Happy New Year!

So I rang in the New Year sober, thanks to my little girl (yes, that’s right, it’s a girl!) whose growth in my UU has been ticking along right on target all these week.  And as my houseguests and DH indulged in glass of wine after glass of wine, or beer after beer, they looked at me with a half-pitying smile and said, “Poor Hope… another New Years sober.”  I don’t like being pitied because I’m pregnant.  I don’t like being pitied for any reason, in fact.

But the truth was, I couldn’t even remember if the 2011-2012 New Years celebration was a sober one for me, either.  Or if the one before that, 2010-2011, was.  They all started to blur together in my mind, especially as the reality of impending infertility began to rear its ugly head.  I think I might have let my guard down three years ago and had a drink or two.  And while many people find New Year’s an occasion to become the reveler you see in movies – doing shot after shot, playing music too loud, getting dressed up in the dead of winter and never wearing a coat – the sadness of my failure as a woman overrode the desire to get a buzz.  Like many other holidays – Christmas especially – it was a somber reminder of the potential memories I would never have: kids falling asleep waiting for the ball to drop, or kids waking me up in their little nightgowns and footie pajamas to tell me it was the new year, or just kids to be thankful for.

I didn’t wake up my son for the celebration of the new year.  I am too protective of his sleep patterns to allow that kind of disruption to take place, but also he’s really blissfully unaware of the meaning of days.  There will come a time he’ll want me to let him stay up.  Instead, I welcomed the new year with a new appreciation of the man my husband has become, to watch him as a father.  I marveled at the family that I thought I would never have – and at the new family member to join us this year – and wondered how I got to be so lucky after what I thought was a dead end.

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Another modern infertilite story

***SPOILER ALERT***  This post contains serious plot spoilers for the movie Young Adult.  DO NOT read any further unless you have already or will never see the movie.  Consider yourself warned.

Charlize Theron as a “hot mess,” writer Diablo Cody (creator of Juno), and sidekick Patton Oswalt, and a healthy dose of early 90s nostalgia: that’s what you get with Young Adult.  I didn’t think it would be a great movie though it had its share of Golden Globe buzz for the 2011 season.  And by all accounts it was a movie billed as a woman struggling in her life and career returning to her hometown to recapture her glory days – and possibly even her ex-boyfriend.  So this could be good, or it could be awful.  Since I’ll be spoiling the crescendo, I figure I owe it to you to tell you to go see this movie – not because it will be uplifting, but because it will show with raw intensity just how much all of us sleepwalk through the present while still caught up in the past – and the cinematography’s pretty great, too. 

The catalyst of Mavis’ (Theron) journey to her hometown is a birth announcement of the first baby of her teenage sweetheart, Buddy, which she receives via mass e-mail.  Interpreting the announcement as a cry for help from Buddy, she flees home and sets up a few attempts to remind Buddy of just what he’s missing out on – the wild freedom of being single and childless.

Mavis is a classic anti-hero protagonist if ever there was one.  She drinks (a lot), she’s cruel, selfish, depressed, demanding, desperate, and saddest of all, evidently has little respect for herself.  We don’t want her to get back with Buddy.  We want her to stop acting so crazy and to stop embarrassing herself.  But we can’t stop watching – probably because we’re afraid one day we may end up like her.

***SPOILER ALERT***  Long story short, Mavis throws us a curveball at the climatic scene of the movie.  She breaks down in front of the entire town, and we the audience believe we’re about to find out exactly why she’s so screwed up.  We listen to her every word waiting for that satisfaction.  And here’s a part of that devastating speech:

“Yeah, Buddy got me pregnant at 20. And we were gonna keep it! We were gonna have a little baby and a little naming party and a Funquarium. All of that. And then 12 weeks into it, well, I had Buddy’s miscarriage. Which I wouldn’t wish for anyone. Maybe if things were just a little bit more hospitable down south in my broken body, Buddy and I would be here right now with a teenager and probably even more kids because we always found each other.”

Didn’t see that one coming.  And what you begin to realize in the wake of this confession is that while her miscarriage and subsequent infertility doesn’t excuse her behavior in the least, it does show how devastating that diagnosis can be, especially for someone in their 20s and madly in love.  Furthermore, we see the impetus of her self-loathing and come to understand that her deep, deep depression (probably from the miscarriage and/or diagnosis) was never treated, and we feel sorry for her to have ever been put in that position.  Us infertilites only know too well just how she must feel.

