Monday, November 28, 2005

There go the waterworks

I don't like to cry. I detest crying in public, I dislike crying on my own in bed. I know it's normal, but I guess it makes me feel weak.

Last week, I was sitting up late talking with my mother. She wanted to know how we were doing. She also wanted me to know she understands just how strong the desire to have children can be, though she has had no experience with IF herself.
Before long, my eyes started filling up. Dreadful.

I can't have a conversation about IF with my mother without crying. Why? I don't cry when I talk about it with my IF friends IRL. And with them I go into much more detail, since they already know what I'm talking about.
I guess it's because I'm picturing my parents with the grand-children we can't give them. They've never asked me about starting a family, but still, I know they would love it.

Lately, I've been thinking again of my plan to inform my in-laws of our struggles. I really, really don't want to cry in front of them. It makes me feel really uncomfortable just to think of it, there go the waterworks again.
So telling them directly to their faces is out of the question. But who ever said I had to put myself through such an ordeal anyway. This is not some sappy movie, this is my life.
I think I will write them a letter explaining our situation. This way, I can give them some hints on how to deal with it/us. I can ask them to spare us a bit and understand if we don't attend all family occasions with enthusiasm (or at all). The message wouldn't get across if I starting choking on my tears after the first sentence. I think I could handle giving them a letter and answering questions after they've read it.

Couldn't DH tell them? In theory he could, I guess. But he doesn't experience IF the same way I do. He doesn't mind too much that two SILs are pregnant, while we're not. So how can I expect him to tell them what I need them to know?

I dropped a hint to my DH about the idea to write it in a letter, but he didn't really like the idea very much. Well, I'm not telling before the new year, so we still have plenty of time to hash it out.

On the ART front, I've finished another 5 days of Clo.mid. My body doesn't seem impressed, my temp only increased a little bit, not the marked spike from last time.
Hope hasn't shown her face yet. I'm not really expecting her any time soon, but it's still early days.

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Monday, November 21, 2005

Temp goes up, temp goes down, ...

... temp goes up, temp goes dooooown. Period arrives.


The college reunion was fun. I saw a couple of old classmates, mostly guys, many of which still single (THE question is not on their minds yet). After dinner, my friend told me the story of how he got together with his girlfriend. A classic tale of how good friends turn into lovers.

The next morning my temperature plummeted. Hope started arguing with me that this could just be a dip, can't be sure till your period arrives, ... I ushered her out of the door quickly and decided this cycle was over. I indulged in two cups of coffee for breakfast. Mhhmm, caffeïne.

As you will recall, I was planning to visit my friend and her two-week old baby that very same day. For I minute, I thought of cancelling, but it's not that often that I get to see her and besides, I need to practice visiting newborns for when my SILs give birth.
I'm glad I went. The baby is adorable. I gave him his bottle and got to burp him and hold him for a while. I truly enjoyed it. Even listening to my friend's concerns and minor complaints (just one or true) didn't really bother me. This visit was all about her and her new baby, not about my IF.

Have I suddenly become a saint? Am I now looking forward to becoming an aunt? Forget it. One foot out of the door and I felt like I was going to break down and cry.
I don't expect I will get much opportunity to cuddle my nephew's/nieces: too many other candidates.

That evening we celebrated my grandfather's birthday with a nice family dinner.
I enjoyed the food and the wine. The evening ended rather early, as my grandparents are morning people. I am an evening person, and went to bed very late, after reading my blogroll.

Sunday morning, my temp was up again. Hope came knocking on the door again, but I didn't answer it. Late night + alcohol = temp spike. Surely enough, today my temp was down and my period arrived. That makes a luteal phase of exactly 14 days. I've already rescheduled my next appointment with Dr. Sunshine for an u/s on day 14.

There is one tiny upside to this BFN. I'm not the complete ART novice I was last month. See that scratch there?
If I had gotten PG on my very first Clo.mid cycle, I fear I would have been unceremoniously kicked of IF island. Tarred and feathered and kicked out. It's ridiculous, I know, but among all the experienced IF'ers I read, I feel I should keep quiet.

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Thursday, November 17, 2005

Distracting weekend

I have a distracting weekend planned, to take my mind off the wait. Friday evening, I'm going to a college reunion. I'm meeting up with a (male) friend of mine. He has a girlfriend since a couple of months, who is incidentally also an old classmate of ours. What, it took you 4 years to muster up the courage to ask her on a date?

