Monday, May 30, 2011

Article: "A Good Enough Life"

I read an article in this morning's Globe & Mail that I can't stop thinking about: "The Secret to Happiness: Live a Good Enough Life." (One of our friends could have written it: he always used to joke about setting the bar low to avoid disappointment later.) Infertility & childless/free living is not mentioned (of course), but I can most certainly see some parallels here, can you?

*** *** ***

The secret to happiness? Live a 'good enough' life

by Sarah Hampson
From Monday's Globe and Mail
Published Sunday, May 29, 2011 4:00PM EDT

Here’s some counterintuitive news. You should aim for The Good Enough Life.

Oh, I know. It sounds pathetic, defeated: the goal of someone who lacks high standards and a good work ethic, someone who is willing to settle for mediocrity. Not a doer; a pessimistic loser.

Well, happiness experts say satisfaction is largely a matter of expectations. Expectations can sink you. You always thought you would live in a nice house with a double-car garage, have a couple of lovely children, an influential, well-paid job, a devoted spouse and savings in your bank account.

And when you don’t? Yeah, help yourself to a slice of misery pie.

On the other hand, when you don’t expect much, when you manage the ideas of what you think your life should be, you can be pleasantly surprised – and grateful – for the good fortune that comes your way.

The trouble is, that attitude doesn’t fit with society’s prevailing imperatives. There’s a fundamental tension at play in how we’re encouraged to think about our lives. We’re exhorted to achieve our dreams and never give up, to think positive, and yet the resulting expectations – some unrealistically high – can make us dissatisfied, even depressed.

Go ahead, start by blaming your parents. “Have you ever heard a parent say ‘I only want what’s good enough for my children?’ ” offers Barry Schwartz, a professor of social theory at Swarthmore College in Pennsylvania and author of The Paradox of Choice: Why More is Less.

“You can’t even get that sentence out, can you?” he says, laughing. “Whatever standards we have for ourselves, they’re not true for our children. We create people who are perfectionist because they observe us trying to provide the very best, showing us day after day that good enough is just not good enough for our precious jewels. And when the time comes to make their own decisions, children adopt the same standards.”

The idea that realistic parenting might yield happier, more well-adjusted adults is also at the heart of Alina Tugend’s new book, Better By Mistake: The Unexpected Benefits of Being Wrong. She identifies a similar tension in the conflicted messages that mistakes should be avoided (and even punished) even though they’re our greatest teachers.

“There are no simple fixes but there are ways all of us can shift our thinking about mistakes, starting with our children,” she writes. “We can emphasize effort and de-emphasize results. We can appreciate that we – and they – can’t be perfect, nor is it a goal we should aim for.”

Apart from the influence of parents, Prof. Schwartz also fingers the culture of abundant choice. Everything about modern Western life encourages a pursuit of “the best,” he says, adding that “every time a company comes out with a new product they’re trying to convince you it’s the best so you will throw out the old one. This notion of best so suffuses the culture that you almost look like a shirker if you go through life trying to live the good enough life.”

The solution is not about lowering standards, he says. It’s about adjusting the way we think. “High standards are very different from wanting or expecting the best all the time,” he says.

And the same is true for how we should think about our personal accomplishments. “Having very high standards of achievement – working hard, persevering, not being satisfied with what is merely acceptable – no doubt spurs people to achieve things that they would otherwise not achieve,” Prof. Schwartz says. “But there’s a crucial difference between shooting for perfection, realizing you can’t achieve it and yet still being satisfied with your accomplishments and shooting for perfection, thinking you can and should achieve it and thereby living a life of misery and perpetual disappointment.”

What’s required for a contented life is a personal investigation into what matters most. “It’s having to figure out what is worth pursuing. If you have high standards, you need to say ‘this is what’s important to me,’ in a job, in a college, in a relationship, in a house or whatever. It takes more reflection than simply allowing externally imposed ideals dictate what you should want.”

Of course, increasing age can make a person adjust the sails on her ship of expectations. Who among us mid-lifers hasn’t had to weather the knocks of life and realize that sometimes just being healthy, solvent and connected to good friends is more important than the big job you lost, the marriage that failed or the house you had to sell?

