Sunday, May 31, 2009

mixed...blessings?

I headed to the grocery store about 8:45PM - I always get a week's groceries on Saturday and we were traveling yesterday, so this evening was it. It was completely dark when I brought the groceries to my car, and I heard the yelling of a small child as I walked across the parking lot. In the cart return area, I saw two adults crouched down on either side of one of those giant plastic toy car type things that are integrated into the front of a shopping cart. At first I assumed they were trying to extricate their injured kiddo (I had injury on the brain, since I had just avoided running an adorable toddler over with my cart), but then I realized that the whining and yelling was actually a tantrum. It required both adults to extract the yelling preschooler, who would not leave the toy car voluntarily. Dad finally stood up with the little one pitched over his shoulder and managed to strap him into the minivan, though the yelling continued, fainter, after the sliding door shut. I didn't hear much of the parents' voices - a few words trying to reason with the child, a comment or two to each other. They sounded exasperated, but mostly tired and quiet. Not yelling. Which I thought was pretty impressive - I bet I would have yelled.

And I thought, I've been traveling all weekend and I haven't gotten much sleep. Grocery shopping late in the evening is not really ideal, and I'm just doing it because it will take even more out of me tomorrow, but I still have to go home, unload all the groceries, put them away, and pay a month's worth of bills (all these things are now done, BTW). And there's just one of me. Nobody to strap in, nobody who might break my eggs or drop my produce, nobody to unstrap and shepherd into the house while I have to deal with all the groceries as well. Nobody but me to bathe or put to bed. Certainly nobody to drag screaming out of a shopping cart toy after fruitless attempts at persuasion and bribery. And I realized as I got in my car that I'm just not sure those are challenges I'm really desperate for right now. Dealing with my groceries is plenty to occupy me, and frankly I wouldn't say no to a little more sleep than I'm getting. Working makes me tired enough as it is.

Huh.

it's back

Apparently, my retrospective calculations were correct. This was not an anovulatory cycle (actually, I ovulated pretty much on time), my temperature change did indeed indicate ovulation, and the very slight indications of fertile CM were just what they appeared to be - but all there was. TCOYF says that stress can cause CM to dry up, so maybe that's all that happened. Either way, after what I approximate as a 12-day luteal phase (that's REALLY ballparked, given that "peak day" is unclear and I have to correct for the fact that my temperature always rises late), CD1 was yesterday. Which was the day of this wedding we were attending. It didn't really matter, because I was clever and packed a dress that wasn't snug on the tummy, naproxen, tampons, the whole nine yards (I guess I had faith in my own calculations even at the time). Unfortunately, because my endo is evil, it DID mean that I got such a stomachache (even WITH the Aleve) that we had to leave the reception really early - around 8, I think - but we snuck away, and we had already had our cake and watched the father-daughter dance, so all was well. That will teach me to consume food on the first day of my period. Like I've never gotten that lesson before.

BTW, I am confident that the bride is already knocked up even as I write this, which will form the final strain on a once-close friendship that didn't really thrive through her engagement and marriage (the groom is a great guy, but it was kind of impossible to spend any time with her after they started dating, and we weren't, I don't know, lifelong friends, where that wouldn't matter. Maybe I'm being unreasonable. Maybe I did the same myself! In fact, of course, I don't have any close law school girlfriends any more, although I had several before I started dating my DH. So, it happens, and it will happen to her too. Sorry, but priorities mean sacrifices. Also, when you call me in your second trimester and want to see how I'm doing since you haven't spent time with any of your friends in five months, and you ask me how my fertility treatments are going, that sudden phone static? Is a sign). Do not ask me why I am so bitter about this wedding, but I've felt this way throughout. Anyway.

I took my first B6 yesterday. Was supposed to take a second in the evening but I forgot. I'll take my second today, and maybe tomorrow (with my first tamoxifen!) I'll take two B6. Will report back on the CM results. We shall see.

Thursday, May 28, 2009

plz send rosaries kthxbai ~ovaries

PSA:
Apparently, according to the accumulated wisdom of my gracious commenters, you shouldn't take more than 200mg daily of vitamin B6 for an extended period. And if your doctor didn't mention that when he prescribed 500mg slow-release, you should ask why. I am going to plan on taking two 50mg tablets daily, one morning and one evening, starting on my next CD1.

It occurred to me that I should not drag all the innocent internetz into my internal spiritual musings. I should figure things out on my own and then present the interwebz with my rosy conclusions in a trite little package. And then I thought, DUDE, THIS IS THE INTERNET. There are some people from whom even the internet may deserve a filter.



But even I don't flatter myself that I'm that harmful, you know?

(Oh, by the way, I do realize this is potentially filter-able as just boring. You can go read someone else's post. I won't be hurt.) Like several other of the blogging gals, I've been thinking recently - well, since before I started the blog, actually, but that's kind of recent - that what I might need to adjust to is that God is not going to give me children. And then I just need to be OK with that. Of course, it makes me bitter and angry. Also bitter. And resentful. Did I mention bitter?

And then I was thinking. I'm not keen on the idea that IF is here to teach me a good lesson I would not otherwise have learned (I'm duly impressed when others say that and seem to mean it, but I just don't). Eighteen months of IF was a growth experience, OK? After that, there has been a diminishing rate of return. Rapidly diminishing. Nevertheless, the other day something occurred to me. I have mentioned this here before: mine is a judgmental God. Because I'm judgmental, obviously (on that Briggs-Meyers test thing, my "J" characteristic comes out well over 90%. I hear this is unusual). Which in turn is shaped in some substantial part by my relationship with my parents. Now, my judgmental God appears to be totally sufficient for a lot of purposes. I actually, intellectually, sincerely believe all of the moral theology I know, and intend to follow God's will because, in addition to the rules making sense, He's God and He makes the rules, and though I wouldn't make that argument to someone else (it's not very persuasive), absent the time and energy for a better one, it is persuasive to me.

I understand as part of this that God's will could include for me to suffer. You know, for good reasons. To expiate my own sins so I can get to heaven faster. To build my character toward virtue or in preparation for some important ordeal. To make reparation for the sins of others. To unite myself with the cross and thereby grow closer to Christ. Whatever works. I know - hey, I'm Catholic - that believing in God does not mean that I will be protected from suffering, or even from suffering the graceful acceptance of which is inconsistent with my personality. And of course, if I believed God were never going to do anything, or permit anything, that upset me, that would hardly represent any kind of spiritual maturity. So on the surface, my judgmental God is fine so far.

But.

As long as the sufferings were small, or temporary, or otherwise something of which I could make sense in my mind (say, according to the laws of nature, X or Y must happen to reach Z desirable result, and I see how the goodness of Z makes X or Y worthwhile), all this was fine. Obedience only was wanted, and I would be at peace. In other words, I didn't have to really trust anybody that much.

Enter infertility. This suffering is not small, it has not proven to be short-term, and it makes not the least earthly sense to me. What's necessary in order that I become a mother (the obvious goal for my current state in life) is that I conceive a child, and that's just exactly what hasn't happened. In other words, this is suffering that my brain - which has a decent grasp of delayed gratification, by the way - can't understand as anything but malign. But if I really trusted God - not to be right about everything, and therefore entitled to have me obey, but to love me more than I love myself and to want my real, actual good (not good in the sense that it will be "good for me," you'll see, it will be character-building and you'll thank me later, but working for my good in a way that I would actually be thankful for, and not grudgingly either, and this side of heaven) - well, then. In that case, I might be able to take the IF without (most of?) the bitterness. (Maybe.)

I have a problem trusting people - that is, with things that are very substantial and very high-risk. I'm not afraid that a friend will steal my car or anything. There are few for whom I would do something manifestly harmful on the assumption that, if they said it would result in good, then it would. But God? Forget about it. When I do, I do manifestly harmful things for His sake is if I'm sure it's He Who is asking (I am sure of this only very rarely, BTW - I don't go jumping off of things or taking up serpents or hearing voices), and because He is in charge, so, I'm supposed to.*
OF COURSE - and, believe me, I have always understood this - this is not the way a relationship with God is actually supposed to work. One is supposed to do things to please Him out of a sincere desire to make Him happy - out of love. I think you get moral credit for doing the right thing because you know it's the right thing, even if you have no enthusiasm for it whatsoever; but if you never have any enthusiasm for doing any good thing, I think that's a problem. St. Therese said that she could no longer suffer for penance because "even suffering is joy to me now." That doesn't mean I get to reject every cross that doesn't make me giddy. But it does indicate what a true trust in God makes of our crosses.

Later in the day on which I was pondering this, a thought tiptoed across my mind, just for a second: what if, instead of all the terribly, tragically inadequate things I could think of doing without children, God has planned for me something that I would love? Not out of obedience - because it's the right thing to train myself to like it because this is all I've got - but spontaneously and sincerely. For just one moment, I had an unspecific image of some future life that was joyful, that was really good for me and not in that take-your-medicine way, and for that moment I felt really happy. Then it vanished, and I was left wondering whether I was even making sense at all.

