You take the good, you take the bad...*

Good:

1. I got an email from my MIL the other day. All I can say is oh my god, she got it. And she got that she didn’t get it before. And she apologised for a couple of things she said back in the not getting it stage of things. This is so important on so many levels, all of which I'm sure you all understand, so I'll stop there.

2. We had good sex the other night - not about timing or positions or EWCM or temps, just good sex. It’s been a while, y’know?

3. I finally went and got my tattoo today - the one I’d been thinking about for ages now but kept putting off because it was the wrong time in my cycle or schedule or whatever. But now I have it. Very happy about this. Trying not to expect too much from it, although Muddy got a similar tattoo a while back and then promptly got herself knocked up. I’m just sayin...

4. There’s a nest of baby birds right outside our bathroom window - we’ve watched the MamaBird bring bugs (and even a tiny lizard!) back for the babies over the past couple of days. Today the little birds ventured out of the nest for the first time - just to the nearby branches, but it’s only a matter of time before they’re gone. But so cute right now!

Bad:

1. Not that I wasn’t pretty sure about this before, but this cycle is a definite bust. Femara seems to do nothing for me (though I was also pretty sick through the first part of this cycle, which I’m sure didn’t help).

2. J’s Kruger analysis sucked. (But he’s about to start treatment with an acupuncturist, so maybe things will change for the better, even a bit.)

3. The injection training we’re going to this week is scheduled to be led by Nurse NBM. Though I figure if she doesn’t have a wand up my twat that I’ll like her more. The whole thing is probably pointless, since we’re gearing up to switch clinics, but I want to go through with the training just in case we end up doing one last cycle with the current clinic.

* More good than bad, really, and most of the bad stuff is nothing new. I’m in a strangely good place with things right now - we’re not sitting around doing nothing, we’re researching options. And we’re researching the strongest options we have - no more pussyfooting around dealing with the crappy clinic. It’s time to move on to the experts. In fact, I have a ‘moving on’ kind of question: What questions should I be asking when interviewing new clinics? Or really, what should I be looking for to get a sense of whether the staff is good and whether I’ll get focused treatment or just be another case file? We’re only consulting with a couple of clinics, and we picked them because they have good numbers from the CDC listings, and good recommendations from other medical folks in the area. So I’m sure they’re both fine, medically. What I’m trying to figure out now is how to gauge the little things that can make or break a clinic experience - compassionate staff, prompt attention, comfortable facilities, etc. I’m hopeful that I’ll just be able to tell that the place is a good fit, but I’d love some guidance from those of you that have gone through this already.

heartbreak not pain

I called the evil HMO the other day to double check that we don’t have acupuncture benefits, just a discount.

“Oh, you have those benefits,” the woman said. And then she told me I needed to get a referral from my primary physician before I could use the benefit.

So yesterday I called to request the referral.

Her: You’ll need to make an appointment with the doctor. How’s August 26?
Me: Nothing sooner?
Her: I’m not seeing anything. For how long have you been experiencing the pain?
Me: Pain?
Her: Acupuncture is only indicated for chronic pain. Where is your pain located?
Me: Well, I think my heart is breaking. Does that count? Um, I was interested in acupuncture for my PCOS and fertility. I’ve read some studies that show...
Her: Oh, for that you can self-refer. It’s not a covered benefit, but you will get a discount. I’ll give you the number to call...
Me: Is there someone I can talk to about that policy? That seems really flawed.
Her: Well, you can call member services.
Me: Will they be able to do anything?
Her: Probably not.

I knew I hated the evil HMO going into this - I used them as a kid and the experience was not pleasant. But they’re good for some things - J’s been getting decent care from them for a couple of years, and they’re good for basic medical needs, and they have at least some level of fertility benefits, which my old insurance didn’t have at all. So we gave them a chance. And now I’m done.

Except for maybe just one more cycle.

* When J called and used the “migraine pain” buzzwords, he got an appointment with the doctor for THIS WEEK. And it’s the same doctor. I think maybe they just don’t like me.

