Wednesday, December 29, 2010

it's still Christmas

This video is actually really cool. Tragically, not embed-able.

Merry Christmas, y'all.

Thursday, December 23, 2010

yet another HCG question

Hey all. So thanks to the suggestion of a lovely lady who lives in the DC area and sent me an email, I stopped by a compounding pharmacy that's really close to my house, open on Saturdays and till 7PM weekdays, and is angelically nice: Preston's Care Pharmacy. (First I called Kubat's - they absolutely have to have the doctor call the prescription in, which is not a requirement I would to risk in view of my phone-related difficulties with Tep.eyac - and then Freedom Pharmacy, which left me on hold for about ten minutes without even estimating a wait time. What kind of call volume could they have on the afternoon of December 23rd?)

The problem: the only brand of HCG their wholesaler carries is Novarel. From the information the (awesome) pharmacist was able to find on the computer, the Novarel people say you're only supposed to inject it intramuscularly - but then, she found mention on the techniques website of some people injecting it subcutaneously (what my prescription calls for, and what I would prefer to do). I was of the understanding that other bloggers who've taken HCG have taken it subcutaneously.

Please, enlighten me: if you've taken HCG (or know of someone else who has), was it intramuscular or subcutaneous? If subcutaneous, what brand did you use? (I believe Ovidrel is commonly used sub-Q, but I'm particularly interested in anyone who has taken Novarel subcutaneously.)

Thanks a million, again, guys!!!

Wednesday, December 22, 2010

good things

Thank you all for your brilliant suggestions on the HCG. Tragically, I left my cell phone at home today, so I will be calling pharmacies tomorrow to see who will send me my drugs, needles and all. I'm actually now toying with the idea of waiting a cycle before starting the HCG shots - among other reasons, it would mean I get to find out whether the mystery cyst is an endometrioma before going forward. Hey...you know how people (you know what kind of people I mean) have little pools on their blogs for people to guess or bet on the baby's due date? I could have one of those with all the known types of cysts...

That's not what this post is about. This post is about good things - for real good things. Not small things for which I endeavor to be grateful as an exercise in good behavior, nor large things for which I ought to be grateful but simply cannot feel that way. I mean actual good things. At least, in my view (the only one that matters...to me).

My marriage has had ups and downs like any marriage. Obviously some of those downs have been a little more of the accidentally-dragged-behind-a-moving-vehicle type than the typical downs, because I, like you people, am infertile. Not good. And there's the fact that my own family is crazy - one divorce, going on two; mom in a convalescent home because she is schizophrenic (or something) and cannot function on her own; various feuds within my nuclear family; father and (soon-to-be-former) stepmother ruining their young kids' lives. General unpleasantness.

And of course, we can't forget the fact that my husband and I, each in our own special way, have a lot of emotional and psychological baggage that we brought into the marriage. Heavy baggage. Some of which we have worked through together. Some of which has just stuck around, un-improved. Some of which has probably been accruing interest all this time.

I think it would probably be fair to say that my beloved husband is depressed. Or manic depressive? Or something. And he has plenty of good reason to be. I am probably not the best person to be married to, if you struggle with that sort of thing. And I know that, what with all of my issues, I have very little resilience to offer in the more difficult phases. I love him, and I want to help, but I really can't deal.

This doesn't sound like a post about good things, does it?

On Friday night, we had a big blow-up. People have those...but there is a difference between the fights that we have that are like the fights that normal people have, and the fights that I know only unhealthy people have. This was one of the latter. As I lay in bed, I thought about how at times like that (and they are not that rare), I know I need help. And I feel desperate - I am lost, there is an actual disaster, maybe it will pass, but I don't really know; and I need someone to talk to who can give me a frame of reference, and I need to talk to that person now. At...10PM on a Friday evening. Not feasible. And I know that I feel that way every now and again, and I think, "I need to find someone who can help me," but then we patch things back up, and life seems OK again, and I am so busy, and I don't seek help. And then it happens again, and there is no one to talk to right now, and I am lost again.

I did two things. I emailed my spiritual director (as calmly as possible) and asked him for a recommendation for a therapist. I told him that I knew I needed help dealing with the infertility, but I also knew I needed help coping with my husband. I don't know how, and I am making things worse. I had begged and pleaded with my DH to seek help, but he refused; but how could I expect him to do so if I would not? Father passed along the name of another priest closer to me, whom I have yet to call. I will call today.

I also started a novena. I realized that it was eight days till Christmas exactly - I had two hours to start a novena that would end on Christmas day. Because the Infant of Prague has been stalking me lately, and it will be His birthday, I knew that was the one to choose. Google "Infant of Prague novena" - click on the top result. I prayed for something very simple: healing for my husband and for me.

There is so much that we need, but it all falls under that heading. Strengthening in faith. Graces for our marriage. Healing for our hearts. My body is falling apart, too. I have had that last in mind throughout the novena, but I don't intend to hold God to it - that's not the most important thing. I have an idea it's not something He wants for me anyway. Much of the other healing is necessitated in order to deal with the fact that He took that away, but it's a fair request - if I can't have a healthy body and a life-giving love, I need the things required to deal with that. But I always feel at greater peace if I ask for something, not merely objectively good, but that I know God must want for me. He wants us to address the things in our lives that drive us away from Him, and each other. He wants our faith to be stronger. He should answer this prayer.

True to form for a fight rooted in real underlying problems, this one hung on, or recurred, throughout the weekend. Even now we're at a fragile peace, and I feel like a basket-case. On Sunday, when he agreed to speak to me, my DH said something astonishing. He had promised, a week previously, to think about trying therapy - even though he was opposed. I figured when he got angry with me he would decide not to consider it after all. He told me that he had looked up the symptoms of long-term untreated PTSD, and he has all of them. He also looked for doctors in the area. He found an older Jewish woman who looked formidable and took his insurance. (This sounds like exactly the sort of person he would want to work with, honestly.)

Then Monday he sent her an email. She called him right away. She asked him to give her a run-down of the things he was dealing with, and he did. She gave him an appointment for today. (He says he is convinced that she accepted him as a patient because he's so fascinatingly screwy, and he is hoping he can get a syndrome named after him.) Before I get home from work today he will have done his first hour.

I haven't entirely absorbed this information yet. There is no question in my mind that supernatural grace was required to change his heart. Obviously it ain't over yet. Maybe professional help will do nothing to help (though I believe it must be some help). But experience has taught me not to become emotionally attached to the best possible outcome of a promising situation. I am absolutely floored by the turn of events so far. In themselves they could only be good. And perhaps the day will dawn when they mean every good thing I could imagine now.

On Friday and Saturday when I was thinking, I came to some conclusions. I still have faint vestiges of the effervescent joy that causes the very young to run barefoot through rain puddles. In my mind, when I was married, I could see the impulse to do such lovely things, but that it was tempered by the plodding reasonableness of adulthood. And then I could picture that sharing life with someone you love would return that childlike lightness - skipping in the rain, making snow angels, walking through Christmas lights, driving in the fall leaves, looking at every restaurant menu on the street before choosing the perfect one, enjoying sappy movies, singing Christmas carols, eating cookie dough out of the bowl, looking at houses that might be our home; all those would seem perfectly natural to spend impractical hours doing with the one you love.

It has not turned out that way. The things that seem magical enough for me to make the effort to plan them often fall through; he doesn't see the same magic, or they happen to fall on a day when he just isn't putting a good face on life, or my sky-high expectations just don't pan out. It's not that every day is awful; it's just that a lot of things in life are difficult, and the little joys seem to help one manage, and I don't manage to have a lot of those.

And I realized that because of how I imagine this should work in my head, I pin most of my joy on my husband. He has to be on board when I think we should be experiencing something magical. If he doesn't love it too, I can't enjoy it. If, heaven forbid, he refuses to participate, I am plunged into sadness. That's a totally normal reaction the very first time it happens. If it happens repeatedly, continuing to hope that all will go beautifully is just asking for problems. I need to recognize that, even if my DH is having too difficult a time to be joyful (or at least, to be reliably joyful), I should be able to find joy in life; otherwise, no joy. Bad for both of us.

And, there are so many things in life that I want to do that I have postponed (indefinitely, I guess), at first because I was broke; and then because we were going to have kids and that would be our life; and then because I needed to save up vacation for maternity leave; and then just because I was busy, and life was difficult, and that could always happen later. You know what? Later is now.

My brother lives in Vienna, Austria, right now, and my sister in Warsaw, Poland. She has the least spare cash (since she's a student), but the brother and I haven't seen Warsaw; the sister and I have spent time in Vienna. The brother refused to come home for Christmas. I didn't know why. He will literally spend Christmas by himself - and then fly home, to spend time with some friends. No family. I didn't think he was angry with me, so I am confused, and it makes me very sad. I miss hanging out with the two of them. For how much of our lives will the three of us all be adults, free to travel, financially independent, and with an easy opportunity to hang out in Europe? Right.

So I emailed them and said that I had a long weekend for President's Day in February - who wants to crash Warsaw? I expected him to demur enigmatically, as he did with Christmas. Nope. Immediate email back: "We need to make this happen." My sister sent a list of places to see in Warsaw and said she had room for both of us. I bought a plane ticket yesterday (under $500 - not bad, right?). My brother bought his today. We have a conference call (yes, really) scheduled for the morning of the 24th to discuss our itinerary. My misanthropic baby brother says he is "very excited." My dear sweet husband, who despite being (some days) crazier than I am, is infinitely more generous than I am, is excited for me. (Even though I didn't invite him to come.)

