Inconceivable

Double Dose

2011-09-01T22:41:00.000-07:00

This blog has become an almost forgotten piece of my past. I only stop by once a year to dump bad news. I miss writing and would like to write about something else, but honestly I've been so preoccupied and depressed that nothing else really comes out. I started off the summer with yet another loss. Two in one year. I didn't learn my lesson the first time. I still got just as hopeful and excited, even as I tried to be guarded. Secretly I thought I couldn't have two miscarriages in a row. My problem was always just getting pregnant, not staying pregnant. This time I only made it to 6 weeks before I started bleeding. I left work a total wreck and went straight to my OB's office. They did an ultrasound and said they couldn't tell for sure, there might be something viable, it was still too early to tell. I should get serial quants and come back in 3 days. The quants were reassuring, and my bleeding stopped, but by three days later the ultrasound was clear. Missed AB. There was nothing like a baby in there. That was it.

It still doesn't feel right to say I lost a baby this time, since there was never much more than some cells that didn't line up quite right, but it was a significant loss. I lost the future I had imagined with that child, and it hurt--bad. It was only a few weeks, but I could already see Jojo as a big brother. Our family would become four. I was pregnant with my sister-in-law and one of my best friends. The kids would be close in age. The pain of the first loss would be soon forgotten, replaced by the joy of a healthy pregnancy, but that's not how the story ended. So here I am at the end of the summer still licking my wounds. Scarred by the experience and wondering what comes next. I'm not sure how many rounds I have in me.

Tilt-A-Whirl

2010-11-22T21:54:00.000-08:00

I've had a crazy month and finally felt like writing about. This old spot in the virtual world seemed the most appropriate place to do it.

Our son is closing in on 2 years the end of December. He's amazing. This post is not about him.

In August MM and I had a casual chat about contraception and the possibility of having #2. We naturally thought it would take us some time to conceive, but finally felt like we were at a place that even if the unthinkable happened and we got pregnant without intervention, and soon, that we would be OK.

You probably know where this is going, now. October 17th I had a positive pregnancy test. TWO MONTHS after being off birth control. ARE YOU KIDDING ME?! We couldn't believe it. After the shock wore off we started getting really exited. I had only been pregnant once before, through IVF, so I thought that was my only real hurdle, the getting pregnant part. Of course we were still cautiously optimistic for the first few weeks, but then at 7 weeks (when I couldn't stand the waiting), one of the OB/GYNs in my office did an US for me (while I waited for my first official prenatal appointment) where I saw one lovely intrauterine pregnancy, a beating heart, and a healthy yolk sac. THIS IS REALLY HAPPENING I thought.

Last Tuesday we had that first official prenatal appointment with "big HMO". MM and I were in the exam room together, my lying on the exam table looking at the ultrasound screen, expecting to see a 9 week fetus and that same reassuring heartbeat, but it was still. No movement. I watched the screen as she moved the probe around, turned the sound up, shifted the contrast on the screen. Nothing. I knew what I was seeing, but didn't want to believe it. She sent us down for a formal ultrasound to confirm what the office ultrasound showed. It did of course.

MM and I took the rest of the day off together. I felt physically fine, no cramping or bleeding, nothing that would have clued me into a problem with the pregnancy. We took a drive, went to the beach, watched a movie, cried and talked. Since I had a trip planned for the following week and wanted to avoid prolonging the inevitable, we went with the D&C option. I went on with life as usual Wednesday and Thursday, and went in on Friday AM for the procedure. MM was with me, and it went as well as those things can I suppose.

Now it's over and part of me feels like it never was. The whole thing was so unexpected and unbelievable. I wanted to believe the universe was paying me back for all the trouble the first time around, but that wasn't the way it turned out.

It's amazing what your mind can do. I only knew I was pregnant for less than 5 weeks, but in that time I saw the rest of our life as a family changed. Jonas with a younger sibling, just 2 1/2 years apart, like me and my brother. A summer baby with time off to bond and hang out with my two kiddos. Family vacations with the four of us. You get the idea.

This last month has been up, down, and around. Sometimes things seemed to be moving too fast, other times in slow motion. Now here I am in a place I didn't want to be. Wanting. It doesn't feel so casual any more.

It's been real

2009-03-26T20:39:00.000-07:00

I've watched several blogger buddies, previously infertile and otherwise, drop out of blogging and wondered when or if I would be ready to call it quits. Over the past three months with Jonas I've watched my posts drop off considerably. Yes, I'm busy being a new mom, but I also just haven't felt the need or desire as much lately.

I looked back over my posts from this time last year when I was dealing with another failed IUI. My post from Feb. 21st 2008 pretty much says it, the disappointment and despair was intense. Now, a little over a year later, that despair has been replaced with fulfillment and joy almost equally intense, though maybe not as blog worthy.

I have appreciated immensely the encouragement and support I have received here. Thanks for joining me on the journey. If you're still reading and wouldn't mind leaving one last comment so I know you're there, that would be great.

If you're interested in Jonas updates I may keep up a very minimal family blog, so send me your e-mail and I'll get you the link.

Adios.

The Pump Returns...

2009-03-20T09:59:00.000-07:00

My return to work date is just 6 weeks away! I am so glad to have had this time with my baby, but am looking forward to going back to a job that I love. There are so many things I thought I'd do with this time. Most of them never got done. The reality of caring for a newborn (and a new mom) all day is not quite like my romantic fantasy. Still, I feel absolutely bonded to my son and have treasured this special time at home with him. MM and I will be sharing childcare starting in May. We'll both be working a reduced schedule so we can be with Jonas most of the time. I'm happy to have a nanny for the other 15 or so hours we'll need to close the gap.

Breastfeeding still isn't as easy and painless as I had hoped it would be, but I'm committed to sticking with it. Yes, it is getting better, still not great though. Now I'm trying to figure out the best way to make sure I can continue to breastfeed him when I go back to work. My job is very breast-feeding friendly, so I'll get "pump breaks" and can go see him at the nanny's on my lunch break the days I'm there a full day. I'm just not sure how much/if I need to be pumping now so I am sure to have enough as he grows. Honestly, I still hate the thing. All the little parts, the noise, the ridiculous feeling of being hooked up to a milking machine...but I'll do it if I need to. If you have successfully managed this transition I'd love to hear from you. It's a little daunting.

Three weeks in baby land

2009-03-15T11:53:00.000-07:00

We've had a pretty busy 3 weeks with our little man. I could write a lengthy post about each of the following, but I won't. Instead here's a quick run down of what's been happening in our world with a few of my favorite photos.

Feb. 24th- Evening training at work. Left Jonas with dad. All good.

Feb. 28th- Date night with MM. Jonas stayed home with awesome friend. No tears.

March 1st- Hosted my birth attendants for dinner to celebrate Jonas' 2 months and say thanks for the awesome care.

March 2nd- First IZs. More traumatic for mom and baby than expected. Cried like he's never cried before. Glad dad was there too.

March 5th- Jonas meets his great-aunt on my dad's side while she visits for a conference in SF.

March 6th- Trial run with nanny-to-be. Jonas stayed with her for 3 hrs while I prepared for company. Hard for me. Jonas was totally cool.

March 6-14th-Friends from St. Louis visit. Whirlwind of activity: Redwoods, Winery, Beach, SF. Jonas was great. Nice to reconnect with old friends and introduce them to our son.

March 9th- Scary night. Jonas spit up bright red blood. Seemed like a lot. Brief panic. Rational brain kicked in. Cracked, bleeding nipple was the culprit. Healing well. No more scary episodes.

March 14th- Planted the placenta under our apple tree in the new community orchard.

In and among all these events Jonas continues to grow and thrive. I am amazed at him daily. It's such a gift to know him and to be his mom.

What's that in the freezer?

2009-02-22T16:21:00.000-08:00

A few days after the delivery, I opened up the freezer looking for something to eat. I noticed a clear Tupperware container with what looked like frozen fruit salad inside, but I didn't remember freezing any cut up fruit & berries. Before I investigated any further I realized what it was--my placenta. If you think that's gross, I apologize. I think it's a little gross myself, and it's my placenta.

Prior to the delivery the midwife had asked if I wanted to keep the placenta to plant or anything. Apparently it's pretty common with home birthers to save the placenta for some other use. I wasn't sure at the time, so I guess she erred on the side of caution and froze it so I could decide later. For quite a while I still wasn't sure what to do with it. It didn't seem right just to throw it out, but we live in a house we rent, and I didn't want to worry about having to dig up a placenta tree every time we move. So it remained in the freezer.

Now I am excited to report that my placenta will have a new home. A non-profit dedicated to developing a sustainable local food system just started an adopt a tree program. You donate toward the purchase of a fruit tree that you can then name and plant on their farm here in town. I was a little nervous about asking the farm manager if it was OK to plant my placenta with our tree. I left an odd message on her voice mail, but she called back and said she loved the idea and that my placenta was welcome there. So in just a few weeks my placenta will become part of the earth that nourishes a fruit tree that will hopefully provide great fresh fruit to local families for years to come. That makes me smile--even if it is a little gross.

Home Alone

2009-02-02T20:24:00.000-08:00

Jonas is 5 weeks old now, and today was our first day home alone together. MM took the first 3 weeks off, then my mom and grandparents came the day before MM had to go back to work. My mom stayed for two weeks and left on Saturday evening (she returned for another brief stint later in the week). It was great to have help for so long, but I also felt like it was time for Jonas and I to get into our own groove.

I know it's different for everyone, but bonding didn't happen instantly like I imagined. I love him deeply, but the feeling of closeness and attachment just wasn't there for a while. The complete dependence of an infant and the selflessness that's required of a mom is intense, and was harder to handle than I thought it would be. Now that we're on our own and some time has passed (and breastfeeding is finally getting easier) The feelings I was missing and wanted at first are coming.

Everything went pretty well today. No major melt-downs for either one of us. I ate, he ate, we walked, he even let me shower while he hung out in his bassinet looking at a book. Not a bad first day home alone.

Unplugged and Unshielded

2009-01-28T12:27:00.000-08:00

I am of course referring to my breasts. I know this is not the experience of everyone, but for me, labor pales in comparison to breastfeeding. Things are just now starting to get a little easier (i.e. less painful). Right around the 3 week mark we started feeding without the nipple shield during the day. We were both too tired and frustrated at night to go without it for the first few days, but now we've been feeding unshielded for a little over a week. The good news about that is I no longer have to pump! The bad news is he's destroyed my nipples. Cracked, bleeding, macerated--not a pretty picture. I've consulted with several nurses and midwives over the past week and have some ointment that's helping. I'm also spending as much time as possible au naturale (which MM loves of course). Jonas has a pretty good latch now, but I think I was just so anxious to get him off the shield I didn't pay much attention to his positioning at first. Then by the time I did, it was too late. It seriously felt like a hot knife stabbing me when he latched on. It took my breath away. Then on top of it I got a plugged milk duct. The combination of the pain, fatigue, and postpartum hormones have made me a little crazy, but at least I recognize it for what it is--part of a difficult transition to motherhood.

I don't say this to scare or discourage anyone from breastfeeding--I'm still glad I'm doing it and know it's good for Jonas and for me (even when it hurts). I was just totally unprepared for the challenge that breastfeeding can be. If anyone else is having trouble breastfeeding or isn't having the blissed-out experience you've read about you're not alone, and it does get better.

There's so much more I'd like to say about my transition, but that will have to wait for another post. Most of my time has been full of feeding, baby-care and breast-care lately, with an afternoon walk in the Moby. It hasn't left much time for blogging. This morning though my son is asleep on my chest and is letting me do some catching up. I can't believe he's a month old today!

Grandma

2009-01-11T13:31:00.000-08:00

MM's mom made this blanket.
She died 4 years ago.
We miss her.
Jonas would make her happy.
She would have been a wonderful grandma.

Home Birth Part II

2009-01-08T19:25:00.001-08:00

I thought it was interesting that the two comments about my first home birth post both mentioned the issue of control. One said that home birth felt uncontrolled, the other that the woman seems to be more in control during a home and/or water birth. As someone who likes to plan and control to a certain extent, this was one of my main challenges to overcome. Some of the best advice I got during my pregnancy regarding labor was that it is the ultimate letting go. There's no controlling it, and the sooner you realize that and let your instincts take over, the better off you'll be. Easier said than done, but by the time I was ready to give birth I was in a pretty good space to just let it happen however it needed to.

An OB nurse and friend likes to say that most women spend way too much time preparing for and worrying about something that will likely last less than 24 hours and will happen regardless (the childbirth part). She recommends spending more time preparing for parenting and breastfeeding. Good advice, but back to the home birth stuff...

We came to home birth out of the desire to have a natural and unmedicated birth in a comfortable environment with minimal intervention. Initially I thought that a birthing center would be the way to go, but when I visited ours I realized that a birth center birth is really just a home birth at someone else's house (assuming the home birth is attended by a professional who has all the necessary equipment and training to handle an emergency). If you were at home or in a birthing center and you needed a c-section, you'd still have an ambulance or car-ride to the hospital.

Fear is another big consideration. For me, I felt safer and more comfortable delivering in my own home, with professionals I know and trust who were committed to being there for me through the whole process and shared my goal for the delivery--a safe and healthy mom and baby with minimal intervention. I realize most people probably don't feel this way, and I'm not against hospital births if that is where you feel most comfortable, but I do think women should have a real choice and not be forced into the hospital because someone scared them into it. The outcomes for attended home births in low risk women are as good as or better than hospital births. I think because of my profession and training as a nurse practitioner, I have more first-hand knowledge about the advantages and limitations of the hospital setting. For me, home just felt right. That said, I was completely willing to go to the hospital if I needed to. Thankfully, I had a positive experience and got what I wanted, a healthy baby and mom.

The other great thing about home birth is you never have to go anywhere. It may sound obvious, but staying home and sleeping in our bed with MM and our baby from the beginning was great, and much different than the hospital. Having control over who was there and when they came was also great. It was just the birth experience I wanted.

I can't think of anything I would have done differently, except maybe turn the hot water heater up. It took forever to fill the AquaDoula.