It’s about how you redefine what is excellence,” observes Dominique Browning, author of Slow Love: How I Lost My Job, Put on my Pajamas and Found Happiness. The former editor of House & Garden lost her job when the magazine folded in 2007 and found herself reeling from a number of changes. Her two sons had left home. Her post-divorce relationship of 10 years ended. She sold her “forever” house and downsized to Rhode Island. A high-achiever, accustomed to the kind of success people could see from the outside – a limo lift to a high-powered job, a house in New York, a social life among the media elite – she was suddenly adrift, caught in a “feeling of loss and disintegration.”

But one step at a time, she built a new life – freelancing, working in her garden and enjoying the beauty of each day – that didn’t have all the external markers of fulfilled expectations that she once had. “It’s about making a distinction between structure and values,” the now-55-year-old explains on the phone from Rhode Island. “My values remain the same. You can still keep your values even if you lose the structure, which can look like failure to others. I want to do the best that I can do. I care about meaningful work. I want to work with people I admire. I want to grow and I want to overcome fear.

“That’s how I would define my good enough life. That’s not defeatist. It’s the best life for me.”

Sunday, May 29, 2011

Right Where I Am: 12 years, 9 months

Angie, the brilliant creative mind behind the blog Still Life With Circles and other related blogs & projects, recently came up with the great idea to have bereaved moms (& dads) write about where they are now in their grief -- how far they've come (or not) & what life after loss is like for them at this point in time.

I have only read a fraction of the 40-odd posts linked to Angie's initial post for this project, but I suspect I am probably further along in my journey than most of the other writers: coming up to 13 years since August 1998.

I have written about this topic before, I think -- most notably on a guest post for Glow in the Woods two years ago. Most if not all of what I wrote there still applies.

Thirteen years later, Katie is still very much a part of our lives. I still miss her, and feel her absence, even though she was never really "here" in the conventional sense, & her prenatal existence less than 7 months.

We still visit the cemetery every weekend. Most times now, I don't cry, unless maybe it's Mother's Day or a special "anniversary" date or just a crappy day for whatever reason. Mostly I just feel sad & wistful about what might have been, & happy to be there, close to her for a little while. She is always with me, of course, but the cemetery is her special place, a quiet place where I can set aside all my other thoughts & obligations, and just be with her and focus on her and think about her for awhile, before resuming the regular rhythm of my life again.

But there is never a day that goes by that I'm not thinking about her in some way -- about my all-too-brief pregnancy and how it ended, about our struggles to conceive again, about how old she would be & what she would be doing now.

In that regard, of course, we have (Not So) Little Girl Next Door, six months younger than Katie would have been, to act as our constant yardstick. Last night, she and half dozen friends were whooping it up for several hours on the trampoline in the backyard, which I can see from my living room & bedroom windows. They were jumping and shrieking and giggling in youthful exuberance, well after dark, even after dh & I had settled into bed with books before going to sleep for the night. I wasn't sure whether to be sad, knowing that Katie would probably have been among them, had she been here, or secretly, smugly pleased, knowing that at least it wasn't MY daughter out there creating a ruckus in the neighbourhood ; ) and that's one thing I will never have to worry about.

Probably the biggest difference between my life 13 years ago and my life today, however, is that I am not a mother (to a living child). I wasn't then either, but I still hoped to be. I am almost 13 years older now -- 50 -- and I know now that the motherhood ship has sailed permanently, that I will never be a mother to Katie's brother or sister. I've had 12+ years to think about this, and write about it and adjust to this reality, but the truth is that I still sometimes feel like the odd woman out, even among other parents who have dealt with loss &/or infertility.

The vast majority of other bereaved parents who lose a child in pregnancy or infancy either already have a child, or go on to have another child, or maybe both. This doesn't minimize their loss in the least, of course (although outsiders to the world of grief might think it does, or should) -- but the fact is, they are still actively parenting and experiencing parenthood in all its joys & sorrows & frustrations (just not parenting the child they lost). The rhythm of their lives is very much the same as most people's -- but much different than mine and dh's. Their lives are full of bedtime stories and temper tantrums, soccer games and daycare arrangements. They will know, eventually, what it is to see a child celebrate a birthday, graduate from high school, leave home to go to college, maybe get married and have a child themselves some day. They will, more likely than not, have someone to worry about them and visit them in the nursing home and leave their most precious belongings to.