NBM

J called and got finally got the clinic to give him his Kruger results on Friday, so I spent the weekend Googling and planning and scheming and stressing. On Monday, I went in for my final ultrasound of this cycle with the nurse I’ve now nicknamed Nurse No Bedside Manner. Nurse NBM prodded me and found me lacking in follicles (despite one VERY tender left ovary yesterday, and some twinges from that general area today - makes me wonder about her technique). This is the first cycle I’ve worked with Nurse NBM, and while I honestly don’t think she’s a bad person (or even a bad nurse), she seems to really be lacking in compassion (in addition to her previously demonstrated lack of humor). She offered no acknowledgemet of the crushing lack of success on Femara, just a quick - “Looks like it will make sense for you to move on to injectables now.” I asked, puzzled, if that really made sense given J’s Kruger results, and she said, “It’s worth a try. We’ve had patients get pregnant from an IUI with results like his - not everyone can afford IVF. ... Of course, who knows if they were having affairs on the side!” I was so stunned I didn’t say anything, though I’ve been making a mental list of comebacks. Foremost among them at the moment is the not-so-snappy observation that perhaps this was her attempt at humor, in which case I again reference the (much greater) need for compassion, above. Instead of a snappy retort, I asked about IVF (which the clinic doesn’t do) and she suggested that I make another appointment with Dr. L to discuss our options. (I’ve already Googled the hell out of the options, but it will be nice to get a second opinion from the professional.

If I cycle again at this clinic (which is a big IF at this point), I WILL NOT be seeing Nurse NBM again.*

*Except if we go for the injection training, since she’s the one who teaches it.

Hey, how's it going?

Lorelai: Hey -- tomorrow, if you have time, I'm planning on despising everyone who says, "Hey, how's it going?"
Luke: You're on.
[A woman enters Luke's restaurant.]
Woman: Hey, how's it going?
Lorelai: [to herself] Oh, now that's just too easy.*


I didn’t have as bad a time as I’d expected at my reunion. Not a ringing endorsement, I know, but as we were driving over there (after I spent an eternity trying to decide which necklace to wear or something equally trivial) I was dreading the entire experience.

I went to a very unique high school, that in some respects was free from the typical inane social activity and cliquishness. (And if that was your thing and you were happy with it, then more power to you. You probably would have hated my school, and I probably would have hated yours. And that’s fine.) My school was a school full of misfits, of kids who would have been the odd ones at their old schools. And my school was a safe haven. In some respects.

The thing is, it was still high school, and we were still teenagers. So there was still a bit of that whole high school thing. Which is all a preface to saying that some things never change. And while there was never one clear popular group, there were still groups, and peripheries to those groups, and weird overlaps between groups and all that. And they’re all still there.

So, the reunion (which was an all-school reunion with people from the last 20 years) was in a private room (well, rooms) at a bar. It was packed, and loud, and I’m still getting over bronchitis so the whole shouting to be heard thing was a real treat for me. But I saw some people I wanted to see, and some people I didn’t know I wanted to see but ended up having the best conversations with. I forgot to bring business cards, so I collected a few from other people and wrote my info on little pieces of paper. And there weren’t any noticably pregnant women (at least, not from my class). One former classmate asked if we had kids (she has a 5 year old) but it seems most everyone else is still single or newly married and many are still in that post-college lifestyle -- working some job that’s vaguely interesting and living alone or with a roommate and just going about their lives. Nothing wrong with that. But it makes my almost five years of marriage and two years of homeownership look so serious and grown up. Weird.

The weirdest part of the whole thing was the discovery that there are a lot of people I don’t really care that I haven’t seen in years. Either we weren’t really close in high school or we’ve completely drifted since then. Those were the “Hey, how’s it going” crowd. You ask, and you look interested, but we both know we don’t really care what’s up with this person, and the whole forced conversation is just pointless. Then, of course, there were the people I did really want to see, who seemed to regard me as a “hey, how’s it going” kind of conversation. Which was a bit sad. As was the absence of my high school best friend, from whom I’ve drifted, but who would have been the only person fully able to grasp some of the weirdnesses. I tried to explain some of them to J, but there’s really no way of condensing three years of history into a thirty-second explanation. So I missed my former BF. But at least now I can say I survived my high school reunion.