Home Birth

2009-01-05T16:00:00.001-08:00

I read a post from a fellow blogger who was on a rant against home birth. It was disappointing to see the misinformation that's out there. Especially after having had such a wonderful home birth experience. It made me wonder if anyone reading my blog had questions about home birth our our decision to birth at home. It's important to distinguish an attended home birth (attended by a licensed professional i.e. MD, CNM, etc.) from an unattended home birth or a birth attended by a lay midwife. I had regular prenatal care and was attended by licensed professionals with years of experience with labor and delivery in a variety of settings. We had all the equipment we needed to monitor the baby and to manage an emergency (oxygen, pitocin for postpartum hemorrhage, etc.). So this is your chance to get your burning home birth questions answered. Fire away.

Due Date and Breastfeeding Boot Camp

2009-01-05T15:21:00.000-08:00

Today is my due date--a date I've been repeating for the past 9 months. It's strange that it's here and I'm holding my one week old son. I'm so glad he decided to come when he did. I think 6 lb 12 oz was about all I could handle. The tax break is also a nice bonus.

I have been in breastfeeding boot camp for the past week, hence the lack of posting. I have had great support throughout the process, from the lactation consultant, MM, my parents, and my midwife. It's not as easy as I thought it would be. It took several days for my milk to come in, and even then, he had trouble getting a good latch. I saw the lactation consultant last Tuesday. She recommended a nipple shield, which has made breastfeeding much easier. Unfortunately the nipple shield can make transferring milk a little more difficult for the baby, so in addition to about 40 minutes of breastfeeding every 2-3 hours, I also have to pump 15 minutes and supplement with the expressed breast milk. So that's pretty much been life for the past week. I breastfeed, MM changes Jonas and gives the supplemental milk while I pump. Between feedings I try to get a shower in, feed myself, and nap. We also spend a lot of time just staring at Jonas. It's truly amazing to see him here after so much anticipation.

It's been so fun to share the excitement of our son's arrival with our friends and family. The support from our community has been great. It's really beautiful to experience the love people share during these important transitions in life. My parents arrived on Thursday and left early this morning. The timing was perfect. It gave us a few days to get settled and be alone with Jonas and they were here to help when we really needed it.

I had a little melt down on Friday. Up until then I had been feeling pretty good (other than a painful perineum). The midwife came over to weigh Jonas and check-in on the breast-feeding. He was looking a little jaundice, had lost weight, and only took 1/2 an ounce in a 40 minute feed (we checked his pre and post feeding weight). I felt horrible about not being able to feed my baby and was so tired I was getting irrational. By the next day though I was feeling better and have made peace with the pump. I still don't like it but I'll pretty much do anything for this little guy.

In other exciting news, I shaved my legs for the first time in months! I almost forgot it was possible. As much as I loved being pregnant, it's nice to have him on the outside now and get my body back.

Happy Birth Day Jonas!

2008-12-29T11:27:00.000-08:00

Our son was born at home December 28th at 10:15 AM weighing 6 lb 12 oz. Our journey to parenthood has been a long one, but thankfully the labor was relatively short. If you're interested in the full details, here's how it all went down.

Saturday around 5 PM our midwife came to the house to check my cervix and strip my membranes. I had also been to acupuncture to "fluff my kidney qi" in hopes for a smooth labor and had started evening primrose oil to get my cervix ready. I had also been taking longer more strenuous walks the past few days. MM was a little nervous about the whole stripping the membranes thing, but she assured us that she does this for almost all her clients (if they're GBS negative) and only once has it put them into labor within 24 hours. Well, I'm not sure if it was the walk, the acupuncture, the oil, or if Jonas was just ready, but at 1:30 AM on Sunday I lost my mucus plug and about 15 minutes later, my water broke. Thankfully it was clear/pinkish with no meconium. I called my midwife and let her know. She said to try and rest and see if my contractions picked up. I called less than an hour later when the contractions were getting pretty strong and closer together, every 5-6 minutes. I had hopes of making banana bread during the early labor stages, but I couldn't get past gathering the ingredients. I was beginning to doubt my ability to do this whole thing unmedicated at home. MM started putting the AquaDoula together and helped me through the tougher contractions. My midwife and the nurse got to the house around 5 AM, followed shortly by our housemate Nena who had just arrived from her Christmas vacation, and Jules, a great friend and natural nurturer. They kept us all fed and hydrated throughout the process and acted as our photographers. I can't thank them enough.

The midwife didn't want to check me at first because my water had broken, but when I said I was having the urge to bear down and my contractions kept getting stronger they checked. I was 7 cm at around 5:30. Finally the AquaDoula was hot and ready, so I got in to help me through transition. It was a really nice change and helped keep me a little more comfortable. Before too long I was completely dilated and ready to push. I think it was around 7:30. I wanted to get out of the tub and move to the bedroom, so that's what we did.

I pushed for what seemed like forever, but was really about 2 1/2 hrs. I begged the midwife to just take him out, but she assured me I was going to push him out myself. I felt his head coming out and finally MM and I delivered our son. It was one of those truly amazing moments in life. To bring life into the world, to see this child who has grown inside of me from just a few cells--it's indescribable. Thanks for joining me on this journey. Hope you like the snapshot.

38 Week Report

2008-12-24T10:45:00.000-08:00

I had my weekly appointment on Monday. My midwife checked my cervix and said I was a "cheap 2." I guess that means I'm somewhere closer to 1.5 cm dilated, but if you stretch it you could call it a 2 and I'm 50% effaced (the cervix is getting thinner). I would like to be a little further along at this point, but I'm not complaining. At least these contractions are doing something.

Monday afternoon I went for my formal ultrasound to check the fetal weight. His estimated weight was 6 lb 14 oz +/- 13 oz. They aren't super accurate this late in the game, but at least we know he's not 10 lbs or something. Everything else looked good. It was fun to watch him playing around in there. We got another good shot of the genitals--still a boy :), but he was shy about giving a good profile picture. He kept getting his feet and hands in the way. I guess we'll see the real thing soon enough.

Now I'm just closing in on the last few things I want to get done before he comes. I finally finished knitting a little sleep sack for him and am almost done making a new cover for the bassinet.

MM and I are looking forward to a few quiet days home alone together. Our families are in the South and Midwest, so it's just us this holiday. We don't have any commitments other than a reservation for Christmas dinner. I think we're going to try and pack in several movies since it looks like it's going to be rainy.

Merry Christmas Eve!

Still Here

2008-12-19T10:31:00.000-08:00

Just wanted to say I'm still here and still pregnant. We've been pretty busy lately. Not so much with baby preparations, but taking care of family stuff. My father-in-law arrived with his wife and her daughter a week ago. He was very sick when he arrived (after a 15 + hour flight from China), and was admitted to the hospital for the next 6 days. Thankfully, he is recovering well and is now home with us for the next few days until he's able to travel to his final destination in Arkansas for the holidays.

In other news, I am still having contractions daily, but nothing regular. They seem to be worse at night and in the early morning. I've still been able to control my diabetes with my diet alone with one exception--I had a little binge the other night. Some friends brought over homemade cookies and fudge for our housemate. It was just too tempting. I had 3 cookies and 2 pieces of fudge. My blood sugar was almost 160 afterward. I apologized to the baby and vowed to do better. It's hard sometimes.

Things are pretty much in place for labor and delivery. I will pick up the AquaDoula on Monday when I'm 38 weeks, so I can labor comfortably (is that really possible?) at home and there's room for MM to join me in the tub if needed.

I had a great episode of "pregnant brain" earlier this week. A friend brought dinner over with some grapefruit to have for dessert. When it came time to cut them up and serve them we could only find one of the two. We blamed it on Sadie (the 16 month old cutie), but later found it in the upper cabinet with the glasses. Yes, I put the grapefruit away with the glasses. Classic.

The time is really getting short and I am realizing more and more that my time "alone" is limited. I'm so excited, and of course a little nervous. I know my life will change. It's just a matter of time now.

No Stops

2008-12-07T21:38:00.000-08:00

I've officially reached the point where no one will try and stop me if my body decides to go into labor! It's pretty crazy to think how close to delivery we are.

The hand-me-down bassinet arrived this weekend, the car seat is in the car (though not properly installed), and diapers are in the washer. Our oven is out, so I'm not cooking and freezing like I had planned, but otherwise I think we're on track.

I have had a few emotional moments the past few days reflecting on where we've been and where we are. We went to get our Christmas tree the other day (I love a real tree in the house). MM and I were decorating it and listening to Christmas music last night. It was a beautiful, quiet night and I just started crying one of those wonderful happy cries. I was thinking about all the Christmases we have shared over the past 8 years together, the happy ones and the sad ones, and looking forward to sharing this tradition with our son for many years to come. It still seems too good to be true sometimes.

Breathing Easy

2008-11-30T19:55:00.000-08:00

With 35 weeks right around the corner (tomorrow in fact), I'm much more relaxed and have let myself get out and enjoy this beautiful time in life a little more.

We had guests in for the Thanksgiving holiday--our house-mate's family. We enjoyed having some pseudo-family around, but didn't feel much pressure around entertaining. The ten of us (8 adults and 2 kids) went to some local vineyards for the Holiday Open House to check out the fall colors and sample some fun food and wine pairings (don't worry, I was a designated driver). The next day we hit the beach.

It's nice to be out in the world again after so many weeks around the house. People are really sweet (for the most part). I do get some of the, "You need to eat more," when people find out when I'm due. I'm always torn between smiling and nodding and telling them, "Actually I have gestational diabetes and am following a strict diet, but thanks for your concern."

It's really hitting me these past few weeks that this is something I may never get to experience again. I know I've said it before, but I'm so thankful for this pregnancy and the little boy that is rowing inside.

Milestone

2008-11-24T15:12:00.000-08:00

If you look at the little baby counter on the right today, you'll notice it says 34 weeks, or 6 weeks to go. I am breathing a huge sigh of relief today, knowing that if my little man decided to make an early appearance, everything would be OK. Sure, I'd still like to get to 36 or 38 weeks, but today I am happy for what I have--a healthy growing boy with 34 weeks of gestation under his belt. The last few days I've really started enjoying the pregnancy and preparation again since the anxiety is fading away. MM asked me the other day if I was ready to have this baby, and I think I am, at least as much as I can be. I haven't been listening to my hypnobirthing CDs like I wanted, I'm not meditating or practicing yoga like I would like, but still, I feel ready.

At my last appointment I talked with my midwife about our plans for the home birth. She said the gestational diabetes makes our window of comfort a little smaller. If everything was normal, she would say home birth is OK between 36 and 41-42 weeks, but since GDM delays fetal lung maturity and he's a white boy (statistically the slowest to mature and worst outcomes pre-term), potentially a very fat white boy (GDM will also mean he's bigger than he would otherwise be), she would feel better if we delivered at home only between 37 and 40 weeks. Also, chances are good that I'll be induced if I go past my due date (again, thanks to GDM) which would of course mean a hospital birth. It's a little disappointing, but I didn't get into this so I could have a home birth, I got into this so I could have a baby and be a mom. However that happens at this point is fine with me.

Part-time work is going well. It's just enough to keep me interacting and engaged with the world outside home and baby preparations, but not so much that I'm contracting and totally exhausted. I have started having some lovely swelling of my lower extremities--yep, some days I have cankles. Otherwise I feel pretty good.

Blood sugar is still in check without insulin thanks to the steady diet of ham (nitrite free :), eggs, cheese, avacado, nuts, and peanut butter, with an occasional half an apple and veggies. I gave myself a pass not to check my blood sugar after meals this weekend. I didn't eat anything I hadn't eaten before, and I was enjoying a much needed day out with MM and didn't want to poke my finger one more time. Otherwise I've been a great patient, I promise.

I can hardly believe we've made it this far. It's truly amazing. He will be here so soon!

Baby Needs

2008-11-11T19:34:00.000-08:00

I'm finally starting to think this whole thing might really work out now that I'm over the 32 week hump. Until the past few days, I hadn't felt much of a sense of urgency about preparing for the little guy. What do babies really need anyway? Mostly boobs and diapers from what I can tell. I actually started leaking some colostrum last week, so it looks like all systems are go on the first count. As far as the diapers, thanks to the generous gift of several friends, we're pretty much all fixed up with our cloth diapering goodies as well.

I think that's one of the best things about this process, experiencing the love and generosity of our community. We've already been given more than we even need. It's really amazing. It feels good to bring this baby into a place where he is so loved. To me, that's just as important as boobs and diapers.

Food for a day

2008-11-06T18:26:00.000-08:00

I know you're just dying to know what I'm eating these days. Listed below is my 24 hour recall from yesterday, my first official day with GDM.
Here's the run-down:

Breakfast: 2 slices of bacon, 1 oz. cheese, 1/2 avacado (3 protein, 1 fat)

Snack I: 1 oz cheese (1 protein)

Lunch: 2 oz grilled chicken, lettuce, tomato--the inside of a grilled chicken sandwich (2 protein, 2 veggies)

Snack II: 1/4 c cashews (1 fat)

Snack III: raw carrots, 2 Tbs. peanut butter, 1 oz. cheese (3 protein, 1 veggie)

Dinner: spinach salad with cheese, dried cranberries, & sunflower seeds, small serving lasagna (2 veggies, 2 protein, 1 fruit, 2 starch)

Dessert: pumpkin pie (small slice) with 2 Tbs. real whipped cream--I only made it with 1/2 the sugar (2 fat, 2 sweet/carb)

Daily Total: Protein-11, Fat-4, Starch-2, Veggie-5, Fruit-1, Sweets-2

I think the nutritionist would be proud. My blood sugars were all under 101. This isn't necessarily the perfect diet for everyone with GDM, but I'm not supposed to worry about calories, so I can eat all the fat and protein my body can handle. Oh, and when it says cheese, I do try to mix it up and not always eat the same kind of cheese, but your right Mo, I do love cheese :).

GDM

2008-11-05T20:06:00.000-08:00

It's official. I have Gestational Diabetes. I got to put off the 3 hour GTT for a few weeks while I was contracting like crazy, but now that things seem to have calmed down I had to buck up and do it.