I will not.

Already, some of my peers -- my friends & cousins -- are becoming GRANDPARENTS, reminding me that not only did I completely miss the parenthood boat, there is another new, related phase of life that will not be mine to share with them. In many ways, my life (& my life with dh) has continued on exactly as it always has. Their lives have expanded and changed in ways that mine never has & never will.

At the same time, my life HAS changed -- just in more subtle ways, and in ways that parents who have never experienced loss will never know or understand. They may know the joys & pains of parenthood in a way that I never will. I have known grief, and I would never have welcomed it willingly into my life -- but it has brought unexpected gifts and richness to my life in ways I never could have imagined.

I have watched, sadly, as friends & relatives have become distant in the years since we lost Katie. At the same time, we have made wonderful new friends, both "in real life" and online, who have also struggled with infertility & childlessness and who have experienced the pain of perinatal loss, who understand us as perhaps no one else can. We've both developed much greater empathy and compassion for the pain & struggles of others, and not just in the sense of infertility and loss. We have given back to the support group that helped us so much, volunteering for more than 10 years, something that many of the parents who attended (who would also have made wonderful facilitators) just don't have time to do. We know that grief has the power to tear some marriages apart -- ours, thankfully, has survived and become stronger. We spend more time together than most couples we know. We appreciate the good things about our life together.

We have endured subtle and not-so-subtle digs over the years about how "it must be nice" to be able to sleep in late, to afford whatever new purchase someone is admiring, to be able to retire early, as we are planning with hope -- the unspoken implication being that we can have and do all of these things because we don't have children. They don't stop to consider -- will never know -- the awful price we paid to have the life we have now. (If they did, I don't think they would envy us quite so much.) We both know that there are much, much more important things in life than things, or money, or clawing our way up the corporate ladder. At the same time, though, I refuse to apologize for having some things that others don't (both material & non). I would give it all up gladly to have my daughter back, but since that isn't going to happen, I will gladly take whatever advantages & nice things life sends my way.

Almost 13 years later, my life IS better than it was, immediately post loss. I have survived.

But I still wish things were different. I still wish she was here.

Thursday, May 26, 2011

The Treatment Diaries: Weighing our options, August 2000

The entries in my journal hint at, but don't entirely reflect, the emotional strain and turbulence that I remember dh & I were going through at this time. The results of our first two Clomid cycles hadn't exactly been encouraging, and the early-morning routine of clinic visits was already taking its toll. At the same time, Dr. RE hinted that better results could be had with injectables, and that was tempting.

We spent the first few weeks of August on vacation visiting my family -- & celebrating my parents' 40th wedding anniversary (without any grandchildren for the guests to fuss over, of course, which just added to my guilt & stress). August 10th, day 28 of my current cycle, I called Dr. RE's office to make an appointment to discuss our options & next steps. The appointment was for August 17th, which happened to be day 2. If we wanted, we had the option of launching into a new cycle immediately afterwards, with the routine day 3 ultrasound & bloodwork.

In my journal, I outlined some of the points & questions I wanted to cover during our visit:
  • How do you decide which meds I should take?
  • Which injectables would you recommend for me?
  • What will it do? (Good/Bad?)
  • How much $$?
  • How taken? (Injectables = training?)
  • How many days?
  • IUIs/wash: want to try!!!

Our conversation with Dr. RE was the usual maddening mix of encouragement & discouragement. On the negative side, I said I hadn't responded very well to the Clomid, & that my LH & FSH numbers were almost inversely proportionate to what they should be. I was only producing half the number of follicles he would expect to see. Ovulating on day 21 was "way too late."

Taking injectables, he said, would be like "stepping on the gas." Even so, he said the success rates for a woman my age were only 6-10% -- "for you, it would be less than 6%." He predicted that we would be spending at least $1500 per cycle, including the sperm wash for the IUI, but said we could return any unused medications for a refund. He assured me that learning to inject myself would be very, very easy & loaned me a video that outlined what to do.