The next day, I'm visiting with another college friend of mine, who just had her second baby. Oddly enough, I don't feel any of the ambivalence towards her good fortune, as I do with my SILs. I'm actually looking forward to seeing her. My friend is an educated fertile, I'm her second IF friend, that helps I guess. Also, I don't feel the pressure of unfulfilled expectations as with my relatives.

In the evening, we're celebrating my grandfather's birthday with the entire family.
I haven't outed myself to the extended family, so I'll have to pull out a good excuse for not drinking any alcohol. Antibiotics are always a good excuse, if anyone gets nosy you can always start explaining what a urinary tract infection is. My relatives are very discrete so I don't expect to be grilled on the matter. Of course my uncle's new girlfriend is still a bit of an unknown. She's rather outspoken, and might start voicing expectations ... Ah, see, I'm distracted already. :-)

In stead of searching for excuses, I could also pee on a stick. The stash I brought from the U.S. says it works 5 days before your expected period (well, for 69% of women). This saturday is exactly 5 days before the expected end of this cycle.
But I don't want to test. If it's negative, I'll just hope I belong to the 30% minority and feel miserable at the same time. I can't imagine a positive result, I just can't.

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Monday, November 14, 2005

Evidence

My 'high' is over, I'm pessimistic realistic again. We would be very, very lucky if this works.

This dip in my mood follows the steep dip in my BBT this morning, after the unprecedented highs of the last days. Still way over the cover line, so no worries yet.
I'm aware of a mythical thing called pre-implantation dip, but I've seen this pattern before. Maybe my doctor has a point when she tells me to quit charting.



On a more positive note, I got the results of my blood test intended to check for ovulation.

Dr. Sunshine said I had good luteal phase values:

16,3 Progesterone
178 Estradiol

I don't know what the scale of measurement is, and I'm not going to ask Dr. Google.
I'm in denial*, what is this 2WW you speak of?


*I confess, I'm faking it. I'm totally obsessed.

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Sunday, November 13, 2005

Book review: Conquering infertility

The internet is a great source of information, but sometimes it's hard to find what you need and there are a lot of worthless pages to sift through. The noise to signal ratio is not good. So sometimes I like to be old fashioned and read a book. While on business in the U.S., I took the opportunity of visiting a large bookstore and going through the health section. I browsed through the books for a long time and selected two.

One of the books I bought is Conquering Infertility, A mind/body guide to enhancing fertility and coping with infertility, by Dr. Alice Domar (304 pages). In my opinion, this is a good book for 'new' infertiles. The tone of the book is pragmatic with a generous dose of empathy. I'm not at all convinced the book helps with enhancing fertility, but it has definitely helped me with coping. I first read this book at I time when I felt my emotions were running away with me, now I feel I have the means to manage my emotions better. Of course, getting the ART show on the road also had much to do with this.

(The rest of this post is all about the book, not about me.)

The first chapter is about infertility, stress and depression. The author gives some statistics about IF in the U.S. and explains the usual steps in diagnosis and treatment. Next she explains the vicious circle of IF and stress. Stress can cause a number of physical ailments, but research suggests that depression is far more likely to affect fertility than stress, writes dr. Domar.

The next chapter is all about coping skills, or more precisely, using techniques to elicit the relaxation response from your body in stead of the stressful fight-or-flight reaction.
The relaxation methods covered are: breath focus, body scan, progressive muscle relaxation, meditation and prayerful meditation, mindfulness, guided imagery, autogenic training, yoga.
Mini-relaxations are a variant to be used on the go and in emergencies (drive-by pregnancy announcements etc.). Cognitive restructuring is a way to drive out those recurring negative thoughts that keep popping up in your head. Journaling is also recommended (oddly enough, she doesn't mention blogging, or whatever it was called before 2002). Next comes self-nurturance (pamper yourself!) and seeking group support (still nothing about the IF blogging community, did it exist then?).

Chapter 3 talks about coping when everyone but you has a baby or dealing with the feelings jealousy, anger, resentfulness, hostility and bitterness. These feelings are normal, but it is important not to let these feelings rule your life. There are a number of things IF women can do to avoid the pain of being around pregnant women, without become socially isolated, writes dr. Domar.

  • Create a how-to-tell-me-plan: tell close friends and family how you prefer to hear about their pregnancies.

  • Draw up a coping list: what to do upon hearing others' good news?

  • Think about your thoughts: more cognitive restructuring.

  • Work to get over it: getting upset is normal, you just have to go through it. Remember that IF will not define you forever, regardless of how your journey ends.



