Sunday, March 29, 2015

1 in 8

I want you all to know more about infertility. Because the truth is, 1 in 8 couples has trouble getting or sustaining a pregnancy.  That means I have no doubt that if you haven't experienced it yourself, you know a couple who has gone, or is going, through it.  And I'd like to think you're an awesome person and you'd like to know how best to help your loved one.  When people are dealing with loss or sadness, we often don't know what to say.  And sometimes in our effort to say something (anything!) to show we are thinking about it, we say unintentionally insensitive things.  This post is meant to help you, and in return, help the 10% of the population dealing with this medical issue.  

First, a little bit about a really amazing organization:

RESOLVE: The National Infertility Association, established in 1974, is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders.

RESOLVE to Know More

There are some awesome links for both those dealing with infertility, as well as their family and friends.  Please consider reading this.

If you don't mind some cursing and some humor, then read on (you're in good company).

Now, let me just come out and say  it:  people say the stupidest shit to us.  You would not believe some of the things we hear.  I'm going to post some awesome links to read, but there's a few that I want to address here first:

1)  Infertility is a medical issue.  This means no amount of "just relaxing" is ever going to work. Stop saying this to us.  Just....stop.

2)  It is not helpful, or relevant, what your views on Assisted Reproductive Technology or adoption are.  I promise you, anyone who is proceeding (or not proceeding) with either one has not taken the decision lightly.  They are both incredibly expensive and emotionally draining, and ART also comes with serious physical hardships on the woman.

3)  A wise friend of mine once said in relation to my miscarriage: "a loss is a loss".  Despite not ever wanting children of her own, this understanding led her to be one of the most truly supportive people through the shit-storm that was the weeks after our loss. Please treat it, and us, just as you would someone who lost a loved one.  Because, you know...we did.

4)  Please stop asking me to pretend this very big thing is not happening in my life.  I've been shocked by the number of people who basically have said a quick, "I'm sorry" and then have never asked me about it again.  It's exhausting having conversations where I have to put on a happy face; please just give me license to talk about it for a few minutes with a simple, "how are you handling everything?"

And now, some links:

How Not to be a Dick to Your Infertile Friend

10 Things Infertiles Want You to Shut the Fuck Up About

Stop Being a Jerk to Someone Dealing with Infertility

Lastly, a great little video.  If there is one little silver lining about my loss, it's that I'm now a more empathetic person;  I can climb down into the dark hole with others:

Still not over

At this point, I am now under the care of an OBGYN who is a part of my RE's office. She explains that I will bleed for a couple of weeks after the D&E, and then it's a waiting game until my next cycle starts, which can be anywhere from 4 to 6 weeks (although I later heard from women who had to wait much longer).

I am lucky as I only have to wait 32 days.  I take this as a sign.  "It's DAY ONE!" I shout in my house (as that day of the cycle is often referred to).  I march myself into the RE and ask if we can start trying again.  I am told it's early, but that she will do what's called a saline infusion sonohysterography (SIS) to make sure everything looks good. I am told by several nurses that the SIS is not nearly as bad as the HSG.  

They are all dirty, rotten liars.  

So I find myself lying on a table, tube and ultrasound in me, in what is quite frankly an unsettling amount of pain, and all I see are the doctors pointing at the ultrasound screen with puzzled looks, and there is an alarming amount of whispering going on.  I proceed to panic.  My wonderful husband had thankfully insisted on coming with me and he knows me well enough to tell the doctors, "you have to tell her what's going on, she's freaking out because she's probably thinking of the worst case scenario" - which of course I was.  So they finally clue me in by showing me the screen and explaining that I've got a whole ton of tissue I really shouldn't have at this point.  The plan?  To get it out.  Right there.  No pain killers besides some Advil in me.   I damn near kicked the OBGYN in the face.  But the real kicker (see what I did there?) is that despite taking some out, I am not healthy enough to try again.  So we count down 28 more days until.....

Another SIS.  

