Monday, February 28, 2005

To make a short story long

Today’s visit with the NP was mostly uneventful. Before I got to see her, the other nurse did the weighing/blood pressure stuff and asked the date of my LMP. And when I said 3 months, she made me take a pregnancy test. Right. Because I wasn’t there for the fertility clinic or anything. (Then again, this is the same place that suggested in the orientation class that some people just needed to have better timing and then lie there for 20 minutes - as if that was a new breakthrough in treatment technology. I guess these are the same people who might not know that they actually did get pregnant while waiting for their fertility appointment.)

But I digress. After the inane test, and the obligatory disrobing and wrapping myself in the paper bolero vest and paper sheet (in case I didn’t already feel like a cog in the machine) we sat around and waited for the NP. And may I just say that I supremely dislike being forced to disrobe and sit in a freezing room to have my nether regions prodded without having previously met the prodder. It’s one thing if they’re just wanding me, but this was a full-on pap and breast exam, and I kind of wanted to exchange pleasantries first, or at least have her see the cute outfit I was wearing. (Okay, nothing really cute, but they were clothes, and they were mine, and that’s got to be good enough.) And for an uneventful story, this is sure taking a long time to tell. Sorry about that.

Anyway - pap, breast exam, and a quick ride on the wand. And J was there for the whole thing, which might have been nice, but was mostly kind of weird. He’s been in the room for an u/s before, just not the more mundane pap and prodding. Add to that her lecture about weight (”I suggest you identify your weakness and then see if you can cut it in half” - to which I replied, “I’ve already given up caffeine, chocolate, sugar, flour, and dairy.” Do you want me to halve my decaf green tea consumption? Yeah, I’m fat, but I’m already trying my best to change that) and I was in a mighty good mood by the end of it. But J was very supportive - he kept trying to maintain contact by touching me on the shoulder or back, which was nice except that with all the other touching that was going on, it was too much and so I kept shaking him off. Next time I think we’ll try some simple hand holding. Also, next time I’ll probably be wearing a shirt, which will help me feel slightly more human. (Especially if it’s this shirt. Or maybe one of these.)

So, the details. My lining is thin, despite the 3 month hiatus my period has taken. Ovaries are fairly normal, with many small cysts, as expected. J’s last SA showed low volume, low count, and low motility, so we’re looking at an IUI almost for sure. And I had to have more blood drawn before we could meet with the RE. No Provera for now - they just ran CD3 and CD21 tests on whatever day it is today (88, but who’s counting?) and will wait to force a visit from the lovely AF until we’re ready to cycle. Which I guess means less waiting when that time finally arrives.

On the plus side, I actually have an appointment to meet with the doctor, who actually is an RE (not all of the doctors in the clinic are). And we already did the last of our bloodwork (another icky experience that I’m trying to let settle before I rant about it here). And so that’s it for now.

I’m off to enjoy a mindless hour of television and a glass of wine. Or maybe an something a little fancier.

Sunday, February 27, 2005

Gravida 0

The good news is that my medical records from the old clinic arrived yesterday - just in the nick of time for my Monday morning appointment at the new clinic. I’ve been reading them over, and have learned some things about myself.

1. I’ve gained weight since I started fertility treatments. Not a huge shocker, I know, but nice to see it clarified right there, so I can blame the fertility treatments for my needing to go buy new pants today. (They’re fairly cute, too - black and baggy, which is pretty much what all of my clothes are like.)

2. My old clinic uses a transcription service for all notes - my file is clear and legible, but lacks any sense of a human being actually having anything to do with the details of my body.

3. In my initial patient history, they got correct that my grandfather died “of suicide”, but got my mother’s age wrong. This is somehow very disturbing to me.

4. Each of my parents is entitled to one medical problem - no more, no less. “Father is a 75 year old living with high cholesterol.” Not, “Father is retired and an artist.” I guess medicine has to reduce us to our bodies.

5. J is “healthy, but he has never fathered children previously.”

6. Aparently, lab results weren’t included in my file. This is mostly fine - the new clinic is going to repeat all the labs anyway, and the u/s results are in the notes (I certainly didn’t expect to see the pictures). But, I’m wondering what I would have had to do, besides check all of the boxes on the form (which I did) to actually get my lab results. Do I have to request them directly from the lab? What’s weird is that the only lab report included is one from the clinic before this last one - perhaps because it shows a prenatal screening panel (Rh factor, antibodies, etc.).