But this isn’t a sappy movie feeding off of the pity of the audience.  Just as quickly as we understand the root of Mavis’ pain, we discover that she will not fundamentally change.  It’s as if she needed to finally tell her infertility story before she could continue living her life (doesn’t truly “move on” but subsists).  I respect Cody for making that choice – because life isn’t neatly packaged, formulaic, and always with a happy ending.  The hero doesn’t always redeem herself.  People don’t always see themselves for what they are.  And all because of another unnamed infertility diagnosis that was swept under the carpet for 15 years.

Slightly depressing, sure, but at least at the end of it you’re thankful that you’re probably much better off than Mavis.

You knew this was coming

This is not my first mother’s day as an infertilite; it’s just the first one that I’m not naïve to my infertility.  All the other ones passed by just fine, happily celebrating my own mother and grandmother, and always thinking in the back of my mind, “Maybe by next year…”  But there never was a “next year.”

So this is the first one that I’m a little worried about.  And, at least all the Resolve.org and other infertility tweets this past week have all be filling me with a little trepidation – that, uh oh, this is a really tough time of year.  You’re probably going to get depressed and wallow in misery, so have your plan prepared now.  I didn’t realize a simple holiday could bring with it warnings of apocalypse; it’s not like we don’t all know there is a Mother’s Day – but we don’t always know when strangers are going to be rude.

Given all these prophesies, I’m a little worried that a switch will go off in my head that will immediately render me depressed, unable to leave the couch, desiring a bag of Tostitos chips and a jar of salsa con queso.  I read what all the websites say about how you should have a contingency plan in place for what to say to people, or to treat yourself extra special, or to keep in touch with your feelings and do whatever the hell you feel like doing.  I’m not sure all of that is really sound advice, and could be very detrimental to someone’s healing process I could imagine.  When you counsel someone suffering from depression, you don’t tell them “Yes, stay in bed all day if that’s what you need.  Don’t make the effort to talk to anyone.”  If that was a valid treatment for depression, would we need pharmaceuticals to make us do the things you really don’t want to do? Right.

What is an infertilite who’s okay with being an infertilite to do?  If I don’t feel twinges of pain and depression in a way that’s going to make me want to hide in a cave all day.  Don’t get me wrong – I still get the jealousy of the excitement certain family members display over friends and family making their announcements of arrivals.  I make slightly bitter jokes about never going to see What to Expect When You’re Expecting: The Movie (which is probably just as predictable and unrevealing about pregnancy as the book is – just guessing).  But does not feeling sad about Mother’s Day (and not being one) make me abnormal?  Shouldn’t we also be recognizing that while there are infertilites who are truly suffering on the day (perhaps after a miscarriage, an adoption process taking too long, or emptied wallets from ARTs that didn’t work), there are also infertilites who are making peace with it – and that’s okay too?

Therefore, for all those out there who don’t want to give any one highly commercialized holiday that much power over how they define their emotions about infertility, a declaration:

“This Mother’s Day I will value the life that I have been given and all the wonderful people in it.  I will honor my own limits in celebrating the day with others.  I have the strength I need because I am a woman – a whole, confident, beautiful woman.”

Ladies, not being a ‘mother’ does not make you less of a woman.

Exercising while TTC: A monthly plan

While I was in the middle of my clomiphene citrate treatment, resulting in some unsightly and unwanted weight gain, I decided to finally get back into a regular exercise routine – partially to help prevent more weight gain, partially to help me get my sanity back.  Exercise has long helped me alleviate symptoms of depression and anxiety, as well as help cure the occasional bout of insomnia.  During treatment, I would spend the two weeks after ovulation petrified of doing any exercise, thinking I might “shake things loose” or that I might rupture an over-stimulating ovary (as a result of the clomiphene).  After all, experts like Dr. Alice Domar suggest taking a whole three months off of exercise just to rule it out as a factor in your infertility.  Unless you’re training for a marathon I really don’t think that’s practical advice; did she ever bloat up to the point that even your “fat” pants become uncomfortable?  Right.

That’s where I started to put together my own plan that I thought might help kill two birds with one stone: integrate more body-mind awareness practices as well as take some time to fight flab.  This included making more of an effort to relax through meditation, both using podcasts at night and making the time at work to join in a weekly 20-minute meditation group.  I mixed this with a monthly exercise plan broken into two parts, and it seemed to satisfy both my need for vigorous exercise and my desire to keep my activity light during the critical days.

I should note that I am not an expert in health and fitness, and I have no training in this area whatsoever.  If you are TTC and want to put together an exercise plan, you should probably discuss your own limitations with your doctor.  And always do what’s right for you, so tweak it as needed.

My plan was extremely simple: 2 weeks of vigorous exercise, starting day 1 of my cycle (first day of menstruation) and lasting through about the time for ovulation; at that point, I would switch to yoga for two weeks, until the start of my next cycle.  With this routine I didn’t feel guilty for not exercising and I didn’t feel guilty for exercising.