*Gilmore Girls 1.16 (Star-Crossed Lovers and Other Strangers) - Yes, I am rather obsessed with GG lately. Such good writing!

eye contact

As I sat in the waiting room this morning, I looked around at all the other unfortunates, and I sort-of wished the waiting room ettiquitte was different. I don’t have any infertile friends IRL (except for one that lives clear across the country) and if anyone would understand the craziness that is the evil HMO, it might be them. (On the other hand, I’m continually amazed at how other people just blindly accept the statements of their medical providers without questioning or challenging. And don’t crack snarky jokes to their wand monkeys. I’ve never witnessed that last part firsthand, of course, but given the nurse’s puzzled look this morning when I made some stupid quip, I have to believe it’s rarer that I’d think after hanging out with all you internets. So maybe they wouldn’t understand. But I digress.) So I sat there thinking how sad it was that none of us could make eye contact until I got called back for my date with the dildocam.

The date, it was not good. CD15 and nothing to show for it. The nurse (who also wasn’t making much eye contact) said that I could have a blood test next week to confirm that I hadn’t ovulated and then start Provera, or I could come back for one more check next week. I’m not holding my breath for that last ultrasound, but since I’ve already had the experience of missing a very late ovulation (at the old clinic) because the doctor counted me out too soon, I’m not really ready to throw in the towel. That said, I have no real hope that things will be different next week. And that’ll be it for oral meds. Nice knowing you - have a safe trip. But the nurse (not my favorite nurse at the clinic) didn’t seem too optimistic. I’m not either, but I could have used a little encouragement from her - at least enough to help me hold it together until I got back to my car. But no, it was another of those half-naked crying on the exam table kinds of days. And there were no fucking tissues in the room.

We’re already signed up for the next available injectables class in about 2 weeks. So ideally, we’ll hold off on inducing a period (if it comes to that) long enough for me to actually apply the ever-so-useful skills I’ll get from the class to our next cycle. It’s the clinic’s last chance, really. Once you get to injectables, it’s Repronex or nothing. And I don’t know that it’s the right drug for me. So I’ll try one cycle, and if that’s not the magic bullet then we’ll be seriously considering a move to a private, out-of-pocket clinic. And potentially skipping right along down the road to IVF. But I’m trying not to think about that too much today.

And in the meantime, they wouldn’t give me the results of J’s Kruger analysis. The one that will tell me if it even matters if we can get me to ovulate on schedule. The one that will help us decide what to do next. The one that was in my file, but couldn’t be released to me because of privacy regulations. I understand that in theory, but why couldn’t they tell me that two days ago when I called to request the results? I mean, I could have dragged J to this appointment. I could have brought in a written request that the results be released to me. I could have had HIM call for the results. But since I’m the patient at the clinic, I tried to take care of it. And look how successful that was.

the perils of academia

From an article about actress Danica McKellar (whom I used to love on The Wonder Years):

The academic world, she said, was too isolating and lonely.

Yeah. For me too, I think.

On another note - I think it's really interesting how several of the stars from my childhood and adolescence have found ways to reinvent themselves without completely trashing what they were back then. This thing with Danica McKellar is one. Another is Wil Wheaton's blog. I'm sure there are more. I guess it's just nice to see child stars find their way to non-fucked-up adulthood.

more funk-y stuff

I had been bopping along thinking I wasn’t really having any emotional side effects from the Femara, and then I had a bit of a meltdown this afternoon. Which was strangely reassuring, because at my ultrasound today I had no follicles to speak of. It’s CD12. On my Clomid cycles, I’ve ovulated pretty late (ovuLATE? heh) - someplace between CD19 and CD21. But on this last unmedicated cycle, I ovulated on CD13. So I was kinda hoping I had started a new phase in my cycles. But not so much. This is always one of the most demoralizing parts of a cycle for me - I go in for a scan after finishing a round of meds and have apparently nothing to show for it and it makes me think the whole cycle is over. And then I have to remind myself that I’ve been here before, and that when I go back on Friday things will probably be different. And having a meltdown I can pretend to blame on the meds makes it feel like the meds are doing SOMETHING in there.

But it still sucks right now, and I’m still in a funk. And my high school reunion is this weekend. Eh.

now is the moment of my discontent

Yesterday we went to a housewarming party for NPF (Newly Pregnant Friend) and her husband, who bought a house 4 months ago, and got pregnant the next month. Perfect timing, isn’t it?