7. And finally, all of the notes once we started trying to get pregnant, begin with “She is a __ year-old gravida 0.” Gravida 0 sounds so serious. I’m gravely zero. What fun. I think now I need to get the T-shirt (props to Akeeyu) to wear to my next appointment. Just put it right out there for them.

Whatever. At least I have the records to show that I have done previous Clomid cycles, and that I didn’t respond to anything lower than 150 mg. And that even on that dosage, they really needed to give me a trigger, because I once I produce a decent follicle, my ovary is in awe of itself and just can’t seem to let go on time.

Meanwhile, my acupuncturist is a bit irked, I think, that I’m going back to traditional medicine. I am too. I was really hoping that she’d at least get my period to show up, but so far no luck. She did a different set of needles this week in addition to the usual suspects, so maybe that will help.

So, new clinic on Monday. Working on flattery strategies to get me in good with the nurses and other staff. It’s never too early to start!

Saturday, February 26, 2005

you get what you pay for

(or, why my new attempts at frugality suck)

I was LONG overdue for a haircut. I had been stalling because my old stylist had been out on maternity leave (I kept hoping that she was contagious as she cut my hair in her very pregnant state, but no such luck) and she was scheduled to be back in February. Except that she’s back at a different branch of the salon (the fancy downtown one, which apparently has on-site day care -- how cool is that?) and it’s further away and costs more. So I kept stalling. I had planned to make an appointment to check the place out at least once before deciding I’m not cool enough to be there, but hadn’t gotten around to it. And it’s such a production. And meanwhile my hair is getting shaggier and harder to manage and I finally had to just break down and do something, anything, right now.

So I went to El Cheapo, no-appointment-necessary salon ($14 student rate!) and hoped for the best. The stylist seemed to be squeezing me in while her other client’s highlights set up. (I know it’s SO MUCH cheaper, but I’m not sure I could bring myself to get highlights done there. Though I was there at all, which says something about my desperation.) I sat down in the chair, and she said “How much do you want cut?” And then I had to try to explain that just taking off an inch wouldn’t really help my curly, but not too curly, hair. We went back and forth about length for about a minute (certainly no longer) before she bustled me off for the fastest shampoo I’ve ever had. I don’t think my scalp even got wet. Then back to the chair where she trimmed the bottom and looked pleased with herself, as I sat there trying to explain that I didn’t want her to cut too much from the upper layers, but that the bottom was shaggy and didn’t curl as well, so it should be shorter. And she trimmed and snipped and started in on the layers and kept telling me how she was doing what I wanted. You know where this is going, right?

It’s not really what I wanted. The top layers are too short, and the bottom is just sitting there (as I said it would). BUT... the middle is okay, I think. And it only cost $14. I guess I knew what I was getting into, and I’m sure it could be a lot worse. Hell, the last stylist I tried (before the pregnant one who understood curly hair) did an equally mediocre, if not worse, job and charged way more.

Now to go play with it and see if I can get it to curl more and frizz less. Wish me luck.

Tuesday, February 22, 2005

no more midnights

Note to self: While perhaps you were able to craft coherent arguments (and indeed, whole papers) at 2am while in college, this is no longer your most productive time. Please try to remember this before blogging in the wee hours of the morning. Thank you.

In other mundane news, it’s CD 82, and by crossing my eyes and hopping on one foot, I got FF to give me a tentative cover line. Lest you cheer, know that to get the coverline I had to let it count my temps from the traveling-funeral-jetlag days that were abnormally low and under particularly stressful circumstances. I’ll probably go back to discarding those temps before the first visit with the new clinic, lest they otherwise miss how totally fucked up my body is.

I’m excited, but not too excited, about this upcoming appointment. It’ll be nice to finally be taking the next steps, but my three month hiatus was supposed to be this magical time when the acupucture and herbs were going to make my body miraculously normal, or at least more normal. Not only have I no period, but even on the acupuncturist’s special (but ill explained) diet, I haven’t lost any weight. I had told people (mostly myself) that the point of the diet was to get my body healthier, not to lose weight. But, of course, it would be healthy for me to lose weight.

So now I’m thinking about nixing the acupuncturist (or finding a new one, but more on that another time) and her herbs and modifying the diet to one that may more likely cause me to lose some weight. I’ve heard people (including Cecily) are trying the Fat Flush Plan, so maybe I’ll try that. Plus, I should find a way to exercise more.