I have decided that in every month of 2011, I am going to do something I should have done five years ago. Some things could be small. But I have really close friends from college I rarely see. And good friends I have not seen since graduation - more than seven years. Some of them live a few hours from here. I am going to get back in touch.

And I have said for years that I will take dancing lessons. Why don't I actually do it? And that I will volunteer with the underprivileged in the city. I've done a little bit toward that in 2010, but I need to get myself a regular commitment. And I say I'll learn another language or two. Would it kill me to do something about that? I mean, I might not have time to get very far, but I won't know until I start. And I have canvases and paint I bought after we returned from our trip in May...unopened. 2011 is going to be my year of eradicating items from my list of regrets, rather than adding.

Other good things - there are more! (You can stop reading eight or ten paragraphs ago - this is interminable, and interesting only to me.) I have been thinking a lot about TCIE and her prayer post. According to what (to me) was the most striking of her comments, prayer changes our minds - not God's. So that means...my novena gave me an opportunity to be grateful and hopeful for the possibility of healing for myself and my husband, a grace God already had in store for me? That doesn't sound too crazy.

Looking back, I realize I've gotten just a wee little bit better about prayer in the last month or so. Made some progress on the awesome St. Therese book a friend lent me. Read some Scripture as well. Have had no trouble keeping up with my novena - in fact, the idea of having to remember for nine consecutive days seems almost easy, where usually, it's a proposition fraught with peril. Periodically at work I remember to pray the Angelus (OK, never actually at noon), which seems particularly special in Advent. I'm trying. Not succeeding, but - baby steps.

I started taking that Adren-All supplement TCIE's awesome doctor recommended in the fantastically detailed letter she posted. (What, it was prescribed to someone else? They sell it on Amazon. That means it's for me!) I figured that although the natural thyroid has cut my overall exhaustion, I am still basically nocturnal and need a crowbar to pry me out of bed in the morning. That seems like enough for an amateur diagnosis of adrenal problems. I was hoping I would be more energetic and lose five pounds, or something. That has not happened. However, I have had an interesting attitude change. My scary list of chores and errands is no longer scary; for whatever reason, I now view it as a challenge - and I will conquer. I now get home far more motivated to clean something and conquer the housework demons than to feed my brain to the internet. I did not know this came in pill form. Strange.

Houses - I've been quiet about houses, right? I'm taking it strangely easy, for me. There are two houses of interest. One is a few miles from me and centrally located among our friends. Good price (for the location), but a real fixer and we wouldn't have a ton of extra funds to sink in at that price. Almost no yard. Busy street. Hmm. Second house is further out (in the area where I more generally am looking). Further from the friends, but an easier commute to my job. Nice yard, awesome neighborhood, rock-solid structurally, though kitchen and bath remodels will be needed ultimately. Priced $175k-200k above market (per comps, assessments, and estimates). If we could get it for market, we could certainly afford it, and whatever remodeling it needed. And I really like it. The seller can't afford to drop his price because of all his refis, so I want to write him a nice letter, with lots of supporting documents, and suggest he try to short. He may not listen; and if he did we might not get it. But, we can give it a reasonable, grown-up sort of a try. And my DH is on board for this. Who knows...maybe the interest rates would drop again by the time it went through...? We shall see. Maybe my comparative peace of mind with this is itself a good thing.

And I'm looking forward to Christmas and New Year's. I would love to have a huge group to feed, but that won't happen; but I am willing to look forward to it in a later year. My sister is coming in tonight (!!) - for some reason this whole time I thought it was tomorrow. (Actually, I think that's what she told me.) I get to visit with two lovely ladies tomorrow amid my cleaning. Friday I can do the bulk of the baking, and cook Christmas Eve dinner. Midnight Mass in Polish. American Christmas dinner Saturday. Helping to host an awesome New Year's Eve party, and I think I will fit into a really pretty dress I got at a thrift store and have not yet worn. (Might have to buy myself some appropriate corsetry.) Delightful friend coming down for that party. And I could not possibly be pregnant at Christmas - I'll be mid-cycle.

Good things.

Monday, December 20, 2010

question: source for HCG?

So I took my prescription for HCG that I scored to my grocery store, where I filled all my prescriptions until I started getting my thyroid meds from Canada (thanks Barbie!) and quit taking tamoxifen. The pharmacist told me that he doesn't have any other customers who buy HCG and he'd have to order ten vials (and I only need one) so he can't really waste hundreds of dollars in un-needed drugs. So I need to get it elsewhere. (He also didn't know whether it came with needles or other things I think I would need to know.)

So, does anyone know of a chain pharmacy that usually offers HCG? Or, if you live in the DC area and have any specific suggestions, that would be delightful too.

I have a week or so to get it, but not forever. So, I'm hoping I can pull it off. Thanks, as always, oh wise infertile women...

Friday, December 17, 2010

an oldie but a goodie

I've spent so much of my life in the past few years feeling abandoned. Not only because I sense that no one is listening when I pray, but because I feel as though my life is a matter of being stranded in the desert. I know many carry heavier crosses than I. I know my life has comforts and riches that I don't deserve and that should make it seem easy. But the crosses I carry seem absurd and senseless to me. I don't see any good that can come from them and I don't understand how it could be God Who has left me here alone.

I have felt truly alone at other times - well, one other time that I can remember. My heart hurt so much I thought I might be dying. But I didn't believe I had been abandoned by God. I could never "run to the cross," as some of the saints have said. But I could collapse on it and beg God to take my suffering away. I don't know how to make that prayer now.

Sometimes it helps, a little, to step back far enough (it's very hard to get that far back) to realize that I'm not actually crazy. I rail and rail about how tough infertility is, but it isn't just good rhetoric - it's true. We're all being put through the furnace, and no amount of toughness would enable any person, no matter how saintly, to walk this way and not stumble and fall under the weight. I may fall more because I am weak; but I am not crushed under the burden because I am worthless, but because it is heavy.

And I am married to an untreated (indeed, undiagnosed) PTSD sufferer. And probably manic depressive. And definitely recovering alcoholic. No one, no matter how long they have known me or my husband (not even if they've known him much longer than I have - although I am sure his old friends would dispute this) knows what our marriage looks like from the inside. I could tell a thousand stories and still no one who has not had a similar cross to carry could understand what it is like to be here.

I'm not crazy. I sometimes think, when I feel like I'm living in hell, and entirely abandoned, I must be losing my mind. But I'm not losing my mind. The suffering I imagine is actually here; and if I get up the next morning, if I keep fighting, it's proof not that I've been delusional, but that I'm a survivor.

I can't claim to have had a close, or even a non-schizophrenic, relationship with God of late. Some things resonate with me and some don't. But this seemed appropriate, I thought, and perhaps it will resonate with some of you as well, familiar though it may be.

One night I dreamed a dream that I was walking along the beach with my Lord. Across the dark sky flashed scenes from my life. Through the scenes, I noticed two sets of footprints in the sand, one belonging to me and one to the Lord.

When the last scene of my life passed before me I looked back at the footprints in the sand. I noticed that during the low periods of my life, when I was suffering from anguish, sorrow or defeat, I could see only one set of footprints. This bothered me and I questioned the Lord about my dilemma.

"Lord, You told me when I decided to follow You, You would walk with me all the way. But during the most troublesome times of my life there is only one set of footprints. I just don't understand why, when I needed You most, You left me."

He whispered, "My precious child, I love you and will never leave you. During your trials and testings, when you saw only one set of footprints, It was then that I carried you."

Thursday, December 16, 2010

more than a river in Egypt

So I guess I've had a great luteal phase, or whatever. I mean, some of my temperatures have dropped below the cover line, which is bad. And my highest temperature was 98.1. And it looks like I'll have had...five days of pre-menstrual spotting. Despite the topical progesterone. So actually, could be a lot better, but this is me. We're celebrating the fact that it looks like I'll have had a thirteen-day luteal phase, and in the last few months when I've been taking temperatures, they've pretty much all been eleven days.

Wait, why am I celebrating having a somewhat improved luteal phase? Isn't the goal not to have a luteal phase, so much as a post-ovulation phase that lasts the next forty weeks?

Today is going to be CD1. I know this because of the tightness I could feel in my stomach starting yesterday evening. I know because swearing off sweets during Advent has been easy - until this past week, when I wanted all the chocolate. Right now. I know because the spotting is, probably, technically still spotting - but looking increasingly ominous. I know because this morning I have a very mild version of what I pretty much have to call cramps.

Fortunately it's getting smaller and weaker throughout the day, but up through at least bedtime last night, why was there still a voice nattering at me ceaselessly, about how spotting is not inconsistent with pregnancy (indeed, some people deliver healthy babies despite pretty heavy bleeding early on), and abdominal pain isn't either, and if I make it to p+13, why not p+15, and p+17? And then, to infinity, and beyond! And we seem to have used the right days this cycle. And I was pretty good about the progesterone cream. And...

This is not helpful. Not helpful at all.

Because there's also a voice, much quieter, and wiser, that reminds me that as of my surgery last October, I had no working fallopian tubes. Dr. L/C said the surgery might have fixed the problem, but "might" only ever works out one way when it's me. I could have perfect hormone levels (though I don't). Be endo-free. Have great CM (not bad these days, actually). Actually be ovulating. Use all the right days. In a cycle when all these things align...nothing changes.

Some day, I hope I learn to accept this fully.