We took the video & a pamphlet & said we would think about it and let him know. In my journal, I recorded dh as saying, "On the one hand, pretty low odds... on the other hand, don't want you to have any regrets. Can't do this indefinitely -- but if it would make you happy, can max out the credit cards."

Below that, I pasted my horoscope for the day: "According to your solar chart, you are on the verge of giving up on something that you just can't seem to crack. What you don't seem to realize is that you are closer to a breakthrough than you have ever been before. Hold on a little longer -- if you give up now, you will always regret it."

!!!!!!

Still, we dithered. I have some notes in my journal, outlining what I wanted to say in a phone message I left on Dr. RE's voice mail that night: "We've decided we're really not ready to make a decision yet... we need some more time to talk this over. We've been away on holidays, we've just passed the second anniversary of our daughter's stillbirth, we've been out the past two nights, so we really haven't had the time we wanted to mull this over. We know that, at this stage, every month counts, but we don't want to be pressured into making a hasty decision that we might regret later. We're going to take another month off to explore this a little further and will call you once we've made a decision one way or another."

In my journal, I wrote these lists:

Factors

  • on holidays
  • parents' 40th wedding anniversary
  • no grandchildren (alive) = GUILT
  • 2nd anniversary of daughter's stillbirth
  • out two nights last week
  • out Wednesday night AND tonight = no time to really discuss
  • period = v. emotional
  • bad back for two weeks
  • = this is no way to make a decision!!

Should we continue with injectables?

Pros/Yes/Positives

  • increase our chances (however slight)
  • keep hope alive...
  • we haven't tried this yet, OR the IUI -- do at least once (= no regret)(could/should have done more...)
  • would only do if the numbers were right (= maybe not that often)
  • less expensive than IVF
  • we could set a limit on # of attempts/$
  • if we give up on drugs, do we give up altogether?
  • biological clock: time is running out -- make the most of it while we can
  • I WANT TO HAVE A BABY!!!!!!!!!!
  • if I don't try at least once, I will probably regret it and always wonder "what if"

Con/No/Negatives

  • 6-10% chance (more like 6% max) -- @ $1,200-1,500 -- a gambler wouldn't take those odds...
  • setting ourselves up for more disappointment, if #s not right this cycle, or if we do it and it doesn't work
  • cost factor (less than IVF but still substantial...)
  • always the urge to keep going: when do we stop?
  • more early mornings, dr's appointments, etc. -- STRESS & EXHAUSTION
  • NEEDLES (YUCK)... feel like a druggie
  • possibility of side effects (what am I doing to my body?)
  • even if pg, no guarantee of a baby, esp. w/bicornuate uterus
  • lack of support from husband? -- he'll do what I want, but... (enthusiasm lacking) = stress and strain on marriage

And below all this, a notation: "Dh agrees: see infertility counsellor, get neutral 3rd party perspective."

*** *** ***

Several months earlier, I had attended an all-day Saturday seminar on IVF, sponsored by a local infertility support group. The guest speakers included various local REs (including my own), embryologists & researchers, representatives from sperm banks, and a couple of infertility counsellors who addressed the emotional aspects of treatment and parenting after infertility. I was particularly impressed with one counsellor who seemed friendly & down to earth, and had some great, practical points in her presentation. I picked up one of her business cards at one of the display tables, which said she did individual & couples counselling, specializing in grief, loss and reproductive issues. Perfect. I mentioned her name to one of our support group colleagues and was told that we regularly referred clients to her for individual counselling, when they requested it.

So on August 18th, I left a message requesting an appointment for dh & me with the infertility counsellor, briefly outlining our story and how I had found her, including the fact that we were wrestling with the decision whether to move on to more aggressive treatment. Our first meeting with her was on August 30th. We left work early and took both the subway and a streetcar to get to her office, in a funky old building in one of Toronto's ethnic neighbourhoods.