If you've never had the pleasure of getting blood drawn 4 times in a 3 hour period while eating or drinking nothing but a syrupy sweet orange glucose drink (100g of glucose), well, I hope you never do.

Between my elevated 1 hour test and this one I had been checking my blood sugars at home. They were OK, so I wasn't too worried. I do have a strong family history of Type II diabetes, but I've always kept a pretty healthy lifestyle and weight. I hoped that would protect me, but pregnancy apparently trumps lifestyle in my case. My 1, 2, and 3 hour blood sugars were high. Difininive diagnosis--GDM.

I met with the nutritionist and reviewed my diet. She agreed it was healthy, but not what my body needs right now. My instructions are to get 10-11 servings of protein/day (including cheese, but excluding other dairy) and only 4 servings of grain, and 1 serving of fruit. No juice, no milk, but all the water and caffeine-free tea (no sugar or honey) I want.

I spent a good part of the day today eating and/or thinking/planning to eat. I was successful in eating my daily recommended servings of protein and didn't even have my fruit. Blood sugars were excellent fasting and after meals (I'm checking 4 X/day). So hopefully if I keep this up I'll be able to avoid any complications or insulin. It's just another annoyance right now, but I can do it for another 2 months.

Progress

2008-10-28T11:27:00.000-07:00

The report on my cervix from the midwife today is still closed, long, and soft. No cervical changes and no meds since Saturday means I'm going to try to go back to work on modified duty (sitting only) a few hours/week starting next week. Nobody wants me to start contracting again, but I'm feeling pretty good and think a change of scenery would be nice. If my uterus starts acting up again I can always come back home.

This weekend was a little bit of a trial run. I got the go ahead to be up and about more than I had been. MM and I went to a movie (W.--worth seeing) and I went out with a girlfriend to a local baby store. I tolerated the outings pretty well, so feel good about trying a little work.

I'm past the 30 week mark and looking forward to 32!

Happy Day

2008-10-25T10:26:00.000-07:00

Things are looking up for me and the little one. I didn't need to take my Nifedipine at all yesterday as the contractions have slowed down considerably. In other good news, I got a negative fetal fibronectin!!! I wasn't expecting it to change, since we were testing so close to the first, but I'm so happy to have this piece of reassuring news. This means the chances of a delivery in the next 10-14 is days very low, which means I'll probably make it to at least 32 weeks. Needless to say I'm thrilled! This also means I'm free to go to a movie this weekend and try being up a little more. If everything is still OK at my appointment on Tuesday I may even be able to go back to work on a very part-time basis.

Thank you so much for your calls, visits, comments, and thoughts during this time of uncertainty. I really appreciate it.

Unchanged

2008-10-21T11:59:00.000-07:00

The last few days have been fairly uneventful--as it should be. I haven't been to the hospital since Saturday, and my cervix was essentially unchanged on exam today. I'm still having contractions, but not very regularly.

I'm doing everything I can to keep my baby safe inside, but the outcome is out of my control. I have probably mentioned before that as a rule, I'm a planner. This whole thing has changed a lot of plans already. The uncertainty and anxiety can be difficult to handle. Will I be able to go back to work? Will he come early? Will he be healthy? It's hard to put these questions aside and just be with myself in the moment. It's also hard not to feel let down by my body. It wasn't enough that I had such a hard time getting pregnant, now my uterus may be trying to get rid of this kid before he's ready. What is wrong with me!

I know it's pointless to go down this road. There's no way of knowing what is really going on in there. It's all a mystery. We take it as it comes.

As for the update on me and my sedentary life, I'm thinking about doing some admin work from home to help keep my mind engaged and help me feel useful. So far I've finished a knitting project, read a book, talked to lots of friends and family, scoured craigslist (I'm kind of an addict), organized some old photos, and thought a lot about my little boy. Nothing else is new. My OB might repeat the fetal fibronectin on Friday, but if everything stays quiet I shouldn't have any more exams or appointments until then.

Oh, one exciting thing is we have a friend coming over to the house tonight to take some pregnant pictures of me and MM. I figure now is as good a time as any. I'll post some in the next few days when I get them back. I'll try not to look too gross and bed resty.

Not Reassured

2008-10-17T17:18:00.000-07:00

By yesterday afternoon/evening my contractions had really slowed down and I was just sure that my fetal fibronectin test would come back negative today (negative being good this time). I was wrong.

MM and I went in this morning for the test. My cervix hadn't changed, so I went back home to wait. I sent MM off to work and a couple of hours later my midwife called. I could tell from the tone of her voice that the results weren't what we had all hoped for. She said I should come in for my betamethasone injection (to mature baby's lungs in case he comes early) and to be monitored. She asked if MM was home, when I told her he wasn't, she offered to come to the house and pick me up. I think she could tell I was kind of loosing it. I called MM, told him the story, packed a few things to keep me distracted in the hospital and waited for my fairy godmother of a midwife to come and get me.

In case you're feeling jilted because your midwife/doctor never came to pick you up from home, I should let you know that I'm getting my prenatal care from the clinic where I work. I'm an NP on the Family Medicine side, but have a great relationship with the OBs and midwives. Sometimes it's nice to be a VIP.

Once we arrived at the hospital, I got hooked up to the monitor and proceeded to start contracting much more frequently than I had been at home--like 5 X in 10 minutes. That was enough to get everyone a little unnerved, so I got a shot of terbutaline to settle things down on top of my regular nifedipine dose. That seemed to do the trick, but they still had me stay for several hours to keep an eye on everything.

Baby Boy didn't seem to mind. He's still movin' and goovin' in there, and his heart rate stayed stable during the contractions, although we both got a little tachycardic after the terbutaline--that stuff is strong.

The OB came to check my cervix again before she let me go. The report is closed, long, and soft. All good except for the soft part, but I'll take long and closed any time.

I'm back home now on modified bed rest. I won't be going in to work for at least the next 2 weeks, which I really wasn't ready for, but it is what it is. I'll do whatever I need to to keep my baby inside for as long as possible. We'll go in tomorrow for the second shot of betamethasone. The OB said the weekend will be critical. We should know more what direction things are headed by Monday.

So that's the story. I wish it was a different one, but it's mine, and it's still not so bad. My baby is healthy and growing inside me, my cervix is closed and long, and my "bag of water" is intact. All things to be happy about.

Thanks so much for sharing your well-wishes and happy-ending stories. It really does help. Now, any fabulous ideas for passing the time while on bedrest?

Sleepless Night

2008-10-15T12:57:00.000-07:00

This morning around 4 AM, I thought we might be meeting our baby boy sooner than we hoped. I woke up last night around 3 AM with steady, regular contractions. They weren't painful, but weren't letting up either. I drank half a liter of water and laid back down. Still no dice. After about an hour, I called the OB, who suggested I come in, get monitored and checked.

Once I got up to the OB floor the monitor confirmed what I had been feeling--I was having regular contractions. When the OB came in to check my cervix I was already pretty freaked out. I had noticed a little bit of fluid leaking, so one of the nurses did an amnio swab that looked positive for amniotic fluid, indicating premature rupture of membranes. If you're reading this and you don't know, when your membrane breaks, you're having the baby within a day or two one way or another. As happy as I was to make it to my 28 week goal, I was still not ready to deal with a pre-term delivery. I was very relieved to find out that lots of things can give you a false-positive amnio swab, and upon further investigation (sterile speculum exam and ferning test) it looked like my membranes were still intact. As far as the other labor markers, it was mostly good news. Even though I was having regular contractions, my cervix was still closed and about 3 cm long. It was getting a little "mushy" though (starting the effacement process). I was given a dose of Nifedipine to help stop the contractions, and stayed on the monitor for several hours.

The ultrasound tech came in and did a formal ultrasound to check my Amniotic Fluid Index (AFI) and fetal weight. It was fun to see him again--and yes, it's still a boy. He weighs right at 3 lbs and my AFI was 18--also good. My blood work showed that I am anemic (yes, I had been slacking on my supplemental iron), but otherwise fine. No signs of infection and no clear cause for my premature contractions. After my contractions slowed to about 1 an hour they released me to go home and rest the rest of the week on Nifedipine every 4-6 hours. The plan is that if I have more than 4-5 contractions/hour I go back to the hospital. If they stay farther apart, like they are now, I will go in Friday morning for a Fetal Fibronectin test. If that's negative, we'll all feel a lot better. Apparently, the negative predictive value of the test is pretty strong. If I get a negative on Friday it means that there is little to no chance that I'll deliver in the next 7-10 days. If it's positive, I may or may not deliver pre-term.

So, it's been an emotional and tiring 15 hours. I was really enjoying the pregnancy and looking forward to the last trimester. Today I had to face the possibility that some of my hopes and dreams for a normal and healthy pregnancy, delivery, and baby might not be realized. I am trying to stay positive. I know that it's possible that this will pass and I'll carry our baby to term, but it's hard right now.

Birth Stories

2008-10-09T20:41:00.000-07:00

This is my 100th post. Apparently this is some kind of blogging milestone. When I started the blog I had no idea how long it would go on (I hoped the IF part would be short and sweet). Fourteen months and 100 posts later I'm writing about my upcoming labor and delivery. Wow.

MM and I went to our first childbirth class this week. We had a hard time coordinating our schedules, but finally found an evening that would work for both of us. The class was at a local birthing center, but is open to anyone regardless of where they plan to deliver. As for us, we have decided to plan for a home birth. The hospital is only 5-10 minutes away if we need to make a move at some point. I've spent a lot of time thinking about this and evaluating my options. I am not against hospital births, but feel like I'll be most comfortable laboring on my own time, however I need to, in an environment where I'm comfortable, and where I know and trust the people around me.

On my recent visit with family I collected birth stories from my grandmothers about their experiences and those of their mothers. It feels good to have great cloud of women who have birthed before me in dining rooms and bedrooms without the benefit of skilled practitioners and technology that is now available to me even at home.

It was striking as I heard their stories to hear the changes that happened over time. As birth moved from home to hospital, there were more problems, more interventions, more "failures". I am not naive about the risks of unattended birth or the complications that often occurred at many of these early home births, but none of the stories I heard ended in death or disability for mother or baby. I understand that interventions are sometimes necessary, but often they are unnecessary and risky.

I know that my labor may not turn out as I hope, that I may end up in the hospital or with a Cesarean, but right now I'm enjoying planning my birth at home. If there are any veteran home-birthers with suggestions/advice I'd love to hear it.

Casual Traveler

2008-10-05T20:22:00.000-07:00

I just returned from my swing state tour (VA, MO, and AR), also known as the end of second trimester, see-everyone-you-need-to-see trip.

When I arrived at the airport, there were new signs at security. The first was for "Families and Special Assistance," the second, "Casual Traveler," and the last, "Expert Traveler." It struck me that this would me my last trip as a casual or expert traveler for quite a while. Apparently once you're traveling with kids, special assistance is required.

I had a great time visiting family and friends. I won't be traveling for the holidays, so it was nice to see everyone now. I got some good belly lovin' on the trip. I also got to hang out with my brother and sister-in-law who is pregnant and due in November. I went to one of her OB appointments while I was there and got to see my nephew on the ultrasound. I wish I could be there to see him when he's born, but I'll be too far along by that time to fly back.

Things are looking good for me in my 27th week. One week 'till my 28 week goal!

Viability Blues

2008-09-21T22:37:00.000-07:00

I've been having a hard time since I hit 24 weeks with what I'm calling the viability blues. As a nurse who worked in Pediatric ICU for almost 3 years, I've seen more than enough ex-preemies with varying degrees of physical, neurological, and developmental deficits to make a momma nervous.

There's still some debate about what the point of viability is, but 24-26 weeks is right on the edge for me. I have fears of preterm labor or premature rupture. I'm having trouble sleeping.

I'm not high risk. All indications are that little man is healthy, growing, and on track for a term delivery. But that's just it--there's no good way to predict who will give birth preterm and who won't.

For now I'm setting smaller goals. I don't need to get to 40 weeks, even 28 would make me feel a lot better. After that, 32 would be great.

It's strange to be here at 24 weeks, wondering and worrying, when for so long I doubted if I'd even get pregnant. Now I am, and I'm really attached. I can't imagine the pain of a loss at this point.

I'm leaving for a 10 day trip on Wed to visit some friends from Nursing school and then to see my family. By the time I get home I'll be 27 weeks. The trip should be a good distraction. I'm taking a copy of my prenatal record, just so nothing will happen.

That's my story here at almost 25 weeks. Thanks for checking in.

Good Days

2008-09-07T19:40:00.000-07:00

The last few weeks have been really fun. I'm enjoying the increased energy of the second trimester and taking advantage of the freedom and kid-less time.

MM has been out of town all week, and out of range (backpacking for a week--for work). It's strange to be without him now. Pregnancy somehow makes me feel a little more vulnerable, but everything has been fine. I freaked out for about an hour yesterday when I had some funny pelvic pain, but it went away.

I went out with friends yesterday to a big festival at the park, "Power to the Peaceful." The music was good and there was some great people-watching. Lots of people were there with kids, but I was glad to be without for now. I didn't get the onesie above at the festival, but it was definitely that kind of thing. Peace, Love, and all that jazz. Ziggy Marley was great.

That's the update for now. Twenty-three weeks tomorrow!

He Moves

2008-08-27T22:40:00.000-07:00

Little man is getting more and more active. I don't feel him much during the day while I'm at work, but at night when I quiet down, he wakes up. Last night MM and our house mate Nena both felt him squirming around in there.

Everyone says it, but it truly is amazing. To feel another little person inside, living and moving. Sometimes it catches me off guard and I can't help but laugh.

There have been so many times when I wondered if I would ever experience this, and now I am. Sometimes it seems too good to be true and I worry that something could still go wrong, but I am trying to leave my anxieties and live in gratitude for this moment.

Half Way!

2008-08-19T21:42:00.001-07:00

This is me at 20 weeks! Definitely pregnant, right? So maybe the baby blue and horizontal stripes accentuate the effect. Still, most people who don't know for sure aren't willing to risk embarrassment by asking--until today. Yes, it's a major milestone worthy of documenting. One of my elderly patients asked if I was expecting. I was thrilled to tell her yes, and she was excited to hear the news. I can't believe it's half way over. I'm still enjoying almost every minute.

