Tuesday, October 31, 2006

IT'S NOT YOUR FAULT: Or What I learned from Good Will Hunting

Remember the scene in Good Will Hunting when Robin Williams (psychiatrist) trys to convince Matt Damon that his crappy childhood is not his fault. I'm thinking I need a similar mantra for all the infertility crap - the early menopause, the not seeking motherhood in my late 20s or early 30s, the fact that when and if I have a baby it will probably be through DE and not have a 'genetic' connection to me - ALL OF IT!!!

Try to play the tape back now, Robin Williams' voice (with thick Bahhston accent) "It's not your fault Will. No really it's not your fault. Listen to me, it's not your fault. It's not your fault."

And just like Will, I still want to rage against the Machine.

But it's not my fault.

Monday, October 30, 2006

The Reproductive Valley of Death

I'm in hell.

FSH 20
e2 106

FSH is not low enough - so, I have to continue what I am doing and come in again next week for more bloodwork to see if we can get it down below 12 (I think).

Meanwhile, nothing....

I have been in this same holding pattern since the end of August. I'm a plane caught in a bad storm, I can't land, can't go anywhere, just keep waiting for the system to move out.

I'm officially 42 1/2 in 28 days from today.

RE Office Visit - the Psycho Drama of it All

I went for blood work this morning - to see if FSH is down and estrogen is rising. Results at 2:30 p.m. - they are very good that way. You call a number at a designated time and 8 times out of 10 they have the results and next steps. No long waits.

The RE waiting room is such a tense place. Sitting, reading Ladies Home Journal and trying not to make eye contact with anyone, just waiting for the next name to be called and the nurse to escort you to the back for whatever poking is on the menu.

Are the women (and men) in the waiting room feeling shame? I know that the first appointment felt that way for me. "I am a failure - yes, can you tell that I am reproductively challenged" would run through my head. In the last 7 months I have been there on the average of 2-3 times a month - I've become somewhat desensitized to any twinge of shame I might of had at first.

Now I 'm in my jealous phase. I look at these other women, many many of whom look older than me (some probably aren't) and I think how unfare this is. I wonder if they are doing DEm have they been told to forget about IVF like I was at my first consult? what do they have that I don't have? Are they already pregnant? how long is it taking them? I am certainely in better shape than they are.

My last wanding was the worst. After 3 weeks of estrogen and bloodwork that revealed an e2 of 267 I was asked to come back for a sonogram to see if there were some follies cooking. The sonogram was awful - the nurse couldn't even find my right ovary. It was as if it had disappeared completely into the menopausal twighlight zone and she finally gave up even trying to find it. I felt demoralized.

Waiting to pay my bill, I stood behind a lesbian couple who were staring at their 6week sonogram with excitement and glee. I thought I was going to lose it right then. I waited until I was in the hallway. The horror.

Sunday, October 29, 2006

Acupuncture Update or Why I refuse to go quietly into the night

"If we remain obsessed with seeds and eggs,
We are married to the fertile reproductive valley
Of the Mysterious Mother
But not to her immeasurable heart
And all-knowing mind."

Hua Hu Ching

Last night I was re-reading the chapter in the The Infertility Cure
on advanced maternal age. The book, if you haven't read it already is by Randine Lewis and is a great primer on how Traditional Chinese Medicine can be used to treat infertility. I like to re-read things because I can always get something new each time. What struck me was the following, (my paraphrase)"Acupuncture can be used to ease the transition to Menopause but when a pregnancy is still desired it can be used to postpone the transition and promote the proper function of the hormones.

That's me, I don't want to ease the transition, I want keep the menopause wolves at bay for a long as possible. I know some woman see it as the next phase of life and even look forward to it. Here is the TCM view according to my book,

When a woman's reproductive life span nears completion, the energies are transferred from the Uterus to the Heart viao the Penetrating and Conception meridians. A woman moves from a state of procreation (represented by the Kidney system) to a state of wisdom (represented by the Heart).