I'll be quick this time: it looked even worse than the first one.  I'm now also rocking a decent sized polyp, and there's no way around it:  headed back to surgery to I go.  

And so we cross off yet another precious cycle.  But at this point, surgery (with anesthesia) is a much nicer prospect than another SIS!

The loss

There's no good title to this post.  This is the loss post.

At 7 weeks we went in for our third ultrasound.  This was the ultrasound to see a heartbeat.  We knew it was important.  

But there was no heartbeat.

There was a sac still, but no sign of life.  No little heart. 

I can not put that amount of devastation into words.  I won't try.  So we drive home, and all I can think about is calling the family.  I want it over with as soon as possible.  I don't want anyone to be hopeful anymore. So we call everyone, and we say that word: "miscarriage".

That word is finite and succinct, neat and tidy - it doesn't convey what it needs to.  Here's what has to happen next:  I have to pretend I am pregnant for a full week.  I have to carry around my sad little sac; I can't drink alcohol and I can't eat any foods I am not supposed to.  I have to figure out a way to work, to get through each block of 24 hours, to get to sleep.  I have to get to the next ultrasound to confirm what we already know.  Miscarriage sounds so final.  So complete.  But it's not.  This is just the beginning of a horrid process.  

But I make it, because what choice do I have?  And I make it yet another 2 days to the D&E.

The last thing I remember is being strapped down to a table and telling the nurses that I couldn't believe that something so happy had led me here.  

And then at least the physical part of this whole mess is over.  Or at least I think it is.  

The second line

We got it.  That second line.

Let me back up a bit.

For 14 months, I have daydreamed about how I would tell my husband I was pregnant.  I watched cute little videos, I heard some really great ideas.  But once you are under the care of an RE, things get...different.  A little less story book.  Pregnancy tests are now blood draws at the office, with a call later that day with either good news, or more likely, a sad nurse on the line saying sorry (seriously, those phone calls must almost be as terrible to make as they are to receive).  But those who know me know I am notoriously impatient.  So on the morning of the blood test, while my husband was still sleeping, I got up to get ready for the blood test.  And by get ready, I mean I took an at home pregnancy test.  So when it came down to it, my "cute announcement" was me screaming from the bathroom, "that's a line! I think that's a line!!" and my poor husband half awake wondering what the hell I am yelling about.

But he sees the line too.  And I take another test, and I'm up to 4 lines now.  And then I get a happy nurse on the other end of the line for a change and's real.  I am pregnant.  

Because I am under the care of an RE, I go for LOTS of blood tests and ultrasounds, and we watch all my numbers look so, so lovely.

At Christmas, I am 5 weeks along.  It's very early, but I've had all these tests, and's Christmas.  Not to mention that every one who knows me also knows I like a cocktail (cocktails), so keeping a ruse of not really drinking in front of people is becoming a full time job.  So, we announce to our (close) family.  And everyone is so, so happy.  And I finally feel like our future has begun.

The less sexy side of TTC

Our first visit to the RE involved some basic testing of both of us.  This will be the first and last time you hear of any testing of my husband (lucky him) as it was very quickly evident that the problem was not with him.  The day after these initial tests we discovered issue #1:

Issue #1: I apparently have had an untreated thyroid problem for (at the very least) several years.  Normally I wouldn't have known that it had begun years ago, but once the RE office called me and told me my levels were low, I recalled years ago being told the very same thing by my general practice doctor, but they were "not low enough to warrant medical intervention".  While that is probably generally true, here's where our society's ignorance of fertility issues shows:  I was a female in my late twenties with a thyroid issue, and despite this being a very well known cause of both infertility and miscarriage, my doctor never thought to ask me if we were trying, or at least just tell me I should have it corrected before TTC.  So, onto Levothyroxine I went.

Another month goes by, and I am officially text book infertile.

Issue #2: During the next cycle, it also became clear that my uterine lining tends to be a little on the light side, and my progesterone levels are too low.  So onto progesterone supplements I go.  So let me tell you a little about progesterone....

