This is Only a Test

So, it was an emotional week and a half while we were out of town. I woke up most mornings disoriented and wondering if it was going to be a happy day (wedding festivities) or a sad day (funeral related events). There is so much to share I hardly know where to start. The fun of the weddings, the sadness of the funeral and the wonderful stories about my grandfather. Then, I realized I hadn’t really posted about our last RE visit because I was still trying to understand what had happened myself. And before I knew it, we had even more developments along that front this very morning so I will tackle the RE visit in this post.

This RE appointment was the one I had made way back in February after a visit with Dr. Receptive. In that time, Dr. Receptive helped me get my FSH retested, along with a progesterone test on 7dpo. There was a total of 3 blood draws for this series of tests and every single one of them, including another day 3 FSH, came back within normal range. My second day 3 FSH was as freakishly normal (5.9!) as my first day 3 FSH was freakishly high (31.1). I had no idea what to make of it and because I was still experiencing perimenopausal symptoms (shorter and lighter periods, shorter cycles, possible night sweats, vaginal dryness) and I knew that women with high FSH could have fluctuating levels, I just waited for my appointment and prepared myself to hear that they would consider only the highest FSH when determining responses to ART and a rehash of the donor egg talk, etc. I also drew up a nice little summary of all my test results and the cycle days they had been done on and prepared questions I had about what to keep on top of in terms of my overall health due to the impending loss of regular hormone function (bone density, heart disease risk). I also prepared myself for the fact that this was a teaching hospital and just like my last RE appointment, I might very well spend most of my time talking to a fellow and have only a little time with the RE, so I made sure I had concise questions and prioritized them for the precious few minutes I may have face-to-face with the RE.

As with most of my experiences with doctors these last two years, I was in for a shock. First of all, we only waited a few minutes for our appointment to begin. Then, the doctor who walked in the door and spent the entire time with us was the RE himself! Dr. Thorough-and-Direct (“TAD”) had actually spent time reading my file before the appointment. He not only said so, but repeatedly throughout the appointment made references to what he had read in my medical file. When I mentioned my additional test results and brought out the summary sheet I had compiled, he asked to look at it and read every footnote I made about each test. Then came the biggest shocker of all. His take on my fluctuating FSH was that one of the tests was probably wrong, perhaps the result of a lab mix up. Because of my lack of hot flashes, I probably was not going through ovarian failure, despite my other symptoms. And so he felt it was probably the first test, the high FSH reading that was wrong. He thought the symptoms I had were troubling and thought that it could mean that I’m nearing the end of my fertile years, which meant we should proceed with some type of fertility treatment sooner rather than later, but we should try with my eggs. He thought we may still have a chance with using my eggs because in my previous ultrasounds during my miscarriage and my last fertility evaluation, they saw follicles! I was confused as to why I wasn’t told this before and it turns out that both times when the doctors saw “cysts” they were referring to the presence of follicles. All along I had thought “cysts” were a bad thing but Dr. TAD said these were antral follicles they saw and there were 4 on one side and 5 follicles on the other. He said that they prefer to see 5 and 6, but the numbers I had were good. Each time, I would bring up something that worried me and he would matter-of-factly explain to me why he felt we should not delay and proceed with treatment to see how I would respond. Throughout our appointment, I got the distinct impression Dr. TAD considered all the issues and concerns I threw at him (and I was throwing it all at him, especially at the end, mainly in disbelief that we were hearing good news) carefully and thoughtfully and still coming to the conclusion that I was not going through ovarian failure. He also mentioned that if he had only the first FSH result to go on, he definitely would have suggested we “close up shop.” But, in light of the normal levels in my second test plus that fact that my progesterone level at 7dpo was much higher than what he would have expected, he felt that at the very least my corpus luteum was functioning correctly which suggests something my ovaries were doing something right. When I brought up my concern that my egg quality may be bad (hence the miscarriage and subsequent difficulty in getting pregnant again) he said that there was really no way to know how good my eggs were. But, he felt that there were still eggs left because it seemed to him that I am ovulating and it could mean just trying to “call out a good egg.” He then suggested we do IUI with clomid or injectible IUI first. By this time, I was so overwhelmed with emotion and so determined not to start bawling like a baby in front of him, I was speechless and choking back tears. Mr. Worrier took over asked about the difference between the two treatments and expressed our desire to go with a more aggressive versus passive route. Dr. TAD thought if we wanted to be more aggressive, we could do the injectible IUI instead of the Clomid. Dr. TAD remarked that he felt my case was very interesting and said that he wanted to bring my case up in their next weekly meeting where all the RE’s and fellows in the medical group discuss their cases. Then, the doctor who runs the ART treatments in their department would contact me and follow up on what they thought we should do next. He told us we would have to get Mr. Worrier’s sperm analysis before we start any treatment and referred Mr. Worrier to an urologist for his ED issues. At no time during our appointment did I feel like he was rushing to finish our appointment and go on to his next one. At no time during our appointment did I feel like I was bothering him with my incessant need for reassurance that he wasn’t missing something and forgetting to take into consideration some aspect of my situation.