Sunday, December 12, 2010

blessed straw

My family is big on the lore of our Polish heritage. I guess we get marginally more credibility with that than we might otherwise, because my father (and uncle) actually speak Polish. And when I was born, my grandmother (who spoke Polish fluently) and my great-grandmother (who was actually born in Poland) were still alive. Anyway, these things seem to manifest themselves more around Christmas and Easter - especially Christmas, I think.

There are a million little things. Christmas Eve (Wigilia - "vigil") dinner is a big deal. Because it's a waiting holiday, there's no meat. All the dishes are fish (or non-meat), and all of them are white. And there has to be an odd number of dishes (up to thirteen, if you do everything). Among the ones we typically did are baked perch; smoked pickled herring (szledzie); leniwe ("lazy man") pierogi; kapusta (sauerkraut) pierogi; mushroom soup; and noodles with poppyseeds. Oh, and Polish wodka (vodka). The rituals also include the excange of oplatki, and forgiveness of one another for the sins of the past year; and the reading the nativity story from Luke 2 (preferably in Polish).

There's also always an extra place set at the table, with a plate from which no one has ever eaten. Under the plate, straw is scattered - blessed straw, if you can get it. (My [non-Polish] parish back in Michigan distributed blessed straw at the beginning of Advent, for scattering under the creche - I kept a bag for a long time, and I wish I had it still.) The place is set for Christ, in the person of an unexpected guest. The really old version of the tradition is that if a wanderer or a beggar should knock at the door on Christmas Eve, he would be welcomed in, seated with the family, and served dinner; because the unexpected guest came in the place of Jesus.

I wrote my college admissions essay on my family's moves, and my memory of this tradition throughout the years - and how, when we celebrated Christmas with my father in a tiny, cramped apartment with no table or chairs, and put dinner on an upside-down VCR box with a green vinyl disposable table cloth, saved from year to year, we always thought that someone might really knock at the door, any moment. Even though he'd have to get through the locked door to the apartment building first. When we finally bought a house years later, we had not only a table and chairs, but an actual dining room - with room for a buffet AND a china cabinet. We always set the place for the Christchild, but, because we were older and because the possibility seemed so remote, in a middle-class village in a normal home, I no longer really believed that a stranger would knock at the door and join us for Wigilia dinner.

My father had told me in no uncertain terms not to write my college admissions essay on anything Catholic. He's a professor himself, and he told me that the standard perspective in academia is that Polish Catholics are anti-Semites. I was confused. Obviously Hitler killed Poland's Jews, and the Poles hid them at the risk of their own lives; and I was friends with all of the (few) Jewish kids in my school. Surely no one could think such a thing. I was not yet acquainted with the "tolerance" of elite academia. But I let him edit my essay anyway, and he didn't tell me to change a thing; he just looked sad.

I have to remember to buy a new plate this year - that's something my family always forgot until the last possible moment. (Actually, since there are probably plates I'd like to add to my collection, maybe I should plan ahead and buy a new plate for Christmas every year that actually matches those from other years. Would that be exploiting the tradition for materialistic ends? I hope not. It would probably be nicer than buying a $3 cookie plate with a Santa on it from the drugstore, which we not infrequently ended up doing when I was younger.)

But I have to say, the bit of scattered straw has new resonance for me this year. My little family has been waiting for an unexpected guest for a lot of Christmases now. We're probably not going to get an infant of our own to welcome at Christmas, though God always has the opportunity to surprise us and I'm not sure yet whether letting go of that hope is part of what He wants from me. But I see, in that little pile of straw, the nest to welcome a baby; the manger where the divine Child lay - something of expectation, anticipation, hope. And we are very much in need of that unexpected guest - Christ walking into our lives and joining our family, our home, and our Christmas would be very welcome. I'm not sure what I'm to anticipate exactly, but then, the unexpectedness of the guest is the whole idea. And since I have no idea what would get my life on the right track now, I would be better off with an un-looked-for visitor than anything I might actually request.

I need to be on the lookout for some straw.

Thursday, December 9, 2010

no such thing as progress

Do I rant more because it's December?

Well, anyway, this one is intended to be short. I am trying to work on this whole "having faith" thing. In the goodness of God - I'm not trending toward heresy, I believe intellectually, it's just being-in-relationship that seems bizarre, pointless, and impossible. (Rotten timing, what with Christmas coming and all.) So I have started reading I Believe in Love by Fr. Jean C.J. d'Elbee. It's a "retreat" on the writings of St. Therese of Lisieux. It's good so far.

But I have problems with the spiritual life in general...this book simply provides an example. And I swear I'm not trying to pick it to death just for the sake of finding fault. But somebody give me an actual, not just theoretical (i.e., would work in a hypothetical universe not consisting of the people who actually inhabit this one) explanation of the following.

Pages 17-18:

Love is life; it is the sun, the light, a divine warmth over our whole life. Without this love, you live a shallow life; you vegetate. Externally you do spiritual exercises, fulfill the duties of your state in life, but if your heart is not there, life is not there. Without love, everything is painful, everything is tiring, everything is burdensome. The Cross, taken up hesitantly, is crushing; taken smilingly, by free will, and with love, it will carry you much more than you carry it. . . . Louis Veuillot wrote, "Dry duty is a cold and hard master who does not console anyone and who is terribly boring. Speak to me of loving God, that I may fulfill with joy the duty He assigns to me, and keep the great joy of love which is sacrifice."

(I'm still on board at this point.)

Page 20:

How often have I heard the objection, "I tell Jesus that I love Him, but I don't feel it. It seems to me that I'm not being sincere." Not to doubt that you love Him when you feel demands great faith, the forgetting of yourself, and a true understanding of sanctity. The greatest saints passed through the dark night of the soul, painful periods of dryness. . . . Love is not sensible piety. Never forget this distinction. Holiness is a disposition of the soul, of the heart, and above all, of the will, toward God; the senses may play a role, but that is not necessary.
So, to clarify: if you exercise your will to perform all acts of piety (prayer, charity, avoiding wrong and doing good), but do so without "love" (not yet defined), your life will be "dry," "cold," and "hard," with no "consolation." If you have "love," you may nevertheless find that life is "dark," "dry," and "painful." But you will know that you love anyway, because of . . . a disposition of the will toward God. (I understand a disposition of the will to mean that you use your discipline to cause yourself to do the things that are good, or right, to do. If I'm mistaken, let me know.) In the first example, you do all the right things, but don't "love" - consequently, life is unpleasant. In the second example, you know that you have "love," despite life being unpleasant in more or less exactly the same way, because . . . you chose to do all the right things.

This is a logical mess. Unless I am missing a trick with the basic definitions, someone with a perfectly rational brain (better than mine) could, I suspect, cross off bits on both sides of the equation until it boiled down to: the difference between living a good life without love for God and living a good life with love for God is saying that you love God, whether you feel that to be true or not, and whether or not it affects any aspect of either your conduct or your lived experience of anything.

I have no problem with the idea that I will never, ever feel close to God, or experience anything that gives me confidence that He considers me other than a disappointment, that my salvation is other than questionable, or that my life is better than worthless. That's how I felt when I was praying three hours a day, going to Mass every day, filling my time with charitable works, doing without valuable possessions and other pleasures, and wasn't dealing with infertility or a husband who is losing (has lost?) his faith - the man who is supposed to be the spiritual head of my family.

Now, of course, I am living an objectively far less pious life, so I have more objective evidence that my salvation is questionable and my life is worth little. But I don't have a verdict now and I didn't then, so the outcome is no more certain. I felt distant from God then, and doubted constantly that anything I could do, or receive, or experience, would mean that I loved Him; I thought it might be unattainable. Now I feel...more distant, but I care less, so usually, it hurts less. That actually seems like an improvement.

I'm not in this case arguing that the goals we're supposed to attain are difficult or costly or not worthwhile; I'm more concerned that they logically are incapable of existing at all. The rational distillation of Fr. d'Elbee's writing is that love is a word. A word (other than the Word, Who is actually a person - let's not start there) is not "life," "the sun," and "the light."

My catechesis and my natural disposition require me to try; I don't know how to give up entirely. But let's be honest: how hard will I be trying when I believe beforehand that the goal actually doesn't exist?

Wednesday, December 8, 2010

in which the misfit issues a slight retraction; and, in defense of infertile career women

So I only ended up having to call Tepeyac three times before the nurse called me back. I feel bad because I must sound like a banshee on their answering machine. Three messages in an hour, telling them it's urgent and that they HAVE TO CALL ME BACK. But there have been days I have left just one or two messages (telling them, for example, that it has been a month and they still have not provided my bloodwork results), and never gotten any answer AT ALL. I don't want to be a monster (most of the time), but I feel like I don't have a choice.

Anyway, the nurse said that Dr. L could fit me in at the end of her day (i.e., stay later). I appreciate that. I really do. I know it's my fault that I couldn't get myself there at the time I had the appointment scheduled, and she shouldn't have to work later for that. However...I work around their schedules to a degree that makes my life extremely difficult and often makes it impossible to schedule treatment. And I know - I know - that if I had simply called the receptionist to ask whether it would work if I were 25-30 minutes late (my first call of the day), rather than calling the receptionist three times; or only called the receptionist three times; or only called the receptionist three times and the nurse once - I would never have gotten a monitoring appointment for yesterday. Or even for my next cycle. They're up-front about how they can't possibly see me during a three-week period (you know, when I need an appointment within a range of three days). But they don't volunteer anything in terms of what they can make work unless I verbally abuse them. What kind of arrangement is that?