I have no idea, by the way. And even if I clarified that thought that I had, I don't know whether I'm healthy enough to achieve it. But it was an interesting thought. I will keep praying for trust, and try to get myself back to reading my daily prayer, which I have been conveniently forgetting far more than appropriate. Out of pique with God. Sigh. And I will wait, because that's what I do. Not patiently, but God can't have free-willed creatures and perfect ones too, and this is where I am.

I have to say, this corner of the internet is very patient with me and my aimless spiritual meanderings. Maybe soon I'll post about something happy. Like shoes.


*I recognize this appears to fly in the face of what I said earlier about my faith. I think this is the difference between intellect and temperament. I believe the truth of my faith, with the free assent of my will; I am convinced it's true. If I were not, I would go elsewhere for my principles. But as far as a personal relationship with God? Well, I think He's mean. I probably always have...because I'm cold-hearted myself. See?

Tuesday, May 26, 2009

hello internet, please send advice

So I was all proud of my B6 that I got on sale. And then I went back to the part in my book where she says what to take exactly (yes, I am self-medicating. My RE didn't mention CM problems and I'm darned if I'm going to play phone tag for a week if I can fix this myself. ENOUGH DOCTORS ALREADY). It says I should take one 500mg slow-release capsule every day all cycle. I didn't get the slow-release, but, well, whatever. But, what I did get is FIFTY mg - not 500! Is it possible there's a typo in the book? What dosage were/are other people on? I don't suppose a 1/10 dosage will have any effect? Or, I could take 10 pills a day, spaced out over time (of course, then I'd need two more bottles for this cycle alone). Sigh.

Also, I am now (again) considering starting an IF support group at a local parish. I'd thought of it before but not really thought it through. I've returned to it. Right now, I also have a first draft written of a letter to a local pastor(s) just suggesting that they be aware of IF as an issue in their overall pastoral ministry, and offering to answer questions if that's helpful. And, noting that I'm thinking about proposing an IF support group, but as yet undecided, and would welcome their perspective. I feel as though, if I'm going to complain about ministry to the infertile, I need to put my money where my mouth is. If I can't even write one lousy letter, who am I to complain about what other people won't do? It's my condition, I ought to care.

And, also, though in many ways I deal with this whole thing worse than anybody I've encountered, my deeply flawed coping mechanisms do give me some advantages in going a little more public. I can deal with any number of pregnant bellies with only mild irritation, and nothing a stranger says would make me cry. Yelling is possible, of course, but I don't see anything wrong with that. So, internets, what do you think? I know Cara has done this. Anyone had success doing it within a church?

Other informations: tamoxifen actually isn't femara, as far as I know. This is tamoxifen:


And this is femara:


And this is clomid:


Clomid is actually VERY similar to tamoxifen, if you look (they're oriented differently, just spin them around in your head. Also, the C-H-H-H is written out for the clomid but indicated by just a line for the tamoxifen. It means the same thing. FIVE WHOLE SEMESTERS OF COLLEGE CHEMISTRY! LOOK WHAT I REMEMBER!). The only differences are that clomid has a chlorine as opposed to a two-carbon chain off that double bond - and that one has its chain off a different benzene ring than the other. That's actually kind of a big difference. (That other unconnected molecule next to the clomid is citrate, by the way. Yes, I looked that up.)

And, AYWH, I go to Tepeyac - probably a bit of a hike from you - but my RE was trained by H.ilgers and maybe yours was too? Also, I want to know ALL ABOUT your side effects. I'm going to have to email and pester you.

(I know I have other points to respond to. I am going to go through my last four sets of comments and send messages soon. I am a GOOD BLOGGER.)

Monday, May 25, 2009

drugs

In my drawer now sleep happily five days' worth of tamoxifen pills. In my basket of bathroom things is a bottle of B6 (bonus: it was on sale). I think I'm about five days from the end of my cycle. This is totally the JV version of IF drugs, but sort of a watershed for me, all at the same time. I'm mostly blase, but a little nervous, a little excited, a little trepidatious.

And, I'm definitely PMSy. I can feel a tight, un-unwindable knot of being difficult in the pit of my stomach. And even though I know just what it is, I have no intention of not being difficult. I want to take a nap, be hostile to others, maybe go somewhere and cry, or maybe have my husband all to myself. Not be flexible and pleasant. This is just how I'm going to be.

My friend who has the returning endo apparently got some really bad news at PPVI, but I heard the "details" from my husband, who heard them from her husband's cousin. Who is a confirmed bachelor. Needless to say, it's not clear to me what the actual problem is - something about her ovaries? (I know.) She was in Nebraska for a week. Please pray for her - apparently she's taken it kind of hard. I mean, obviously.

And, please pray for LIM and her family.

Sunday, May 24, 2009

a weekend

Activities

It was really nice to see my sister. Though she's far more sarcastic even than yours truly, and has a lot of personality, she's always been very shy around new people. So, instead of planning a big party for Friday when she got in, on Friday, she and I walked around DC and saw some stuff she hadn't seen the last time. Then we had dinner at an Italian place in Arlington I hadn't been to before (food was great, service was strange-ish).

Saturday we went running on the trail I like so much. Then we went shopping - she needed new running shoes, which we found at I think a pretty good price, she came along for my weekly grocery shopping, and we got lunch at DQ. Then we came home and polished off a container of hummus while watching Fried Green Tomatoes - I own it, but she'd never seen it. But before we started the movie, reminded of many, many episodes sitting around watching a VHS tape in my mom's kitchen, we called my mom (who, as I've previously mentioned, is mentally unwell). It was a pretty good call. Sunday we went to Tridentine Mass - choir was lovely. I didn't plan anything rollicking to do; neither of us is a barfly, she's seen most of the tourist stuff, and I just thought we should spend time doing normal stuff, since she'll be headed to Poland for the summer in two weeks. We went to the National Zoo (I'd never been). It was shaping up to be kind of a disappointment - all the animals were in for the night or hiding. Luckily, the indigenous wildlife was filling in:


Ultimately, we did see some exhibits. The Mexican Wolves were probably the prettiest.


But my favorite were the pelicans. I've had some sort of thing with pelicans for years, but I don't think I'd ever seen them in "person." We even got to watch them being fed.


After the zoo closed, we went to Gravelly Point Park to watch the planes take off. Neither of us did all that well trying to capture the planes as they landed, but she probably did a better job.


I got a picture of the picture-takers.


IF Meditations

I also did some thinking. I realized a few things. I've been trying to think of better ways to pray about this IF mess. I realize I'm not half spiritually centered, and the IF has dislodged me - well, by pushing on a spot where the structure was weak to start with. On Saturday, I thought about how I should offer up the suffering of IVF for graces for others. It's been almost four years, I haven't done that...all those wasted graces. And I found myself unable to think of a restrictive clause strong enough to prevent God from taking my offering-up as a license to extend whatever time I would already have to spend infertile. (It's not that I can't make it through one more year. I don't know that it would bother me making it through 2009 [but maybe it would!], it's just that I don't want it extended one unnecessary day. Let alone unnecessary decades.) I finally said that I would offer it up today. I know I'm not going to get pregnant today. I can offer today. The problem is, it means I have to remember every day. But maybe I can get in the habit.

I realized that this means that, if what God thinks is best for me is that I suffer this way for years, then I am not open to that being His will. Isn't that interesting? Actually, it's slightly more complicated than that. It's that I think that God would "snap up" an unrestricted prayer like that, not because it's part of His grand design for my life and me getting to heaven, but as part of His overall posture of taking advantage of a vulnerable bargaining position to sock me with sufferings I really don't want. And that is an interesting realization too. Not open to offering things up to God because I don't trust Him not to stick it to me. Great.

Then I thought about how that wasn't right - the problem here is me. I'm supposed to embrace God's will even if it's hard. And I have no problem with that in theory. I've done it well on many occasions. Just not with this. The thing is - if God is going to take the babies away from me, He's going to give me something else instead - not by way of a consolation prize, but another way (and not a pointless way) to occupy my time and energy. So I should think about that.

Today, in Mass, I was praying about that. The goal: ask God to lead me toward, and show me, what it is He is asking of me instead (assuming there is an instead) - what it is He actually wants with my life. (I've already thought about how it might be adoption. Believe it or not, I am much less closed to adoption now, although I'd rather have biological children. But, learning more about the logistics of adoption, I think we'd never end up with a big family of adopted kids - and with our luck, we'd never get through the process on the first kid. So as soon as I decide adoption is something I want, God will jinx that one too. So I'm not pursuing that. If it falls into my lap, fine.)

You know what I realized? I'm not willing to ask God to lead me to what else He wants with my life. Not because there isn't anything else and He hit the delete key by accident and my life is purposeless (I say that, I fear that, but I think I just realized I might not believe that). Because if He's asking of me something other than raising a family, I know it's going to be something really demanding and I'm going to want to run screaming. It won't be something I want anything to do with. I don't have a specific idea in mind, just a strong sense of formless unpleasantness.