Mr. Worrier and I walked out of that appointment stunned and shell-shocked. Of all the things we were prepared to hear, ovulation induction with IUI was not one of them. We were and still are being cautious with our hopes. I am willing to accept that one of the FSH tests was wrong, but I feel like I have had my hopes dashed too many times to completely trust Dr. TAD’s assessment that the error lies in the high FSH result and not the normal FSH result. I have trust in him, but I am too fearful and protective of my heart to trust my trust in him, you know? I don’t even want to know what the chances of pregnancy with ovulation induction/IUI are. I know it is lower than IVF but I find that I am not even remotely curious at this point. I just want to know what the truth is. I just want to know if I have any eggs that will respond to ovulation induction. I feel like a possible answer to that is the only thing I’m assured of if we do this and that is all I’m counting on.

(I did notice I allowed myself to let in the possibility that I can get pregnant with my eggs. I found myself fondly searching and looking for babies and toddlers for a couple of days after meeting with Dr. TAD. And seeing my visibly pregnant cousin, C. at her brother’s wedding was a lot easier to do knowing that possibility was out there.)

While we were gone, we got our follow up call. It was from the same doctor who gave us the news about my high FSH in October (and who I have yet to meet in person). He is the doctor who works with all the patients undergoing fertility treatment (they only do Clomid and injectible IUI here. For IVF, they send you to their another clinic.) I called Dr. No Face back this morning and found out that they’re suggesting we start with Clomid for the ovulation induction/IUI instead of injectibles. The reasons for this are:

1) I'm young and they believe with the test results I have that I am ovulating. But, I'm not getting pregnant with one egg so they want to try to induce more than one.
2) Injectibles are stronger meds, so they want to go with Clomid first to reduce the chance of multiples because of my age (he actually said "complications" which I take to mean multiples among other things).
3) Clomid would also tell us if my high FSH was the mistake or my normal FSH was the mistake. If my FSH is high, Clomid would not do anything and they would know since they would monitor the follicle stimulation via ultrasound. Clomid is also the cheaper alternative and less involved than doing injectibles, but will tell us the same thing about my response to FSH.
4) They want to start this for my next cycle without waiting for Mr. Worrier’s sperm analysis and urology appointment. Their thinking is that we've waited long enough and he’s gotten two women pregnant so even if there are issues with his sperm it's not so bad that there is no possibility of fertilizing an egg.

So, all of a sudden it's like we've jumped back on the speeding train again and I
wonder, is this where I want to be? When we were trying, Mr. Worrier’s ED made an already stressful time, even more stressful. In some ways these last 6 or 7 months of thinking there was no chance we’d get pregnant with my eggs have allowed us to live our lives more contently.

We’ll have the option to try to freeze some of Mr. Worrier’s sperm ahead of time to reduce some of the stress, but another part of me thinks, hey, we might not even need to worry about having sperm. There is no guarantee this IUI won’t get canceled because of cysts (the bad kind) or my lack of response. So, to keep my sanity intact, I am treating this as another test, not as a chance of getting pregnant. A test to see if I have any eggs at all and if I do, if any of them will respond like the 33 going 34 eggs they should be.

Because being told that the first FSH results may be wrong is almost impossible to believe. It is like being told you don’t have cancer anymore, that it has miraculously disappeared. And much as I would like to believe in that possibility, I just can’t go there yet. So, if I get close to actually going through with the IUI, be a friend, won’t you, and remind me that this is only a test, ok?

Two weddings and a funeral

The weekend with my mom and grandma was not as comforting as I hoped it would be. I think my grandmother is being scammed and paying way too much for the funeral and cremation. There is also a lot of family drama so the weekend was quite tiring and stressful.