I guess I am just not ready to accept wisdom...

I went to acupuncture yesterday and we now have a plan - cool the heat, feed the yin - work more on being as opposed to doing. This is sooooo hard for me. I am not a be-er , I am a doer and my whole approach to infertility has been to do as much as possible. Ironically this approach to life in general is what has supposedly lead to this deficiency of kidney yin (aka estrogen production). I must work on shifting my framework in all areas of my life. I was given two different herb combinations to take and I go back again next week.

Must practice breathing...being....calmness......ohm.....

Friday, October 27, 2006

The Patch Saved My Life

Does it sound like the lead-in to a corny pharmaceutical commercial? Well perhaps it's a little dramatic, but it is also true.

I wear the Vivelle Patch - you stick this piece of sticky tape on your stomach ever 3 1/2 days and it releases estrogen into your system - bypassing the liver - right into the bloodstream. Without the patch when I am not ovulating I am a mess. Hot flashes up the ying yang, fatigue, irritability - a menu of menopausal symptons. But with the patch, I am reborn - and the sex is better too! So that is my commercial for the Vivelle patch.

B* calls it my scotch tape.

The RE's approach is to use the patch as a strategy to calm down the FSH - get the number down by tricking the brain into thinking that I am ovulating. In turn, the little follies, in the absence of FSH bombardment, become more receptive to the FSH signals and start to cook.

I am not a candidate for the stims because I am stim myself naturally and it is having an adverse affect. The RE says that I don't have that many receptor sensitive follies left and if you scream at them all the time they kind of go deaf in a way - no receptivity. It's like being at a loud concert. The kicker is that even if the follies do respond we have the quality/lack there of to deal with as well which is why I am in the 5% or less category for conception.

I go back to the RE on Monday for blood work to see if the patch is doing it's job. If all is quiet on the Western front we take off the patch and see if the estrogen levels start to rise on their own (indicating folllie development). Last time we tried this my estrogen crashed and it was back to the drawing board. I'm keeping my fingers and toes crossed as always.

Thursday, October 26, 2006

Back in the Spin Cycle

I am going to spinning class at lunch time today. This will be my first spinning class since finding out about the menopausal issues 7 months ago.

I stopped going to spinning class because I thought that maybe I was overstressing my body and that this was causing the low adrenal, underperforming thyroid and estrogen/ovary problems.

My body has adapted to doing yoga and the elliptical machine - but I miss my leg muscles and I don't like getting winded climbing up stairs.

I use to be very macho about my excercise (like everything else). I actually use to teach Spinning, I was the b*tch screaming at the class to work harder and not to stop. And now I am anxious about going to class - yikes!

I've also gained 5lbs in the last 7 months and that is not serving me well in the self-esteem category, especially combined with the low estrogen and as a result low progesterone/sex drive category. I don't want to become one of these asexual women wearing loose baggy clothes and hoping not to be noticed.

Sunday, October 22, 2006

Acupunture and Acrimony

Yesterday was my first visit with a new acupuncturist. I have already gone the Traditional Chinese medicine route for 6 months and since my estrogen levels are "in the basement" (term used by RE nurse) I thought it was worth mixing things up a little. I haven't ovulated since early August and so far being back on the estrogen patch has not produced any results - so why not trying somehting new or atleast different.