I walk this fine line - I’d like my body to be in better shape to sustain a pregnancy. So, I should incorporate more exercise. But, I don’t want to do anything too strenuous that will be contraindicated in pregnancy (or active TTC). So, I was going to a yoga class once a week, which was gentle, but probably not enough to count as my exercise for the week. I think about joining Curves on and off, but tend to skip it both because I’m not sure it would be the right plan for me, and because in my fantasy world I’d just have to stop soon. My latest thought is that I’ll join the Y - yoga classes and NIA (which I think I might like) and a pool - and prenatal fitness classes too, should I ever get that far. J has been talking about getting an exercise bike, so he could get some exercise in while watching TV. Given how much TV we watch, I guess this isn’t a bad idea. It just seems so 80s.

Saturday, February 19, 2005

midnight (well, 2am) musings

I should be asleep. Or writing something more “real” and “important” than this. That is, if I plan to complete my graduate program sometime this century. Instead, I’m designing my ideal job in my head and noting how grad school and academia don’t seem to fit in the picture. This should tell me something, but I don’t think it’s as clear cut as it seems. Or else it is, which is too much to deal with right now.

It’s the beginning of J’s crazy time of year - back to back projects that require a lot of hours and stress and that keep him from having the energy or attention span to engage in any lengthy meaningful conversations. Which is a shame, since I have to decide really soon if I’m going to stick this out or throw my hands up in the air and say I’m done.

This is not what I envisioned for myself, or for us. I think I had assumed I’d get pregnant and take a leave of absence at that point, and then decide if I really wanted to finish. But without the pregnancy, I have to just decide - or take a leave without the pregnancy and sit around in my pity puddle.

Just the bright post you came for, right?


Okay, here’s something. I heard a program on infertility on our NPR station today. (The audio is available from the link, if you’re interested.) The hour-long episode of “Health Dialogues” featured a fertility doctor, a medical ethicist, a therapist specializing in infertility, a member of RESOLVE, and author Peggy Orenstein, who is apparently writing a book about her struggles with infertility. (IIRC, she got pregnant naturally at age 41, after 3 failed IVFs.)

[Peggy Orenstein wrote a beautiful piece published in the New York Times Magazine about (one of ) her miscarriage(s). Her other articles are also quite interesting - moreso than her books, I think - at least more than Schoolgirls, which I read in college at some point.]

Anyway, the radio show spent what felt to me like too much time talking about factors such as maternal age, especially in the discussion of ethics and insurance coverage. They didn’t mention PCOS at all, even when talking about common known causes of infertility. I didn’t expect much, since talking about ICSI (which the woman prononced “ick-see” -- is that normal?) is way sexier than talking about overweight hormonally imbalanced anovulatory PCOSers like me. It’s easier, and cleaner, to talk about IVF and the ramifications of PGD or the benefits of ick-see than to deal with the messy nature of my kind of infertility.

The show wasn’t all bad, though. Mostly what was good was that the show aired at all - perhaps this will have some kind of advocacy effect. Maybe this will help catalyze a political movement to mandate insurance coverage for fertility treatments, and to increase the availablilty of support systems such as child-care, though these were touted as important in convincing women to begin TTC sooner in life (as Orenstein suggested).

Or maybe this is just a day for me to be living in a bit of a fantasy world. And not the good computer-game kind. Though maybe we should make one, kind of like Ollie’s board game.

Going to bed to dream of a job and a pregnancy. Not necessarily in that order.


p.s. I have no idea why the links are behaving so weirdly. I apologize, but I can't fix it. Any hints?
** UPDATED: I've fixed the links. Not that anyone cares, but still. I triumph over technology. Yay. **

Monday, February 14, 2005

Thank you universe. I think.

It’s Valentine’s Day, and I have what looks like EWCM.

And we’re at my in-laws’ house, in a room that shares a wall with my BIL.


Thursday, February 10, 2005

ready and waiting

It’s a common practice to name a baby after a member of the family. In Judaism (at least in my practice of it), it is more appropriate to name a baby after someone who is no longer living, for fear that naming the child after a living relative will confuse the angel of death - or something along those lines. (Not that my parents bought into that superstition. I was named after my father’s parents who were very much alive - and in attendance - at the time of my birth.) In any case, I like the idea that the name is a connection to the past.