NPF is just past her first trimester, and just barely showing. And showing it off - she’s very slender, and she was wearing fitted clothing. (I’m never going to look that good pregnant - it’s just not my body type.) It’s not that she was flaunting it, and she seems appropriately appreciative of having reached the 12 week milestone (except she said 3 months - I had forgotten that normal people talk about pregnancy in months, not weeks). And they haven’t done anything to the “guest room” yet, which is good because that would have been entirely too much for me to handle. As it was, I did pretty well. I asked how she was doing, and followed up on some things she said. We talked about the birth center and the midwives she’s planning to use. (The same ones I’d always thought I’d use.) We discussed her yoga class (right now she and her hubby are taking one together, but she has to skip about half the stuff ). I suggested that she enroll in a prenatal yoga class in her new area, both for the obvious yoga reasons, and because they don’t really know anyone in their area yet. And of course we toured their house (I’d been there before they moved in to help paint, so it was nice to see how far it’s come).

Even though things went really well, and I held it together nicely and didn’t even have a complete breakdown in the car on the way home as I’d expected and feared, the whole thing was a bit depressing. I’m not sure if I can put this into words, but I’m going to try, so bear with me.

J and I have been married for almost 5 years. NPF and her hubby have been married for a year and a half. (I shot their wedding video, and J brought and ran their sound system.) We’ve been in our house for over two years, they’ve been in for about 4 months. (We referred them to our realtor.) We’ve got half-finished projects everywhere, and their house is finished. (I helped them paint.) We’ve been trying to get pregnant for a year and a half, and they’re pregnant right now. (I used to confide in her.) I’m 4 years into my grad program, and struggling with whether this is really what I want to be doing. She left the same program after two years, and has a job she’s enjoying. It’s not that I want their life, it’s just that it seems like things are going so well for them on all fronts, and are so incredibly challenging for us in all the same areas. (And most are things we’ve helped them - in some small way - achieve.)

I think looking at their seemingly-perfect lives makes me all the more dissatisfied with what my life (and our life together) looks like. I love J and I love our house, but I wish we could finish our projects and have the house feel ready for company - we used to love to entertain, and we never even had a housewarming party in this house. I considered taking a leave of absense from my grad program, but I have a (hopefully) fantastic on-campus job opportunity next year that depends on my being a grad student in good standing. And then there’s the fucking pregnancy. (And fucking is right - I’m a bit sick, and I not-so-jokingly mentioned to J that it was a good thing that we have an IUI planned for this cycle, since the chances of our feeling much like having sex every other day are pretty slim. And other people get to just have sex and get pregnant. Fuck.)

The part of me that used to want to be a therapist has stepped back and pointed out that it’s not really about them, it’s about my dissatisfaction with my own life. And I can see that. But the rest of me is just jealous. Which makes me sad. And makes me feel like I’ve lost a friend, through no fault of my own. And in some ways, I feel like I’ve lost myself - if I can see that I’m dissatisfied with my life, shouldn’t I do something to change it? Right now, I’m just spending energy on the pregnancy thing as if that’s going to solve all my problems. I think part of me thinks it will - it would allow me to take a leave of absence from school without it being about my confusion over my professional future. It might motivate us to finish our projects. It would enable me to ask for help when I need it, to justify being taken care of, to allow me to say no to things. And that’s just sad. None of that really has anything to do with the pregnancy I so desperately crave. It’s just an excuse. And now I like a bit of a loser. If I can see all that, why can’t I just do something about it? And yet I can’t. All I can do is write a ridiculously long and rambling post about it. Really effective, no? (On the plus side, I could be paying money for a therapist to tell me what I just said, so I guess I just saved $150 bucks or whatever it would have cost.)

the meeting (a love note)

I had a grin on my face for the entire day - in anticipation of meeting Bugs, the entire time we were hanging out and taking San Francisco (or at least the park) by storm, and then into the night, remembering the fun. It’s not that we did anything particularly spectacular, though we certainly had a good time. It’s more that we didn’t do anything spectacular. That sitting and talking and being completely open was so comfortable and natural and completely unremarkable. It was only afterwards that I realized how momentous that was. How I didn’t feel alone. How I felt so understood. So comfortable.