The practitioners are primarily woman, so that by itself is a change for me. My new acupuncturist has studied a variety of approaches and likes to blend methods. She is also an herbalist. She is much more gentle with the needles than the guy I was seeing and I could feel my body releasing tension as she worked. I liked that she was checking my pulses as she worked to see if she was hitting the right spots -- she seemed pleased with how I responded. I liked her and made appointments for the next two saturdays -

Acrimony --- I had hoped to go on vacation the week of Thanksgiving but given current budget conditions B* and I have decided it is not the right time to be spending money and taking time away. My Mother had been quite upset about our vacation plans because she had thought this would be the time when she, my Father and my Sister would come to town and see my new house. So when I called her yesterday and said we had changed our plans and I would now like to host Thanksgiving she said she would need to get back to me -

When I got back from acupuncture there was a voicemail that they tickets were looking very expensive and she wasn't sure they would be coming. I called and offered to find better deals on flights. When I called back to let then know about the cheaper flights I was informed that they were not going to come for the holidays. It was really not about the money, they were still upset that having them for Thanksgiving was not my first choice activity and so forget it.

My brain knows that it is actually better if they don't come for the holidays - it will only be stressful and likely unpleasant. However, the rejection still hurts and their spitefullness pisses me off. Two weeks ago my Mother cancelled her trip to visit my Grandmother in Brooklyn because my Uncle had suggested that they go to the cemetary while she was there. She didn't want him controlling her visit and opted not to see her 91 year old Mother rather than letting her Brother control the situation. When was the last time she saw her Mother? a year ago. The woman is 91 years old!!!

I just have to focus on my own family - B* and four rambunctous dogs - who love me and want to be with me. My Parents are twisted, lonely and isolated and I never want this to be my life.

I don't tell them much about what's going on with my health - my Mother would simply pick away at me with questions - peeling back the scab and throwing in some salt for good measure.

Friday, October 20, 2006

Success is Overrated

I spent 19 years thinking that if I didn't devote myself to my job 100% I was a loser.

In a town like Washington DC the first question at cocktail parties is always " what do you do? "
Stay at home Mom is considered a kiss of death answer, unless you are married to someone like George Stephanopoulus, and then it's okay. It's called the coat tails effect.

When some asks how you are, the appropriate answer is "insanely busy at work" -- it is very politically incorrect to say bored or underutilized or that things are simply slow.

There is a distinct caste system. For example, if you are a Federal employee with a ranking below GS-15 (pay band and grade level) you are considered an underachiever. If you are a Schedule C (political appointment) or SES (Senior Executive Service) you are considered someone worth getting to know.

In DC achieving work/life balance is considred an excuse for those who just simply lacked the talent to get ahead and this is a means of self-justification.

After my last job, which fried me to a complete crisp with way too much travel and stress, I vowed never again. It took a huge toll on my health (which I am still recovering from 18 months later) and I am sick of having no quality of life. No job is that interesting or that important (unless you are Condaleeza Rice) to sacrafice your life.

It has taken me a long time to get to this conclusion - perhaps it seems obvious, but for me it wasn't. And to be honest, I still feel guilty about not working harder or trying to "get ahead." When I read about someone I know and that they have just been appointed Chief of Staff to Senator So-and-So's office I have a twinge, but then I take a deep breadth and go do some Yoga and it helps.

Thursday, October 19, 2006

Grandparents, Mom & Uncle - 1938

I love this photo. My Grandmother was 23 in this picture. She had her two kids - one at age 19 and the other at age 21 and then she was done.

I take after her quite a bit (we even have the same birth mark). When she got married she didn't even know where babies came from. She is 91 and lives in Brooklyn. She has been in the same apartment since 1942.

The Unvarnished Truth

Today was the big appointment with the RE. He is the go-to guy when faced with infertility problems. Everyone I know has gone to him and gotten pregnant - except me (so far).

B* came with me which was good, because when I told him that I didn't have many good eggs left a few months ago he asked me "where did they go?" - the Doc provided an excellent primer on the lifecycle of the follicle from in utero to where we are today.

Best case, I probably have 1,000 pre-follicles left, how many are good? how many are receptive to FSH stimulation - science doesn't know. Accord to the Doc, with a high FSH (40 plus) the (my) ovaries are already getting as much stimulation as they would with the expensive drugs. he said that we could top it off with some Follistim but it probably wont make a difference.