I had my second RE appointment (finally!) yesterday. We got some news that was…unexpected. I hesitate to say it was good news because that’s the kind of scaredy cat I am and Mr. Warrior and I both need some time to process the new information. Plus, I feel like I’ve ridden this ride before and it may seem exciting and full of possibilities at the beginning but all the other times I’ve ridden it, it’s ended with me holed up under my covers, crying my eyes out. So, I’m trying to be cautiously optimistic, but I don’t do it that well (I’m an all or nothing kind of girl). Once I can wrap my head around this latest development, I will certainly post more about it.

I’m taking off tomorrow for my cousin’s wedding in LA, then to Northern California for my grandfather’s funeral and a friend’s wedding. We won’t be home again for almost two weeks.

Anyway, I probably won’t be posting for awhile but I will be keeping up on everyone when I can while I am away. Especially, you, Thalia! Keep the good news coming!

Grandpa

Last night around 9 pm my grandfather died. He had been unconscious and on a feeding tube for over the last year. My mom told me that Tuesday night, my grandmother consented to take him off any support. I know it was a difficult decision for my grandma and one she struggled with. My parents were there to see him last night. Five minutes into their hour and half drive back home they got a call from her family that he had died. My brother lives close to where my grandfather died as does the rest of my mom’s family, so they were all able to be there soon after it happened.

I’m flying up to Northern California for the weekend to be with my mom and grandmother and the rest of my family. Grandpa will be cremated and I guess it takes some time to arrange that so the funeral will take place in about a week or so.

It feels good to think I’ll be seeing my family this weekend. Usually, I try to limit the amount of time I spend with them because it’s nice to see them, but after awhile the old, unhealthy interactions with them start creeping back in. The distance between Northern and Southern California never felt too big and was a nice buffer. Today, the distance feels immense and I long to be closer.

Red Light, Green Light (Updated)

So after the initial shock and awe of last week’s baby news followed by some crying and shopping therapy, I started to deal with it better. At least the idea of having to deal with follow-up baby news doesn’t seem so hard to deal with. But, it’s still a pretty Jekyll and Hyde situation. Some news sends me wanting to run to the bathroom crying (like people talking about doing a group baby gift) but other situations I have no problems with (I was oohing and ahhing with the best of them when the email came in with a link to baby pictures). After giving it some thought, I realized that I was prepared to look at pictures of the baby because I anticipated it would happen at some point. Last night the image of the parents with their newborn popped in my head as I was going to sleep and I thought to myself, ok, that wasn’t so bad, I can handle that. But I wasn’t prepared for being asked to be involved in doing a group gift (since I already gave them something). And those things that I don’t anticipate I seem to react to the least well to. I found myself wishing people could understand how hard it was sometimes. And I wished there was some signal on my forehead people could see so that they could tell what kind of mindset I was in at the moment. Red light: Don’t you dare come near me with any baby talk or I will chew you up, spit you out then turn back time so I can do it all over again. Yellow light: I could be perfectly fine. I could lose it and cry my eyes out. You’ve been warned, proceed with caution. Green light: I’m good today but limit all baby talk to no more than 5 minutes per 3 hours. (Come to think of it, I could use a system like this for myself just so I can know how I am feeling.)

Anyway, I thought about sending this email to my coworkers:

Hi Everyone,

I wanted to ask a favor of everyone and thought this was the best way to do it instead of approaching each person separately. Some of you know or may remember I had a miscarriage two years ago. After that, C. and I shared our trials and struggles and supported each other when we were both trying to get pregnant the year before her pregnancy. Since then, I found out it may be difficult or impossible for me to have biological children. Which is not to say I’m not happy for the birth of J. and C.’s baby. I am incredibly happy their pregnancy went well and was successful. I know this is an exciting time for them and also for us as their friends and co-workers. But these last days since the baby’s birth I realized I am having a more difficult time than I anticipated. Most of the time, I am ok and can participate in the excitement of trading the latest news from J. and C. But there are times when someone asks me a question or makes a comment unexpectedly and it throws me off guard and I find myself a bit emotional.

I don’t want to make things weird and uncomfortable for people or for people to stop talking around me. I know the questions and comments are not meant to be hurtful. But I would like to ask if you have a direct question or comment for me related to J., C. or the baby if you could preface it with something like, I’d like to ask you something about J’s baby. Or we have some news about the baby would you like to hear it? This would help me see if I’m in a place to hear the questions or news you have and let you know if I need some time to process it.