Chapter 4 deals with the strain IF may put on the relationship with your husband. IF has an impact on your sex life and on your finances, the two top causes of marital strife. Depression is often a factor as well. To make things worse, men and women deal with IF differently. Dr. Domar suggests a number of things couples can do to better understand each other and strengthen their relationship.

Chapter 5 covers turning to family and friends for support. Deciding whether to tell or not to tell is a very personal decision, dr. Domar agrees. However, if your friends and family don't know what you're going to they can't support you or be sensitive of your feelings.
When you decide to tell, you will probably find that not everyone can give you the support you need. There are four key things you should do: educate about IF, communicate your needs, attach yourself to people that respond well, dodge the people who don't.
Many people are totally clueless about IF, because they have never had to deal with it before, first or second hand. This is where selective avoidance comes in, give yourself permission to steer clear of certain particularly painful social events (like baby showers).

Chapter 6 is about infertility and your career. The worries that come with IF and the treatments are a source of distraction, also your motivation may be compromised, writes dr. Domar. There is no research that suggests work stress is a factor in infertility and quiting to become a 'full-time infertile' is not a good idea for everyone. Deciding whether to tell colleagues and supervisors is a very tricky question. Dr. Domar explains how a number of the coping skills from chapter 3 can be used effectively at work.

Chapter 7 covers some special cases: secondary infertility and infertility in the unmarried woman. Women suffering from secondary IF often find it more difficult to find support, the fertile crowd doesn't see their problem and they don't fit in easily with the primary IF crowd either. Also, there is no avoiding all things child-related, as you already have one.
The part about unmarried women encompasses single women and lesbian's. Often these women have to face disapproval of their desire to have a child, let alone pursue IF treatment, from family, friends, and perhaps even the doctor.

Chapter 8 is called 'Why won't God give me a baby'. This chapter is intended to support women who struggle with their faith as a result of their IF.

Chapter 9 turns to the 'Nitty-Gritty of Infertility Treatment': financial and medical issues. Dr. Domar addresses questions like should you see an OB/Gyn or go to an RE immediately or how to prepare for your first visit with a specialist. She also writes how important it is to be your own health advocate and to speak up when you disagree with a certain course of action. The author also talks about dealing with stressful situations at the doctor's office and dealing with anxiety.

Chapter 10 is called 'When miracles don't happen: coping when treatment fails'. The author talks about having realistic expectations for treatments and coping with failures. Taking a break can be very beneficial in coping with IF. Next dr. Domar addresses surviving miscarriage and suggests a variety of coping strategies.
Next, the author talks about one of the hardest decisions of all, when to call it quits.

The final chapter covers other paths to parenthood. Are you ready to give up on having a biological child? Have you mourned the loss of having a biological child? The first thing to do is explore all the reasons you may have against adopting, and addressing them. Donation and surrogacy are discussed as well.
Finally, the alternative of choosing childlessness if covered.

In Appendix 1 'Lifestyle changes that enhance fertility' the author gives some facts and recommendations on a number of lifestyle changes (caffeine, smoking, weight, ...) as well as alternative/complementary remedies (herbs, acupuncture, vitamins, ...) often offered to IF women.

In Appendix 2: 'Resources' the author lists some (U.S.) organisations and treatment centres, as well as some books.

In short, there is no quick fix, but there are good coping skills you can learn.

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Tuesday, November 08, 2005

Pop said the

...egg.

The appointment with Dr. Sunshine went very well. The egg had already made a run for it, as I had predicted. At least, that is what the doctor said she saw on the u/s. She thought she saw the remains of a follicle on each ovary (o dear), but said it could be a small lingering cyst from the last cycle. My lining was good as well, so I'm all set for an exiting 2WW.

The current plan is to stick to Clomid for 4 cycles. Well the real plan is not to make it that far of course. If it doesn't work, I have an HSG to look forward to. :-/

The doctor said I don't need to go back for monitoring the next cycles. Is that normal? I talked on the phone to a friend of mine (PG after IVF) who said she had been monitored during each Clomid cycle.

Dr. Sunshine was her cheerful self. As she sent me on my way, she said she hoped to see me again soon for other reasons entirely. For once, her optimism didn't bother me, because I was feeling a bit elated myself. For the first time I felt that this treatment might actually work! It's been a while since I've felt optimistic about us becoming parents any time soon.
If it fails, I will be devastated. But I will have to endure the lows no matter what, so I might as well enjoy the few highs in between.

