managed without met.formin until I stopped nursing/pumping for my second daughter, but at that point, the PCOS symptoms returned with a vengeance – acne, wonky cycles, the whole nine yards.  I called my OB/GYN who was fine with putting me back on the met.formin and things have calmed down since.

I’m fortunate when it comes to PCOS because I have a fairly reliable external indicator about whether or not the PCOS is under control: acne.  If I’m breaking out massively, generally, I have cysts on my ovaries and the attendant issues.  I’m also fortunate that (so far) I’ve been able to find treatments that abate the symptoms considerably.

Despite the fact that my OB/GYN is good and I can somewhat see how well controlled my PCOS is, I know that I need a good primary care provider, especially since I’ll be able to stop seeing my RE (who has helped with managing my PCOS and been my back-up with that for years now).  At the moment, I’m starting to work on searching for the right doctor.  PCOS isn’t ending just because my infertility is resolving.

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

Advertisements

Infertility, Stigma, and Reading

Content note: Infertility portrayed in very problematic ways – possibly not the post to read if you’re in a tough place right now.

It’s old news now, but a month or so ago I read the Slate article that has been making the rounds in the infertility community – for good reason, it’s an excellent article hitting up a wide variety of issues and reasons infertility is particularly tricky when it comes to the workplace.  It also gets into how, despite more openness and acceptance for infertility, there’s still a very long way to go.

Since my own experiences with infertility/miscarriage, I’ve definitely noticed storylines or even short bits in books/films/TV relating to adoption/loss/infertility (ALI) far more than I did before.  While infertility is becoming more realistically depicted at times, I’m still somewhat surprised at how often I run across a particular trope that I strongly dislike: that women struggling with infertility/loss are scary.

Perhaps it’s because this came up in two books I read recently: The Alice Network (Kate Quinn) and Daughters of the Lake (Wendy Webb).

The Alice Network is largely about the female spy network that operated during WWI in France, interspersed with a young woman searching for her lost cousin in the wake of her brother’s suicide post WWII.  All the trigger warnings apply on this book both from the ALI perspective (unplanned pregnancies, abortion, loss) and generally (war, torture, Nazis, rape, etc.).  There’s a short bit, however, for a side character that includes infertility.

[Very minor spoiler ahead]

Spy trainer Captain Cameron went to jail because his wife decided to commit insurance fraud to provide for a child she couldn’t conceive.  Her infertility causes her to go to desperate, not entirely sane, lengths.  She conceives and recovers her mind.

[End spoiler]

Honestly, despite how much I was immersed in the rest of the story, this part almost made me put it down because it infuriated me so much.

Shortly thereafter, I picked up Wendy Webb’s Daughters of the Lake, a gothic suspense novel, on sale at some point and finally got around to reading it.  It’s definitely a ghost story, but in a mildly shivery sort of way that I enjoyed (I then promptly picked up a couple of her other books from the library and those descend into terrifying outright horror stories – this one I found much milder).

The novel had a baby/baby loss subplot, however.  Again, the theme of women deranged by loss and not having a child came up toward the end of the book.

Even setting aside artistic license and drama in novels, this Dear Prudence letter headlined “Help!  Sometimes I Worry That My Infertile Friend Wants to Kidnap My Baby” (I would not click over if you’re in a fragile place because yes, this accurately sums up the substance of the letter).  Prudie calls the letter writer’s comment to the friend unkind and gives the letter writer a thorough tongue lashing, but the letter itself definitely displays a truly alarming attitude toward those struggling with infertility.

I am so tired of women struggling to conceive or dealing with loss being portrayed as dangerous or harmful.  Infertility made me feel a lot of emotions.  Sad.  Angry.  Conflicted.  Anxious.  Frustrated.  Jealous.  Certainly these and many more, but while it’s true that I chose not to attend baby showers, disliked pregnancy announcements for the most part, and had to unfollow streams with lots of new baby/child pictures at times, I never wanted to harm anyone.  I never wanted to take anyone’s baby.  I never lost touch with reality.  I never wished that difficulty or sadness would befall anyone.  I’m not going to say that no one was ever disappointed in my reactions or that a few people insisted that I should be visibly overjoyed for pregnant women, but I tried – hard – to be kind and keep my feelings to myself in public.  Mostly because it wasn’t other people’s fault and I knew they weren’t having babies at me.  I just wished it was my turn and that conceiving had been easier (and – not going to lie – highly resented the amount of money we were shelling out for IVF).