I don’t wish to make my personal issues with this into a big, uncomfortable thing or a burden for the people around me. Like I said, I understand people just naturally want to express their excitement for this wonderful event. But I may excuse myself or walk away as people chat about these things. I hope you will be able to understand that if I do, it’s something I need to do for myself and I don’t feel any ill-will towards you.

Thanks for “listening,”

Summer

I don’t know if I’ll actually send it. I’ve sent this out to a couple of friends, who don’t work in the same lab I do, to see what they think. I don’t want to come off as needy and bitter (even though I feel that way sometimes). I just wish I had more warning and a little control over what is thrown at me. Is that possible to have? Maybe this is too much to ask of my coworkers? Would it seem too unprofessional to send an email such as this? Too dramatic? I don’t really want them walking on eggshells around me, just be more, I don’t know, aware? Would you send something like this out to people you work with, that you get along with fairly well and share some aspects of your personal life with (though I have only talked about my infertility with one coworker)?

An alternative is to say something like this to the people I’m talking to in my red light/yellow light moments. But, I don’t know if I’ll be able to do it at those times and maybe have to repeat it several times in one day. Or, I could just not say anything at all and let it be awkward if I have to just walk away, but that doesn’t feel completely right. Plus, we have weekly meetings and I know this baby talk will come up in one of those meetings (it already has to some degree) and I couldn’t really just walk out of the meeting.

Updated to add: I decided to send a copy of the email to a couple of friends, one who used to be a coworker and knows some of the people in my lab. Both thought it was ok to send and one suggested I sit on it for awhile to see how I feel. I thought it was a good idea since I wasn’t completely happy with it. I showed it to Mr. Warrior after I got home and he thought it was a good email to send out but thought I should take out the paragraph about asking for people to say things a certain way. He said having it in there puts the responsibility on other people and if I just expressed that I was having a hard time, people will figure out how best to act. (He always has more faith in people and their actions than I do!) So, I looked at the email again, but without that paragraph and it did seem much better. I sent it out this morning and people have responded to it in a caring, sensitive way. J. made it a point to stop by and tell me how much J and C cared about us and how much they appreciated our support during their time trying. I was very touched by that.

Daughters

I have been thinking a lot about the women I know and their fertility “journeys” (for lack of a better term). I posted some of those thoughts in the Moms post. This post (and maybe one or two more to follow) are more stories about the women I have been thinking about.

Growing up, there was little fanfare for birthdays and wedding anniversaries in my family. Chinese culture explains part of it. Birthdays are usually not a big deal (until a person turns 60). In fact, everybody “celebrates” being one year older on Chinese New Year’s instead of on the day of their birth. As my brother and I got older and the time in which my parents have lived in the US got longer, we began celebrating our individual birthdays. We would go out for birthday dinners and our family eventually developed a tradition of having ice-cream cake on each of our birthdays. I’m not sure if the lack of celebrating wedding anniversaries is also a Chinese thing. But, I have never heard my parents talk about their anniversary. Every February 14^th, my dad would buy my mom a dozen red roses and a card, but I have never seen my dad buy my mom an anniversary gift or my parents mark any of their “big” (10^th, 25^th) anniversaries. Whenever my brother or I would ask my parents how long they had been married, their standard reply was to tell us to add one year to my age as I am the oldest. If we ever asked when they were married, they would tell us they married on the Christmas Eve prior to when I was born. Since I was born in September, that makes it an almost perfect nine months from wedding to baby. Though it always seemed a little awkward the manner they answered our questions, we didn’t think much about it.*

One day when I was about 15 or 16, my mom brought out a picture album I had never seen before. It was very exciting because I thought I had seen all our family pictures at least 10 times. My dad is a huge fan of taking pictures, both stills and movies, and at least once a year we would break out the pictures and the movie projector. But here was a whole album of never-before-seen pictures of their engagement. On the last page of their album was a copy of their wedding invitation. It was in Chinese, of course, and even though my parents forced me to attend Saturday Chinese school for two years, I never became literate. Chinese numerals, though, I could recognize. I was surprised to see my parents wedding date was sometime in mid-February of the same year in which I was born. Which means I was born 7 months after their wedding. (My guess is that whole Christmas Eve story was based on the fact that it was the day I was conceived.) When I expressed my confusion (! because I can be just that stupid) to my mom, she just giggled self-consciously, closed the album and put it away, never to be seen again.