This is my first ride on the roller coaster, so forgive me for being giddy.

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Monday, November 07, 2005

Just waiting

The family dinner at the in laws went fine. No smacking was required, as no one came near to asking THE question to anyone.

There was surprisingly little talk about babies and pregnancy, but that suited me fine. On the drive back home, I almost had a breakdown, but fought my tears. Deep breath in, slow breath out. ...

We do need to tell the in laws what is up. The family gatherings aren't going to get any easier for me. My MIL asked me if I disliked being with them because I was so quiet.

My first u/s for this cycle is tomorrow. According to my body's signals (BBT, EWMC, ...) the egg will pop soon, perhaps before the u/s. I better not mention this to Dr. Sunshine, she's very dismissive of BBT (too hard to interpret). It is hard, but still useful in my opinion.

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Friday, November 04, 2005

The punch line

(Don't panic till you read the end)

Yesterday evening, I came home after dinner and a movie with a friend only to be greeted with the announcement that we had become aunt and uncle that day.
DH had received a text message stating that SIL and BIL#1's baby weighed 1.8 kg, measured 42 cm and the baby is doing well.
This meant that SIL#1 had given birth 2 months too early! Which is horrible news. Babies born that prematurely have to stay in NICU for extensive periods of time while their life hangs in the line and they risk permanent health damage. This is a bit overwhelming, even for an aunt.

The premature birth was not altogether unexpected. SIL#1 had been told by her doctor she needed to take plenty of rest and not to exert herself in any way. BIL#1 had told me before she wasn't heeding that advice as much as she should, but he couldn't force her to. Great, a careless fertile.
Despite my feelings of sympathy for SIL and BIL#1, the news of the premature birth really stung. While she has the option to flaunt her doctors orders regarding her pregnancy, I'm following doctors orders to even get there. Not that I felt she deserved it, no way. I also realize that there are no guarantees, she might still have gone into labor if she had heeded her doctors advice. An ob/gyn is a bit like a witch doctor, if it works he takes the credit, if not you're to blame.

All kinds of thoughts were going through my mind. How do you support parents of a premature baby? When do you offer to visit? What is an appropriate gift, one that shows faith in a good outcome but without referring directly to a healthy full term baby? Where do I get this gift online?

Anyway, it was too late to call them, so I had to sleep on it.

The next morning, I told DH send them a text message back, asking if we had a niece or a nephew, what the baby's name was (the original message didn't say) and saying we would come to visit whenever they felt ready.

Here comes the punch line (text message to me from DH).
"False alarm. They were giving us the measurements from the latest echo"

WTF!? Drive-by pregnancy announcements aren't enough? Now I have to worry about drive-by echo-results??? Some punch, huh.

Don't get me wrong, I am very relieved. Baby not in NICU = good. And they sent the message with good intentions, spreading their news fairly over all relatives and such. But I don't want to hear it, I want to hide.

I am angry. I'm angry for the misunderstanding, all that turmoil for nothing. I am also angry because they are fertile and we're not. My anger has been smoldering beneath the surface for a long time, but now it flared.
The problem is I can't direct my anger anywhere. The fertiles of this world are not to blame. It isn't my fault my body isn't rising to the occasion. There is no point in blaming the Universe, it's just a giant chemistry set.

Tomorrow is the dreaded family dinner with the in laws, including both pregnant SIL's. If BIL#1 has the nerve of asking me the question again, I'm going to smack him. How's that for anger management?

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Wednesday, November 02, 2005

Relaxation

I was chatting over on Persephone's blog the other day about relaxation techniques.

I like guided imagery a lot because it's easy and can be done anywhere discretely.
I imagine being at the seaside, smelling the salty air, watching the waves crash on the beach, feeling the sand ... My family all live close to the sea and consequently I've spent a lot of time playing on the beach as a child. Happy times.

This weekend we went to the coast to visit my relatives again. The weather was nice, so I took a stroll along the beach. I was shocked to see how different reality is from the picture in my head. I always picture myself alone on the beach, well I don't consciously add people to the picture, there's no need.
In reality, the beach is filled with people, generally parents with children. Blatant fertility, all over the place, no escape possible. It was actually quite upsetting.

I haven't used guided imagery to relax since we got back, but I hope this reality check doesn't ruin my safe haven. Nothing is safe from IF, is it.

I still have a lot to learn.

On the bright side, my family is doing well and it was nice to visit with them.

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