More Results

2008-08-17T20:38:00.000-07:00

Our Genetics Counselor called last week to give us the numbers. The odds of our baby having Trisomy 18, 21, or a Neural Tube Defect all came back better than our age-adjusted risk. Great News! That's really the last big hoop. Now we're just settling into the last half of pregnancy.

An Anniversary

2008-08-17T20:17:00.000-07:00

This has to be one of the most wanted and planned pregnancies ever. I guess that's why I was surprised last week when I started feeling a little sadness and loss about the change that is coming.

MM and I just celebrated our 8th wedding anniversary. I feel like we're at a really good place in our relationship, and I'm getting a little nervous about how things are going to change when our baby boy is born. I know this is a natural part of the process, and that even though things will change, it doesn't mean our relationship as we know it is over. I'm trying to stop judging my feelings and accept them for what they are. I realize our time as a family of 2 isn't going to last much longer, so we're enjoying it while we can.

We spent our anniversary weekend at at B&B on the coast--just the getaway we needed. I hope we get a few more mini-vacations in before the baby comes. The place was beautiful. There was even a wedding in the garden the afternoon we arrived. It was perfect. The seals cooperated too. I could sit and watch them for hours. They're hilarious.

X & Y

2008-08-07T19:20:00.000-07:00

MM got cold feet about finding out the gender of our little one last night. He didn't feel ready to know that much about our baby. I decided not to fight it, but to let him sleep on it. I was pretty sure he'd come around. It's a good thing he did, because even if we didn't want to know, it would have been hard to miss. Yes, that's right, it's a boy! Complete with all his requisite parts (brain, heart, kidneys, bladder, stomach, penis, etc.) in a 9 oz. package. The placenta isn't over my cervix and we saw the blood flow through the perfect 3 vessel cord just as it should. I got a little teary looking at our little boy there on the screen, thinking about him inside of me, and as a little boy in our arms. This will be our last glimpse before delivery (assuming all continues to go smoothly). I can hardly believe it's almost half over! I'm so, so happy and humbled by the whole experience.

Christmas in August

2008-08-06T22:22:00.000-07:00

It feels like Christmas Eve. The night before we find out if we will have a son or a daughter. I'm so excited! Not sure if I can sleep.

Birth is like a marathon?

2008-08-04T15:25:00.000-07:00

We spent last weekend in the city for the SF Marathon. MM had been training for months, and was excited to finally run the race. The last marathon he ran, we ran together (not exactly together, but we both ran it) almost 8 years ago. I didn't even think about running this one, but that didn't stop me from getting almost teary listening to a woman talk about the pace teams at the expo the day before--that's not normal, it's hormones. I ran one marathon yes, but I am by no means a runner, and don't really aspire to be. Hormones are the only semi-rational explanation.

After the grueling 26.2 mile course around the very hilly city of San Francisco, MM was in a considerable amount of pain. He took the opportunity to tell me that maybe this would help him empathize with my pain in childbirth. While I'm not sure how similar the experiences are, I appreciate the thought.

I've been thinking and reading more about the birth process in the past few weeks. Birthing from Within is a book that was recommended by one of my preceptors in school who was a midwife. I've always remembered it and have given it and recommended it to pregnant friends before me, always looking forward to the day when it would be relevant to me. I bought my own copy about a week ago and have already almost finished it. Her approach is natural and intuitive. MM and I have both found it to be valuable.

As a result, I've also become very interested in the birth stories of other women in my life. If anyone feels like sharing her birth story either here in the comments or by e-mail (or by connecting me to your blog about it) that would be great. I'm not as interested in the play by play as the challenges and emotions of the whole thing. What you remember most, what you loved, what you might change.

So, that's the update at 18 weeks. Still haven't felt any movement, and can't wait to see the little one on ultrasound this Thursday! Looks like the votes are pretty evenly split boy/girl.

Toe in

2008-07-24T21:41:00.000-07:00

Now that I'm 4 months and safely out of the first trimester, I've been able to take hold of this whole pregnancy thing a little more. I've been doing some online searches for baby items, checking out the local retailers, and hitting the consignment and second-hand stores. I haven't actually bought anything baby yet--I'm trying to be an informed and cautious shopper--but I'm definitely testing the waters. If you have kids or have looked into "the industry" it can get a bit overwhelming. I really don't want to go consumer crazy. I've decided that craigslist might be my new best friend.

As for the belly, it continues to grow. I am very grateful to have friends who delivered before me (who are more or less my size), which has cut down on my maternity buying considerably. MM asked the other day, "How much bigger is it going to get?" At first I was a little upset, then I realized he was just sincerely curious. He loves me and my belly at any size.

We had an appointment with our midwife today. I was a little nervous, just because I hadn't had a Doppler or ultrasound since the bleeding episode, but everything looked great. Heart rate in the 150's, uterus sized for my dates, weight and everything right on track. The next exciting step is our level II ultrasound which is scheduled for August 7th. After much thought and minor disagreements, we have decided to find out the gender of this little one if he/she will cooperate. We're so thrilled just to be pregnant, that we don't care what it is--as long as it's a baby. So cast your vote, and we'll let you in on the results in a few weeks!

Baby Bump

2008-07-15T21:10:00.000-07:00

You asked, so here I am at 15 weeks. An almost unmistakeably pregnant belly. I went shopping with a skinny girlfriend who's 1 year postpartum the other day. I had to admit that the only pants I'll be buying for the next 6 months will be unflattering and stretchy. Oh well.

Bright Spots

2008-07-13T22:41:00.000-07:00

I went for my prenatal intake appointment a few weeks ago. I'm a pretty healthy girl (except for the whole IF thing), and hadn't been to the doctor for anything other than fertility-related concerns in over 3 years.

The prenatal intake is extensive. They want to know about everything that has ever been wrong with you or anyone related to you. It's also a bunch of social history questions (drugs, alcohol, etc.). I'm pretty boring all the way around. Then she got to the psychiatric history, "Have you ever been depressed?" Until about a year ago I would have said no, not really. But as you can imagine, the experience of infertility can be a pretty serious blow to the psyche. The support of friends and family was great, but there really is something different about the therapeutic relationship.

I've mentioned going to counseling sessions a couple of times on the blog, but today I felt like giving a little credit to my therapist. I started seeing therapist last spring just before my first appointment with the RE. I've seen her almost every week since then. Some sessions it seemed like I didn't do much except cry. At other times we were able to explore my fears and feelings about family and what it is to be a woman. I've learned to examine myself and my reactions, and to be more authentic in relationships.

The day after I found out I was pregnant I was scheduled to have a phone session with therapist (we were traveling and I couldn't see her in person). On the phone with therapist, for the first time since getting the great news, I cried. I was overwhelmed with appreciation for the relationship that we have developed over the past year and for the ways in which she has helped me grow. That's the crazy thing about therapy. If done well, it creates space and a safe relationship where you are able to question, examine, and grow. Over a year later, pregnant and waiting, I'm a healthier person at least in part because of my work with therapist. I feel more ready to handle motherhood or whatever else comes. If it hadn't been for this whole IF thing, I might never have made the effort to go to therapy. That's my bright spot for today.

Disaster Averted

2008-07-09T22:11:00.000-07:00

Thank you so much for all the thoughts and words of support. After resting for the past 2 days things lightened up considerably, so I went back to work today. I gave myself permission to leave anytime if the bleeding returned, but so far so good. The bleeding seems to have stopped and I feel fine. I'm definitely a little more guarded and cautious than I was before, but am mostly back to my positive pregnant self. Thanks again. I'll keep you posted on me and the babe.

Scared

2008-07-08T13:10:00.000-07:00

Yesterday morning I woke up with a scare--bright red blood. Not a ton, but enough to cause a little freak out. I pulled it together enough to call my midwife who told me to come in right away. I was off work (day after my b-day) and planned to spend a fun day with MM and his dad who is visiting from China. Plans changed.

We left dad at home and went to the clinic to try and find out why I was bleeding. My midwife was great. She said bleeding is never good, but she bled for a month with her 3rd child--heavy--and everything turned out OK. So although she always takes it seriously, she's not quite as scared about it as she used to be.

The little one was still squirming around inside on ultrasound, heart beating and everything. My cervix was closed and long, but the bleeding was definitely coming from there. She said it looked like part of the placenta may have separated from the wall of my uterus. There's nothing to do but wait. She told me to take it easy for a few days and come back if the bleeding gets worse. So far I'm not having any cramping, I'm just laying around at home trying to convince this little baby to stick around. I was just starting to let myself be really excited now that I'm 14 weeks. I don't know what I would do if we lost this child. I'm trying to stay positive, but it's scary. We're just waiting--again.

Testing, testing...

2008-06-27T09:46:00.000-07:00

The weeks keep ticking by, and the little life inside keeps growing. It's still hard to believe (you know, that I'm really pregnant and am going to have a baby). I think most mom's at this stage feel the same way, but maybe more so after infertility. It did become a little more real yesterday when we had the ultrasound for our integrated screen (more on that later). Our last ultrasound was 4 weeks ago. The little blob inside looked more alien than human back then. When our baby came up on the screen yesterday it was undoubtedly a baby. MM was so cute and excited. They had a monitor mounted on the wall so we could watch. He couldn't stay sitting by my side, he had to stand up and get a closer look. We got to see the little one squirming around, standing on his head, stretching out with his little arms behind his head (I'm using the male pronoun in the generic sense). It was lots of fun for both of us. When MM saw the printed profile shot he said, "I think he looks like me," and I think he was totally serious. I had to laugh.

The ultrasound tech said everything looked just fine. Baby measures equal with my dates and the area of nuchal translucency measured 1.2, which is good I guess. This ultrasound was part of the integrated screening test for Downs Syndrome, Trisomy 18, and neural tube defects. It's non invasive and combines the results of a first trimester ultrasound with blood tests in your first and second trimester to give a personalized risk assessment. It's not definitive, since they're not actually looking at the chromosomes, but will give us some more information. Our risk at baseline is very low just because of my age, about 1 in 850 for Downs, 1 in 3000 for Trisomy 18. We almost decided not to do it after we got all the info from the genetic counselor, but since we were already there and we knew we were going to get to see the baby, we decided to go ahead. We won't get any results until after the second trimester blood draw.

In other testing news, I passed my 3 hour glucose tolerance test! So at least for now I do not have gestational diabetes. I'll get screened again in the second trimester, so I'm trying to watch my carb intake.

I think that's the latest and greatest for now. Here are two of the best pictures from the ultrasound yesterday. The first is a full body shot. The head is on the right, the belly on the left with a little hand sticking out in the middle. The second one is a profile shot of the baby's face with a hand up by his mouth. Pretty amazing to think that this little life is actually inside me.

Failed

2008-06-19T18:11:00.000-07:00

I can hardly believe it. I had to do the screening for Gestational Diabetes in my first trimester since my dad has diabetes. I wasn't to worried about it. I'm pretty conscious about healthy eating, I'm active, and not overweight. Nothing to worry about. Then I got the results--failed. The cutoff is 135, my blood sugar was 143 an hour after drinking the glucola. It doesn't mean I have Gestational Diabetes, but I have to take the extended 3 hour test with 4 blood draws. Fun, fun.

I had been pretty much sailing through this pregnancy thing. This is my first real bump in the road. It's not the end of the world, and completely manageable I know, it's just that this wasn't even on my worry list, and here it is. I'll do the fasting 3 hour test tomorrow. Vamos a ver.

10 week updates

2008-06-11T19:37:00.000-07:00

Yes, it's been a while. I'm just not sure what to do with the blog these days. I didn't really intend to write another pregnant person blog--but I'm pregnant--and I have a blog. What to do....for now, I'll roll with the pregnancy thing.

"You look so...healthy." I'm still not exactly sure what this means, but I've been hearing it a lot lately. Is it my face, the extra pounds maybe? I'm only 10 weeks, and I haven't actually gained that much weight, but my body is definitely changing. It's strange and great all at once.

As for the birth center vs. hospital, for now I'm moving forward with the home/hospital scenario. The birth center is still my first choice, but logistically it's a little harder to work out. I still have time to change my mind though.

After my 8 week ultrasound checked out OK my RE said my miscarriage risk went down to less than 2%, so I've stopped worrying so much started freely sharing the good news. The various reactions have been great. Most people knew (or at least suspected) that we'd been trying for a while, so they've all been super-excited. One of my favorite comments was from a medical assistant at work in her 50's who I love and respect. She's a mom of 3 and a grandma. When I told her, she said, "I'd like to be your kid." One of the sweetest compliments ever.

So that's the update. If you are still reading and have any input about the status of the blog feel free to send a comment my way.

Birth Center vs. Hospital

2008-05-25T17:31:00.001-07:00

MM and I visited a free-standing Birth Center close to home last week. We both really liked it. It's a group of 4 CNMs who rotate call. They provide all your prenatal care and are with you through your entire birth. They also provide a dula and have the option of water birth. They focus on birth as a natural and normal process, expecting that things will go well, and are prepared when they don't. Their c-section rate is 5-8% (national average is 30%). They do 220 births/year with an average of 1 ambulance transfer/year. They have a great relationship with the local hospital and will go with you if you have to transfer for any reason. It sounds exactly what I want. So why is there still a question? Insurance of course. My current plan is not contracted with them. I might be able to upgrade to a different plan, but it would still be more out-of-pocket expenses for us. Our system is so screwed up. Care with the midwives at the birth center costs less overall and has great outcomes--but because of the way insurance works it will cost me more. I still have some time to decide. I'm just frustrated that this is even an issue.

Just Gestatin'

2008-05-25T17:08:00.000-07:00

Not much new around here. Just trying to grow a baby. I've been more tired lately, which explains the lack of posting. I went to bed before 9 PM two nights this week (not normal for me). Otherwise, I can't really tell I'm pregnant. I feel so normal that I made the OB I work with do another ultrasound last week just to be sure everything was still OK. I felt so silly. I had seen the heartbeat less than a week ago, I hadn't had any cramping or bleeding, but I was still anxious that something was wrong. Of course it wasn't. The baby is growing, heart is beating, everything is as it should be. I think it's normal to be a little hyper vigilant after this much effort to get here. I'm trying to relax and trust my body. It would be ridiculous to have an ultrasound every week for 34 weeks, right?
This isn't actually my ultrasound, but it looked similar. There's definitely a baby in there.