Isn't that interesting - I don't trust God not to give me a raw deal just because He can. And after all this time - discerning a vocation, getting married, everything - I'm not interested in hearing the plans God has for my life. In the short-term, impulse-motivation sense, I'd rather keep wandering around blind than have to do something hard or undesirable.

Now, I don't want not to want these things. I mean, I recognize those inclinations are defects, and I don't like having defects. But I'm not ready to pray, "God, lead me to the thing you've asked of me instead." It's not a prayer I want answered right now. For now, I'd rather be angry about IF than have to take a(nother) big risk. "Help me to find my way" I've been praying for months, but the other one is a little too specific. I think I have to start a few steps back, maybe - "Help me to want the right things." Or, "Help me to trust you." Maybe that's the simplest one of all. That would be OK - that's a prayer I'd like answered. It's general. It's benign.

I also realized about myself, that what I really want out of this whole IF mess is not a baby. Baby would be OK. But what I want more than a baby is a life that an objectively reasonable person would not feel sorry for. Not the talk of the town or the envy of everyone. Not a life without hardship or suffering. Not an un-difficult life. Not fame or accomplishment. But a life that someone acquainted with what I'm up to and what I value would look at and say, "She got a chance to do something valuable. She's living a good life." Even if they recognized that I couldn't have kids and would have wanted to. But not "How sad that she doesn't have any kids." Or "It's nice that she's finding things to fill in the hole where the kids would be." Or "I'm so glad I've been able to have kids, look at those childless couples." Or, "How empty her life is. We should pray for her." Or, "Look at how superficial the things are that you take on when you can't have what really matters - a family." Or, "Look at the frenzy she's throwing at all her other activities - like if she works hard enough, she won't remember she doesn't have kids."

I'm not trying to be superficial; I don't mean that actual people have to approve of my life. Many actual people probably will not and I can ignore them. I mean that it would be reasonable for a theoretical person to conclude that my life is valuable. That's what I actually want. Not to be a reject from the scrap heap of meaning and direction and vocation.

Treatment

I don't know how this squares with my filling my prescription for tamoxifen, but I'm going to.

And, BTW, you'll all be happy to know that I did ovulate this month - fairly timely, too. But my CM was totally screwed up - that's why I was confused. (Good thing I'm doing temps!) Has anyone else ever had screwed-up CM as a result of HSGs and the like? It seems logical, but my book and Dr. Google have never heard of it.

Also, is it true that tamoxifen causes CM to dry up? And if so, why didn't my RE mention this when I specifically asked? Any reason I shouldn't go get some B6 to take as well?

Thanks interwebz. Sleep tight...

Thursday, May 21, 2009

idling along

I had some other things I was going to post about, but I reminded myself I would be a good blogger and try to give a serious answer to a fair question (below). But I'm tuckered out by my own seriousness. So, I wanted to share. First of all, "infertilitees" comes so trippingly off the tongue that I'm sure someone else has thought of it and I've read it before. Actually, that's true. I've seen other bloggers post something similar. But I wanted to make my own contribution to the canon. Here's one; I have another I've done too that I'll post later.

(If you want to make one of your own, I find that for image capture purposes, at least, the best version to use is this one. As far as t-shirt quality - couldn't tell you.)

Also, I'm clearly losing the contest for the weirdest cycle this month. But no fertile phase after waaaay more days than it usually takes me to ovulate and then a rise in temperature (or, so it appears so far...verdict in a few more days) without having had a fertile phase, well, that's some strange stuff. At least for me it is. I'm starting to think my cycle will never come back, and then what will I do with this prescription for tamoxifen? That I still need to fill. Oops.

And then, let's see...there was a question about my friend with the impending second endo surgery: did Dr. Hi.lgers perform the first one? I thought yes, but DH says no. I would be mad about having more surgery so soon either way, but there you have it: don't know.

Rounding off this grab bag of notions, my baby sister (well, the 25yo) is visiting this weekend. She's in town for a conference. We've gone to see the Capitol but not the White House, so we'll do that, and I'll take her to Tridentine Mass on the Feast of the Ascension (which was today, but I digress), and go shopping, and she'll be coming with me to see my house (which I've mentioned before, I think. I've decided it must be mine. Except, I've never seen the inside. And I probably can't afford it). I talked to the realtor yesterday (for the first time) and asked to view it this weekend - surely, this was a guaranteed yes - and he said that he couldn't do that, but maybe in the ensuing week. Weird.

I told him I'd call him back another time when I was ready to see it - wanted to see it with my sister, so no dice for next week. Also, bad news: looks like the (elderly) owners are trying to sell all three "lots" (seriously, this is one decent-sized lot, whatever genius thinks it should be subdivided is cracked), for which they want over $1M. Half an acre with a falling-down house. It's not in Georgetown, BTW. This is just silly. But we're still going to go visit and skulk around the outside. And whatever other fun things we come up with to do.

I might not, however, keep up religiously on blogs. My sister doesn't know about the blogging; the only person who does is my DH, who respects my privacy here. I think anyone else would be too tempted to try to "find" me. (I feel safe from accidental finding - the only people looking would be other IFers, sooo...) I'm close to my sister, and I do trust her. But, she's my little sister. I don't lean on her. And I can't tell her that I'm just a wreck over this IF thing. I don't know why, I just know it wouldn't work. There's really no one in my family - other than my DH, no one in the world - on whom I really lean. I can't. They're just not...lean-able. I've known them my whole life.

That's sort of weird, huh?

being Catholic

I'm right out here with the truth in labeling, y'all. If you're not interested, you have been duly warned!

However. Leah asked a question about what I really think in terms of moral theology (OK, she didn't put it that way), and I have not forgotten! At first, I thought, why would she ask that question? Surely if it weren't inherently obvious, my SA post would have made it all ABUNDANTLY clear. Then I read my SA post again.

Oh.

So I am going to try, so so hard, to be concise but still clear. And I think this answer is in three parts, plus an application bit:

1. Why do I talk (write) like this?

This is what I figured out when I re-read my SA post. I'm going to try to explain this without making any unwarranted assumptions about how other people think. But the thing about Catholicism is, it's got strong elements of a culture, and even stronger elements of being a coherent theory. I am sure there are other groupings that have this too. (I'm thinking any hierarchical church would - I bet Mormons do? And probably non-religious groups as well.) This is super-handy, but in a way that causes the problem in my post. Namely: there's a whole lot of theory out there. And that's just what I know. It's at least standardized, if not normative. I.e., you can look it up. There are theologians who will argue about this and that, and any individual Catholic may choose to take or leave any part of it (normatively it's an all or nothing proposition, I'm just saying that's what people do). I can't fit all that even I know about Catholic, well, stuff, into every post. Or a book. Several books. And I'm not an expert.

Fortunately for everyone innocently surfing the web, it wouldn't occur to me to try, because I tend to simply communicate as if everyone had about the same assumptions that I have, or meant about the same things by the same words. Rationally, I know this is not true. So where I'm aware of differences - I've learned that the Catholic approach is distinctive - I'll try to point that out. Sometimes, I think my approach is distinctive when it is not. So I put caveats with things that don't need them. But I think there are lots of distinctive bits that escape my notice, so I end up saying things that don't make total sense to other people.

Which brings me to...

2. Procedure

Now I'm invoking lawyer-speak. Out of the frying pan, you know...

Anyway, Leah's question was, I think, what I really believe, deep down, as opposed to what the Church teaches. I'm thinking that as a neutral observer, if I heard someone cite an external authority all the time for definitive opinions, I would think that person couldn't think for himself. Which I'm guessing is the impression I give. It's not how I see it, though. This is where the procedural part comes in.

I was baptized Catholic, but "lapsed" in my teens, then returned to going to church on Sunday, then went to college and continued - but grossly undereducated about my faith. It's always struck me as odd - and I've taught confirmation classes and supervised high school youth group - that kids who are expected to learn calculus and read Shakespeare are considered too tender to learn the definition of sin, or the teaching on the Trinity, or the tradition of Catholic mystics. I think most Catholic twelfth-graders know more about Buddhism than Catholicism, and how can you make a mature decision about the faith in which you were raised when you don't know even the most basic things about it?

At any rate, I was no exception. My parents knew a pretty decent amount of theology, but somehow this didn't all make it to me. I was basically committed to most of what I did understand - but even that I didn't try very often to apply to my life. A good friend pointed out at one point that if I believed what I myself claimed to believe, then my life ought, logically, to look a little different. I gave this some thought, and realized it was true. I was living a schizophrenic life. There began a long period of soul-searching, tons of reading, prayer, and a lot of thinking. I came conscientiously and informedly to the realization that I did, in fact, believe what I had been saying I believed. Among other things, I believed that the Catholic Church was in fact institutionally entrusted with proclaiming the truth on matters of faith and morals. If this was true, it followed that any individual thing the Church proclaimed authoritatively (see here on magisterium) as teaching was true. Certainly a handy reference point for new moral questions.