A couple of years after the unplanned pregnancy, shotgun wedding and my birth, my mom got pregnant again. My father’s parents were all hoping for a boy because, well, when you’re Chinese that’s what you wish for. In Taiwan, at the time, there was a pill for pregnant women that was purported to ensure the sex of the child they were carrying would be a boy. (I’m sure it probably worked, say, 50% of the time?) My mom was talked into taking these boy-making pills during her pregnancy. When the baby was born, the doctors saw that the baby would not survive for long. My mom was not allowed to see the baby but was told that the baby had no brain because the baby’s head was sunken in. My mom believes that my dad was allowed to see the baby and knew the sex but he always denied it. Because of his denials, she believes that he didn’t want her knowing it was another daughter and then blaming herself for the baby’s death because of the pills she took.

My parents tried to get pregnant again soon after the death of their second child. In the aftermath of my miscarriage, my mom told me how she spent every day for over a year obsessing about getting pregnant. But, it never happened. At some point she stopped hoping and obsessing. My mom did get pregnant again. My brother was born three months shy of my 5^th birthday, the first boy born of my generation and my grandmother’s sole favorite out of 13 grandchildren.**

So, like her Ma, my mom experienced what it was like to desperately want to be pregnant, but not get pregnant. Like her Ma and her own daughter, she knows the pain of losing a child. And though the pain of infertility never completely goes away and any children that come later never replace the ones lost, there is a coming to terms and acceptance of the hand life has dealt you. And, ultimately, you make the best of what you do have in life.

At least, that’s what I hope is in store for me.

*Later after my brother and I had both moved out of my parents’ house, I brought this up with my brother. When I told him I thought our parents had to get married because mom had gotten pregnant, it was clear from his response that it never occurred to him until that moment.

**I remember once when she lived with us for awhile, she went out and bought a new bowl and chopsticks for my brother. Then, she gave my brother’s old bowl and chopsticks to me. When I expressed my anger and indignity at being given my younger brother’s used dinnerware, my grandmother retorted that I was a girl and should be grateful she treated me with such kindness and generosity! I can laugh about it now, but this was one of many reasons why I loved my mother’s Mama so much more. I can also forgive her now for her ways because I understand that many of the things she did was the result of the traditional mindset she grew up with. Even for her generation, she was the last of a rare group of women who had their foot bound (warning, the link has some graphic descriptions and pictures). One time when she was in the hospital after a stroke, I saw the doctors bring all their interns to her room so they could parade through and examine a living example of bound feet.

I've had better days (or I need to buy myself something pretty)

For as far as I’ve come in the last couple years, I forget sometimes that some days can still be hard.

We heard this morning at work that my pregnant friend (and the wife of one of my coworkers) went into labor and to the hospital early this morning. The word is that they may have a bit of a hospital stay before the baby is born. There is a lot of excitement at work and our meeting this morning was filled with guesses of when the baby would be born and if it would be a boy or a girl (the parents didn’t want to know the sex beforehand). All during the meeting, my mind kept wandering and it was hard to keep focus. I had tried not to think about the impending birth this last week or so (which should have been my first clue I might not take the news well) but I couldn’t keep thoughts back this morning. I tried joining in with some of the baby banter (dumb idea), but found myself welling with emotion. Knowing tears might be next, I disengaged. But, disengagement feels like adding salt to the wound, because now I not only feel sad from the news, but alienated from other people. It’s hard not to have people recognize that the news may be difficult for me. I feel slightly bitter that the same coworkers who were kind and caring when I miscarried two years ago can say things today like “There can’t be anything more emotionally difficult than knowing your baby is about to be born but not knowing exactly when.” I wanted to say, yes, there is. There is carrying nothing but an empty sac and knowing the baby you thought was there will never be born.

I know all this banter is not about me or people wanting to intentionally hurt me. Times like these I just want a little sensitivity. But asking for it feels selfish and I’m afraid of what people will think of me trying to bring my pain into the midst of all this “exiting” news.

I know this will pass and I can be strong again, but I also know when the baby is born, there will be more banter to endure. Then, more inevitable baby talk when my coworker comes back to work. And I’m sure there will be more stories about the baby and how it’s doing in the months to come. Fuck. I guess I didn’t realize until I wrote that last sentence that there would be all this baby banter to deal with at work for the coming days (weeks? months?). Maybe this won’t just all pass. Or, it will pass for this bit of news, but there will be more baby news so it will just come back and hit me again. And again. And again.

Fuck.

Anyone else not want to be where they are right now? Care to trade places?