Polls Closed

2008-05-15T17:31:00.000-07:00

Today was the day. We've been preparing ourselves for the possibility of twins since we got my betas 2 weeks ago. It was a little strange to be back at the REs office, the place where my eggs were retrieved, where "conception" happened, where our embryos spent their fist days. This time I was there not as infertile, but pregnant. Kind of a trip.

Before she went looking around with the ultrasound probe, I asked her if she thought she'd see twins or a singleton. She laughed and said, "Twins--but there might be just one, I've seen about everything." Then the probe went in. First she checked my ovaries, still a little large, but overall they looked good. Then it was on to the uterus, where she found a perfect, single fetus measuring just right for my dates with cardiac movement and everything. Absolutely amazing.

It was a little bit of a let down (more for MM) that the second one didn't stick around, but overall I'm excited at the prospect of a "normal" pregnancy. I wasn't looking forward to the high risk multiples scenario, even though I know there are tons of twin gestations that go perfectly well. For me, it's one less thing to worry about. So, if you were hoping this was going to turn into one of those fabulous blogs about multiples (Suz), you're going to be a little disappointed. Sorry. I'm just excited about my low risk pregnancy. I even called a birthing center today and set up an appointment for a tour and consultation next week!

Madres

2008-05-11T14:48:00.000-07:00

I was so wrapped up in this whole IVF cycle and the shock of pregnancy that I almost missed Mother's Day. Mom's Day is a mixed bag for me and MM. His mom died 3 1/2 years ago, so it's always a little sad. We still have his grandma and aunts, my mom and grandmas, but we both feel the loss of his mom. These "special" days bring it out.

I remember last year when we were trying to get pregnant. I had fantasies of taking a HPT on Mother's Day and getting the plus sign so I could tell MM we were going to be parents. It didn't happen that way of course.

Now, a year later I got my positive result, but I still don't feel like I have license to celebrate the day for myself. I don't look pregnant, I don't feel pregnant, but I am in fact pregnant (I took a HPT a few days ago just to confirm that the betas were actually mine). Maybe the ultrasound on Thursday will make me feel a little more pregnant. I'm looking forward to seeing something other than an empty uterus and hyper-stimulated ovaries.

Next year I hope to be celebrating this day with a 5 month old (or two). Happy Mother's Day.

Clean Sheets

2008-05-06T20:53:00.000-07:00

Monday night I came home to find our bed stripped. While normally this would make me happy, yesterday I was annoyed. I had just washed our sheets the day before, but since I was asleep (on our clean sheets) when MM got home from work I didn't get a chance to tell him. Being the industrious man that he is, he took it upon himself to wash the sheets while I was at work.

I guess there are worse problems to have. Now we have doubly clean sheets, and I have a great husband who is going to be a great dad.

In case you're wondering, I feel fine. No morning sickness or anything yet. I hear it kicks in around 6 weeks, so it should be here before long.

The moment we've all been waiting for...

2008-05-04T10:29:00.000-07:00

Sorry to have left everyone waiting so long for this post. I wasn’t trying to be mean, just wanted to make some phone calls first, then didn’t have wireless like I thought we would this weekend.

I resisted the urge to take a home pregnancy test (mostly because I asked our house mate to hide them) because I decided it would be best to wait for a meaningful result. A paired beta Hcg would be meaningful--a negative or positive home pregnancy test wouldn’t give me as much info. Besides, I had based my plans for work and travel around the assumption that we would find out Wednesday night or Thursday morning. If I waited until then, MM and I would have 3 days together to either celebrate together or comfort each other. That didn't make the wait any easier.

Wednesday was a long day. I got up early and went for a walk with a girlfriend before going in for my second beta. I asked the MA at the office who took my blood if they really made women come in for the second one even if the first one was zero. She said yes. Apparently since she started working there 5 years ago, 2 women have had a positive second beta after their first one was zero. It still seems cruel. I asked them to call the results to MMs phone and leave a message. We decided we would listen to the message together when we both got home from work. After a therapeutic muffin and herbal tea at a local coffee shop, I went to work for one of the most distracted days ever.

During our lunch meeting I looked longingly at my friend and co-worker’s belly—she’s 34 weeks pregnant—and wondered if that would ever be me. I made it through the rest of the day, including a long evening clinic, before I got home to meet MM and get our results. I know I wrote a rather hopeful post on Tuesday night, but by Wednesday I had convinced myself that I probably wasn’t pregnant, but that I would be OK. MM was worried too. I reassured him that I really would survive. Then we listened to the message, “This is Jamie from Dr. __ office. I’m supposed to leave a message with your results. Your wife is totally pregnant…” there was some more after that about instructions for follow-up, etc. but we had both stopped listening. I really couldn’t believe it. I’m pregnant! I’ve never been pregnant and now I am. I thought I would feel different.

It was strange after so many negative results to finally get the positive we’ve been waiting for. Suddenly I'm shifting gears from trying to get pregnant to trying to take care of the little life inside me. Of course I'm aware that this pregnancy is still very early and anything could happen. Right now though, I'm pregnant, and that's cause for lots of celebration.

This experience is at the same time deeply affirming and humbling. I can't help but think about all the other women who are still waiting for their positive. They want it just as bad. Why did it work for me and not them? The mystery and randomness of life is hard to comprehend.

The looming question now is still, how many babies. We won’t know until our ultrasound on May 15th. My quants were 167 and 409. Anybody want to take a guess--one or two?

Good Stuff

2008-04-29T22:40:00.000-07:00

On the eve of the big news, I'm trying to think of things to look forward to--regardless of the result:

1. No more shots! (after tomorrow AM)
2. Road trip with MM this weekend
3. I can make Christmas plans (my EDD will be the first week in Jan)
4. I know I can survive an IVF cycle
5. I have a husband who loves me
6. I have friends and family who support me

I can't believe we'll have our answer in less than 24 hours. Depending on how things go I may not get to post before we leave for our trip, but I have a good feeling. I really think it worked.

Countdown

2008-04-28T20:11:00.000-07:00

We're in the final hours of the wait. This is the worst part. Uncertainty. I had my first quant Hcg today, but won't know anything until after the second one on on Wednesday.

I've been feeling quiet and private lately (hence the lack of posts). I hope to have great news to report soon. Until then, the wait continues and I do what I can to distract myself and hold on to hope.

Addendum: I know I'm just asking for twins with that big 2, but the first countdown graphic I posted (that actually counted down) just ended up staying at 0--which is much more depressing, so I went with 2. Besides, we do have just 2 more days to wait.

Pregnant until proven otherwise

2008-04-20T21:56:00.000-07:00

The 3 days post-transfer have flown by. I'm feeling great, body and spirit. MM and the rest of my support system here have done a great job taking care of me. The shots are starting to wear on me a bit, but I'll do them for nine months if it means we get to be parents.

I'm posting a picture of the embryos or "the twins" as my brother refers to them. I hope at least one has found my womb to be an inviting space to stay for the next nine months or so. I've been thinking about them a lot, floating around in there, hopefully stuck by now. It's crazy that this is how we all started out, just a few cells.

I've decided the best way for me to get through the next two weeks is to assume I am pregnant until a quant Hcg tells me otherwise. Three days down, eleven to go.

The Embryos are in!

2008-04-17T16:31:00.000-07:00

We did it! Transfer day was great (as far as I can tell). We got to the office just as my acupuncturist was arriving. MM was more nervous last night and this morning than I was. I've actually been remarkably calm all week. I really feel like this is going to work. This is huge coming from me, consistently the more pessimistic one throughout the whole process. Anyway, Laurel gave me a treatment before we met with the Doc to go over the embryologist report. The fertilization rate was a little low (7/12). She thought some of the eggs were probably a little immature. Here's what happened to the 7 that fertilized:

One Grade I that had started compacting (still not sure what that means, but it's a good thing)
One 8 celled Grade II
One 6 celled Grade II
Two 5 celled Grade II
One 4 celled Grade II
One 4 celled grade III

She gave us pictures of the top two performers (the Grade I and the 8 celled Grade II) which she then proceeded to transfer into my uterus. Then Laurel returned for a post-transfer treatment. Pretty amazing. We're freezing the others in case this doesn't work.

As far as I can tell we couldn't have asked for much better. Now the waiting begins! I'm trying to plan some nice treats for myself over the next two weeks. I really hope this calm, positive attitude holds out a little longer. It's nice not to be so anxious. I'll try to post a pic of the little embryos that are not inside of me later. I can't believe we really did it. Big stuff.

One or Two

2008-04-15T19:11:00.000-07:00

Apparently my doctor doesn't believe in fertilization reports. It just produces "anxiety" and/or "false hope" since it's common for embryos to arrest between days two and three. So I'm left to wait until Thursday with no other info about my little embryos.

All I can think about is how many we'll transfer. One or two. I know my doctor will give me a recommendation, but she's understandably biased since her reputation depends on her success rates and twins would be a much bigger deal for me than they would be to her. I know we'll have to make the decision in a short and emotionally charged time, so I'm trying to get all the info I can. I really want this to work, but I also want a normal singleton pregnancy. I know we would make adjustments and handle it if we had twins, but the risks of carrying them and the increased cost (not to mention extra work) really scares me.

I'm a little more open to the idea of transferring two after my blind date of sorts. A friend of a friend is pregnant with twins from her third IVF. It was nice to talk to someone in person who has been through this. I had never met her or even seen a picture. Luckily she was the only pregnant woman in the cafe. We had a great chat. She said after the pain and expense of 3 IVFs she's glad she's completing her family all at once. I'm still not convinced, but we could end up with twins even if we transfer one. Maybe I need to stop worrying about it so much.

Otherwise, her main pieces of advice were to pamper myself during the 2ww, not to spend too much time alone, and to plan a getaway the weekend after we find out. Whether we're ecstatic or devastated it will be nice to have something to look forward to.

I'm requesting any and all advice r/t the one or two question, so feel free to leave a comment.

I can't believe the transfer is tomorrow!

Retrieval Report

2008-04-14T22:37:00.000-07:00

First of all, I hate being NPO. Nothing to eat or drink after midnight last night until after my 12:30 PM egg retrieval today (which really meant 2PM). I kept thinking about food, almost reaching for it before I would catch myself. Last night I dreamed that I forgot about the rule and had a huge breakfast so they had to cancel the whole thing. The anesthesiologist was nice and at least let me have clear liquids until 6:30 this morning. I actually set my alarm so I could wake up and drink water. Strange but true.

MM went into work this morning, then came home in time to pick me up for the big day. Everyone at the office was great. The anesthesiologist was very chatty and matronly, probably in her early 60's. I was asking my doctor some questions about where they were going to put the eggs when I started feeling the effects of the propofol. It's such a strange feeling when you're going under. No matter how much you want to hear the answer, or make a smart remark, you're on your way out and there's nothing you can do about it. The next thing I knew I was asking, "Am I supposed to be awake?" and crying. That's what I do post-anesthesia--I cry. It has nothing to do with pain or the emotional nature of the procedure. It's happened before with much less sentimental procedures. I just cry. Luckily I was aware enough to realize what was going on and laugh at myself through the tears. When I was finally coherent enough to speak I asked about the egg count. They retrieved 12! A whole dozen! I was very excited and relieved. The semen specimen looked great as well, so the embryologist said there was no need for ICSI. BTW, the picture at right is a diagram of how the egg retrieval is done. In case you needed a visual.

MM came in to sit with me in my "recovery" while the cute old anesthesiologist went on and on about her sister who went into counseling after she retired from her first career and her son who has some psych issues and her daughter who trains horses. Funny lady. I was a little crampy right at first, but have felt fine ever since. I'm glad that part is over and will anxiously await the embryology report. We're scheduled for the embryo transfer on Thursday. It's so weird to think that right now we could have little 2 celled embryos in a lab. Crazy. I really hope this works.

Trigger Happy

2008-04-13T00:02:00.000-07:00

That's right, it's almost trigger time! Everything looked great on ultrasound today. I still had 12 follicles that look ready to go, so we're scheduled for retrieval at 12:30PM on Monday. Since the trigger injection has to be given exactly 36 hours before retrieval, I get to wake MM up at 12:30 AM to give me the shot.

He's been so great about everything--even the weight gain. I've intentionally gained 5-6 lbs in the past 3 weeks (still trying to boost my BMI a bit). It doesn't sound like much, but I think it all went to my rear. I went to a memorial service for a friend's mom today and had to try on 4 outfits before I found something that fit--and even that was questionable. I keep trying to avoid buying new clothes in the hopes that I'll be getting into maternity clothes, but if that doesn't happen pretty soon I'm going to have to break down and at least buy some new pants.

I'm getting really excited about everything. I can't believe the retrieval is 36 hours away! Thanks again for all the support. It really does help to know there are so many friends and fellow travelers of the infertility path thinking about us.

Huevos Jueves

2008-04-10T19:51:00.000-07:00

Nena lovingly termed today "Huevos Jueves". We made a spinach and chicken chorizo scramble for dinner last night with 12 eggs for good luck. I was a little nervous because I haven't felt anything going on down there. I know some women feel a little abdominal pain or bloating, but I haven't felt a thing.

I have a friend at work who started an IVF cycle, but was a "poor responder" and didn't make it to retrieval. So this felt like a big first test. I was so nervous I couldn't sit still in the waiting room. I kept getting up to get a drink, to look at the books & magazines, anything not to sit still. They came and took my blood for the estradiol level, then escorted me to the room with the ultrasound machine that would tell us if all these hormones and shots were doing any good.

She looked at the lining first--8mm, then the right ovary--6 follicles 11-15 mm each, then the left--8 follicles 11-15 mm. Considering my low antral follicle count and elevated FSH, this is a pretty good response.

I was relieved, but not as excited as I thought I would be. I am painfully aware that this is just the first in a series of small steps that may or may not end in a healthy pregnancy and birth. It is nice to get some good news though. So we'll celebrate the small successes along the way too. The next step is an ultrasound and blood test on Saturday.