3. Substance

Of course, being an adult Catholic also requires being an adult, period (though many, Catholic and non-Catholic, appear to regard this step as optional). Parroting the teachings of the Church mindlessly won't get you very far, for at least two reasons: first of all, principles don't always translate automatically into decisions on actual events in your life. You generally have to extrapolate (although some things are pretty clear). Second, if you make no effort to understand and own an idea, it's not really a conviction, per se. I think morals and faith have to be the conviction of your heart. Which means they have to be examined, weighed, pondered, lived in, and made your own. Stridency is only a substitute for sincerity in the very young - and I know whereof I speak, because I did that, too.

I was fortunate enough to have in my path a lot of writing and information on a lot of Catholic moral principles before I actually had to apply them, so a lot of the moral questions that would affect - say - fertility and fertility treatment, were comfortably broken in by the time I started down this path. What this also means is that in addition to having faith in the Church institutionally, I also agree specifically with the teachings I actually know about, and confront and use in my life. They make sense to me, I think I understand their implications, and they seem to me to proceed necessarily from first principles that I believe are solid.

4. So what's the bottom line?

The three above points do, believe it or not, tie in together. Because I believe that Church teaching is actually the truth, I have a bad habit of speaking and writing as if everyone else thought just the same way. So in a given sentence, I'll interchangeably say that "the moral quality of an act depends on intention, nature, and circumstances," and "the Church teaches that subjective culpability can be mitigated even if an action is objectively gravely wrong." I'm actually invoking the same degree of authority with both of those statements - I'm quoting even in the first one, and I'm agreeing even in the second one.

What about when I said that the Church's analysis is insufficient if it takes into account only openness to life in evaluating the moral quality of particular conduct as part of fertility treatment? Well, admittedly, that was a straw man, because that's not the only factor cited even in widely-quoted documents - see, for example, Donum Vitae and IVF (openness to life is not the deciding factor).

And, I don't disagree with the importance of openness to life. In fact, and despite my complaining, I'd probably have poked a hole in the condom myself if I hadn't been told there was already one there; although the gesture is symbolic, in my case, I think symbolism can be important. What my complaint was about, instead (well, other than just venting), was that the Church tends not to provide any further guidance. Now, silence isn't teaching. So it's not that I don't agree. I just think that parish priests have a pastoral responsibility to reach out especially to their parishioners who suffer most greatly, and especially to those most in need of moral guidance. And as far as I can see, they're not. "Don't use IVF" is not comprehensive pastoral care for the infertile. First of all, nobody ever explains why. The theory on IVF is never cited or explained; Donum Vitae is never read or named; and IVF is never addressed as if it were a treatment being prescribed to actual Catholics, including some sitting right in the pews right now! When it is. And, if pastors want their parishioners to avoid it, then they could start by explaining why.

Moreover, even if the obedient parishioner immediately whips out the ol' crackberry to type, Note to self: Should I be unable to conceive, do not use IVF, I just think that's inadequate. OK, me: I don't use IVF. Somehow, my travails aren't over. There's actually more questions out there. And some of them have moral aspects! Shocking.

I'm not suggesting the Church should bury all its members in norms when norms aren't needed. I'm not asking for an encyclical that says I may only visit an RE whose last name begins with an "X" and who can recite the Magnificat in Latin backward standing on one foot. I'm saying that beyond the realm of absolute norms - which I think are pretty close to covered in the IF world - there are many questions that require sensitivity and sound judgment. Some guidance, or even acknowledgment that the issues exist, would be appreciated.

Which brings me to the real culprit here: me. You see, I'm so used to having to dig in my heels and defend what I believe - I was steeling myself for the conversation with the clinic: No, we are not "providing" the sample on-site. We don't do that sort of thing. I don't care if it's more convenient for you. Our faith is important to us, and I have to ask you to respect that - that I'm totally unprepared for problems that come from elsewhere. The condom thing respects all the right boundaries, in theory. So it did not occur to me to tell my (Catholic) RE, Hey, wait. This is frankly grotesque. So what else have you got for me? Because we're not a couple of sex monkeys here, and I refused to be any further dehumanized by my treatment. In fairness (to me!), I have no experience with condoms, and the implications weren't entirely clear until I was presented with them concretely.

But I've learned an important lesson, a lesson that those of you who don't have the blessing/crutch of a church teaching authority probably learned early in the process: I need to keep my brain on "on" at all times during this process, and think carefully about what I really want to be doing. As many of you wisely suggested in the comments, even if my confessor wouldn't bat an eye, I need to say something if I think a particular treatment would be wrong for me and my marriage.

Tuesday, May 19, 2009

I got better



So, I shall not dwell in the hellish Land of the Sperm Analysis forever. (I know, you were worried.) I appreciate all your kind words and wise advice (seriously, some of the suggestions made so much sense. I need to go back and take basic physics. And maybe biology. Or one of those X-rated courses they were always offering in college under the heading of "sociology." Anything with "sexualities" in the title was good for at least a few nudie photographs. On that subject, sort of, I have some VERY Catholic friends who on their honeymoon, despite not being, er, novices [you know, they were reformed], were having such a difficult go of things that they went to the store and bought a how-to book. And not the "for Dummies" one, I believe, something with pictures).

Also enormously reassuring is that even people who are not working from quite the same framework I am found this whole ordeal awful as well. Why does that make me feel better? Maybe for kind of the same reason it's so nice to have other people with whom to go through infertility...it makes me feel human, when IF often inclines me not to.

Also good for dredging one from the depths of the Lake of Spermlessness is a sense of humor. Fortunately, my husband has one. When I came home yesterday, I told him how traumatized I was and that I may never want to (try to) have sex again, and he laughed at me for being a prude, and, honestly, I felt better. If he'd fetched out a crucifix and the holy water (we have some, actually), I'd have been pretty worried.

There is, after all, an appropriate role for sperm.


Frankly, my DH had a worse day than I did. Our elderly neighbors have a beautiful rose garden - I mean, magnificent. Over seventy individual rose bushes, dozens of varieties. All now in bloom. And the ladies from the wife's art group were at her home for their regular meeting, so they held it in the rose garden. My DH was sitting on our patio having a cup of coffee, and a gaggle of grandmothers were wandering around the garden, oohing and ahing in the most or.gasmic of tones, and the mockery was more than he could take. He said he barely restrained himself from marching over there and doing in the whole lot of them. (This shared inclination toward sudden violence is what makes us SOUL MATES.)

So we were at home yesterday evening discussing our recent traumatic experiences, when he suddenly called over from our room, "Should I throw out these condoms next to the bed?" GROSS. Ten hours after the fact, we still had condoms strewn about our bedroom like the scene of some junior high incompetently attempted contraceptive orgy. "No," I replied, "I'm making a scrapbook of our journey to have a baby, and I'm going to stick them to one of the pages." He emerged from our room. "Hey, that's a really good idea."

Seriously?

Monday, May 18, 2009

rotten

Sperm Day was a total bust. Without OD'ing on the TMI, let's just say, condoms - not so hot. At all. I think I wrecked two of them (they appeared to be fused together, however. Surely that's not how it's supposed to work?), no sample, no nothing, and my DH was kind enough to drive me to work so I wouldn't be later than my leave slip said for the appointment we cancelled, but we were barely speaking. I get that this would be, at least, more straightforward if we collected the stupid sample in the "ordinary" way. But neither of us is cool with that. Fidelity to our marriage means no dirty pictures and no "individual activities." And to break that commitment to have some lab poke and prod us further seems even more disordered and wrong than it would be by reason of temptation, or weakness, or anything else. My God, we're human beings. We're supposed to have some sort of dignity. What a crock that is.

Meanwhile - and I would be genuinely interested to hear the reactions of others who've done this already - the collection method that's kosher with the Church seems almost more wrong, if that were possible. I suppose this could be sour grapes because it didn't go so hot for us, but first of all, we're not the only ones (more on that later), and second, I think there are good reasons it didn't work. How, I ask you, are the unitive and procreative aspects united by engaging in some parody of sex just to fiddle with a stupid condom and hightail it to a lab with a jar of sperm in one hand? What's loving and unifying about that? And the stock response (which I do not want to hear) is that it's ultimately ordered to a baby. Well, lots of things are ultimately ordered to a baby, including IVF, turkey basters full of sperm, and abduction, just off the top of my head. The Church isn't cool with those, because while necessary to the moral equation, the ultimate ends do not justify any means. The means itself has to be morally acceptable before the importance of the end can outweigh any other drawbacks of the means. (I think this mode of analysis crosses religious lines. At least, it sounds like good common sense to me. It's when we get to specifics that it becomes specifically Catholic. If you follow.)