So yes, the meet with Ms. Bugs (and a later meet with the hubbies along, too) was wonderful. She’s funny and poised and snarky and beautiful and a great tour guide and listener. She and her hubs are adorable together - they complement each other so very nicely. I can’t possibly capture how fanstastic it all was.

She picked me up at the hotel. She said “nice to meet you” and I thought “nice to see you again” as if we’d hung out before. We had, you know. In the computer. We drove around and talked and went to the park and talked and sat on a bench and talked. Someplace in there we laughed. A lot. There was a funny plant, and there were some student filmmakers taking themselves very seriously (much to our amusement), and there were kids in strollers (of course), and there were turtles swimming in a pond. And we said the words vagina, and cervix, and ovary, and we said them loudly and without hesitation. Which is to say, it was a good day. And then we got to repeat it with the guys along, and that was equally fantastic. It was, of course, the highlight of the trip for me.

I think the couples outing was also really important for J. Here we were having lunch with another couple dealing with infertility, and being able to talk about it all together, even a little bit. I get tons of support from my friends in the computer. I know I’m not alone. But I don’t think he gets that same kind of support, and mostly it seems like he doesn’t need it. But of course he does, and even though they didn’t have some deep heart-to-heart, I think just being around another guy in a similar situation and having the topic be open and casual was all very good. For all of us.

getting my affairs in order

I have a confession to make. I was having an affair with Hope this cycle. There, now I’ve said it. I was sneaking around with her, trying to keep the news away from you and everyone else. How could I admit that I was having this affair?

It all started innocently enough. I had no interest in Hope. This was a rest cycle, after all. How would I even meet her? And then I had some EWCM and well timed sex and a temp dip and a steady temp rise. And Hope and I had a cup of tea, but it wasn’t anything serious. But that Hope, she just hangs on. And so when I started feeling slightly tender nips, and got just a tiny bit nauseous, and suddenly felt the need to eat every two hours, she was there. Me and Hope, Hope and me. It felt so right.

And then, just as suddenly, it was over. She broke up with me during the fireworks on the 4th of July, causing a total meltdown and a pitiful case of the breakup blues. (And how to explain those hysterics to the in-laws?) Oh sure, she came back a couple of times over the week, but deep down I knew it was over right then. Even before a drop of blood was shed.

What I didn’t know was that J was having an affair with her too. I think they’ve broken up now, but I bet we’ll both take up with her again really soon.

I'm back and I'm boring

I have several bits and pieces of posts I started and didn’t finish over the past week, including the sordid details of my affair with Hope, lots of stories about my in-laws, and, of course, my raves about the fantastic Bugs. But I’ve also got foggy post-trip brain and so I’m worried that I’m incapable of writing fluidly or with any coherence at all (as evidenced by the fact that I had to re-read this section twice before I realized I had left out a couple of key pronouns). I promise, the updates they are a-coming. Just let me sleep a bit more first.

I’ll leave you with this cycle update instead:

Last cycle was unmedicated and freakishly textbook. I ovulated, we had forced sex at all the right times, my temps went up, I was just the tiniest bit nauseous and hungry every two hours, and then it all stopped and I got my period. One day earlier than was ideal for this next cycle’s timing. So then I spent a couple of days ranting about the suckiness of having to sit out another cycle and how maybe we’d just skip to injectables after this since this cycle was supposed to be a sort of filler while they sort out the administrative aspects of the injectables (yeah, maybe I’ll write about that at some point, too). So I called the clinic today and they managed to get me an ultrasound appointment with Dr. L herself as wand monkey, and she gave the go-ahead to run this cycle CD4-8 instead of 3-7. So I took my tiny beige Femara pills and my pretty blue estradiol pill and now I sit and wait and see what happens.

So that’s the cycle update. And now I’m going to bed.

brief update

I know I promised to post an update about our appointment with Dr. L, but it’s really not all that exciting. She’s sending J for a Kruger analysis (finally), and she’s starting the ball rolling on injectables (they have to be approved by some board at the evil HMO - more on that another time) and in the meantime we’ll probably try a cycle of Letrozole.

---

We're off to San Francisco for a family vacation (with J’s parents and brother). I already know that the highlight will be taking to the streets with the fantastic Bugs, but I’m sure I’ll have fun family things to write about, too. Back next weekend, but I think one of the hotels has wireless, so you may hear from me sooner.