So I appreciate the office being accomodating, even if I feel like I have to become the worst person in the world to get them to treat me like a human being.

Sadly, the happy(ish) thoughts end there, because the results of the appointment itself were a total disappointment. I wanted to know: (1) do I have endometrial cysts again (I am convinced the answer is yes); (2) if not, what is making my ovaries hurt; (3) have I actually ovulated, or do I have an unruptured follicle; (4) what is the thickness of my lining. It was logically impossible to get answers to fewer than three of those questions. How many answers do I get? One: my lining was 1cm, which is good. Isn't that nice - a great implantation site for my eggs that are never fertilized.

So, how is this possible, you ask? Well, keeping in mind that I am neither a gynecologist nor a sonographer, here's my understanding. On my right ovary there is a 3.5cm cyst. (Dr. L/C didn't think that size was anything remarkable, but I've had a lot of cysts, and that's not small! Certainly enough reason to cause pain - I had right-side ovarian twinges just yesterday before the ultrasound, and I have to assume they're related.) It has blood in it, so it could perhaps be an endometrioma (it's my cyst, and that's what I think it is), but Dr. L/C was more inclined to think it's a hemorrhagic corpus luteum. The fun part is, she tells me, with a hemorrhagic corpus luteum, it's not clear whether it ruptured and released an egg, or not. So I didn't even get that answer! Good news or bad news - I don't even know.

She didn't find anything else of note on my ovaries that would explain the pain. But, she couldn't find my left ovary at all. I remember AYWH said she often had this problem, so I didn't freak out. I can't imagine she would have given me a post-surgical debriefing last October and omitted to mention that she removed my left ovary, and I had one before that, so I have to assume it's still there, and hiding somewhere.

Here are a few other complications I thought of: my CM pattern indicates that Thursday was definitely peak day - nothing at all after that, and a good five-day pattern before. And on Friday my temperature spiked (it never happens that fast for me, so I was delighted). But when I took temperatures again on Monday and Wednesday, it was just 97.7, which is the same as several pre-peak temperatures. That makes the cycle look anovulatory, but...why the textbook CM pattern, then? Presumably if the pre-peak pattern is that clear (i.e., high estrogen), a corpus luteum at least formed...and maybe didn't rupture? But in that case, where was is? The cyst she found would be one candidate. But if that cyst is an endometrioma, where did the corpus luteum go? I assume here that the left ovary would not have been invisible if it had had the corpus luteum, since those are big, right?

Finally, we discussed medication options. I said that until we can rule out further endo activity as the cause of the pain (and the cyst), I don't want to take tamoxifen, clomid, femara, or anything that stimulates ovulation. Especially since the beginning of my cycle looks normal, and I've always figured I was ovulating. But the end of my cycle is clearly weird. So she gave me a prescription for HCG shots, which I will fill soon, and be able to take next cycle.

With respect to the cyst, I am going to set another ultrasound appointment for pre-peak, two cycles from now (next cycle that phase will be over the holidays), and if the cyst remains, we know it's an endometrioma.

Oh, yes, and lastly: I am going to continue getting treatment at Tepeyac as long as they have something to offer me. If I find out another doctor can do better, then I'll switch. And TCIE, yes, the distance is precisely the problem. Scheduling appointments around work is already such a headache I am often tempted not to make them at all, and Tepeyac is under an hour from my house (around two hours from work). If I switched to Dr. S, as a practical matter, I would cease to get treatment at all. I cannot have my job and undertake that kind of travel for regular treatment. I think most of the people who are able to have variable/non-traditional work schedules, substantial amounts of regular time off (i.e., academic calendars), or don't work. I know there are exceptions (people who take two or three straight weeks off to go to Omaha, for example), but I don't think the typical American job makes that remotely feasible.

I think this may be one of the many fronts in which I'm a freak from the point of view of other infertiles, and I'd like to get this explanation out there. I wanted motherhood to be my primary career, and was willing to give up being a lawyer for that. I think being a lawyer is good (there are benefits and drawbacks). I think being a mother would be better. I think being in treatment for infertility ranks somewhere above having my fingernails pulled out with pliers - just above. Another woman who had been willing to put motherhood first, the way I wanted to, would just have sent her eldest child off to start school this past fall. I have spent that same period dealing with, or being emotionally incapable of dealing with, fertility treatment. Conceivably (no pun intended) I could spend the entire period it would take a child to get from conception to moving out to go to college, getting treatment. Many people seem to see being in treatment as part of being a mother. I see the two things as so different I can hardly even fathom a connection. It's like the difference between being an artist and being waterboarded with paint. Would I accept being an artist for five years? Sure. Waterboarded with paint? Obviously, no.

I fully understand that a lot of the other IFers (the majority, it sometimes seems), work on a schedule that offers three months off (plus multi-week holidays); or work on a flex-time schedule; or work with the medical facility that offers their treatment; or don't work at all. For people with these arrangements, I imagine that the hassle of getting treatment seems like a small thing, such that flying to Omaha or making a two-day trip out of seeking treatment in Pennsylvania would appear reasonable. To do these things, I would have to accept that I cannot actually be useful to my employer. And I would have to put my job in jeopardy in that fashion for the sake of treatment, which I hate. Hate. Which, for me, has almost no hope of success - I'm just checking a box. I cannot even imagine a rational basis for doing that. So I am always surprised when somebody suggests that I travel farther than I already do, or undertake treatment more inconvenient than the serious inconveniences I already have. I know other people make decisions to do this, and I respect their decisions, but I cannot understand them.

It's obvious to me that others are no better able to understand me (this is even harder to comprehend, but I have to assume that it's true). That's why I get so many comments - in person and on my blog - about "why don't you just go to __________." Even "why don't you just find a different doctor," while apparently an obvious comment, doesn't make a lot of sense. Finding another doctor who will offer the treatment I need (and am willing to accept), and accepted my insurance (not willing to pay out of pocket when insurance is part of my compensation for my job) would probably be worthwhile, if it did not entail a 40 hr/wk job in itself, and if it were even possible, which it may or may not be. But it's certainly not simple. Again, if I did not work, it might be; I'm not sure.

So, in sum: I'm divisive, argumentative, often belligerent. Even if I get angry about it, telling me I should just do x or y for treatment is probably fair game. But I am not sure that every infertile wants to have every one of her difficult decisions picked apart by the peanut gallery on a regular basis. I don't even criticize people's decisions to use IVF, and I disagree with them morally. (I might take up the issue in a one-on-one in-person conversation, in which the other woman had an opportunity for give-and-take, and I could see whether I was upsetting her.)

However good your doctor is, or your treatment regimen is, or your herbal remedy is (and this isn't directed at you, TCIE - I have no problem with you cheerleading for Dr. S, this is a broader issue I want to take up), telling someone else that that's what she should be doing has the underlying message that she is not doing a good enough job finding treatment; that however much treatment takes out of her emotionally, it's inadequate; that she doesn't want to be a mother as much as you do; and, perhaps, that if her treatment is ultimately unsuccessful, it will be her fault, because she didn't do everything she could have done.

After all the hurtful things the world says to infertiles, I think it's our obligation not to heap more criticism on each other. (I generally distinguish "have you heard of" or "you might be interested in" or "I've heard"-type comments as being harmless and merely sharing information, but other people might not take these in the way that I do. For anyone I've hurt with my comments, which I hope were merely unintentionally judgmental, I'm sorry.)

Again, I appear to think differently from at least half the infertile population on most matters, so if you take a different perspective on the suggestions to others, please chime in - I am interested to hear what others think.

Tuesday, December 7, 2010

some days are just bad

So I have my ultrasound monitoring appointment today, so they can see what's wrong with my ovaries. It's got all sorts of interesting potential: they can find out whether I have cysts (and what I have if not), and whether there's anything they can give me so that I'm no longer in pain CD7-10. And although the appointment was supposed to be pre-peak, when she thought she'd get a better look at my ovaries, it ended up being p+5, because I ovulated early. And so I would find out, for the first time ever, whether I actually ovulate at all.

And the brilliant TCIE told me that I should also ask them to measure the thickness of my lining. I actually got up this morning excited for a GYN appointment - even one that involved a wanding. How often does that happen? Also, of course, I entertain hopes that they will take a look around, say that I had a strong ovulation, and offer me post-peak HCG supplementation on the spot, including my first shot in the office, and I'll get a BFP before Christmas - OK, that's not hopes, that's delusions. Whatever.

Oh, the appointment is also later in my cycle than expected for another reason: because even if the appointment is ZOMG so important that it has to fall on a specific day, and Tepeyac will prioritize it at the top of the list and "fit me in" - to get a "fit in" appointment, you have to call the nurses' line, as the receptionists only do regularly scheduled appointments. So I called the nurses' line, I think, three times. First, on November 24, I called and left a message at the front desk. Front desk called me back and told me to call the nurses. I did, and left a message. No answer (ever). So I called the nurses again on November 29. No answer, so I called the receptionists to ask why the nurses were not answering. They put me on hold with the nurses for about ten minutes, but the nurse still hadn't answered and I was at work, so I left another message. Then I called the receptionists again, and they finally just scheduled me a regular appointment (i.e., gave up with out the nurses ever answering), for Tuesday (today), although I had wanted Monday. I think the nurses did actually call back a couple of days later. Very helpful, that.