It sucks.  Alright, in the scheme of things it's really the least of the issues, but that doesn't make it a picnic.  At it's heart, it's hormones, and we are all pretty aware of how much hormones can impact your body and your mood.  So during the 2 weeks I am on progesterone, I slowly deteriorate into every stereotype afforded to a woman who is...well, pumped up with hormones.  But I'll get back to that in a minute, because while progesterone makes most women sleepy, it gave me terrible insomnia.   The day I started taking it, I was reduced to about 2 hours of sleep.  So now picture this:  a woman who is stuffed (literally, but I will spare you the details) of hormones, and running on very little sleep. Basically, I become an emotional mess during the 2 weeks of every cycle I am on progesterone.  I often found myself crying during commercials.  I once broke into sobs just relaying a commercial to my husband.  It wasn't pretty.  Luckily they were able to switch my prescription to a version that would at least stop the insomnia, but I'd be lying if I said that damn commercial where the couple uses Coca Cola cans to announce their pregnancy doesn't still get to me while on this stuff.

So we try again.  And fail.  And I use that word deliberately, because if you've never been there, you can't imagine what a failure it feels like to not get that second line at the end of 28 days (or more) of doing everything you possibly can to get it.  At this point, my months now consist of 4 to 5 visits to an RE that is 45 minutes away from me to get blood drawn and an ultrasound.  If you're picturing the cute little ultrasound that goes on a belly with some gel - let me tell you: that's unfortunately not the kind of ultrasound I am talking about.  This ultrasound is a little more on the internal side.

Speaking of uncomfortable things - at this point I am also scheduled to go for a test that makes those ultrasounds and blood draws seem like a day at the beach: the hysterosalpingogram (or HSG, or as I like to refer to it: that test that can go straight to hell).  Lucky for me, it shows that there is no blockage in my fallopian tubes, which if you recall from sex ed, are kind of important to the getting pregnant process.

Lucky.  Let me say this word again: lucky.  I know I am doing a lot of complaining (I'm really good at that - ask my husband), but in the scheme of things, we are already extremely lucky.  I have no major issues, I ovulate, and I have regular cycles.  So many women at this point in the process are finding out that they have a much bigger mountain to climb.  I will talk more about these couples later, but suffice it to say that my story is just one experience, and I recognize that there are many who have it much worse than me.  (I'm probably still going to complain though, okay?)

So after my HSG, we try for another cycle, and that's when shit really starts to get real.

Friday, March 27, 2015

The road to the RE

Our journey began in October 2013.  Well, maybe it begins before that.  After all, I spent 32 years of my life never really wanting children.  I thought my motherly instinct was defunct, and my biological clock was permanently off.

And yet, when I pictured my future, which in my mind was still so ridiculously far away (I still don't believe I am in my 30's), I pictured a kid.  It was a very fuzzy picture, but it was there.  So I kept waiting for that switch to go off, that call to be a mother to sound with fury.  But the truth is that's just not how it happened for me.  I knew where I wanted to go, and although I didn't feel ready (okay, I was terrified) for the steps it took to get there, I knew they had to be done, and so I dipped my toes into the trying to conceive (TTC) waters.

I vowed I would never become one of those "crazy" women who timed their cycles, or who cried when the test was  negative.  At risk of giving away the ending:  I now refer to this as the blissfully ignorant stage.

Cut to 6 months later, and a conversation with a friend who struggled for years TTC, and I started to get a little more serious.  I peed on a lot of things, quite frankly.  But still no success.

Another 5 months went by.  For those of you doing the math, and with a basic understanding of what constitutes infertility, we were now only one month shy of infertility.  For those of you who don't know, Resolve defines infertility as:

"...the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive.  If you are over the age of 35, the time of trying to conceive is reduced to 6 months.  It is important to see a specialist, or a Reproductive Endocrinologist, or in some cases your OB/Gyn or urologist for a complete fertility work-up and diagnosis."

And so off to the Reproductive Endocrinologist (RE) we went.