The night before our meeting, I had a strange and vivid dream that I described in my journal. I was trying to decide whether to give myself the Gonal-F injections... and I decided to just try giving myself shots -- so I was drawing up fluid from Vitamin E capsules (!) & injected myself in the stomach with them. It HURT, & I had blood and Vitamin E oozing out of holes everywhere on my stomach. Yuck.

Then the dream changed, and dh and I were on a bus with all of my coworkers -- only instead of seats, there were beds up & down the aisle. We were in bed, & I woke up and started fumbling with my thermometer to take my temperature (beep, beep...) & with the stuff to inject myself with. Dh rolled over, got up and went to the bathroom -- came back, but walked by me and crawled into bed with one of my (younger) coworkers!! who patted him on the back!! I started crying & crying, and hissing at him (trying not to make a scene), "Come BACK here!!"

I woke up in a cold sweat. I figured it reflected my subliminal fears that dh would quickly get tired of all this infertility crap and move on to a younger, more fertile woman. :(

My horoscope for the day read: "Someone you work with or know socially can be of inestimable value to you today -- all you have to do is let them help you out. Not even a Capricorn knows all the answers, but you will meet someone today who has the one answer you really need. Listen and learn."

*** *** ***

We hit it off with the counsellor immediately. Besides having infertility in common, she was originally from my home province, and we discovered we even knew a few of the same people. She told us a bit about her story, and we told her ours.

She started off by asking us what we needed from each other, and what we feared. Dh said he personally was ready to call it quits, but he didn't want me to have any regrets. He said his greatest fear was actually another pregnancy. The counsellor told him that was entirely understandable.

I said that while I wasn't wild about the idea of further, more aggessive treatment, and I didn't think I wanted to still be doing this when I was 45, I didn't want to give up just yet. I wanted to try the IUI at least once and see if the numbers improved. My fears: (1) the money & stress, (2) what am I doing to my body?? & (3) the needles. The counsellor said that was a very common fear.

The counsellor commented that to limit ourselves to just one try would be putting a whole lot of stress on ourselves (all our eggs in one basket). She suggested three trys -- setting a limit, as Dr. RE had suggested at our very first meeting. By three trys, she meant three "good" cycles, where we actually got to go through the whole cycle & do the IUI. If we were unsuccessful after three tries, she suggested either moving on to IVF, or stopping treatment altogether. "Call me then," she said. "It will help in making the transition."

She recommended Alice Domar's "Healing Mind, Healthy Woman" to me, and suggested a website I might want to check out (I didn't write down what it was & I can no longer remember).

We left feeling MUCH better and that it had been an hour, and money, well spent.

Monday, May 23, 2011

The Treatment Diaries: The Clomid Capers I & II, May- July 2000

We decided to go ahead & try Clomid for the next cycle. I got my first package on my day 3 visit to the clinic on May 10, 2000, & got the go-ahead to start after my bloodwork came back later that afternoon. (I also got told my triglycerides were slightly elevated, & my thyroid readings were slightly out of whack, which led to an adjustment in my medication.)

I started off on a dose of 50 mg (one pill per day). Cost: $32. In my journal, I listed the side effects I was feeling: sensitivity to bright light, FATIGUE, dry mouth in the morning, and a constant, dull headache.

We were at the clinic for ultrasounds & bloodwork on days 3, 8, 11 & 15, which (like today) was our Victoria Day holiday Monday. The follicles in my right ovary that day actually measured smaller than they had on day 11. "I'm shrinking??" I wrote in my journal. When I returned on day 18, the follicles in the right ovary were measuring more or less the same, but there were NO follicles visible in my left ovary. ??? Did I ovulate? I was asked to return on day 24, at which point there were no follicles in either ovary.

My notes from my conversation with Dr. RE that morning include this quote from him: "Your follicles went ppphhhttt." He said either I needed a higher dosage of Clomid or a different drug, & that we'd try a higher dosage first. Later that evening, he called me at home: my progesterone levels were way up, indicating I had ovulated. "How? I can't tell you," he said. "You can't be making that much progesterone & not have ovulated." He once again expressed interest in seeing the film of my HSG, & I signed a release form at my next office visit (on day 26) so that he could get it from the hospital.

We were back on day 33 for a pregnancy test -- which was, of course, negative. Dr. RE said he wanted to increase my dosage for the next cycle, although he warned that it would also likely increase the side effects.