Fast forward to today. My husband took my car into the shop on Sunday night (timing I would never have used, but whatever). So I was supposed to borrow his car to go to my 10:30 appointment today, but he took the key with him to work. I really should have double-checked that he left it before going to bed last night, but I didn't. This morning at 9:34 when I was about to walk out the door, I realized I didn't have the key. Eventually I verified with him that he had indeed brought it to work, and I called a cab. ($40 each way, plus, since this is my day off for the next two weeks - and I had to move it from Friday to make this appointment, because it takes five total hours to do an appointment with Tepeyac in the middle of a work day, which is why I wanted an 8AM Monday appointment, which is what I would have asked for if the nurses had called me back - I need a car to do another list of errands as long as your arm, since we're throwing a big party on Saturday AND I have to send Christmas presents to 22 people at 7 addresses, including some in Europe, before the month is out. So the cab will only help a little. I need MY CAR.)

Then I called Tepeyac to let them know I would be late. I ballparked that I would be there at 11AM for a 10:30 appointment (and I was calling 45 minutes ahead!). The receptionist said she didn't think she could do that. My next mid-cycle opportunity will come the week between Christmas and New Year's, when I can definitely make time for an appointment, but Dr. Cvetkovich - will not be in the office at all. Oh, so I'll miss two cycles, while I'm in pain from an unknown (but sure to be horrendous) cause...sure, why not? Oh, my other option was to see some doctor at Tepeyac I've never heard of - a man, of course. And the receptionist sounded highly skeptical about someone other than Dr. Cvetkovich doing it at all, since she ordered the ultrasound. My tolerance for wanding has some limits, and I'm not going to a male doctor (seriously, that's just creepy, and I don't know how anyone puts up with it).

My husband then called to say that he was leaving work, picking up my car at the shop, and bringing it home, so I should see whether there was a cancellation for the afternoon. (Sometimes there has to be a cancellation - I had just cancelled. Why couldn't it happen when it would benefit me?)

No, there are no openings this afternoon. I got off the phone and realized that being "fit in" and finding an opening are necessarily not the same thing. If I were pregnant, I am positive they would have found time. So I called Tepeyac for the third time today. I asked the receptionist to explain to me the concept of "fitting in" and how that worked, exactly. She told me that the nurses do that, and, had I mentioned that it was a cycle-dependent appointment, she would have forwarded me to the nurses' line, which she then did. But I had to call back again to ask...why is this necessary?

It goes without saying that the nurses did not answer their line and I had to leave a voicemail. In that message, I pointed out that it was urgent, as in, today, and that I had previously had my appointment bumped back by 25 minutes when another patient cancelled in the morning and came in later, so I think my number should be up. CALL ME BEFORE NOON. I called again, twenty minutes later. My plan is to call every twenty minutes, all day. Hey...maybe I should call the practice administrator, and ask him to go and find one of the nurses in person and make her call me back? I don't even really care if they don't have an opening for me. I want them to RETURN MY F*&KING PHONE CALLS. The day I make them. Like I do for all of my clients, none of whom is sick!

I don't want anyone there to bless my day ever again. If I want a blessing, I'll talk to a priest (oh, with whom I had to cancel my spiritual direction appointment this week because they cannot "fit me in" in a way that will allow me to use sick leave rather than an entire day off). I don't care if they say a nightly Rosary for the intention that my soul be consigned to eternal fire. I don't care if they sacrifice to idols. JUST DO YOUR DAMN JOB.

So, the other thing I did, of course, was call the OB/GYN my colleague recommended, at a local university. (Why didn't I do this two months ago when she gave me the number?) This doctor sees only pregnant women and infertility patients. (Hmm.) Her office is walking distance from my work, and accessible by metro. She doesn't have another new-patient appointment before March, and I want to find out things about what she does, first. An assistant verifies that she answers emails from patients. Hmm. I ask about options other than IUI or IVF, and I tell her I've talked to other clinics that go straight from clomid to IUI and will consider nothing else. The assistant tells me the doctor's initial IF appointment is a whole hour and she tailors her approach to the patient, so the assistant can't predict what she will do. That's not a bad thing, so I get on the waiting list. The assistant tells me she will send me the giant packet of information I have to fill out (wait, she wants to know things about me? Even before I show up?). And that I am to bring my "partner" to the first appointment. OK, now she wins. Regardless of what else happens (OK, unless I get pregnant - hahahahaha), I am seeing this woman in March.

Maybe God has to yell this loudly to get through to me - not that I think He even troubles Himself with little details like where I get fertility treatment while I slowly realize that it's never going to make a difference.

I've now called a third time. Message number three calls attention to the fact that I am making the time to call them every twenty minutes - this should be an indication that it's urgent enough that they need to make the time to call me once.

SURPRISE YOURSELF, TEPEYAC. MAKE A FIVE-MINUTE PHONE CALL ON THE DAY THE MESSAGE WAS LEFT. YOU NEVER KNOW WHAT POSSIBILITIES LIFE OFFERS IF YOU DON'T EMBRACE THEM.

Friday, December 3, 2010

God acts

I imagine many are familiar with Ceiling Cat:


and Basement Cat:


And some may even be familiar with the lol Bible translation. I've only read bits, but I particularly enjoy Genesis:

Oh hai. In teh beginnin Ceiling Cat made maded teh skiez An da Urfs, but he did not eated dem.
Genesis 1:1. The Gospel of Luke and the nativity story are also available, but somehow the translation seems less...faithful to the language.

Anyway, on the bus home yesterday, I managed to apologize to God. (It's probably for the best that my fellow bus passengers cannot hear my musings.) I decided not to focus a lot on the things that have been upsetting me (lest I should just get angry again), but I genuinely felt contrite for my anger, and I thought I should pray for help in coming to peace with my situation; for the ability to be less angry; and for the ability to trust God. I have prayed for greater trust before (so I don't have any special "magic bullet" theory of coming up with a wise intention, assuming it is wise). But it seems like a good thing for me to be doing, so that's...better than the alternative.

I went to my book club. I wanted to get home by 10:30 at latest so I could make chocolate cheesecake for a delightful Christmas caroling party this evening. However, a friend I hadn't seen in a while, who also attends the book club, broke up a month ago with the boy she was sure she would marry (I rather thought so too, actually). She needed to explain the story to someone, and when I finally got in my car, I realized it was 1AM. Hmm. And that my phone was still off from the conference earlier in the day. Well...my husband was tired, and had planned to go to bed very early, so he probably wouldn't realize I was not yet home.

Nope...he had called five minutes previously. I called him back. Why was he awake? Well...he should probably wait until I get home to tell me, but...the ceiling fell in. (For the second time since we've lived here.)

For reasons I cannot explain (um, it was late?), we neglected to take a picture, and our landlords are fixing it today. But it looked remarkably like this (except about five feet by five feet):


Someone is trying to tell me something.

Wednesday, December 1, 2010

New liturgical year, old calendar year. All difficult.

So about a year ago I wrote a list of resolutions for 2010. I was going to repost them here and note which ones I had accomplished, but after re-reading, I am too depressed. The successes sound impressive: I was supposed to do more non-work reading and I've joined a book club and well surpassed my goal; I wanted to get into better shape and though I've not gotten quite as much exercise as planned, I am in much better shape; I was struggling to find a spiritual director and now I have one; I had been dreading dental work for years and now it's done.

But the prayer-related resolutions (other than spiritual direction, I guess) were not only failures, but I rapidly forgot that the resolution ever existed and made zero efforts to fulfill it. I had written out the details, but I have deleted them because they upset me. I will be seriously thinking about the wisdom of such a list for next year.

This also prompts me to take stock of my year in more general ways.

I've realized lately that for the last few weeks or months I've been in A Phase. Rather than my general distance from/vague anger with God (yes, I tried stating it all to Him directly, and it doesn't appear to have helped - but it may help you, so give it a shot), I'm much more actively angry and much less hopeful about the possibility of having a fruitful relationship with Him. As I do more spiritual reading (which has been reasonably regular), I get angrier.

I started reading a nice book on St. Catherine of Siena (my patron saint for 2011). She talks, in just the first few pages, about how with greater love (of God) comes greater grief and suffering. What she means is that the soul will suffer more greatly on account of the things that grieve God (i.e., souls turning away from him), and the greater love will prompt the soul to do more reparation. I understand what she means. I have no doubt it's true. In the abstract I'm sure it's a great idea. If I'm being honest, here's my reaction. I am extremely distant from God. My love, such as it is, is hanging on by a thread. I am profoundly miserable, although I may be OK on any particular day. The misery itself makes it impossible for me to see how I could get closer to Him. The thought of drawing myself nearer makes me truly upset. I am angry with Him and I do not see a resolution; He has not repented, and I do not think I am capable of rejecting the priorities measured against which He has failed me. (I don't think this is a defect of character, or at least, not a deliberate one. I could say I'm not aggrieved by the things I've lost, out of piety, but I would be lying. Saying so will not help unless it is true.) Further to all of this, the authoritative spiritual perspective I am absorbing indicates that if I somehow grew closer to God in spite of all of these things, I would suffer more. I don't think I'm capable of making a conscious decision to suffer more right now. (I recognize that St. Catherine would - and in a later chapter probably does - say that greater love also brings greater joy, but since the love part seems impossible, this is not helpful anyway.)