I really like challenging workouts, so during my 2-week vigorous time I would do circuit training like with Jillian Michaels’ 30 Day Shred (or, really, any of her other videos), or jogging.  For the 2-week restful-exercise time, I would do power yoga or pilates.  I like JM’s Yoga Meltdown video, as well as the MTV Pilates, Pilates Mix, and Power Yoga videos.  I exercised about every other day, or however my schedule allowed for it.  I was doing yoga so much more than I had ever done that I would get excited for sun salutations, waiting to slide into upward dog – a pose I never had much respect for until I became strong and flexible enough to do it correctly and feel an awesome stretch in both my back and my core.  It’s as comforting to me as chocolate…  but I’ll save the “yogasm” talk for another post.  😉

Sharing with strangers: “That’s fun!”

On today’s episode of Sharing My Infertility Story with Absolute Strangers: the bloodwork laboratory technician!

Meet your bloodwork laboratory technician who’s going to perform your fertility workup today. She’s got a bucket – yes, a bucket – full of empty vials, and every single one of them is going to be filled today. She’ll ask you to spell your name and identifying information, just to make sure you haven’t sent in a patsy to take your place. Then she’ll look pointedly at your right arm, tie the tournaquet, poke at the inside of your elbow and frown. This is where you say, “The left arm is usually better.” Without an argument, she accepts your offer of the alternative arm and agrees with your vein-viability assessment. The only unfortunate part is that the blood-drawing leather loveseat you’re in (I told you this hospital was secretly a spa) doesn’t have an arm table on the left side, so you’re stuck sitting in the chair sideways with your left arm stretched across your body.

I have had horrendous experiences giving blood both for blood donations and for simple blood tests.  People either hit the vein or they don’t. If they’re not experienced enough, they don’t even think a vein is there. Twice I’ve had to have the pediatric butterfly needle used on me. I’ve had multiple pokes, I’ve had digs (which are the absolute worst), and I’ve had collapsed veins.

On today’s episode of SMISWAS, the tech hits the good vein the first time and despite drawing a bucket full of blood, your vein doesn’t collapse or give her a hard time.  BUT just because there wasn’t any vein drama doesn’t mean there won’t be plenty of awkwardness!

*Thup* The first vial is attached and starts filling with blood. “So will this be your first child?” What a way to start a conversation. “Yes.”
“How long have you been trying?”  *Thup* Next vial.
“A year and a half.”
“Have you done IVF yet?” Woah, a little personal!
“No.”
“My husband and I have been trying for two. I have hyperthyroidism.” *Thup* “I had my thyroid removed in December.”
I note the pink scar on her neck. “That must have been very difficult for you.” I had switched into counselor mode and had wanted to tell her I was sorry to hear that, but in some other meaningful way – because when you’re struggling with infertility the last thing you want someone to say is, “I’m sorry.”
*Thup* “Yeah, it was.” The conversation seemed to stop. So I thought I’d volunteer my story, since it seemed we were sharing…
“I have a unicornuate uterus.”
I never expect to hear this answer from a medical professional but unfortunately I hear it all the time: “What’s that?”
“Basically I have half a uterus.” *Thup*
“That’s fun!” She means that statement. It’s not sarcastic at all. “I mean, not fun for you, but fun.”
I wasn’t sure what she meant. “It showed up as a deflated balloon on the HSG.”
This is where the other technican jumps in – either to save her colleague from continuing down the insensitive, flippant path or just out of curiosity – “Are you draining your patient?” she said, laughing at the sound of yet another vial being tossed into the bucket.
“Yep, draining her. And as a matter of fact – ” she pulls out the needle and wraps up the wound – “I need you to sit here for a few minutes because I took so much blood from you.” I watched as she wrapped individual labels on each of the vials, presumably with my information and the test intended for the vial. She asked me how I was then dismissed me. I mustered up a “Thank you, have a nice day,” although part of me really wanted to wish her luck.

Part of me wanted to acknowledge the pain and disappointment that I know she’s experiencing; but then part of me was angry at her comments and wanted to punish her for not being more sensitive to a fellow grieving infertilite. I felt her comment “That’s fun!” came out of some place of anger, like anger that her thyroid was removed and mine wasn’t. But I’m not angry at her for having a (presumably) normal uterus; I feel sorry for her that she might feel anger or jealousy towards me even though we’re in the same boat.

So writing this post now I think I should have been a better person and wished her good luck. After all, when there’s that much negativity, depression, sorrow, hurt, and guilt already surrounding you from these endless trials, there is more of a need for hope and love than there is for spite.