Which brings me to another point. The whole unroll-a-condom-in-a-jar-with-a-popsicle-stick method is supposed to be kosher because it's open to life. I get how, the condom having holes in it, the method is open to life. That does sound like an extreme legalism - honestly, I'm not going to get pregnant without the condom, so the holes are kind of angels on the head of a pin, you know? But not having the holes wouldn't solve the real problem I'm positing, which is this: since when did openness to life become the only moral norm worth considering? I mean, I could have sex with someone else's husband, and be totally open to life. Obviously, that wouldn't cut it. So there has to be a further analysis before we can determine whether something is morally ordered. I would say that the with-condom sperm collection activity is bordering on morally disordered by its very nature. How many professionals do we need to have giving directions, and then making post-hoc commentary, on the activity in our bedroom? How many devices should be implemented so we can have sex? (We had three at hand - one condom, one collection cup, and a ruler to turn the darn thing inside out. And eleven-step instructions.) At what point have you crossed the line from a loving marital sexual relationship into some other kind of activity entirely, which could best be described as deviant?

I know I said I would be brave. Even increasing, beyond my hoped-for lifetime maximum of one, the number of men who would closely examine my reproductive organs. Even though a lot of the procedures were painful. Even though I hate taking time off for procedures I am uncomfortable naming to my boss. Even though I am sick to death of doctors. But this isn't brave in the face of embarassment or pain. This is our marriage this garbage is marching into. And it's not right.

After I left for work (to react with rage to the slightest provocation at any inconvenience in my projects, I might add), my DH called a friend of ours who's down in Nebraska at Pope Paul VI Institute right now. She had the crazy-thorough endo removal surgery about 18 months ago. She got married just over a year ago. She knew she had Stage IV endo, so they got on the ball with fertility treatment immediately. They've been ttc, obviously. She's not pregnant. PPVI has reviewed her charts. She went down for - whatever, a consult? They found out the endo has all come raging back and she needs another surgery. (Which is going to be effective where the last one wasn't because...?) They're out of pocket $8k for this visit. Not counting the surgery. Not counting the adoption fees they will pay, because if her idiot doctors can't stop cutting her open long enough to treat her, they will never get pregnant.

She ran into a third mutual friend down there, also in town for treatment (no, none of these people lives in or even near Nebraska). This gal (who's like 24, BTW), isn't even ovulating. H.ilgers doesn't even know why. He suspects it's "something in her brain," says DH - I believe the hypothalamus controls ovulation, so that could be. Now she may have an OB/GYN (granted, a darn good one) messing with her brain. This is why I preserve the option to have a hysterectomy and fax the lot of the medical profession the bird when I have had enough. (Which may be today.) Meanwhile, we've heard from another couple who are ttc (the wife also has endo) who tried the whole sperm/condom method and just couldn't bring themselves to do it. I don't know whether they pulled it off on a later try. The gal with the recurrent endo and her husband also had a bust their first time; so the second time, they rented a hotel room next to the clinic. Apparently that time worked. (I originally assumed they meant that the first try didn't work for them because the sample didn't survive that long, but now, I suspect that was not the reason. Anyway, I don't think there are hotels next to our clinic. And this is NOT romantic and I am NOT spending money on a hotel in suburban Northern Virginia and taking an entire day off from work for this BS and the clinic opens at 10 and we'd have to check out within minutes of "collecting the sample" - like that would be any less stressful and unnatural - and I am going to RIP SOMEONE'S HEAD FROM HIS SHOULDERS. ANY MINUTE NOW.)

Finally, lowly has a charming quote from St. Josemaria on her blog about how "God is asking more" from the infertile [N.B.: This is not directed at lowly, as I hope will become clear...]. I think that's the sort of darling platitude that one can utter with confidence only if one has never been there, but I will tell you all, since you're burning up with curiosity, what God is asking of me. To be a good and virtuous and loving and pure Catholic woman and wife, and, should any babies ever show up on my doorstep, delivered by some exotic bird, a good mother. I do my best not to swear. I dress modestly. I don't spend money excessively on anything (except fertility treatment). I need to pray more and get up early enough to go to daily Mass in English. I need to be kinder and less self-centered, and less angry (HAH!). I need to put my DH first more than I do. I need to call people back, even when I don't want to talk to them. I do not need to learn to have sex with a condom, perforated or otherwise, on a schedule with a stupid clinic with stupid hours. If that's the "more" God is asking of me, He's cracked. Motherhood is a vocation, not some sort of grotesque contortion.

In other words, St. Josemaria, if you're listening, you're completely full of crap. Or, you were - I bet you know better now. And thanks a lot on that job my husband prayed a novena for. He's now been unemployed for four months. That's helping a lot, too.

P.S. I'm slightly less mad now, and considering apologizing to St. Josemaria, about the job part anyway, on the basis that God might have something better in store. I still think the IF quote is shortsighted. If the Church wants to honor IF as an additional cross, then she and her priests need to take on some pastoral responsibility for the infertile. 'Cause as of right now, we're completely on our own ('cept no AI or IVF. Now we know what we can't do. What else you got for us?).

Saturday, May 16, 2009

good things, and sex

While I've been busy obsessing over my diagnoses, past, present, and putative (perhaps a new slogan: infelix hodie, heri, et semper), other interesting things have been happening in my house. My husband has been smoking around a pack a day on average since he was fifteen. That will very soon be twenty years. I've already told him I've picked out my second husband, but even before the lung cancer gets him (sorry to be blase, but these are his decisions, not mine, and heaven knows I nag enough), of course this has potential implications for infertility.

The SA is on Monday, and I've been largely overlooking the fact that in the last week or two he has been gearing up the smoking reduction that he started, in a smaller way, during Lent. In the past week, he's cut down to 1-3 cigarettes a day. I am always cautiously (if at all) supportive of such plans, because I know if you're merely cutting down, one bad day means five, and then ten, and then twenty again, and weeks of hard work (to say nothing of months of dragging his feet before he tries it) can be squandered in an hour. Also, it's another weekend, and he has never, ever gotten together with his guy friends and not chain-smoked for at least four hours. Never ever. He had actually quit for about four days last year (the only time since I've known him that he has ACTUALLY quit) and came down to DC (while we were living in MI) to interview and I asked him whether he was going to tell everyone he had quit when he saw them. He said no. I got angry right then, because the next steps were then written in stone: he got down here, he went out with his buddies, he mentioned he didn't have any cigarettes, one of them bought him a pack, and he finished it that same night.

Anyway, right now, he's on a general health kick - when he wakes up in the morning, if he wants a cigarette, he goes running instead. (Actually, he goes running several times a day, albeit not very far. I am a slug by comparison.) Part of his motivation has been to lose his tummy. One of his guy friends - who quit smoking several years ago, is about the DH's age (middle thirties), and is in fantastic shape (works out, did a triathalon) - has undertaken a campaign of benevolent harassment, all on his own. He waits until I or other guy friends are there as an audience, and then tells my husband that he's out of shape, eats terribly, and he's afraid for his health. And that he looks awful. Apparently, this has had an enormously salutary effect - I guess men and women react to things very differently. (Who knew?)

So my DH has been running several times a day, smoking far fewer cigarettes, reading The Easy Way to Quit Smoking (I am very optimistic that this will actually help - I know others who have had good results), using a punching bag he got as to work out with, and insisting I buy vegetable juice for him to drink. (I won't touch that garbage, but he has really been drinking it.) He also noted, however, that an unconscious part of his motivation might be that he wants to be favorably evaluated on Sperm Day.


I have thought about how this will work. I assume, without having any results yet, that the results will be sub-standard but not incurable - because I think he's probably basically healthy but that years and years of smoking must have taken a toll. So, I figure that a "you can improve this, but you'll need to" diagnosis will indicate that his efforts to date have had an effect (no despondency), but can't be allowed to lapse. See how I convince myself that it will all work out. Because I really, really want him to quit smoking. And getting in shape generally would be a great perk (bonus if I get in shape too. We could be a hot infertile couple. Why not?).

Here's the amusing side effect (oh, plus TMI): as we learned last year when he briefly quit (and cut back on another occasion), both lots of exercise and cutting back on cigarettes enormously increase his sex drive. This is particularly interesting because that means adjusting things from him propositioning me once a week (and more often, me propositioning him) to daily or every other day. It's not like he's calling me at lunch or something. So, what I mean is, I think this level of interest is actually probably healthy - it's the level when he is smoking that's unhealthy, though that's what we're used to. All this is good, because, as I've explained to him, once I get on medication, we're going to have to start the Sexual Marathon every month. I don't want to go in for my evaluation after a few months of tamoxifen and ask for a new treatment and have my RE look at my charts and say, "Were you even trying?" 'Cause that would just be embarassing.

Oh, one other amusing TMI-related note: I almost didn't schedule the SA for Monday, because my RE says to abstain for four days beforehand, and of course that's the whole weekend. Oh, including my fertile phase (well, you know what I mean). So this happily married, never-contracepting infertile couple will be spending the weekend sexually frustrated.

Hope y'all are having a good one...I think maybe I'll go shopping. (I bought the panties yesterday.)

Friday, May 15, 2009

what's wrong with me

This will be, of course, an abbreviated list.