St. Catherine also says that love for God necessarily means a desire to suffer (extra!) for the sake of the salvation of souls. I remember a time in my life when the salvation of souls was quite a priority of mine. Right now, ponder on the subject though I might, I can't seem to get passionate about it. I am sincere and impassioned in my petitions that my dear ones be spared greater earthly suffering - that a blogger not suffer another miscarriage, not be called on to suffer more and more months of childlessness than she has already borne, that a lonely friend find someone with whom to share his life, or a desperately seeking person find employment. My only regular petition that touches on the salvation of souls is for my husband to return to the faith. That intention is heartfelt, but I don't think it's because I fear for his salvation. Right now, I'm not capable of thinking that far ahead.

I understand that the bigger picture is the whole point. I can recite all the theology fairly well. I know, too, that if I could convince myself to see only the long-term goal (heaven), the short-term details (kids or no kids) would recede in comparison. There's just one catch. I can't see around the mountain in front of me at all. It's huge - enormous. It consumes my focus. This may sound silly, but I don't think I'm capable of taking an eternal perspective when the cross that wakes up with me every morning takes such a great majority of my emotional energy. I don't know how to relate to, let alone look forward to, a God who is the God I'm contending with now, today, in this struggle. I can recite the pretty theology about spending eternity with Him in bliss, but if He is the same fellow who minds my day-to-day, how can I just leap over this relationship and this experience of reality into one of which I have no experience? Based on what I see, the current questions are who He really is and whether it would be bliss. I don't have good answers, and I don't know how to skip that step without my faith being entirely empty.

"It could be worse" and "I have lots of blessings" - not helping at all.

So my present spot is far darker than usual. At the same time, for whatever reason, I am tempted by the thought that what appears to be a deterioration may in some way be progress. Perhaps this is true. We shall see.

I also realized lately that I have just a glimmer of the ability to peer through the looking glass from the other way. I was talking to an IF friend who is adopting, and was trying to say something positive about the degree to which our friendship will (inevitably) change when she has a child. In situations like this, my instinctive thoughts are so dark that I grope for platitudes that will defend me from having to say something horrible, or nothing at all. My grasp landed on "Well, you'll get to be part of the mommy group then, and go on play dates...what we all wanted...so you'll have lots of friends around you."

Halfway through uttering a sentence I saw as tinged with evil (evil play dates. Evil mommies) I realized that it could be the truth. The bitterness-drenched images of the happy experiences I once thought to have really do have the power to bring happiness. I find them hateful and false because I will not attain them, and for me they are a mockery; but some will. The muscles that would allow me to say something positive and sincere about the IF journey were very rusty, and my comment came out hackneyed, I know. But I realized that I could say something genuinely good, and genuinely mean it, if I tried.

I wonder when I lost the power to think happy thoughts about getting out of the IF concentration camp, where I expect to spend the rest of my days. I have the germ of a theory that I developed a fairly wide-ranging insincerity (with a few exceptions) in saying nice things about babies and pregnancies at the same time I was developing a conviction that I had no right to tell the truth. I rail and rail about how no one has a right to expect us to make them feel better. How we infertiles are the aggrieved party in every relationship with someone who is expecting a healthy child; how they have their blessings, and we should at least have their consideration. How this is not a punishment from God. We're not worth less.

Many infertile women struggle very clearly with the conviction that they are valueless because they are reproductively defective. I am well-catechized and I can articulate clearly why this is not so. As a result, it never crossed my mind that I believed it. I have realized that I do believe it. For every time I say, "Confront that receptionist and tell her not to [unthinking behavior that is needlessly hurtful to infertile patients]! If you had a different illness, you wouldn't think twice!" - I have an opportunity to do something similar myself, and I do not. Once, or twice, in the last year, I have told the truth. Typically I grit my teeth and internalize whatever the grief is until I am enraged to the point at which no one could relate to me. Or, in social situations, I gloss over, smooth out, and evade, so that nothing unpleasant need ever be said. Some things are unpleasant, and they need to be said.

I have a friend who went through reproductive health issues (and is SUPER-fertile) who loves to talk about inappropriate social topics; for example, telling everyone at a (different, bachelor) friend's birthday party that her water was likely to break on their shoes. She is a very nice person. She should know better. She just doesn't. There is no law, anywhere, that says I can't tell her that I would prefer not to talk about her children, pregnancies, or deliveries. That I have already avoided being a guest in her home when I suspect these will be the topics (I was right, by the way), and that she need not value my friendship, but if she does, avoiding these topics will be the price.

I am capable of saying this kindly, if I don't hoard my rage until it consumes me. I could give her the choice between the baby talk and the friendship, instead of making the choice for her. I don't, because I can't fathom asking her to be considerate. So I quietly harbor daydreams that she is hit by a bus. If I were her, I would want me to be honest. Why don't I say so? Because I don't feel I have any right, and because I cannot even imagine a reality in which she would actually be considerate if I asked. Why not?

And of the two other couples with whom DH and I regularly spend our time...the newlywed couple is now expecting. I predicted this with great accuracy and have no reason now to be devastated. I am devastated anyway, far more than by bloggers' pregnancy announcements. I realized why: this young woman reminds me so much of me, before I was embittered and jaded by this process. And she has the light-hearted, hopeful, grateful view of her marriage, life, and vocation that I was supposed to have. I don't envy her her child, but I envy her that situation. If I somehow had a dozen biological children now, I would never get that innocence back. And I can't look her in the face.

Sharing this would be too much. The innocence itself means she will never understand it. She is tactful almost to a fault; they were very considerate in how they conveyed the information. I don't want to punish her, I just don't want to see her ever again. But I don't have that option. All my carefully trained habits say that I should be pleasant, avoid the subject, volunteer platitudes if it is raised. I don't feel pleasant; I want to crawl into a hole in the ground and never come out. Her news forces me to face all that I have lost, all at once. I don't want a baby so much, really; I just want to be a whole woman, a real woman, a woman created the way God intended, whose love for her husband is generous and fruitful enough to bring about new life. If somehow I were not going to have children, but I could have them...that would make a world of difference.

As I said, I can't tell her this. And I don't know what I can tell her, or should tell her. And maybe it's not her; maybe polite lies are the way to go with this couple, until we can slowly drift apart. But maybe with the next conflict, I can steel myself to say, "I'm so sorry to trouble you, but I have a very difficult time dealing with..." Words I want never to say. But if they're the truth, then shouldn't I learn?

Saturday, November 27, 2010

pipe dreams

This Thanksgiving I found myself telling my mother-in-law a snippet of a story my siblings and I all know, but I don't believe I've ever repeated. Here's how it goes. I think that my mother ended every Thanksgiving of my childhood with her head on the kitchen table sobbing after she sent my brother and sister and me to our rooms. I don't literally remember witnessing this every year, but every year I would have been able to witness the whole scene, I did. And she certainly bellowed us into our rooms every year well before the end of dinner.

At the time, I had very little idea why. I didn't really feel sorry for her (I know that's awful); I thought her crying was horrifying, but that's about it. Of course, this has its roots in how much we hated my mother, which, in turn, is rooted in both my parents' use of their divorce (when I was six) as an opportunity to use their three children for rhetorical points: my mother's theme was that divorce is evil (I don't disagree, but that was not the forum in which to make that point), and my father's theme was that my mother was crazy and he had no choice (true and false, respectively).

As I've mentioned before, my mother is mentally ill. As near as I can figure, the great annual Thanksgiving disaster worked a little something like this. She grew up in a big Irish family, the second-youngest of seven. Her mother was the matriarch's matriarch - neurotic housekeeper, prolific cook, demonic disciplinarian, mistress of her domain. (Her children were not allowed to enter the kitchen without express permission - on any day, ever.) Of course they had a huge traditional American Thanksgiving dinner. My father's family thought Thanksgiving was stupid, but after my father left (and maybe before? I don't remember) my mother tried to institute the tradition.

We often didn't have enough money for basic food (I remember her trying to economize by buying powdered milk, which we wouldn't drink), but she'd really work hard to do special occasions right. The turkey was never even moderately sized - it was always huge, even just for one adult and three little kids. She didn't do sweet potato casserole or anything distressingly modern, but there were mashed potatoes, gravy, stuffing, cranberry sauce - all made from scratch (though I think she eventually switched to canned cranberry sauce). Hours and hours of work, all while trying to keep us from burning the house down. All by herself.

Because, apparently, Thanksgiving dinner had to be picture-perfect, for her totally imperfect family. The problem was, none of the three of us gave a hoot about Thanksgiving. We didn't have warm memories of Thanksgivings past (see above), had no other family visiting in whom we were interested, and were rebellious and difficult every day of the year. After just a few comments about how dark meat was gross or we hated gravy (we all hated gravy. I guess she liked gravy, but it seemed like a waste of effort), and a few instances of us playing with our food and yelling at each other and chewing with our mouths open and talking back, we were all sent upstairs, forbidden to have the made-from-scratch pies she had also slaved over. Another miscalculation: only one of us even liked pumpkin pie, and nobody was passionate about it. So, eager to withstand a punishment bravely, we told her that we didn't care. We marched upstairs and commenced hooting and hollering at each other, and she looked around at eight hours of wasted work (just like last year), and four hours of cleaning still to be done (without help, and without even a dishwasher), and broke down.

And...scene.

Obviously, the woman should have gotten a bunch of turkey subs at Subway and called it a holiday. But she never did; she trotted out the pointless, doomed melodrama with the turkey every year. By the way, her turkey was always perfect. Perfect. Like on the commercials. I can't roast a turkey (or even a chicken) correctly, and I'm a decent cook, in general. But she never missed.