"Menopausal babies do happen." Odds at this point less than 5% . At one point I even heard him use the figure "2% chance" when describing me.

He drew lots of pictures and pulled out some photos of fertilized egg division when chromosomes go bad.

So what next, we had the big DE discussion. They recruit based on the individuals interests/preferences and the turnaround time from the moment we say yes is 3-6 months. He has an 80% rate of success - if not with the first cycle with a follow-up FET cycle. "Much better than 2%" - ah that's where it came in. And no one ever has to know (more on this point later).

We went down stairs and got briefed on the forms, the social worker contact info, and the price sheet. $24,000. It could have been worse. I was prepared for $30,000 -so there was a bit of relief in the figure.

The cost for me is a wash - adoption would be the same and childless is not an option. So it is what it is.

B* is going to teach abroad in early 2007 for a few months (tax free) and he will be making close to the amount that will cover these costs. He was cute afterwards, he said that if he has to go teach in Iraq next summer to make some extra dough he will do it. He'll just make sure to wear a helmet.

I think the fact that B* can raise the cash makes him feel important in the process. And when he found out his extremely high sperm count - you would have thought he had won the gold at the Olmpics.

I have a lot to process. Feelings of failure, disappointment. Part of me feels like I have ancient sexual organs, all shriveled up and worthless. I always find myself comparing my age and youthfulness to the other women in the waiting room. I always win.

I have always been the young looking one, the ingenue, the healthy and physically industructable one. And now, the gumball machine appears to be just about empty.....

Wednesday, October 18, 2006

Did I mention that I have 4 dogs?

I never thought I would have 4, maybe 1, but never 4.
Sort of like potato chips, I just couldn't stop once I got started.

Actually, it's not as crazy as it sounds, I adopted 2 and then B* adopted 2 and then one day we decided to merge households and just like the Brady Bunch we became a family of 4 wonderful dogs.

This is Mr. the dog, he is a love bug and terrorist all rolled into one.

B* calls them his babies which I think is very sweet.

How Did I Get Here?

I'm one of the lurkers in the blogosphere who has been living through the lives of others and yet now I feel the need to let my voice emerge.

I want to join the virtual conversation because I have realized that "the love you take is equal to the love you make."

My life so far....
I am 42 years old and about one year ago my body started falling apart on me just as the baby thing was starting to take hold and feel much more urgent (yes 41 is a little late for urgency but more on that soon enough). After 5 months of no answers the truth emerged - I was in full blown menopause, so deal with it. Since March I have been fighting the dreaded infertility beast and refusing to age gracefully.


Wasn't it just yesterday that I was skipping geometry and socializing with juvenile deliquents?

I spent my teenage years surviving my family and trying to get good grades. My twenties and thirities were about becoming successful, excercising compulsively and managing to find time to squeeze in some dates and sort of relationships.

My Mother raised me to be a "career girl" - nice 1950's terminology. She still uses it when she runs into her friends who ask about me, "oh she is in Washington DC, she's a career girl." My Mother - her lovely picture displayed on this Blog, is a product of her environment, Brooklyn College class of 58, worked for an insurance company for 1 1/2 years and then quit to get married in 1961, and never worked again. She wanted me to have the glamorous career that she gave up when she married my Father.

I also grew up in the era of "women can have it all." Is this really true? I don't have it all. I was so busy being "career girl" that I forgot to have children (which I do want) and now my body is telling me that although I may only be 42 my ovaries are 53 (this is the age when my mother went through mentalpause (sic) ).

My Mother raised two daughters as the stay at home Mom who greated us at the door each afternoon when we arrived home from school. She greated my Father with a fully prepared dinner every night and spent her days ensuring that the house was scrubbed from top to bottom.

I don't long for what she had. But I do believe that things do come full circle. Fish can choose to take rides on bicycles - they don't have to, but maybe they want to, just a thought...

So how did I get here? your guess is as good as mine.