My Cervix is a Freak

First, the colpo biopsy results: biopsy says we're back to CIN1-CIN2 (pap showed CIN2-CIN3). CIN1 is mild dysplasia (= abnormal cells); CIN2 is moderate.* While mild might well heal on its own given time, moderate is not expected to do so. My RE thus recommends having the abnormal cells frozen off. The options are cryo; LEEP (removing the cells with electrified objects); conization (removing a cone-shaped portion of the cervix with sharp implements); and removal of the cervix. That's in order of invasiveness. The last is obviously too invasive unless you have cancer. Conization has virtually zero recurrence rate for carcinoma and so on (which I don't have) - but, it can permanently knock out your CM, and, I just learned today, can create an incompetent cervix and thus late-term miscarriage.

My regular doc wanted LEEP, but my RE says it might also create a heightened risk of miscarriage, so she recommends cryo - no fertility implications. It's supposed to be done in the week before your period, which would be next week, and she said they could schedule me right away. I asked whether I could just wait a few months. I've had a lot of procedures. My ovulation has been delayed and my CM messed up as it is. I want to feel normal (for me) again before the next round of sharp things. Is that crazy? I don't know, I thought it sounded pretty sane. She says there's no real risk in waiting. Except, she noted, if I got pregnant, it would be trickier to do the procedure. I told her that I would be willing to wait nine more months, and I wasn't getting pregnant, anyway. (Seriously, woman, to whom do you think you're talking?)

I'm Infertile

Starting next cycle, I've been prescribed tamoxifen for three to six months. (I have a feeling I'll be calling to do something else after just three, but who knows. I can be patient, if I forget I'm waiting for something. What I'm waiting for in this case, in case you've forgotten, is a hysterectomy.) Y'all probably know far more about it than I, but apparently, like clomid, it spikes your FSH, and from there on out controls your estrogen and progesterone as well. Which is good, because, as I've mentioned, I'm convinced I have low progesterone. I was tested last cycle, but for whatever stupid reason, the lab hasn't sent those results to my RE. I was kind of taken aback that she didn't seem bothered by this. Also, the hospital hasn't yet sent the 2004 endo surgery records I requested WEEKS ago. Which reminds me, I need to call and yell. (Note: done. Sadly, I had to leave a message, but it was firm.)

Oddly, though, without progesterone test results (that she ordered!), and with only one recent FSH result, she felt perfectly comfortable prescribing tamoxifen. I suggested more progesterone tests (I assumed I would get the every-other-day routine next), and another FSH test just to check (I'd actually like to hear what the next number is), but she was happy with the tamoxifen anyway, and once she explained it, it made sense. I'll have a p+7 draw to see how it's working with things. She did note that FSH=9 is still high for a 27yo (I suspected that), but said that the tamoxifen could still work. She prescribes that instead of clomid because it doesn't interfere with CM and she thinks it doesn't have the same increased risk of twins (which is a real bummer, because I want multiples, already. I feel like I deserve a two-fer. Or therapy). Of course, since it ramps up estrogen along with everything else, it could exacerbate the endo, but since I've been off suppression for 4.5 years and am still surviving, I am not worried about 3-6 months of tamoxifen.

I Have Edometriosis

I know, it's just shocking information all over the place today. One thing that was a shocker: apparently my ultrasound techs (and my doctors) have been lying to me. I have cyst measurements from 2008 and just this week that were max 2ish cm (on the left) and 3ish cm (on the right). Except apparently even my 2008 results - at a different practice! - were actually 5-6cm. Which is the size at which THAT practice told me they'd have to be removed, because there is risk of ovarian torque, cutting off blood supply through the fallopian tubes, and necrotic ovaries. (Which seems like it might be another jackpot of infertility. Also, a great name for an all-girl punk rock band. Actually, can anybody around here sing?)

The good news is, those cysts haven't really grown in a year or a few. The ultrasound this past Monday (as part of the SHG) showed several cysts on each side, but she thought that might just be as a result of ovulation (since it was at CD8), with three or so total endometrial cysts and one suspected to be dermoid (GROSS. I mean, I have lots of things wrong with me, but there are just a few I was hoping to avoid as adding insult to injury, you know?).

Anyway, my longer-term prognosis is, if I don't get pregnant on the tamoxifen (which I'm not planning to), then they'll want to do surgery. This is the one where I get all my ducks in a row and save bullets, because they'll get to remove (1) several endometriomas; (2) hopefully ALL the adhesions; (3) maybe a dermoid cyst; (4) a uterine polyp; and (5) maybe even some abnormal cervical cells at the same time. I figured I'd set a lifetime record with my triple-header surgery in '04, but this could blow that out of the water. Once that's done, obviously they'll hope impediments to conception have been removed, and probably I'll go back on tamoxifen or whatever. And then, supposedly, get pregnant or something. (Hah!)

Law School Makes You Antisocial

Also, I cross-examined. I did - politely, but very firmly. Since there was SO MUCH to ask her (I'm including half of it here, maybe), I did, of course, forget something (namely: the other doctor said the biopsy would show whether the cervical cells were HPV-type, and since both DH and I tested negative before we were married, if they are, I want both of us to go back for a full round of STD tests. The only thing I've ever immaculately conceived is, apparently, an STD...sigh). However, I remembered to ask about a great many things, some of which I have related above. I also asked her what she thought was probably the cause of me not getting pregnant for almost four years. She said the endo. Seems like a safe bet. But, I pointed out, tamoxifen does not treat endo. Well, she responds, but endo causes low progesterone (they don't know how), which the tamoxifen will treat. So, basically, that is what it addresses. I buy that.

Et Cetera

In response to your question, Kischa, I do think I ovulated that cycle. My temps are never a textbook pattern, but they all show that just after peak day the average temp shifts to about .3-.5 higher than before peak day. (Ignoring the ones where I took my temperature too late in the day and one goofy day early in the cycle, I can even draw a cover line on that chart using the standard rule.) It may be that the increase in temperature should be greater, but in my elaborate theory, all this can be explained by low progesterone.

I feel good about what my doctor has recommended. Going in, I was worried that she would order batteries more tests and I would have to wait and wait. It turns out, I'm actually slightly miffed that she's writing scrips on as little as she knows! She's not even seen much of my charts (well, she saw them last time). But I'm being silly - it makes perfect sense that she would prescribe tamoxifen even if my next FSH came back different and regardless of what repeated progesterone blood draws say. (They already know I have endo.) I do wish she had volunteered more information without me having to grill her, but I'm glad that happened to me rather than someone who has a hard time interrupting her doctor. Next time, I will bring my questions written out so I don't forget anything.

I also feel really good about doing something. I'm convinced that I have screwy hormone levels, so not doing anything won't get me any closer to my goal (see above). My two-year reprieve from all treatment to let God get me pregnant on His time may have been spiritually healthy, keeping all the nasty medical intervention out of my vocation, but it was medically nonsense. I need to do something to move myself forward, because I am not getting any healthier sitting around. Also, I need to do something to put the ball back in God's court. With a lot of my major life decisions on which I was unclear, I've left things up to God and waited for Him to sort them out. I know - rage, sarcasm, cynicism, fatalism, flagging in my faith, all these nasty things I say. You don't believe it. But it's true. I've made some HUGE leaps of faith, things that should have gotten me locked up for the sheer audacity of their imprudence. But I knew in my heart I could see where God was leading, and because I followed, I was vindicated.

(This image always leaps to my mind as a metaphor in such situations. Funny how pop culture is almost like real culture in that way.)

I did the same with the infertility, and if I had that decision to make another hundred times, I would do it the same way again every time. I was angry with the doctors, angry with my body, and angry with God, but also, at bottom, I knew that if I had faith and waited for things to straighten themselves out and stopped worrying - and stopped trying always to be in control - then I would get pregnant. It didn't happen. But it was still the right approach. Two (or so) years of trying that method and getting gradually worse with the endo have made clear that I'm on the wrong path.

So now, I feel, as I wouldn't have felt before, that I have a blank check to march into the fray like the Visigoths over the city walls and take things the heck over. I am free to seek treatment in a way that seems rational, no longer at all emotionally attached to the idea that I'm actually healthy and the unpleasant diagnoses I've heard so far are all the ones I'll ever have, and don't feel at all guilty or oh-ye-of-little-faith about lining up available procedures according to convenience or whim, very much as I see fit. I would have been happy to take a random, un-timed pregnancy, sacrifice all my other pursuits, and raise the baby with gratitude. Didn't happen. Now, I am going to exploit the resources of human ingenuity to find out what's wrong with me and what treatment options are available. There are plenty of avenues I won't pursue, but among those that are acceptable, I feel that the choice is mine. Once I start fixing the naturally occurring problems with my body that God saw fit to just leave there, and get the whole system back in shape to work the way nature intended, He can decide what He wants to do in response. Well played, God, and it will be a few months before you're at bat again - but the next move is yours.

*I originally wanted a picture of a cervix with goth makeup or tattoos or something, but saw this and went with it - it's scary, but also kind of informative.