She did the same thing with Christmas, except that for Christmas, the focus wasn't the meal. The drama there was ramped up by the fact that my father's family tradition is to celebrate on Christmas Eve. So we'd do the Polish vigil dinner with him on the 24th, and then presents, and then midnight Mass (which ends well after 2AM), and sometimes he'd be too tired to drive us to her house from the city (and get home at 4AM). So often we'd get there the next morning, and kids never get underway efficiently, so it would never be early, and she'd already be furious.

He also always (somehow) had more money to spend on presents. Of course, she spent untold hours making whatever gifts she could afford look absolutely magnificent. No one can wrap a package like my mother. She bought all her paper (in her signature Swiss dot print) for about nine cents on sale in January, but it looked like a Tiffany's window every year. She might have used computer-aided drafting to get the stacks of gifts perfect. And then there was the heirloom creche that we broke several pieces of (never on purpose, but they were ceramic, and we were kids). I doubt we ever said a nice word to her about how incredible a job she did - but then, we never saw it with joy and wonderment. We saw it after 45 minutes' anticipation in the car of how angry she was going to be (and my father never calmed her down so that we and she would have a more peaceful morning - heavens, no), and then her screaming and my father leaving, and her threatening not to let us have our presents at all (so we would typically say, "we don't care"). Then when we opened the presents, we knew they were going to be underpants, and strange aspirational gifts intended to mold us into different people (cookbooks for my brother, for example). Of course she had to buy what was on sale, but she never had any idea what any of us wanted for Christmas, or even what we liked, and she never inquired. So the presents were always weird.

In other words: my mother obviously did not get the life she wanted, or even a remotely fair one. Being poor was one thing, but being poor and mentally ill and having your husband walk out on you and take up with one of his students and turn your three kids against you - well, that's a bit much for anyone to take, and she wasn't all that resilient to start with. But she never adjusted to the circumstances she had. In later years, she made concessions (she decided we would celebrate Epiphany with her instead of Christmas, for example). She never stopped expecting that the holidays would look like an L.L.Bean catalog, though. And it was absolutely out of the question that that would happen. She was setting herself up for failure before she bought the first potato or spool of ribbon.

Presently my goal for my holidays is to have enough family around to feel like there's a point making food, and for the members of my insane family not to be so insane that they really offend or hurt one another or anybody else. (Frankly, I need to have perfect strangers at the table to act as a buffer.)

But the holiday picture I try not to think about, the one always there in the back of my mind that's breaking my heart, is of a big house (not too expensive) with a giant fire in the fireplace, pine garland everywhere, stockings hung on the mantle, a ridiculously tall tree hung in hand-me-down ornaments, snow on the ground outside, a table full of food, the whole family gathered around (an act of Congress would not make this possible - but some year, I want not to have to make apologies to anyone for missing them. I have been angering someone with my absence at Christmas since I was seven years old, maybe six, and I am tired of it). And, of course, on Christmas morning (or maybe after Wigilia dinner), a parade of small children in red pyjamas with messy hair running to open their presents, labeled, as my mother's always were, "from Santa Claus."

It won't happen, and the cynicism has settled down deep enough that I really don't expect it any more. But I still know that it's supposed to; I still know that my in-laws wish they could be nearer their grandchildren (my SIL's five beautiful children), and would be very happy with a set here on the East Coast to visit for when they can't get to the Southwest to see the others. I still know that we could credibly invite everyone to visit us, if we had little ones here, instead of being the best situated to buy plane tickets. I still know that the animosity and division created by my parents (and others in my family) over the holidays are supposed to be healed in my generation, and that's exactly what we would be doing, if we had a next generation to structure this around. But we don't.

But I don't get to dwell on that. Unless I want to join my mother in the "mentally ill" club, I'm going to have to work with the family I have. I just wish I knew how.

Tuesday, November 23, 2010

Braver with Pants On

So I went to my appointment yesterday. I was good and introduced myself to the practice administrator guy before I went in. That was fine. I brought copies of my charts since my last appointment (May), carefully marked with my all-new premenstrual spotting, as well as the intermittent ovarian pain. (I discovered when marking it that it generally appears somewhere around CD7-10, generally lasts about three days, and remains through the first day of fertile CM, then leaves.)

Dr. L/C was focused on getting me a new prescription to stimulate ovulation, but I managed to drag the focus back to doing something about the ovarian pain, which I believe to be cysts. She did an exam and said that there was no indication of cysts, and also noted that the pain doesn't appear in my cycle where an endometrioma would cause pain. (I already knew that, but darn it, it feels like cysts to me.) She didn't have any specific ideas - possibly scar tissue around the ovaries that tightens leading up to ovulation, she said, but she wasn't sure.

So, the plan is that I will get an ultrasound right before ovulation and see whether the culprit can be spotted. If it is something cyst-related, we can make a treatment decision then. She didn't think depo would be all that helpful (lupron and the like shrink adhesions, but endometriomas are more serious and she would not expect them to comply). If there's nothing wrong with me (you know, other than me being in pain), then I have various treatment options...she proposed tamoxifen, clomid, or femara (oh joy! Apparently, femara is now an option without a fight).

I also asked about HCG shots, and she said this supports good hormone levels post-ovulation, rather than a strong ovulation. She seems more concerned with the latter (I mean, fair enough, since I'm not pregnant). Because of the premenstrual spotting, it seems to me that the only thing obviously in need of remedy is my post-peak progesterone level. So maybe I will lobby for femara and HCG, or something. But only after seeking out the cysts (I still believe they're cysts) and doing post-peak bloodwork to check on the hormone levels.

My husband is very relieved to hear that the doctor does not think I have cysts. While I cannot argue with the reasonableness of this response, I disagree completely. I have had lots of cysts. If the prognosis is that surgery could (temporarily) fix the problem and something else might perhaps help in the meantime, and the problem is a serious impediment to fertility (but hardly the only one), that doesn't seem so bad to me. If the prognosis is that surgery probably will not help the problem and would not in any case be advisable, and that no medication (including analgesics) will do anything whatsoever to limit it, and I will be in pain for years (but there's no impairment to my reproductive health) - then I'm not happy. At all.

I guess this means I'm not just kidding myself when I say that I no longer hold out hope for a child, and just don't want to live the rest of my life in pain. I know there are people with much worse problems, but that seems like so little to ask.

Oh, and I didn't actually discuss my historic problems with Dr. Lorna. She appeared in a massive rush from her last appointment (mine was late because some pre-op patient decided to show up three hours late and the nurses had committed to seeing her "whenever she could make it," which I don't hold against the doctor). And she didn't seem hostile. And she offered the femara,* which is what I had originally wanted. Some people like to hash things out, some don't...some (like my crazy family) prefer to make nice by making up for problems rather than talking about them.

For now, I am going to accept that that's where we are and proceed with the next round of diagnostics. And, at the same time, I need to be looking into other options. At some point, I will gather my courage to make the requisite phone calls.

*For some peculiar reason, I initially wrote "tamoxifen" here. As I have documented thoroughly elsewhere, I DO NOT LIKE TAMOXIFEN.

Sunday, November 21, 2010

the week loometh

I continue to nest in my mind. Today I spent just a wee little bit of time in a thrift store and somehow still came home with an Asian-themed folding screen (due to the stupendous bargaining efforts of an IF friend, I got it for $35! All I seem to do with other infertile gals is eat chocolate and shop. It's a good life, really) and a really pretty ivory jacquard flat sheet that goes with my duvet.

We went to see the house in our neighborhood and the things the former owners did to it are bewildering and shocking. I'm not entirely bewildered that they decided to finish a cellar-type basement with serious dampness problems; that's just an extreme form of run-of-the-mill stupidity. But the resulting mold down there was really scary, and between the probably high cost to buy it, the high cost to fix the innumerable problems, and the fact that it would not be safe to inhabit for the first couple of months...just more than we can take on. So, it's out. The pretty Victorian that was similarly too much money we did not visit (someone who shall remain nameless was more attached to watching his football team play during the open house hours). The too-small house is...still too small.

My over-nurturing has found another target, however. I discovered a house which, on all the objective information, is a "middle ground" house - bigger than the too-small, smaller than the too-big; not over-finished, so it shouldn't be too expensive. Problem is, the owners refi'd it to the hilt and are (after a price reduction!) asking $220,000 more than the tax assessment (and $150,000 more than the highest independent assessment). It would be admirably suited to us if it were selling at market value, but how to make that happen? My realtor says we should go see it, and I'd be OK with that. Maybe I can pass the owners a note that says, "Talk to your bank about maybe doing a short sale! Love, the misfit (future owner of your home)."

Oh, and my DH and I have decided to spend Christmas here rather than traveling to see family (we will see some at Thanksgiving and visit others early next year). I'm touched that that's what he wants to do; that he has a special place in his heart for Christmas with us. (My sister will be with us too, I think, and my brother has been invited but probably will not come). And I'm excited about that - I love doing the holiday cooking and I love the idea of being responsible to find a tree and decorate everything and make sure home is ready for Christmas. Plus the traveling can all be so exhausting.

Of course, this causes me to daydream manically about closing on a house and moving before Christmas. That will never happen, so I shall have to pry myself free mentally from those images so I can focus my energies on getting the Christmas shopping (and packing and shipping) underway, cleaning the house, and taking stock of the decoration situation.

Daydreams I am not entertaining include celebrating a BFP at Christmas. I will have to make do with the babe in the manger.