The Business of Being Born

2008-04-06T22:38:00.000-07:00

I realize this may seem premature to some. Honestly though, what woman hasn't thought about labor and delivery? Fertile or not.

If you haven't heard of it, The Business of Being Born is a documentary about birth in the US. I highly recommend it. I watched it with a girlfriend who delivered last August. She had a pretty standard hospital birth, (Pitocin, Epidural, etc.) even though that's not really what she wanted. The film really resonated with her.

I know I'm going all high intervention to conceive, but I still want a natural, low intervention birth. All interventions have their place, and I'm open to using the technology we have if and when it really does help, I just don't want to use it blindly or when it's not really needed.

Anyway, check out the movie, let me know what you think. It's available for "instant viewing" on Netflix.

In other news, my estradiol was 85 today. I'm not sure what that really means, but my doctor didn't change my meds, so I guess that's within the expected range. The next blood test/ultrasound is Thursday.

Let the Stim Begin

2008-04-03T21:59:00.000-07:00

Ovaries looked good on ultrasound today. No cysts or anything weird, so tonight we start pumping up my follicles with FSH.

MM was hesitant about the injections at first. The image of having to stick me with a needle to get me pregnant just didn't sit well with him, but he's pretty much over it now.

So far I haven't experienced any side effects from the Lupron. I'm actually feeling more emotionally stable than I have in months, something the whole house is happy about.

I've also noticed my internal monologue around casual encounters with mom's and babies has changed recently. When I see them out for a walk I think, "That's going to be me soon," instead of, "Why can't that be me." I think it's a healthy change. I just hope all this optimism and hope doesn't come crashing down on me if this IVF cycle doesn't work.

"Expect Period Here"

2008-03-30T21:54:00.000-07:00

That's what it says on my cycle calendar for today and sure enough--it came. For the first time in 17 months I didn't have to wonder if I was pregnant. I had no hope or expectation for two lines since I've been on birth control pills for the past 4 weeks. Those little pills are amazingly effective, especially if you're infertile anyway.

This period puts us right on track for the ultrasound on Thursday. The goal is "quiet" ovaries with no cysts or dominant follicles that would delay the start of stimulation. If everything checks out OK I'll start the FSH injections on Thursday night. I'm getting excited, and a little nervous. Thanks for checking in!

Baby in a Box

2008-03-23T22:51:00.000-07:00

First of all I want to say thank you to everyone who commented on the last ICSI post. It was helpful to get more perspectives.

In the end I had a conversation with my doc about it and we decided not to do it. She said she was just worried that I might not have very many eggs to work with, but I think we'll be fine. As far as the "rescue ICSI" you all were right. She said there's no proven efficacy, so they don't do it.

In other news, I finally got my box of meds last week which I have lovingly nicknamed my "baby in a box". The whole process was a bit of a saga, but in the end they arrived on time and intact.

I started my Lupron injections this morning. So far I haven't had any hot flashes, mood swings, or short-term memory loss. I'll keep you posted.

My target week for egg harvest and embryo transfer is April 14th. It's coming soon and I'm feeling more and more confident about our decision to go ahead with it. I initially thought I wouldn't make the April cycle, and was thrown off a bit by the sooner-than-anticipated start. I even considered putting it off another month for no particular reason. I just wasn't sure I was "ready", whatever that means. How can you ever be ready for this?

So here we go. I'm expecting a roller coaster. I just hope that I'm exhilarated and smiling at the end, not throwing up and crying.

ICSI

2008-03-17T21:49:00.000-07:00

I need a little input. For those of you that have been here, what can you tell me about ICSI? We aren't dealing with any male factor issues, but one of my doctors is recommending it (at least she wants me to go ahead and pay for it). I'd rather not do it at this point (I think I've signed up for about all the intervention I can stand already). Thoughts?

A Welcome Reminder

2008-03-17T21:22:00.000-07:00

Over the past month I've had an unusually large number of opportunities to hang out with friends and their kids. I knew it was coming, and was honestly a little nervous about how I would handle it all. In the end it was great. Hanging out with these kids didn't make me bitter (though I'm aware that if this IVF cycle doesn't work out I could easily go there), it just reminded me that I really love kids and I'd be a good mom. This isn't just a quest just to get pregnant (though that is admittedly the first hurdle), it's a quest to have a child and be a mom. It seems obvious, but sometimes I get lost in the process.

Thanks Hannah, Jeremiah, Sadie, Arlo, Ella, and Landon. I've had lots of fun with you and think I'm ready for one of my own.

and the winner is....

2008-03-13T18:13:00.000-07:00

After a week and a half of weighing the options (surgery & waiting vs. IVF) we've decided to go the IVF route (applause & support please).

There were several road blocks to surgery including insurance issues (Dr. C isn't covered on my plan), cost (still not clear if insurance would cover it, even if we changed Docs), and wait time (2 months minimum, then 6-12 months of "trying" again). We just decided that for us right now IVF seems like the best option. It still sounds strange to say, and I'm not completely confident in the decision, but I'm getting there.

The Dance

2008-03-05T21:01:00.001-08:00

MM and I visited this amazing gallery in Mendocino when we were there a few weeks ago. We were walking back into town after catching the sunset. It was after six and all the other galleries were closed, but the Wisdom House was open. We had to check it out.

The artist was there, trying to close up I'm sure, but she didn't rush us. The large canvas works were incredible, but decidedly out of my price range. I found some reasonably priced and beautiful cards that combined Shiloh's artwork with the poetry of Alice Walker. I couldn't find the image online for my favorite, but it said simply, "Hard Times Require Furious Dancing". I had to smile.

Maybe this isn't true for everyone, but I've found that good music and dancing is just about the best pick-me-up. When my body is moving with the rhythm I feel connected to the energy of life. I could be at a live concert or home alone in my living room, it doesn't really matter. I can't be sad when I'm dancing.

Maybe Alice was right, what the world needs is more dancing, less suffering.

No Wrong Decision

2008-03-04T21:36:00.000-08:00

Yesterday MM and I went to see Dr. C. Our appointment was at 7:30 AM about 30 miles from home. With commuter traffic, we were less than thrilled, but glad she was able to squeeze us in. I didn't sleep well the night before because I was alternately afraid that we would 1.) oversleep and miss the appointment or 2.) we would arrive on time only to find that the appointment was actually at 7:30 PM or some other day altogether. Luckily neither nightmare came to pass. We arrived at the appointed date and time.

This appointment was one of those, "Where do we go from here?" visits that you'd just rather not have. She answered all our questions and laid out our options as she saw them. We could attempt a tubal repair (the integrity of the left tube is still questionable) then try "the old fashioned way" for another 6 months to a year or we could move on to IVF. Insurance may or may not cover the surgery ($20K if not covered) and the success rate is unknown, since we won't know exactly what we're dealing with until after the procedure. As I said before, she's pretty conservative, so if it weren't for my low antral follicle count (8 as opposed to 20) she would definitely recommend the surgical option. But since the count is so low, it makes things a little more gray. I think she could see our stress in trying to make the "right" decision. She finally looked at us and said, "There's no wrong decision, do whatever feels best to you." We're taking some time to look into all the options, but are leaning toward an IVF cycle sooner than later.

If I could see the future this would be so much simpler. My fear with the surgery is that we'll try for another year and be in this same place next year, only I'm a year older. Of course I would prefer to conceive "the old fashioned way" but maybe I need to just get over it.

Voices

2008-02-24T22:20:00.000-08:00

Sometimes I feel like I'm hearing voices. Not the really crazy kind, just the back and forth, play the angles, get you all confused kind.

This is what it sounds like:

If we didn't do any other interventions from this point on, we would still conceive "naturally" at some point. I mean, they don't even know for sure why I'm not getting pregnant now.

But what if you don't. You're young now. If you wait another 3-4 years and then try IVF it may be too late.

I know, that's what I'm afraid of. I just wish it would happen now.

This barren time is here to teach you to be at peace and let go of control.

That's ridiculous. This time is only what I make of it. There's no supernatural reason for the state of my womb. It may be a good time to work on my control issues while I'm waiting, but that doesn't mean it will change anything.

You need to wait until you're really ready to do IVF. It will require more of you than you know. Much more than you've had to give up to this point.

How can I ever be ready? What does that even mean? Ready to submit my body to science in hopes of creating life?

That's a little dramatic, don't you think? "Submit your body to science" it's not like they're going to dissect you.

Maybe not, but it just isn't the way I thought it would be. It's not how I wanted it to be. Why is it so hard?!

You're making it even harder by beating yourself up all the time. Just relax. Take a break if you need to.

How can I? There's no real break until we play out all our options and settle somewhere.

What if you shifted all this energy you're putting into trying to get pregnant into some other pursuit? Explore your creativity, throw yourself into your work, go deep into meditation, become a yogi, go back to school, move overseas. This is still your life. You can do so many things.

But I really want a baby. Sooner than later. Maybe I will do those things, but I don't feel like I can do much of anything until I get some resolution to the baby issue.

Fine, if that's really how you feel then go for it, but not right now. You're still too vulnerable from the disappointments and failures of the past year. Take a month to breathe and gather your strength to start again.

No Mas

2008-02-21T17:44:00.000-08:00

This is definitely my least favorite post to write. You know, the one that comes after the two week wait where I have to say it didn't work (again). We tried, we hoped, we waited, we got one line.

I could tell from the way I was feeling on Monday that I wasn't pregnant, but it's hard to say anything before you get the official negative. Everyone wants you to be so positive, like my fatigue and emotional liability could be the result of those blasted hormones or even better yet--pregnancy! I knew it wasn't either of these things. It was just me on the downward spiral to cycle day 1. It's kind of nice to get some warning. It softens the fall a little.

Of course I still took the pregnancy test and had a sliver of hope that I was wrong about the whole thing. That maybe it finally worked, that we would have a baby in November and spend the holidays with family and our newborn baby. Still, I was expecting one line, and wasn't surprised when that's what I got.

After 4 IUIs I think we've played it out. My doc is on vacation, but I talked to her nurse today and I think we're going to move toward IVF. I need some better odds. The disappointment and despair is deep.

An Omen?

2008-02-17T22:05:00.001-08:00

Our time away couldn't have been better. The ocean was beautiful and the weather was sunny with hardly any wind, just like it was supposed to be. It was nice to get totally out of my routine and spend lots of quality time with my man. One day we went beach combing for abalone shells. I'm usually horrible at this kind of thing, but this time I found the most beautiful "baby" abalone shell fully intact. I'm hoping it's a sign of good things to come. Currently I'm 11 days into the wait. I've promised not to pee on a stick until Thursday. I figure with the Provera suppositories my cycle will be longer, so I'm really trying not to get too excited even if I haven't started spotting by then.

If I'm not pregnant this cycle I've decided to blame it on the fact that I ate ice cream at a local creamery while we were away. They had this crazy mushroom ice cream and I had to try it. It tasted more like maple syrup than mushroom. Apparently the flavor comes from candy cap mushrooms that grow in the region--who knew. Anyway, I'm supposed to be avoiding cold/frozen foods since they can drain the kidney yang (I think, or maybe it's just the qui). Don't tell Laurel. I missed my appointment with her and my therapist last week because of our little get away, but it was well worth it.

I'll leave you with a picture of the perfect little abalone shell I found. I hope it brings me good luck this cycle!

Diversion

2008-02-13T21:42:00.000-08:00

I'm about to get a much needed diversion in the midst of the 2ww and I can hardly contain my excitement! It's been too long since MM and I ran away together, so tomorrow we're hitting the road and heading north. I booked a room at a beautiful B&B on the coast. The forecast is mid 60's and sunny with light winds. Not bad for a February weekend.

I'm so excited I almost don't care that I'm still doing these horrible progesterone suppositories three times a day (does that seem excessive to anyone else), or that I'm probably not pregnant this time. I wish we could do this long weekend away thing every cycle to break up the wait. It's nice to have something fun to anticipate instead of just dreading another failed cycle. Diversion is good.

There's a Baby in the House

2008-02-10T10:34:00.000-08:00

I've been thinking about writing about the baby in the house for a while now, but wasn't sure how to do it. I think I didn't want to deal with people's reactions to or judgments about it. But she's been living with us for 2 months now, and she's part of the journey. So here's a little story about the baby in our house.

A very good friend of mine, Nena, got pregnant unexpectedly a little over a year ago. In August she delivered a beautiful baby girl. In September MM and I decided we were ready to move into a bigger place. Around the same time, Nena was looking for a new space for her and the baby. We found a great 4 bedroom 2 bath house and wondered, "What if we lived together?" We decided to give it a go. MM works 4 nights a week until 11 PM, leaving me home and lonely at times, and Nena could use some extra support with the little one too, so it seemed like a good deal for everybody.

We moved in together Dec. 1st, all 4 of us, and it's really been a great 2 months. I think our friends were a little worried at first, "Do they know what they're getting into living with a baby? Won't you miss your privacy?" Honestly I had some reservations too, but so far living with Nena and her little one has been a wonderful gift. I don't even think it's changed the intensity of my desire for motherhood (for better or worse). I want to be a mom and I'm not, she can't change that. What she has done is given me a baby to love and play "auntie" to for now as well as some extra live-in emotional support when things look dark. It's also helped reinforce our capacity to love children that aren't biologically related to us, and makes adoption look like more of an option if this doesn't work out.

Waiting Rooms

2008-02-07T19:21:00.001-08:00

I spent the vast majority of my day "off" today in appointments and waiting rooms. I failed to bring any knitting, so I was forced to catch up on celebrity gossip and the economy.

We kicked off the big day with IUI #4. I had a positive surge yesterday (though I always feel like maybe I imagined it), and since it's a weekday we skipped the trip over the Golden Gate and went looking for the Marin office. It was a much smaller scale operation than the main campus in the city, which was nice in a way. There were only two other women that came in and out while we were there. The doctor made some borderline inappropriate comment about how there was only one person that ejaculated in the office today, so not to worry about a mix up. Thanks--I wasn't worried until you said that.