Thursday, May 14, 2009

healthy and normal

Yes, me. Well, obviously, I'm being at least somewhat sarcastic. But just look at this chart:

For some reason, it's very small. But that's OK, I will draw your attention to the important parts. First of all, no tail-end spotting in the previous cycle! Though this cycle starts with a "light" day, that's red spotting, not brown (hence pink, see?). Also note, instead of going straight from a series of spotting (brown) into slippery (white), it takes just a bit of time off there to do something normal. SEE? And then FOUR days of slippery. I mean, not all day, because, as I've actually mentioned before on this blog (wow), my CM is all messed up because somebody was screwing around with my cervix, and not in a good way.

Now, if you'll direct your attention to the somewhat more difficult to follow line above, I'll be happy to explain. The blue line is my waking temperature. The red dots are temperature on days when I woke significantly late (so they don't count, but I've graphed them anyway, because I have to do this). It hits a high temperature three days after "peak day" (which is the last day of fertile, the white box), but even curiouser - two days after peak day, there's a temperature dip. That's the first time I've ever seen one of those.

Oh, yes, and, this is hard to tell because of the way I label the axes, but my last point: peak day is day 14; temperature spikes on day 17 (maybe a little late - perhaps further evidence that my progesterone is low???); and the whole cycle is twenty-seven days long. (The last day marked is actually the first day of the next cycle - hence red.) That's practically normal. (The previous cycle was 25. I think this one will actually be longer - delayed ovulation due to further TRAUMA TO MY CERVIX.) Does that mean my luteal phase is thirteen days? Or how many? You count from the day after peak day, right? I just can't keep this straight.

I recognize that entirely too many of those boxes are brown. Also, that I am now reduced to posting illustrations of my menstrual cycle on the internet. But I don't have time for therapy right now, because I'm taking off so much work for semen analysis and to have things shoved through my cervix. And even though there's too much spotting, this could all play into my theory that all that's really wrong with me is that I'm progesterone deficient.

Oh. Sorry. For a minute there, I forgot about the atypical cells on my cervix, the defunct ovary, the severe endometriosis, the 3+ endometrial cysts, the IBS, the retroverted uterus, and the uterine polyp (did I forget anything? Oh, yes, the insanity). And yet, for some reason, in my mind, the goal is not to get pregnant but to make my menstrual cycle normal, and to identify the maybe one simple but significant thing (obviously, there will just be one thing) that needs to be changed to do that. Because if I can manage a semi-normal chart, then it will all be OK.

You know, I didn't use to have any attachment to how much fertile CM I produced or how long my cycles were. I blame the Catholic IF bloggers. You did this to me. Now, if only I could find somewhere to print this in color so I can show all my hard work to my RE tomorrow...

Wednesday, May 13, 2009

blogging: bad for your @$$

I have promised myself that I am really, actually getting in shape this time. I know that in just a week or two the Virginia weather will closely resemble the fiery pits of hell, and even if I try to run at dusk, when the evil sun, and its plot to induce dermatologists to razor off all my skin so it scars even before I have time to get wrinkles, will be largely at bay, it will be too miserably hot and I won't go.

So when I get home, and drag my pathetic carcass to Mass, and then get back home at about 7:45 and it's still going to be somewhat light till 8:30, and I could go running on the trail even, since it's daylight, I need to go. Because let's not pretend that I'm going to be making dinner during that time or anything insane like that. That just strains credulity. Instead, I'm going to crank up my aging laptop and peer into my blogroll for something, anything that will consume my attention.

Of course, no degree of posting frequency (and is it me, or is everyone sort of wimping out lately? I guess that includes me) can sate my appetite for New Postings!, so when I've read everything and it's still light out, do I get my togs on and head out? No. I troll the internets looking for new blogs to put on my little blogroll. (Sometimes, I need them to replace blogs I have removed. I have decided to be something approaching ruthless about this. If I am not going to want to read every new post, or if something has irked me, the blog leaves the blogroll. Doesn't mean I'll never read it, of course. Or that I won't put it back on at some point.) This is the part with the silver lining, of course, because there are so many very excellent IF blogs out there that I have not yet discovered, and I need to discover them, even though they don't post enough either.

And then I look at the wretched computer clock thingy and it is 11 - or so. This happens consistently. And I have not folded the laundry or gotten any exercise. I have, however, eaten three chocolate truffles, half a loaf of French bread with butter (this is not even a slight exaggeration), a small but tasty bowl of homemade soup, and about a cup of store-bought Chex mix. That's an anti-inflammatory dinner, right?

At first there was a risk that I would be insufficiently committed to blogging to do it justice - I would never get around to formatting my blog the way I wanted it (done), I would forget to update my blogroll (done regularly), I would be patchy about commenting (I think I've been pretty good), I wouldn't keep up with my reading (au contraire. See above), or I wouldn't post enough (let's be honest, this was always an illusory risk. I never shut up, and my blog posting has been true to type). I think I have not only accomplished all of these things, but have ingrained good, firm habits of keeping them going.

Frankly, I've only been blogging since this January, but the new acquaintances I have already made are keeping me (my version of) sane. Even my IRL friends who specifically ask about the treatment and whom I am willing to tell in detail lose interest and ask for the bottom line after about two minutes. I could go on for two hours (just to get through the early IF history), and nobody but my husband has heard any kind of serious detail. But they don't want to hear. I am fascinated - not morbidly - by other people's suffering. If someone wants to tell me the entire story of their heaviest cross, and they don't appear to be becoming visibly unstable during the telling, I'll listen to the whole thing. Possibly I am simply not as compelling a communicator as others, but after playing relatively close-to-the-vest with this business for years and finally being willing to trot out more than an amusing offhand comment, guess what? Nobody is interested. For anyone to GRA, I needed the internet, and former strangers, whose future motherhood I have become frankly more attached to than my own.

All this being said, however, I was in abdominal pain today, and I realized with surprise that it had nothing to do with the endo. No, my skirt (that is, one of the ones I'm still wearing) is now so snug that it was actually digging into my plush tummy fat. So while I need the blogging, I don't think I'm going to have any trouble keeping up, and I don't think the bloggy world will be deeply wounded if I limit my evening consumption to maybe half an hour (this doesn't restrict my lunch hour or my Blackberry-mediated commuting consumption, of course) and get myself outside and get some exercise, so I stop feeling like I'm on high doses of Valium and the world is ending, and my behind stops its slow but perceptible impending takeover of the Eastern seaboard.

(Also, I was going to post about this family, and its unbelievable, amazing faith in the face of an absolutely heartbreaking loss. I was about 60% sorted out as to why, although I can't even imagine having their strength and acceptance in the face of so heavy a blow, I do take and have taken losses related to living people with much stronger faith than I take the realistically much less terrible loss of some indeterminate number of theoretical people who might never be. But I never made it to 100%, because of the aforementioned lethargy, and I just don't know what to say to such grievous suffering. Anyway, please pray for the Freemans.)

Sunday, May 10, 2009

vignettes

1st. I think these people administer my blog, right? Oh, whatever.


2d. All told, the weekend wasn't bad. Sunday was pretty good. One of my only goals for Mother's Day was not to have anybody give me a flower(s), as I will happily be a frigid hag before a wanna-be, and refuse to be celebrated as a sort of consolation prize. Of course, as we walked into the church, a woman was selling pink and white carnations to raise funds for Birthright, a cause dear to my heart, and underserved in the diocese of Rochester. My FIL leaned over to select one for his wife, asking her whether she would prefer pink or white. She decisively explained that only white would be appropriate: "My mother is dead." I tried to slip away from the immediate vicinity of the flowers, but a moment later, I found myself being handed a pink carnation by my MIL, she intoning firmly, "Your mother is still alive." No mention was made of whether I had children or not, as this is apparently irrelevant to a tradition of which I was theretofore unaware. Under such circumstances, I could not but accept the flower with grace. Before I left, however, I left it in front of the statue of St. Therese. Her mother is no longer with us, but then neither is she, and as many flowers as she has sent me, I thought she would appreciate receiving one of her own. She didn't have any children, either.

3d. The way home is a state route through the southern part of Western New York and then central Pennsylvania - the perfect drive. Not as fast (in some parts) as a high-speed interstate, but much faster than DC traffic, and the sort of road that goes for 300 miles and also has a Pete's Used Tractors with a driveway that feeds right onto the road. I had two goals for the lovely drive: one, visit a rural antique store (preferably in a barn). This was not to be; though we saw many compellingly tempting antique shops, none were open, as it was past five on Sunday. (In case this is not immediately obvious, the attraction is born of the fact that it is only possible to obtain antique pieces with character at affordable prices in semi-rural areas. In northern Virginia, one may instead have the unique privilege of paying $300 for a faded used sofa at a Salvation Army.) Two, secure my sustenance from a roadside stop that features a large painted ice cream cone outside to hail passers-by. We found the Platonic ideal of such a place in Kristy's Whistle Stop, which I commend in the highest terms to anyone driving up (or down) Route 15. As always, ice cream eaten out of a cone in the open air tastes incomparably better than any other kind. Their fries, chili cheese fries, and pulled pork sandwiches also met with approval, and they served their line with an efficiency and hospitality that well explained the unending stream of traffic on a quiet Sunday evening. Sharing such heart-filling little adventures with my DH is, I think, one of the precious perks of marriage - that our lives should consist of such small but lovely moments, experienced together.