This is why I write about infertility, in the hopes that reality will help to dispel some of the more pernicious bits of stigma surrounding this condition.  But it doesn’t help when a scene giving a picture so much to the contrary are popping up in a novel as widely read as The Alice Network.

Mile Eleven

microblog_mondays

About a month after my PCOS diagnosis and before falling fully down the rabbit hole of infertility treatments, I ran a half-marathon.  It was one of those “bucket list” kinds of things I’d begun training for in earnest shortly after we originally began trying to conceive in April because I knew deep down something felt “off” and didn’t want to face it.  I took my running habit, ramped up, and signed the papers to run in November.  If I was wrong, I figured, I’d walk or give my registration to someone else.  In the meantime, the long runs gave me something else to focus on.

The day of the race was a mildly overcast, cool but not cold November day – perfect weather.  I lined up at the start and took off with the other runners.  The first mile was great.  I was excited, my adrenaline was high, and it flew by.

The second and third miles were not so great.  This was the point where I began to realize what I’d gotten myself into and I fought the part of my brain that kept telling me I’d never make it 13.1 miles.  When I passed 3.1 miles, I wondered why I hadn’t just signed up for a nice 5K.  Then I’d be done.  However, as I kept running, mile four felt easier and I started enjoying the thing.

I ran through the countryside.  This particular race tends to be quiet, isolated, and doesn’t have the quantity of spectators or cheering that I’ve read others have.  I ran over country roads, admiring the farmland, enjoying the quiet.  I caught up with an old buddy and ran a mile or so with her, chatting.  Otherwise, however, I was by myself with my i.pod and loving every minute.  Seven miles passed.  I have this.

Then I hit mile eleven.

I really wanted to run the entire race without taking sections to walk.  But as soon as I got into that eleventh mile, it wasn’t merely that I wanted to walk.  I wanted – seriously – to lay down at the side of the road, quit, and let the race organizers come pick me up.  I hit the wall, and I hit it bad.

A combination of factors were probably at play here: eleven miles is a long way to run, it had been a bit since I’d had water or electrolyte replenishment, and in a 13.1 mile race, eleven is right at that nasty spot where I was close to the finish line and yet far enough away not to have the adrenaline rush of being “close”.  It did not matter.  It sucked.

A hill rose up in front of me.  You have got to be kidding me, I thought.  This wasn’t even a real hill.  I grew up in the Blue Ridge Mountains of Virginia, so I know hills.  This was more of a tuft of dirt but the placement infuriated me.  The irritation gave me strength.  I ran up it and finished out mile eleven.

I finished shortly thereafter, just in time to see the winner of the marathon cross the finish line, get some water, and celebrate with Arthur and a few friends and family who had come to cheer me on.  I was glad I had done it and I had managed to complete it my way – without walking a single step, and well under three hours.

~*~

Really, in the vast majority of ways these days, I’m fine.  Happy, really.  Not needing the support the way I once did.  At this point, I love where we are in life and it’s good.

There’s one more embryo, frozen.  Tested.  Waiting.

I’m procrastinating on calling the RE’s office even though Arthur and I have a reasonably solid plan because…well, it opens doors.  It reminds me that I’m not all powerful, that plans fall apart, that doing everything right can still result in heartbreak in both expected and unexpected ways.

I like feeling in control.  I know I’m not, but on a day to day basis, it’s really easy to pretend, to slip into the minutiae and let the illusion remain.  Calling the RE, putting in motion the final plan, means letting go.

It’s time to run mile eleven in this race.  Face the tuft of dirt.  Keep putting one foot in front of the other.

Because the finish line is somewhere close.

This (long-form 😉 ) post has been a part of Microblog Mondays, where the idea is to write in your space, usually a short post but whatever moves you.  If you want to read more, head over to Stirrup Queens!  Thanks to Mel for originating and hosting.  

Budgeting Life

microblog_mondays

This weekend, I picked up Dr. Paul Kalanithi’s extraordinary memoir When Breath Becomes Air.  I had bought it on a fire sale as an e-book before Christmas (thanks to this Stirrup Queens post) and when my lunch break rolled around, I thought I’d start on it.