Tomorrow I will be teleworking (somehow the opportunity to put in a productive day's work from a fluffy blanket on my beloved couch with a mug of whipped-cream covered chai always makes me feel better) so that I can head to my appointment at Tepeyac during the middle of the day. I've printed out my charts in color, and I still need to mark "ovarian pain" in the appropriate places to explain why I'm sure the cysts are back.

I talked to my DH about dealing with me if I take depo, and I think we will be able to make it work. (Hormone drugs make me psycho, and he generally reacts to that by trying to teach me a good lesson. I have explained to him that I will still have an obligation to be reasonable, but that can't happen until I calm down and the problem is that I have a very hard time being calm when I'm on this stuff - so he needs to calm me down first and then address the problem. I think this could work.)

Of course, I also need to talk to Dr. L/C about continuing with Tep.eyac. Right now my inclination is that I will not continue with them much longer. Finding another situation that would work well has not been easy thus far (though I have the number of a friend's doctor whom I should call). But since I have not spoken with her in person since all the nonsense happened, I would like to do that first.

I talked with the practice administrator there last week. He is very very nice (although, honestly, sometimes I wish Catholic professionals would not mention God at all but be ruthlessly competent. Wouldn't God be glorified by that so much more? It would at least make my life better). He said that the communication issues should never have happened and he was really sorry. Apparently there was a lot of Dr. L/C being out at the hospital on the day I would call, and then messages getting shuffled around and lost. And apparently she said that she had responded to my email earlier and it went to the wrong address (but no one has seen any evidence of this, I guess. It could be true, but it doesn't explain why she didn't re-send it when I kept calling).

He said that the practice as a whole is working on a general problem getting in touch with doctors who are on days at the hospital, since the GYN doctors never respond to each other's patients (but the OBs do). While I sort of understand why this distinction would exist, given that that's how OBs practice generally (i.e., when you go into labor, my understanding is that you get the on-duty OB, whether it's your doctor or not), it's just another way in which it's extra, and unjustifiably, hard to be an infertility patient.

Although I was frustrated that it took so long for me to talk to someone at Tep.eyac about all of these problems, I realized that it's a good thing I ended up waiting so long. I was much calmer when I talked to him, and I was able to listen to what he had to say and make my points with a minimum of emotion. But I said some things I'm very glad I got a chance to say, and I felt as though I was not only telling them things they needed to know about how to serve their patients, but saying things that infertility patients everywhere should get to tell their doctors.

I said that I understand why panicky pregnant women get calls back immediately and panicky infertile women who have to have a dosage clarified TODAY or they will have to wait an entire month before starting a new medication - might get a call back in several days. I understand it -but it's not fair that, in addition to being second-class citizens in society in general, when we go to get treatment so we can join all the lucky mommies, we're second-class citizens to our fertility doctors too.

I said that no one who has not been here could understand how hard it is to be in treatment for infertility, and that just making an appointment and facing another round of testing or treatment can be emotionally exhausting. I often avoid making the phone calls for weeks. If I have to make five phone calls to accomplish one thing, my life becomes unmanageable.

I said that I often feel that my doctor has no idea who I am, has not read some of my charts ever, and does not remember whether I've had the surgery - that she performed. I forget the details of my clients' histories too, but it's only right to brush up before the appointment.

And I also said that I think the practice would be well-served by using email as the primary method for asking routine questions of the doctor. Their official method (patient leaves voicemail, nurse plays voicemail, nurse writes voicemail down, nurse reads notes to doctor, doctor gives answer to nurse, nurse writes answer down, nurse calls patient and reads answer, patient asks clarification question, nurse begins process again) is extremely ineffective and frustrating. If patients could send emails to their doctors, everything would work better. He didn't promise to adopt such a policy, but I hope I've planted a seed.

Finally, he said that they're in the midst of a review and improvement of their office communication policy. And, when I said that I didn't really care whether Dr. L/C cares about my treatment, as long as someone will tell me if she doesn't so I can find another doctor (believe it or not, I wasn't snotty at all. I wanted to him to understand that this is actually the bottom line for me), he said that he can't tell me what doctor to see, but he would like me to give them another chance.

I don't feel that that obliges me to stick with them if I don't think it's advisable (and right now, I don't), but I was surprised to realize that it actually made me feel better to hear that. My impression has long been that people who have to deal with infertile women, in their capacity as infertile women, think that we are worse than worthless, and deserving of every kind of disdain and inconsiderateness. That he would even think that they'd want to keep me as a patient is almost shocking.

So that was that conversation. And tomorrow, treatment...as always, I am sort of emotionally bracing myself because it's so draining, but I'm as prepared as anybody in this state could be. And that...is the week ahead. Oh - plus Thanksgiving :).

Friday, November 19, 2010

holiday nesting

You know how I was being so good about taking my progesterone and I was celebrating not spotting? Right after I wrote that, I forgot to use the progesterone cream that night. No problem; I put it on the next morning (and then also used some the next night. So I got the same amount, and once was about nine hours late). But the day after I forgot it...I started spotting. (On p+8.) And have continued.

I tell myself that this was going to happen either way, and that while I probably delayed the spotting with the progesterone cream, I was never going to prevent it altogether. One late application wouldn't make that big of a difference. And if getting back up to speed hasn't made the spotting stop, then it was definitely coming either way.

Of course, the other side of this is that, since (thanks to the spotting) I start having symptoms of my next period as much as a week in advance, it shortens my available period of denial (AKA the 2ww). Or, alternatively, it just makes that denial much more severe. I.e., I know perfectly well what this means; but I come up with all sorts of secret theories about why this isn't inconsistent with a BFP this month, even though the same symptom didn't lead to pregnancy for the last several months. Infertility: a nuanced study in mental illness.

Also, even though he is no longer traveling internationally or for long periods of time, my DH is scheduled to miss my entire "fertile" phase in the upcoming cycle (the one that I was going to time perfectly after I figured things out with this cycle - this cycle that's already a bust, that is). I am pissed. I haven't told him yet. I probably have to find a way to do so with less hostility.

Finally, the spotting also means one other thing: I am PMSing. For me, this means an intensification of all my negative emotions, the suspension of my ability to be reasonable if I don't feel inclined to, and the amplification of any kind of emotionally immature fixations to the point that they drown out all other aspects of my personality.

It's November. It's almost Thanksgiving. In the last week or so, it finally got cold-ish. My yard is covered in leaves (no, I am not contemplating raking just now. Life is difficult enough). I have already made pie this fall (three apple pies, to be exact). I am wearing boots on a daily basis. Today is casual Friday, so I have wrapped myself in cozy layers of wool. I can make some defense that the outfit is stylish, but I'm basically wearing blankets and sitting in my office chair. All I need is some cocoa. (Actually, I really do need some cocoa. Note to self: carefully schedule afternoon...)

All of this adds up to one inevitable conclusion. I want a house, and I want one now. A big house - OK, not unnecessarily huge (though some of the things on the market now do fall into that category). I always think of the beautiful Chicago home (er, mansion) in the first Home Alone movie. That was a house. And a house at Christmas - as all houses should always be. I don't want one that large or that expensive (there's only two of us). But something with that sort of feel. So though there are no really promising options out there just now (well, none that haven't been vetoed by my husband), I am madly going over and over the rejected options to find one with potential.

There's a handsome house in my neighborhood that's in foreclosure, which my DH loves. It's priced above what we'd be willing to pay, and I know there are other offers on it, so getting it for the price we want might well be impossible. Two other problems: (1) I have never seen the inside. It could cost more to repair than we could afford. And, it was built in 1938. While it's got an older look, given my preference for Victorian-era architecture, I may just be unable to love it...I'll have to see. (2) It's right in my neighborhood. While this is a nice place to live, part of me really wants to move somewhere else - near to a parish with a real community, and, frankly, a little farther away from all our friends who have kids or are about to have them. I need a polite reason to put down roots in a new community and not spend all my time visiting them and their kids. I think a new town would give us a fresh start.

There's a really adorable house in the area I'd prefer. It's in a plenty nice neighborhood, it's adorable, it's in good shape, it's a really good price, it's got a lovely yard, it's commutable, and it's near a church that is acceptable. But it's so little...we've been thinking that since we're grown-ups some day we should have a queen bed. This house has three bedrooms, and none would fit a queen (they're all miniscule, and we can't combine two - there would only be two left!). Only one room even has a closet. The full bath also has a mini (not even standard-sized) tub, and no room to expand to fit a bigger one. We'd like a decent-sized bathtub. Is that so much to ask in a home we own? And it has no room for a dining room or a study. I keep trying to convince myself that it's perfect, but I just don't think it would work.

And...there's a giant (way, way more space than we need) gorgeous Victorian-style home as well. It costs too much (same as the one in our neighborhood, actually). And it would be a pretty inconvenient commute. Some of the decor is really weird and should be changed, but it's in good condition.

At another time, I would reject all of these options. But I cannot bring myself to let go right now. I must nurture whatever possibilities exist. I want to throw a (formal-dress) New Year's Eve party this year, and my rental house is not big enough to swing it, so I am at the mercy of others; others who are wonderful people, but will not understand that New Year's is a formal occasion. And I think we may be staying home for Christmas (and inviting some of the family to join us if they wish), and I could do wonders with a house with multiple bedrooms. And a dining room.

It's Christmas. I need my own house. More expensive than the tiny house would be fine. Less expensive than the other two is necessary (and smaller would be just fine). I don't mind if it has an insane kitchen and ludicrous decor and things falling off as long as, underneath, there are wood floors and real fireplaces and antique casements and working radiators and strange useless nooks and crannies. Why doesn't the real estate market understand this???