4th. Today, as anyone would know who had nothing better than to mark down in his agenda the trivial milestones of my life, if such a person even existed, was the date of my sono-hysterogram. I am pleased to report that I was brave, faced with the twin onslaught of a male doctor and the passage of instruments through my beleaguered cervix. My fond, but faint, hope was that the previously-discovered uterine shadow would prove but a mirage in the very real desert that is my uterus. Predictably, the shadow was made of sterner stuff (sterner, anyway, than my sometime reproductive health, which has lifted and dissipated as the dew in the sun). The doctor first asked whether I had had any "procedures," as it might be scar tissue. The answer is obviously yes, and I proceeded to list them. He was unsatisfied; apparently he was looking for a procedure that involved sharp things in my uterus, a day that I may be thankful has not yet dawned. I assured him that I have never had a D&C, and he decided that the small and unremarkable item discovered was probably a polyp. (I have decided not to be concerned about the fact that his first thought was uterine scarring.) He printed up the pictures (and, because he is both brilliant and magnanimous, paused unasked to examine my endometrial cysts, take measurements, and send images of those along as well; there is now a third, but the larger two have not grown) and sent them to my RE. It falls to her to interpret them and recommend a course of treatment, he says.

5th. After I got to work, I got a call from the OB/GYN clinic - the results of my cervical biopsy are in. The nurse explained that I would ordinarily schedule an appointment to have them explained by my regular OB/GYN, but since I am seeing my RE on Friday, she has offered to explain them instead. I could hardly have asked for a better arrangement. Not only can she opine on how this might affect my fertility treatment, but she is a native speaker of English. Though my regular OB/GYN is bright and competent, and speaks good English, it's clear she doesn't understand a word I say no matter how carefully I speak, and our conversations about my medical state invariably take the form of a humorless, and gynecological, rendition of "Who's on First?"

6th. On that subject, at my RE consult on Friday, I will have all the things she wanted done save one - plus I had two procedures done she didn't request. But which one won't be done? Of course, it's the SA. Thus, she can draw plenty of conclusions about my health, but only mine. I recognize this is a signal omission (I'm hoping to be able to schedule the SA for Friday, but then, of course, the results won't be in). On the other hand, the remedies addressed to female infertility are so much more time-consuming and complicated, so I don't know that it will upset the apple cart if my next round of tests is scheduled and any supplementation prescribed before we get to focus, laser-like, on the sperm end of things.

7th. I wanted to share this fascinatingly hostile dialogue on the subject of badly-raised children. And I want to be able to muse on it only briefly, but this is difficult for me. On the one hand, I sympathize entirely with the sentiments of those who defend children (and large families). This is consonant with the truths of my faith and the treasured blessings of Catholic culture, blessings I desire for myself. On the other hand, I find it easier and easier simply to sympathize with those who have slim patience for children, period. I have less than I would like in common with their parents, and I prefer to spend relatively less time around them. I can cut this Gordian knot with the observation that I had strong negative opinions about badly raised children even in the halcyon days when I expected to get pregnant on my honeymoon (and again every year thereafter), which is absolutely true, but it's not as simple as that. Those - such as my in-laws - who revere the mother with a young child (i.e., my SIL) as leading a selfless and blessed life are not wrong; in fact, I agree with them. But they leave no room at all for those who have been just as ready to sacrifice for a family, and whose burdens have been heavier, perhaps, than hers (taking care of all the children), but who have no blessings to show for their travails. I don't suppose I would prefer my suffering to be wholly obvious to the world; there is a strength in not having to engage those who would want to, but could not, understand. A small voice in my head says, Doesn't my father-in-law say - maybe less than once a year - in serious tones that he's praying for me, implying clear as the day that he knows it must be hard to want a child and not have one? And doesn't he make a ridiculous fuss over his daughter's baby while I sit right there and watch? But I am supposing a degree of transparency that doesn't exist. He can't see anything but his beautiful grandson, and that anyone should fail to take the same delight in the child is beyond him. That is, probably, as it should be. He is a good man, and one I care for, but not my confidant. Let him coo at the baby; it doesn't, after all, take so very much from me. If I needed more from him, and his family, it might. But I try not to need anybody who isn't essential. People are so hard, if not impossible, to rely on.

8th. Though some of the green peppers - indeed, an increasing number - had lived despite my husband's well-intended ministrations, and a single basil shoot, bereft of its former companions, is growing ever taller, the rosemary and eggplant died off completely. I was loath to pitch out the barren soil, though, hoping pointlessly that they would rally despite their evident total extinction. When we got back from the weekend, I examined them, prepared to revel once again in the exquisite agony of their demise. My plans were stymied by the fact that three separate pots of eggplant now have tiny shoots, and one itty green sprout of rosemary is now growing as well. Where they came from I have no idea, but my husband proudly explained he had watered them before he left, hoping against hope that they would come back. Perhaps there is a lesson in this for me...

9th. I still need to go panty-shopping. I don't suppose anyone in the DC area has that same errand planned for Saturday morning?

Saturday, May 9, 2009

funny thing

BTW, I've obviously learned to post from my Blackberry. The internets will never be safe again...

You'll be glad to know that I'm still married and no blood has been shed. I've tried really hard to be good today - been nice to everyone (easier because I'm so fond of them and they're so good to me). Helped with dishes. Helped with dinner. I spent all afternoon running errands with my SIL (no baby though), and had a great time. I did have an outburst when I waited for 90 minutes after we were supposed to leave, and my husband actually snapped at his sister for making me wait (I wasn't actually waiting on her, I planned to go by myself). He has never yelled at someone else to defend my prerogatives - ever. Certainly not a member of his family. He usually acts like he has to prevent ME from offending everyone. In general, he's been solicitous all day of whether I'm OK, even when I seem fine.

The weekend does turn out to be much harder than I thought. I don't anticipate problems tomorrow - we're having a private Mass said by my BIL, so no one's going to ask the mothers to stand up (that would be more like a spotlight on me and my other SIL, who's also childless, and doesn't want kids - she's well into her 40s, so avoiding them won't be hard, I think). I enjoyed picking out roses for my MIL, and a present we haven't given her yet.

But. Because I told my husband how upset I was about the baby, now it's An Issue. He doesn't get to hold him, so I can't (that wouldn't be fair). So I haven't offered to feed him though SIL could use the help. I haven't touched him, or said much to him, though everyone else coos at him endlessly, making it appear very slightly odd that I don't. (Then again, my other SIL hasn't paid him a moment's notice, and I didn't even think about it till just now...)

Because I told the truth, I have to tiptoe around, and it makes things a little awkard. If I had deceived my husband and pretended to be fine, I wouldn't just have the power trip of concealing my emotions, and the benefit of not upsetting him - it would actually be an easier weekend. Pretending, even with family and even in my marriage, would in fact make the IF burden easier to bear.

Is it supposed to work like that?

Friday, May 8, 2009

i'm an idiot

Of course it doesn't bother me that my SIL brought the baby (like she could leave a four-month-old home). But why did I not realize my husband (not very dear just now) would immediately swoop in and try to parent her child?

We got in at almost midnight, but of course immediately he wanted to see the baby. I thought about staying downstairs, but figured I could stand a visit to a sleeping child. OK, almost sleeping. And who had to take him out of the crib? And bring him downstairs? And hold him, and feed him, for the entire duration of the wretched evening? That's right. Keep in mind, this child has been on TWO flights today, is sleeping in a strange house, and is from a different time zone. I think I mentioned - cheerily - that he would have a bad day tomorrow if he didn't get to sleep now five times before we left the bedroom. I continued to bring it up when we were in the living room. Of course, his parents and sister see nothing odd about him holding his nephew. Only I saw it.

And it wasn't a provocation - it was a knife. It was like I had been taken over by a monster; I couldn't look at him without becoming more upset and I couldn't pay attention to anything else. I found myself being curt and sarcastic with my 70yo FIL, to whom I have never spoken a disrespectful word. I couldn't stop myself. I wanted everyone in that room to die. I wanted to run screaming, but where do I go? Finally I just went to bed.

When my H joined me I just wanted to be left alone; I said it had been a long day. Was it the baby, he asks. I started crying. Now he is on baby probation, can't even hold his own nephew. (Who is a beautiful child. If only he were a troll...) I fled to the bathroom and collapsed in tears on the floor. I haven't cried over IF in years. I am a disaster. I'm four inches taller than my SIL, 20 pounds lighter, I have pretty hair and she has an unflattering dye job (update: after I saw it done the next day, I decided the hair color actually looks really good. And, in fact, she's gotten in great shape since she had the baby. But still). I know she thinks I'm worthy of envy. I can't even watch my husband hold her son.

I want to tell him to go home to Arizona with her, since her family is the one that he wants. I know he wasn't trying to hurt me, but as of now I am planning to spend the night in the bathroom. I thought I was so tough. I am a failure. And I don't even give a rat's ass about mother's day. I want to go home, and I don't want to be married any more.