Reading it at two in the morning, just down the hall from the ORs, wearing periwinkle blue surgical scrubs, a vital sign monitor on my desk that I needed to put away after my break made the story more real, and I was pulled in almost immediately.  It was not at all hard to imagine Dr. Paul Kalanithi as a physician, as a neurosurgeon, walking in and issuing his postop orders, doing the usual things surgeons do.

But of course, that is not the whole of the story, nor its most brilliant, poignant part: Paul Kalanithi was an undeniable genius, yes, clearly a gifted physician, yes, but he was also a patient.  The two personas, brought together in one who could clearly articulate the connections, tensions, and even find humor between them are what make this one of the most exceptional books I’ve read in a long time.

Kalanithi’s book was published posthumously and while it is absolutely about dying, it’s about more than that.  It’s about living within limits – unusually cruel tight ones in Kalanithi’s case – but limits are a fairly universal human experience.  I think what I found particularly instructive and lovely about When Breath Becomes Air is its acceptance of human limitation.  Kalanithi accepts that his cancer is terminal and seeks to live within that diagnosis – there’s no talk of “fighting” or being the exception or beating cancer.  Instead, he thoughtfully decides to live fully whatever time he has left.

It’s rare in this day and age where a relentlessly ‘positive’ mindset is stressed and the acknowledgement of the chance that an outcome might be anything less than miraculous restoration of health or a return to previous life is often met with “oh, don’t say that!” to see a treatise like this one.  Even outside of life and death situations, there’s a cultural notion about being able to accomplish anything with enough effort/investment – one with which I know much of the infertility community is intimately familiar.  I think the way this book challenges that is a central part of the appeal, or at least, it certainly was for me.  Kalanithi’s resolution to move forward by grieving his losses, knowing his death will come untimely early, and doing his best to both find and continue in what he valued until that death reads as far more positive than an empty promise to seek a ‘cure’ at any cost.

Personally, when confronted with limitations that truly grieved me, I’ve tended towards anger.  Maybe it’s because sadness and grief seem passive and anger gives the illusion that there’s something I can do, something that with enough force might change the distressing situation (even when I know better).  Kalanithi suggests a very different path.  He interrogates himself to find the values he wishes to cling to within the whirlwind.  And then he does it.  It’s not a denial of emotions or grief or putting a good spin on a tough situation, it’s a measured choosing of response.  “It felt like someone had taken away my credit card and I was having to learn how to budget” he writes.

There’s so much more to consider in the book – and hopefully write about – but that felt particularly resonant.  The next time I must budget my life, I know I’ll return to Kalanithi’s thoughts on doing so.

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

Those Ads

Reading the other day, I came across this article on Slate about ad algorithms, grief, and social media (TW for stillbirth).  Basically, it explores the phenomenon where, post loss, people are still bombarded with ads for baby or pregnancy items when they go online.  It also has the FB shortcut to hide some of these ads but less advice about the vexing problem of FB’s tendency to “celebrate” anniversaries of particular posts.

When it happened to me, I was pretty sure I wasn’t the only one who had it occurring.  I can vividly remember getting baby ads after my first miscarriage because I’d spent time looking up pregnancy-related websites.  It sucked, especially in those first few days after arriving home from the hospital post D&C when I was physically and emotionally achy.

My second loss was a little less problematic in terms of the ads – mostly because I had known something was wrong from the start and my searching had been confined to things like “ectopic pregnancy symptoms” and “really low beta HcG” and “pregnant but bleeding”.

The one that really wrecked me, however, was after E’s birth at 28w4d when I kept getting ads for maternity clothes while she was in the NICU.

The Slate article goes on to talk about why there aren’t better algorithms to prevent these triggering ads: “The real problem is that there’s no quick capitalistic incentive for Face.book to do the work of sorting ads or pictures for you.  As one grieving woman told the Australian website…’There’s no money in miscarriages, obviously.’”

Having walked through infertility and miscarriage, I can’t help but think, as do the women featured in the article, that there really does have to be a better way.