This is your body on Clomid

About two weeks after taking Clomid – your midcycle, about the time you ovulate – your body starts rebelling against you in cruel and unusual ways.  My symptoms have ranged from bloating to cravings to painful intercourse, and the severity lessens the more cycles you do.  I have done 4 cycles of 50mg clomiphene citrate, and I am on the 3rd cycle of 100 mg.  (Apparently my body didn’t really ovulate during the 50mg cycles, according to my OB/GYN, though given the bloating and pain I experienced you could have fooled me!).  During my very first cycle, I thought I was having kidney stones I had so much pain in my lower abdomen.  I could barely sit down, stand, or move.  Going to the bathroom was extremely painful.  And it wasn’t gastrointestinal pain – it was far deeper than that.  It was awful, and it makes you not want to move for days.  The pain disappears in about a week, and with every cycle it isn’t quite so bad as your body gets used to it.  But still, it’s enough to make me wonder how much more patience I can have in being uncomfortable in my own body.

My abdomen becomes very bloated from mid-cycle through the onset of menstruation.  My pants don’t fit as they usually do, and I look like I’ve gain about 10-15 pounds in my midsection, though I may not be eating anything more.  I try to do yoga as much as possible during this time, since I’ve read that vigorous exercise could twist your tubes and disrupt your ovaries in this state.  But it isn’t enough to make me feel like my normal, skinny self again.  In fact, I won’t feel normal and fit into my skinny clothes again until the onset of menstruation.

In short, I go through two weeks of bloating, a few days of extreme abdominal/pelvic discomfort and in some cases pain, topped off with two weeks of self-loathing.  And lately, after over half a year of this emotional and physical roller coaster, the two-week wait is a pessimist and uncomfortable march to the inevitable.  I try to be positive – I exercise, I meditate, I pray – but somewhere deep inside I’m not convinced this month is the month.  Not since I got overly excited a year ago and bought the onesies have I had true, honest, authentic, and trusting hope.

This is your brain on Clomid

You know how you get those printouts at the pharmacy with your prescription that tells you all about your side effects?  You know how they say mental or mood disturbances are an extremely rare side effect?  Yeah, me too.

Don’t believe it.

Every woman I’ve talked to who has taken clomid (and for the record I am on generic clomiphene citrate) had warned me about the mood side effects.  Wild mood swings and depression were the chief complaints.  I didn’t believe them, because when I took the medication I didn’t feel anything.  It felt a lot like a sugar pill to me, with the lack of immediate side effects – compared to other medications which tend to make you feel woozy, drowsy, hyper, relaxed – in other words, make you feel something.  But when I started my first round of 50mg clomiphene citrate and I didn’t feel any differently – and didn’t notice any change in how I was thinking – I believed I had escaped that side effect.

In fact, it wasn’t until the second round of clomid that I began to realize, “Hey, this isn’t me.  This isn’t normal.”  Having suffered through depression on and off through my teens and 20s, I thought I’d be able to recognize the signs.  I was entirely fooled, until I started taking cheap shots at my husband and realized, “Stop! What did I just do?  And why?”  The worst thing was, acting so bitchy felt entirely natural to me even if it really isn’t my nature.

Here’s what I went through (and continue to battle, now on my second round of 100mg): A complete and utter lack of desire to go to work – every day. A negative view of everything happening – at my job, at home, on tv. I become a human Eeyore, a grey cloudy sky following me everywhere I go, drenching everything I encounter with sad and morose overtones. My husband can’t do anything right, and (exasperated sigh!) my life is soooooo stressful and overwhelming.  I couldn’t stand to be around anyone. Grrr!!!

The pharmacist ought to hand you a little placard with your prescription that reads, “Don’t mind me, I’m on clomid.” Maybe a warning sign is more appropriate.  But I advise informing those you love about what’s going on, why you might be acting strange.

Only you know yourself best.  So make sure that when you’re on any kind of medication that affects your mood, you keep up your usual lifestyle regimen that you have come to expect.  Keep exercising – it is the only thing that returns me to my “normal” state during the 5 day cycle of hormones.  Keep eating healthy foods.  And, if it makes you feel better, indulge yourself in a retreat: give yourself a pedicure, get a massage, or lay on the couch and do nothing – and don’t feel guilty about it.

One cognitive effect I have experienced which actually has a physiological impact is that it makes you think you’re hungry even when you’re not.  Maybe it is a psychological way to cope with the depression and mood swings, to eat chocolate and comfort foods.  But either way, I’ve had to train myself to stop snacking as often as I had been – because only a short week to 10 days after starting clomid, my body would begin to see the rest of its side effects.

To be continued…