All that is background for saying that when I dream about baby names, I tend to start with family names. When my grandfather died a couple of years ago, I pondered how to use his name for one of my future children. His name is somewhat dated, and I thought that really what I’d like to do is modify it to be used as a girl’s name. It was the perfect middle name to the first name I wanted to use - a blending of names from both sides of the family. The first name comes from J’s grandmother, and a close cousin, both on his mom’s side of the family. But, they were both living, and if we’re following the notion that we shouldn’t name after the living, then that name was off the table.

At the time, we weren’t actively trying to conceive, so it was clear that even in the best scenario this was planning for the future. When we actively started trying to get pregnant, I kept my list of baby names private. I’d toy around with them from time to time - to give me hope for the future or something to focus on besides tests and medications. But mostly the names would sit, gathering dust in the back of my mind. Friends would have babies, and I’d think, “please don’t let them take my names” - and so far it’s worked.

This week, I pulled out my list of names again. At the top of the list is this name - the blending of J’s grandmother and my grandfather. And as of this week, I can use it. J’s grandmother (Nana) died. Nana had been ill for many years and for the entire time I’ve been a part of this family, was in another place mentally. And so I never really knew her. J mourns the loss of his grandmother, though she’d been mostly gone for a long time. I am saddened that I never got to know Nana as she was. My MIL spent the evening writing her mother’s eulogy and reminiscing about summer trips, volunteer work, jokes... and I’m sad I never really got to know this woman who led such an interesting life.

And, in the back of my mind, is another thought. Maybe now that her name is available, the child will come to be. Maybe it was too soon before, and now that both of our grandparents have released their hold on these names the cosmic-powers-that-be/god/the-great-spirit-in-the-sky/my-ovaries/his-sperm will somehow get it together to produce this child. Her name is ready and waiting for her.

Friday, February 04, 2005

spam spam spam

Two items caught by my spam folder today:

1. did they turn you down because you don't...
2. Have children? Should have a big house!

Um. Well. Okay.

If you're looking for a laugh along these lines, check out Spamusement - cartoons based on spam subject lines.

I also have an offer of a "Phd for sale" which you know would be so much easier than actually finishing my grad program. Now if they just had one that said "Your application for a baby has been approved" I might open it.

Tuesday, February 01, 2005

neverending cycle

la gringa said somethng recently about thinking in cycles instead of months. I think this may be why I’m in a funk right now - this is a neverending cycle. I’m not just on hold for the appointment with the new doctor, I’m on hold for any reminder that there are cycles by which I could measure time. I’m on CD 61 and counting, with almost a month to go before my first appointment at the new clinic. I have an old prescription for Provera, but I don’t want to use it because I want the new doctor to see how ridiculously pathetic my cycles are. That’s not totally sick, is it?

It just gets better and better, though. I just got off the phone with the receptionist at the new clinic. Apparently, my first appointment is not with the RE, but with a nurse practitioner. So, there’s still no end in sight to the waiting period.

This is so frustrating and seems ridiculous. The initial visit is where they’ll do a pap (I already had one scheduled for next week, but if they’re going to do one anyway, then I don’t need TWO) and order bloodwork and a semen analysis. Except that my GP already ran a ton of bloodwork in preparation, and J has had THREE SA’s in the past 6 months. Granted, I haven’t had CD3 bloodwork in a long time - but this is partially because I haven’t had a CD3 in a long time! So, I’ll go in for this visit (trying not to be the surly patient they come to hate, but rather the well-informed patient they respect) and get my pap, and probably an ultrasound, and an order for some bloodwork. Then, and only then, will I be able to get an appointment with an actual RE. Apparently my clear lack of ovulation and two failed Clomid cycles don’t mean I get to jump right in.

Unless I try tactics for skipping the NP. J suggested calling to speak with the NP, and explaining that I’m transferring from another RE and so I’m not totally new to all this. The receptionist said I could check to see if there had been any cancellations to move up that first visit. Personally, I’m thinking hibernation sounds really good right now. Can’t I just go to sleep and wake up when I can actually see a medical practitioner who will help me? But then, that might leave me asleep for years.

Is this what it’s like in the UK or other state-managed health systems? I vent and complain because it’s much worse with the massive HMO than it was with the regular private insurance company, but maybe this is just a field of daisies in comparison. If so, I’m sorry for whining. Well, maybe not. But I’ll make room in my cave if you want to hibernate with me.