*** *** ***

AF arrived on June 1, kicking off Clomic cycle #2. My dosage was increased to 100 mg or two pills per day (cost: $64), and the side effects I had experienced during my first Clomid cycle continued.

When we arrived at the clinic for our usual day 3 bloodwork, however, V., the friendly girl who had been taking my blood & answering my questions, was gone. She was replaced by N., an older woman who said little & had a much heavier hand with the needle (OW!). By Wednesday, I had a big yellow bruise on my arm. I later learned from the girls in the lineup at the u/s clinic that the dr had let V. go, wanting someone with more clinical experience. :( What a shame -- she made the experience so much more pleasant.

Day 7: the follicles on my right side were minuscule & on the left side, none could be seen. Great. :p

Day 14: We sat in the waiting room for 20 minutes, while N., the new technician, wandered (seemingly aimlessly) from the fridge to the lab & back again. There was nobody else in sight. Finally, as the waiting room began to fill up, I actually went to find her and ASK her to take my blood. Dh hates to be kept waiting at the best of times, & he was furious. It was almost 8:30, a half hour later than usual, when I finally slunk into the office (& we hadn't even seen the dr, either). Day 18, I had six women ahead of me in line at the ultrasound clinic, had to wait half an hour to chat with the dr, & didn't get into the office until nearly 9.

The chat hadn't been that encouraging either: Dr. RE walked in, shaking his head & saying, "Lori, Lori, Lori..." He told me my estrogen levels were half of what they should be, and (not for the first time) hinted that I might want to consider "other options." He told me to return in two days, but suggested that if my results continued to be poor, I should consider timed intercourse, instead of spending money on an IUI. Which was what happened.

My notes quote the dr as saying, "You have to think about what you want to do... how long you want to keep doing this..." and "there's no point in having you come in every two days if your numbers aren't better than this." (Reading this now, I keep wondering how I managed to keep slogging on as long as I did...!)

Later that night, dh & I must have had a talk, because I have some quotes from him too (along with a note: "discouraged/angry"): "I know he's just giving us the truth as he sees it... but he could be nicer/less negative about it!" And: "I'm most concerned about you... Maybe we should just live our lives. Don't need negativity, feeling bad about ourselves." My notes end: "Agreed: will talk more later."

Surprise! Our next visit on day 20 showed an LH surge. TI it was.We returned on day 27 (our 15th wedding anniversary) & day 34 for a pregnancy test -- which was negative.

"So what do you want to do next?" K., the office manager asked me over the phone, after delivering the bad (but not unexpected) news. "Have you thought about getting a little more aggressive?" What we were thinking about most, actually, was our upcoming vacation. I told her we would call when we returned.

Sunday, May 22, 2011

The Treatment Diaries: Dr. RE & a diagnostic cycle (February-May 2000)

While waiting for my RE appointment on Feb. 24, 2000, I was trying to track down the results of dh's SA. He'd (finally) taken his sample to a local lab on Jan. 12th, & while I knew my family dr's office had the results as of Jan. 20th, we still didn't know what they were. I called his office again on Feb. 10th (four weeks after the test, three weeks after I knew the dr had the results and two weeks before my RE appointment) & was told the dr STILL hadn't reviewed them. The receptionist did tell me that the count was low and motility only 50%, when 70-100% was what the drs wanted to see. We went to the RE's office still in the dark.

Dr. RE's office was in an office tower a couple of subway stops north of where we worked. In my journal, I noted "35ish? Well spoken, seems to know his stuff. Not board certified yet, but trained in U.S." He had only recently set up shop in our city, which is why our wait to see him was (relatively) short; I later heard from other patients that the waiting lists at other local fertility drs & clinics were anywhere from six weeks to six months.