The fourth try doesn't feel very hopeful. I actually started crying a little on the table when he was doing the IUI. Not because it hurt, but because I know what's coming. The unbearable 2ww and, most likely, another negative. It's hard to hope again every cycle when all I get is disappointment.

Luckily we finished up with the RE just in time to make it to my counseling appointment (I really needed it). From there I went to get my teeth cleaned before ending the day with acupuncture. Sometimes acupuncture is like a second counseling session. I shared my frustrations with Laurel today and she helped me see how I might try to shift my thinking about all the meds and procedures and to see them as my ally rather than my enemy. As much as I want to get pregnant, I have resented the interventions it's taking to get there. I'm realizing more and more how that just doesn't serve me well, so I'm going to work on it.

Thanks for checking in and keeping up. Let the 2 week wait begin.

27 yo G 0 - unexplained infertility

2008-02-04T20:59:00.000-08:00

That's me. 27 year old gravida 0 with unexplained infertility. I was a little taken aback when I saw it typed out on the ultrasound screen yesterday, but that's the pertinent info. My entire OB/GYN history in one line. I've never been pregnant and we're not exactly sure why.

I guess the visit was worthwhile yesterday. I came home with a little more information and another transvaginal ultrasound under my belt. I also got to see my doctor and touch bases about the plan if this doesn't work. This is only the second time I've seen her. The first time I came alone and the second I brought a girlfriend. I'm sure she's used to having various support people come, but I always feel like I need to explain my husband's absence, "He really is supportive and wants this baby, he just works crazy hours." Instead I didn't say anything and just let her do her thing.

As far as the plan, we agreed to start one more clomid/IUI cycle if this one is unsuccessful, and schedule a visit with her about the IVF options during that cycle. That will bring the grand total of medicated IUIs to 5, plus one cycle of meds with timed intercourse. The news about this cycle is that it's still early (I should have started counting from day one of heavy, bright red flow in case you were wondering), so I just had 4 small (12mm) follicles--three on the left (the side that's iffy) and one on the right. Not to worry though, I'm sure two or three will fizzle before it's ovulation time, they always do with me. If I haven't had a positive surge by Friday I'll call for a trigger. Otherwise I should surge Wed or Th and go in for the IUI the following day.

The last week and a half were pretty rough, but I feel like things are settling out a little now. I don't know whether to blame it on the clomid, the lack of acupuncture, too many overnight shifts for MM, stress at work, or the fact that Mercury was in retrograde. Whatever the cause, it's good to feel stable for now. I don't know how long it will last, but I'm not crying now, and that's a good thing.

What day is it?

2008-02-01T10:09:00.000-08:00

When you're trying to conceive, it's not enough to remember that it's Friday, February 1st. It's also cycle day...something. After over a year of trying I still can't get it right. The fact that I'm a nurse has not helped in this regard. Somehow, when you're the one with the problem (not a patient), even things that seemed very obvious and straightforward are no longer so.

Cycle day one. Everyone knows this is counted as the first day of your flow. But what is flow? If I have spotting and light bleeding for 4 days, is that flow? Or is flow that 5th day of heavier bright red blood that only lasts a day? Am I waiting too long to start my meds if I wait until that 5th day or am I starting them too soon when I start on the 3rd day of light flow? I have yet to get a satisfactory answer from any doctor or nurse. Everyones' menses is different, and everyone has a different perception about said menses. Light for me might be heavy to someone else. Why is this so hard?! I thought maybe charting would help, but that hasn't given me any clarity either. After 17 years of periods and 15 months of pretty close scrutiny, I still don't understand my cycles.

So, this round I agreed to an ultrasound on day 8 or 11 (depending on when you start counting) to try and sort things out. That means I'm going to the city on Sunday. The good thing is my doctor is working this weekend, so I'll get to check-in with her. The bad thing is that MM works all day on Sunday. Thankfully a girlfriend is going with me. I just hate going to those things alone. It's hard not to have some expectation, and I never get what I'm expecting. You'd think I would learn to go in with no expectation, but I can't. At least not yet.

Aww Shucks

2008-01-28T22:24:00.000-08:00

Thank you so much for all the hugs and kind words. It's good to know that there are people willing to sit with me in my grief and (someday) in my joy.

OK, I'm done gushing now. No time to rest. That's one of the worst parts of this process, the competing need to rest and keep going at the same time. From the day I start my period I have to start thinking about the next cycle. Call the office...get more meds...the count begins again. This cycle we're going back to Clomid (I didn't feel noticeably different on the Letrazole) with another IUI (#4).

Thanks again for the support. It helps.

Three down...? to go

2008-01-23T22:36:00.000-08:00

There's really no reason to drag it out any longer. I'm not pregnant. This cycle "failed". I thought I wouldn't take it so hard this time. I tried not to get my expectations up, but I'm just not that strong. I wish I could face this deep disappointment with grace and strength, but I can't do much more than just go on. Even that is hard sometimes.

I am tired--deeply tired. I guess most people have been there at some point. The kind of tired that comes from waiting and hoping again and again, from enduring disappointment and loss. The cycle of hope and despair is taking its toll. It's just as painful as it was the first time. It's not getting easier. Every month I feel my body failing me in a way that's hard to explain. It's a disappointment to me, my husband, our family, and everyone who cares about us and there's no end in sight.

I have read the blogs of women who have been on this path much longer than I have, and while it's good to know that life goes on after the third or fourth IVF cycle, it's also scary to think I may be there someday. I'm also afraid of the toll this may take on relationships. At what point do friends and family start to loose hope and instead see us as sad and angry? Will I loose hope? How much disappointment and failure can I take? Will it ever cease to feel like this?

1/24: I wrote this post last night when everything was a little more raw. I cried a lot. MM was great (and disappointed of course). I was able to see my therapist this morning where I cried a lot more. Right now I'm feeling much better and am preparing to face another cycle.

One week down...one to go

2008-01-19T16:06:00.000-08:00

I wish I had something interesting to report, but there's really nothing going on. Our biology dictates this two week wait without sign or symptom and there's nothing nice about it. I was able to sustain my positive momentum for the first 5 days after the IUI. I was visualizing fertilization, the cells dividing, implantation, the whole nine yards. One can only do that for so long. I hit the wall.

Today I feel like I'm probably not pregnant, but that's the trick of it all, there's really no way to know at this point. I have started taking my BBT again, which may be of some use I guess. I've stayed a pretty steady 97.6 since ovulation (which is actually higher than baseline for me), but I keep expecting the big drop every morning when I wake up.

Everyone who has been through it knows that this 2ww seems like such a cruel mind game. I just want to know so I can cry (from joy or grief) and get on with it. Thanks for waiting with me.

Addicted to Acupuncture

2008-01-16T22:44:00.000-08:00

It's never good when your acupuncturist calls past 9PM.
I've been looking forward to my treatment this week since our IUI on Sat. I even contemplated trying to squeeze in an extra visit this week, then decided that was a little ridiculous. I mean, who even knows if this stuff works, right? So when I got the message that she was getting over a bad stomach flu and needed to reschedule I almost cried. I know I should be more compassionate toward her but all I could think was, "What, this is the most important week for me? I've been diligently taking my herbs, rubbing progesterone cream on my belly nightly, and eating more eggs and seeds than I care to admit. I need my acupuncture." I held it together and called her back to tell her our IUI was Sat. and that it would mean so much to me if she could see me anytime tomorrow. I need the needles. I guess she sensed my desperation, so she's seeing me early tomorrow morning. Thanks Laurel!

The Report

2008-01-13T14:32:00.000-08:00

IUI #3 went smoothly. It was our first one at UCSF, so a few things were different. The biggest differences being 1.) MM had to "produce" there at the clinic due to the timing and distance and 2.) we weren't the only ones there on a Sat AM for IUI. It's a strange feeling to be in a room with other couples who you know are there for the same thing you are. You can't exactly strike up a conversation about it, but a part of me wants to.

We had a little time between specimen production and insemination, so went out for brunch. I planned to have an omelelet (my acupuncturist recommend I eat lots of eggs and seeds during this time--a little weird, but what the heck), unfortunately we accidentally ended up at a vegan restaurant, so eggs were out of the question. It was a good, healthy meal nonetheless.

When we arrived back for the IUI we got the Semen Preparation Report. Our previous clinic would just give us a generic, "looks good" or something, but here we got the full report: volume, motility, progression, total motile count--the works. Everything checked out great and MM was pleased with himself. It's crazy to think that 0.3 mL of washed, spun semen can have 47 million sperm. Surely my stubborn eggs will accept one of them, right?

We left the office feeling pretty good. Now we just wait. I got some new herbs to keep me busy (I feel better when I'm doing something), and am trying to meditate to keep myself a little more sane and less anxious in the wait. All positive thoughts are appreciated. I'll let you know how it goes.

Right on track...

2008-01-11T20:39:00.000-08:00

It's cycle day 12 and I got my positive LH surge today! That means we go to the city for IUI in the morning. Send me good egg vibes :). I'll send a complete update in the next few days.

Surge

2008-01-08T22:26:00.000-08:00

That's what I'm waiting for these days-- a surge of LH (luteinizing hormone). That surge triggers ovulation and lets us know it's time for our IUI.

How does one detect a surge? Pee on a stick of course. My new protocol dictates that said pee should be tested between 12 and 3:30 PM, which means I brought my clear blue easy to work and will be discretely testing on my lunch break. Isn't that special. I opted for the basic model, so I don't get the smiley face, just two blue lines. Why do they make the LH predictor kits so much like pregnancy tests? I keep thinking I'm going to pee on the wrong stick one of these days, though I think I went through my stash of pregnancy tests.

This half of the cycle is the easy (well easier) part. The hopeful time when anything is possible. I'm meditating on strong and healthy eggs and looking for the second blue line that means I'm going to ovulate. I so hope it works this time. It seems too good to be true. What if this was really the last month of me not being pregnant? I can hardly imagine. This process, this desire, has become so much a part of my life. What if I got what I wanted? I hope, I hope, I hope!

The Breakup

2008-01-05T10:48:00.000-08:00

I need to tell my previous doctor that I'm seeing someone else. It just wasn't working between us. I think she knows her stuff and is totally competent, but her bedside manner is harsh and cold. I also feel like she's too aggressive and doesn't listen. That being said, I don't want to totally burn the bridge. I still may have to have limited professional interaction with her and I guess there's always a possibility I would need to go back to her at some point.

So I have some options. I could just tell her I'm not going to do the IVF cycle in Feb as planned, and that I'll let her know when I'm ready. That would be partly true. But if I gave her honest feedback about the reason I'm leaving it might give her a little wake-up call. Realistically though, she's probably heard it before and isn't going to change much at this point. Anybody else have experience dumping doctors?

New Year-New Cycle

2008-01-02T21:24:00.000-08:00

This isn't fun anymore. I've been on hiatus from any medical treatments since August. When we stopped, the plan was always to restart in 2008. I thought after 4 months off I'd be ready to "do" something again. And up until a few days ago I was. I didn't want anything to get in the way of starting treatments with this cycle. But for some reason when day one came and it was actually time to pick up the meds and get started I just didn't want to. I want to get pregnant the way "everyone" else does. Without any pills or intrauterine inseminations or urine tests. I'm mad that this is the way it is. I'm not excited (even though everyone acts like I should be) and I'm not very hopeful. I'm just doing it because it's the next step and there's an 8-10/100 chance it could work. Maybe I'll be one of the eight. But odds are I won't. This is just how it is, so here I go again.

Disney Dreams

2007-12-17T21:59:00.000-08:00

I recently returned from a conference in Orlando. I decided it would be just wrong to go there for any length of time and not go to Disney World, so I did. I was 10 or 12 and accompanied by my parents and younger brother the last time I went to the Magic Kingdom. Needless to say, things have changed a bit since then--for me more so than the Magic Kingdom I discovered.

"When you wish upon a star...anything your heart desires will come to you," just didn't have the same ring it did back then. I spent some time trying to come up with new lyrics to the Disney tune that are more reflective of life's complexity. You know, something like, "Please don't wish upon a star, it won't get you very far, sometimes you'll get what you want, or you may not."

Granted, it's not very catchy, but it's more honest. Maybe the whole Disney thing is a necessary stage of development, I don't know. When are kids able to understand and accept the somewhat ordered chaos that is life without fearing that they'll be overcome?

It feels like a lot of adults want to escape to the land of Disney too--to go to a place where everything is magical and your wishes come true. Not that I've stopped wishing or hoping, but I'm putting some action with my hopes.

Second Opinions

2007-12-08T21:58:00.000-08:00

My appointment with the Repo Endo at UCSF was surprising…but good…or at least not bad. Granted, it was a terrible time for the appointment (I’m highly emotional pre-menstrually), and I cried at regular intervals (I didn't even make it through the "how long is your cycle" question--no kidding).

I really just wanted to talk and get a second opinion, but of course I got another complete intake exam, including my favorite--transvaginal ultrasound with antral follicle count. It’s not your average ultrasound. When they’re probing around deep and looking for follicles in your ovaries, it can get a little painful. Not to mention the anticipation of watching the screen for any signs of follicles, and hearing the count—8 (that’s 4 less than my other doctor saw 6 months ago).

I was sure she would agree with my other doc's recommendation and give me her blessing to go forward with IVF. When she didn’t, I was stunned. You’d think I’d be happy to hear that I may not be as bad off as I thought. But when she said she thinks I should do two more cycles of clomid (or letrozole) with IUI before moving on to IVF my heart dropped. I was so ready to go forward, pull out the “big guns” and get some answers. I already had a week off work and have been telling everyone February is the month.

I asked a lot of questions and she was very patient with me. She showed me some concrete data and talked about research that she is involved in. She said that FSH is not predictive of pregnancy rates (for IVF cycles) in women under 38. She's also seen cases in young women who don't respond to aggressive stimulation (as in egg donors), but can produce one good egg and have a successful pregnancy.

She also wants to actually see the films from my HSG. Depending on where the adhesions are she felt like surgery might be helpful.