Meditations on Moving

microblog_mondays

One of the few authors I’ll spring for straight up (instead of waiting at the library or until I find it on sale) is Louise Penny.  I’ve written a few (okay, okay, probably more than a few) times about how much I love Penny’s mystery novels here.  She’s one of the authors writing today that I really want to meet, though I’ll admit that I’m a little terrified that if I did, in fact, meet her, I’d just fan-girl all over the place and embarrass myself.

In any case, Penny’s latest, Kingdom of the Blind came out last week and I’ve spent the last few days reading.  Yet again, I’m struck by Penny’s ability to get to the heart of life, living, and human emotions.  One of my favorite parts of the books are the author’s note at the end, where Penny writes so evocatively about her own life and struggles.  For a number of years, Penny’s husband Michael suffered from dementia and died in 2016.  Penny has also been open about being a recovering alcoholic and the incredible loneliness, anger, and sadness she felt for so long as well as many wonderful things she values in her life now.

“A funny thing happened on my way to not writing this book,” Penny notes, “I started writing.”

“How could I go on when half of me was missing?  I could barely get out of bed.” She continues.  “But then, a few months later, I found myself sitting at the long pine dining table where I always wrote.  Laptop open.”

I relate to that in such a big way.  While I’ve never lost a spouse, I have lost loved ones, as well as other, less tangible bits and pieces along the way.

It’s hard, losing, whatever that loss comprises.  Especially at this time of the year, when everything seems suffused with traditions and the place at the table seems all the more empty than usual.  When it’s impossible not to remember and the commercials and pictures and expectations are designed to evoke emotions that often I’d rather leave in the background or unexamined.

Sometimes living, moving, feels a bit like a betrayal.  With an ache that has the sharpness of a gunshot echoing from 2015 and holes that rend the threads to keep weaving it all together, it feels impossible to tie the knots and work to keep creating.  To set the empty place and also hold the feast.

That’s been a struggle for me lately, even though my grief isn’t new.  I’ve reached that sort of half-mourning stage, where the sadness doesn’t seep into every moment or corner, but comes out at both expected and unexpected times with a startling strength.

I’m grateful to Penny for not denying the darkness, but also for the joy she takes in how moving forward encompasses her loss: “Far from leaving Michael behind, he became even more infused in the books.  All the things we had together came together in Three Pines.  Love, companionship, friendship.  His integrity.  His courage.  Laughter.”

In so many ways, that’s what I’m seeking.  Not to leave behind, but to hold the love and live.

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

When It Comes to the Holidays, “Pleasant” and “Unmemorable” are Quite Underrated

 microblog_mondays

For a long time, I’ve sort of more-or-less subconsciously and sometimes overtly had a tendency to try to make holidays “the best ever!”  In some ways, this is testimony to a pretty happy childhood where Christmas and Thanksgiving were days to anticipate.  For a long time, we went to my maternal grandparents’ house yearly for Thanksgiving and I used to spend hours staring at boxes around the Christmas tree trying to anticipate what was inside (I was allowed to look but not touch/shake).  In other ways, I think it’s the influence of advertising/Insta.gram/Pin.terest/Face.book.

The thing is, I’ve had my share of great holidays (Arthur proposed to me on December 21, 2002), and also really crappy ones.  With infertility and treatments, I found out we’d need to see an RE in December of 2012 and had a miscarriage a few days before Christmas in 2013.  In 2014, I was on bedrest, bleeding a lot, and the doctors were trying to be kind but also not particularly optimistic about the pregnancy.  In 2015, my brother died in late October and Christmas entailed a huge kerfuffle with my in-laws and in 2017, more in-law unhappiness stuff.

Thanksgiving in the US was this past Thursday, and I have a tendency to get anxious leading into the holidays.  Thursday morning, we headed out, and the holiday was…no big deal.  The food was good, I mostly enjoyed the company, and it was fairly low key for as big a group as was present.

In short, it was pleasant and largely unmemorable, which was lovely.

“Pleasant” gives me a more realistic goal to shoot for and mentally, lets me off the hook for “perfect” or “great”.  It allows for the mixed emotions that accompany this time of the year for me.  It’s okay to be happy or excited when I feel it, but also, to be sad or grieving when those moments come.  It doesn’t have to be a holiday season “to remember” (and it’s also okay to just “take the year off”).

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