When I left her office I was totally confused, but over the next few days things settled out a little. There's really not much to loose with two more cycles, and there's a lot of potential gain (less cost, less stress, less risk) if it works. I know the odds are still only 8-10% per cycle, but my acupuncturist is sure we can bump the odds up a bit with acupuncture and herbs. I also think I need a little more experience with disappointment before I potentially face the BIG disappointment that a failed IVF cycle would be.

So, I'm waiting to hear about possible surgery, then gearing up for a few more IUI cycles before the big IVF.

Open Enrollment

2007-11-28T19:54:00.000-08:00

It's open enrollment time at my place of employment. I'm considering doing what I never thought I'd do--sign up for Kaiser. You may or may not be familiar with the HMO giant of the west coast. To some it's the devil to others a savior. I won't go into my personal feelings about it, let's just say they're mixed.

The reason I'm thinking of going to the "other side" is that they will cover 50% of infertility services including IVF (at least according the reps, I'll call member services to confirm). My current Blue Cross plan covers 0%. That's a significant difference. My only concern is that there will be a long waiting list or they'll make me jump through a bunch of hoops that I've already been through to prove that I really need IVF. I'm hoping that with two independent recommendations and my demonstrated "failures" with other means they'll let me move quickly to IVF.

Has anyone else used Kaiser for IVF? I'd really like to get some feedback from women who have done both the private and big HMO way. I have to decide by Dec. 12, so I have a little time to do some more research. Thoughts?

Exposed

2007-11-26T20:03:00.000-08:00

If you didn't hear Fresh Air today, please listen to the podcast (available at www.npr.org by selecting programs tab, then Fresh Air...sorry, I'm incapable of making links work).

Mark Schapiro spoke with Terry Gross about his new book, Exposed: The Toxic Chemistry of Everyday Products and What's at Stake for American Power. I could give you my interpretation of the interview, but I think NPR has a pretty good synopsis:

Investigative reporter Mark Schapiro explains in a new book that toxic chemicals exist in many of the products we handle every day — agents that can cause cancer, genetic damage and birth defects, lacing everything from our gadgets to our toys to our beauty products.

And unlike the European Union, the U.S. doesn't require businesses to minimize them — or even to list them, so consumers can evaluate the risks. Schapiro argues that that policy isn't just bad for public health: In an increasingly green economy, he says, American businesses stand to get shut out of a huge market.

One of the main reasons the EU is so inclined to look ahead to long-term health consequences of chemicals used to manufacture these products is that European governments pay for health care (it's not just because they're so progressive and environmentally conscious). They actually have an incentive to keep people healthy, what a concept! When you get cancer in the US it's on your dime. Too often our government is more concerned about what's good for business than what's good for people (I know, it's been said a million times, but it's too true).

The crazy about this "bad for business" argument, is that when the EU implemented stricter regulations on chemicals and toxins they did not experience the big hit to business that US regulators and businesses are so concerned about. There wasn't any measurable effect to the market.

Call me crazy, but I strongly believe that these toxins, so pervasive in our modern life, are one of the factors contributing to the rise in endocrine and hormone related problems, including infertility.

Let's stop being afraid to demand more from our elected officials and regulatory bodies. I'm tired of seeing the consequences of inaction.

Culture and conception

2007-11-20T21:37:00.000-08:00

I saw a young father and his daughter in clinic the other day. We were finishing up the visit when he asked if I had children. I shook my head and told him no, not yet. In response he said something that roughly translates to, "that's weird".

To this young Mexican immigrant the idea that a married woman of my age would not have children was just that--weird. He didn't mean any offense, he just thought it was strange. On the other hand, I know people in their 30's who are single, or married but not ready for kids, who would be find it equally strange that we're even thinking of having kids at such a young age.

We all make decisions. Which is better? I guess it depends on where you're coming from. At every stage of life and in seemingly every decision, we are influenced by our culture, why should conception be any different.

Shopping

2007-11-18T22:35:00.000-08:00

Many mundane and everyday things take on new significance when you're living in the limbo land that is "trying" to get pregnant. For example, shopping.

My sister-in-law is getting married in December. I've been thinking about buying a new dress for months now. Every time I went into a store to look I couldn't stop thinking (hoping), "...maybe I'll be pregnant by then...I don't want to buy a dress I won't be able to fit into." Then I would look at things with empire waists that I might be able to pull off either way (like the one pictured). The thing about this strategy is that you run the risk of looking pregnant when you aren't. I don't want people jumping the gun on me. Besides, if I'm not pregnant I need to embrace my non-pregnant body. I finally decided to go for it and bought a dress this weekend (that doesn't make me look pregnant). By this time even if I were to conceive between now and December 22 I wouldn't be showing. So I figure I'm safe.

It's really happening...

2007-11-11T17:07:00.001-08:00

We finally had our pre-IVF visit last week to go over the treatment calendar, medications, etc. I had hoped we wouldn't get to this point, but my ovaries aren't getting any younger, and I'm still not pregnant, so we're moving forward. I do have an appointment for a second opinion at UCSF in early December, but I don't really expect they'll tell me anything different. It will just be nice to have another set of experts review my history and give recommendations.

The IVF consult was overwhelming to say the least. I'll have to be on 9 different medications throughout the cycle including an injection in the morning and two in the evening. I'll have 6-8 appointments for various ultrasounds and blood tests before and after the egg retrieval and embryo transfer.

We left the office feeling a mix of excitement and fear. Excited that we might be pregnant in the next 4-6 months, afraid we won't be. What else can you do though. I guess those are pretty normal feelings.

We decided to wait to start any of the meds until after the holidays. I don't want to be all pumped up on hormones, worried about keeping my follistim cold and staying on schedule while we're visiting family. I can't help but hope that next year we'll be taking a baby to meet the extended family too, but I'm trying to take it a day (at least a month) at a time.

There's always a reason

2007-11-05T21:20:00.001-08:00

One thing I still have a hard time getting away from with all this is the need for cause and effect. I believe (I think I've said this before) that some things just happen. There's no reason, at least no good reason. Still, I find my self wondering, trying to pin the blame on something.

Yes, my doctors have given me reasons: my hormones are off, my left tube is blocked, I don't have many antral folicles, I have endometriosis...but why is all that stuff messed up?

"Well, I did have a glass of wine that night...I didn't eat very much today...I have a stressful job...I forgot to take my herbs...it's been a while since I went to yoga...I can't take care of myself sometimes, maybe I'm not ready for a baby..."

In my rational mind I know that none of these things are preventing me from conceiving right now, but when I'm looking for a reason it's easy to go there--to blame myself somehow. It must be my fault. Something I did or didn't do. I don't know if there's really any getting over that feeling. I am working on it though, and it's not as strong as it has been.

It's a hard balance. I know what I do or don't do has an impact, so I want to do everything I can, while at the same time leaving space for the mysterious. As I've said before, a lot of stuff doesn't make sense, and I have to learn to live with that.

Seasons

2007-11-01T21:23:00.000-07:00

I'm a little peeved with Lauryl (the acupuncturist). At my appointment this week I mentioned that I'm meeting with the IVF coordinator at the RE's office next week and am still planning to to the IVF cycle sometime in Jan or Feb. She proceeded to tell me how this was not a good idea. It went something like this, "Oh, don't do it in the winter, kindey yang is low in the winter, the spring would be much better...just look at nature."

While a part of me would like to be all earth mother about this, I'm also afraid of waiting too long and missing my chance. Not that another few months would make a big difference, it just seems ridiculous that in the context of something high intervention like IVF the seasons or cycles of the moon would really have anything to do with it. Babies are conceived all the time, every season.

So, I'd like to take an informal poll, when did you conceive? Winter, Spring, Summer, Fall? Is there anything to this seasonal stuff?

Zero to Four

2007-10-24T18:40:00.000-07:00

I just returned from a three-day introduction to life with quads. Two girlfriends from nursing school and I went to Texas to hang out with our friend Suzanne and her four bundles of joy.

I know that multiple births is a risk with infertility treatments, but I really just want one at a time. Which I guess is what most if not all parents of multiples wanted, but fate had a different idea so they adjust their expectations and boldly go forward (Suz and Joe, you're truly amazing).

I always wonder what it will be like when I spend time with newborns, what kind of feelings will come up. Honestly, I loved every minute of it. I feel hopeful about our next step with the IVF, and have been able to avoid the sadness and resentment that has come up in the past.

Holding those babies for hours and hours had a wonderful and calming effect on me I think. I am confident that somehow, someday, I will be a mom. That feels good.

Tears and Needles

2007-10-15T21:44:00.000-07:00

The place I go for acupuncture is in the country just outside this "groovy" little town in the Russian River wine country. The place is small and tranquil. It has this almost other-worldly vibe to it. Laurel (the acupuncturist) has been doing it for over 20 years and her practice is almost exclusively dedicated to women before, during, and after childbirth. She's treated hundreds, probably thousands, of women over the years and is acutely attuned to what it is to be a woman and live in your body and its cycles.

I was her first morning appointment last week. We usually talk for a little bit, she sticks me with needles from my head to my toes and then leaves me to myself for the next 30-40 minutes. At this last appointment though, she stayed for a little while after the needles were in. She talked to me about my body and this child that I long to carry within me. She encouraged me to trust that life is unfolding as it should and to try and see this waiting as a gift. I'm usually just annoyed and turned off by this kind of thing, but for some reason it struck me differently that day. I started crying, and kept crying for the first 5-10 minutes of my session. It was the first time this had happened on the acupuncture table. I've heard that people can have all kinds of different emotional reactions during treatments, but I've always just felt relaxed and restful. I guess it was just time to cry.

Watch your mouth

2007-10-11T17:42:00.000-07:00

Today after my weekly therapy appointment (which is great by the way, really changing the way I process and perceive myself and the things around me) I went to get my hair cut. I mentioned to the stylist that I was going to visit my friend who recently gave birth to quadruplets. She didn't say anything for a second, then said something like, "She must have taken the pills, right?" Which is really none of her business, but yes in fact she did. Then she proceeded to go on a mini rant about how she thinks that reproduction really isn't something to be "messed with" and that she thinks some people can't have kids for a reason, etc., etc. I mostly tuned out, but am pretty sure she included some comment about how it's dangerous when you start playing God too.

I was shocked. It felt like the kind of completely inappropriate thing that Michael Scott would say to the woman who just got pregnant through IVF, making everyone really uncomfortable (if you don't watch The Office, you should).

Especially in this area where it seems like every other woman you talk to has had some type of fertility treatment. Who does this woman think she is? Does she live in the same world I do? Since when is it only OK for the sick and dying take advantage of every advanced medical technology available while those trying to create life are restricted and accused of "playing God"? I guess there must also be a "reason" that couples and single women much less "fit" to be parents than we are have more kids than they can take care of. I kept my mouth shut, neither agreeing or disagreeing. My therapist would probably say I should have spoken up for myself, but I didn't. Maybe I'll be more prepared next time.

Liver Congestion and Castor Oil

2007-10-07T20:02:00.000-07:00

I've had three visits with my acupuncturist now and this is my diagnosis: Liver Congestion. If you aren't familiar with Chinese medicine, as far as I can tell they view disease as disruptions or imbalances in Qi. Organs usually involved in infertility are the kidney, spleen, and liver. My diagnosis was made based on my pulses (measured at three different places on the radial artery at three different depths) and the appearance of my tongue, which looks pretty good according to Laurel, especially compared to my pulses.

In order to smooth out my Qi and get the blood moving to "decongest" my liver I'm taking herbs (Qui Gong Peony), getting acupuncture, doing yoga (especially twisting postures), and applying Castor oil packs. I'm not giving up on Western Medicine fixes, just taking a break and exploring other possibilities. The Castor oil isn't as bad as it sounds either. I'm supposed to apply it to my abdomen, cover with a flannel cloth and a hot water bottle and leave it for at least an hour three nights a week. The University of Maryland Medical Center actually endorses it as a treatment for endometriosis. I still haven't found an explanation for why or how it works, but it's kind of a nice quiet time with my hot water bottle and Castor oil, so I'll keep doing it I guess.

Writing it all out like that makes it sound like I'm desperate. In a way I guess I am, but that's not how I feel most of the time. I just that this (having a baby) is really important to me and I want to give it a good try. If I have to let go of this hope at some point I will feel better knowing that I tried (almost) everything.

I think every woman in this situation at some point asks herself, "What am I willing to do? What can I live with? When is it OK to stop?" I'm still trying to answer those questions, but for now I feel authentic about where I am and what I'm doing.

Hormone Free

2007-10-03T22:10:00.000-07:00

This cycle was the first one in the past 4 months that was free from synthetic hormones (no Clomid!). If you were around me during the Clomid days you know that for about a week around my period I went a little crazy. At the time I denied the effects of the meds. I thought it was just me reacting to stress and disappointment (I tend to be overly emotional anyway--especially premenstrually). Now that I've had a cycle without intervention to compare it to, I can see that the Clomid was definitely a factor. I know my poor husband and parents were worried about me. I cried uncontrollably. I would call my folks and end up hanging up because I couldn't talk between the sobs. My husband would come home to his wife laying in the middle of the living room floor listening to sad music, tears streaming. Yes, it was bad.

These days I'm feeling much more stable and the tears are less frequent. I still got a little weepy when one of my co-workers (who is my age with 3 adorable kids) asked me if I wanted to have kids, but I was able to talk to her about it and recovered quite nicely. I guess when you wait seven years people start to think maybe you don't want kids, when actually I am trying everything to have them.

BBT

2007-09-27T22:02:00.000-07:00

Although the desire for pregnancy has consumed much of my energy for the past year, one thing I've managed to avoid is charting my basal body temperature (BBT). None of my doctors are particularly interested in it, and I wasn't about to sign myself for anything else to do that would cause me to focus on my fertility or lack thereof. But it looks like that's about to change.

Last week I went for my first appointment with my new acupuncturist--she wants to see my charts. She was really nice about it, tried to sell me on the idea, "it's about checking in with yourself, knowing your body better," but I'm still not excited. I'm not sure exactly why I'm so resistant to the idea. Maybe hidden in my BBT charts we will find some key to my troubles, or maybe I'll just spend my first waking moments with a thermometer stuck in my mouth and a chart on my bedside table, reminding me that I'm trying to get pregnant.