Dr. RE had various records & test results that Dr. Ob-gyn had faxed to him, including my temp charts. Our chat was a maddening mix of encouragement and discouragement. I was glad he seemed to be being honest with us, but also thinking he didn't have to be THAT honest, lol. My notes from our visit outlined some of the issues:

  • While Dr. RE had received my Pap results & endometrial biopsy results, he didn't have my HSG results or any of my bloodwork results (or dh's SA results).
  • My last Pap test in October had discovered some abnormal cells. !!! This was news to me. I was stunned. Why hadn't I been told before this?
  • While Dr. Ob-gyn had pronounced the results of my endometrial biopsy as normal, Dr. RE said the results pointed to a luteal phase defect.
  • My temp charts showed that "if you're ovulating at all, you're not doing it very well." He said if I was ovulating, it was happening "too late." This was my first indication of one of my main gripes with Dr. RE -- his seeming obsession with having me ovulate on day 14. From everything I had read, only a small percentage of women ovulate on day 14, & I knew I was not one of them. My cycles were generally around 35 days, which I didn't think was abnormal, but not according to Dr. RE, who kept talking about 28 day cycles as the gold standard.
  • Contrary to what Dr. Ob-gyn & the radiologist had told me when it was discovered, my bicorunate uterus most definitely COULD be a problem in sustaining a future pregnancy. Dr. RE told me there was a 30% loss rate associated with these kinds of uterine abnomalities. At the same time, he agreed with Dr. Ob-gyn that he wouldn't recommend surgery to repair it. "It's there -- it may or may not be a problem -- there's not a lot we can do about it," he said.
  • My age (39) was an obvious negative, which I already had figured out. I got the "after age 37, there is a dramatic decline in fertility" talk. Success rates are not too good for women in their 40s, even not including a bicornate uterus. "Getting pregnant is one thing, carrying to term is another," he said.

All this said, Dr. RE recommended starting with a monitored cycle to see just what my body was doing. We talked a bit about the various kinds of treatment & the costs involved. Dr. RE said he recommended three cycles of any given kind of treatment. "Set a limit up front," he encouraged us.

*** *** ***

I went back to the office -- and called Dr. Ob-gyn's office. I'd been told they would call me if there was anything out of the normal to report from my Pap back in October. Why hadn't I been called about my abnormal results???

The secretary agreed that I should have been called. She said in these cases, the Pap was usually followed up with another six months later, & made me an appointment for April 14th.

*** *** ***

Friday, April 1st, I started spotting. I knew AF was imminent, so I called Dr. RE's office. What next? A friendly young woman named V. told me we would start cycle monitoring on Monday, day 3. First, she told me to report to a radiology clinic near Dr. RE's office between 7 & 8 a.m. for an ultrasound, then bring the results to the office, where I would have some bloodwork done, and possibly a short chat with the dr.

Dh & I normally get to the office at 8 a.m., rising at 5 & leaving the house by 6:30. We checked the train schedules & found that if we took the earliest train, shortly after 6 a.m. (gulp), then the subway, we could get to the radiology clinic just before it opened at 7. We set the alarm clock for the ungodly hour of 4 a.m.

We got to the radiology clinic about 10 minutes before 7. The door was locked, but there was already a small group of women in the hallway. Dh was the lone male, as he usually was in the months that followed. Nobody spoke. Just before 7, a middle-aged woman got off the elevator, & opened the door with a key. Everyone seemed to know the drill, except me. I think I had to ask someone what to do. We signed our names in a binder on the front desk, picked up a hospital gown & went to a series of cubicles at the back to change. (Dh remained in the main reception area.) It was first come, first serve, and I soon got quite adept at quickly shedding my street clothes, changing into my gown & getting into line.

Sometimes, we'd chat among ourselves, sometimes we'd just stand alone with our thoughts. Dr. RE was one of several independent REs using this clinic's ultrasound services, and many of the women had been to other REs in the past. They compared REs, dosages & protocols. Encouragingly, many of them said Dr. RE was the best they'd ever been to.

Some of the women had quit their jobs or downscaled to part-time employment to focus on getting pregnant. I didn't feel quite so sorry for myself about my commute when I heard that one woman had driven in that morning from Niagara Falls, which was about two hours in good traffic. I also heard a woman in Dr. RE's waiting room who had come from Sudbury, about six hours to the north. She did her regular monitoring there & came to see Dr. RE at critical points in her cycle.

When it was finally my turn, I walked uncertainly into the room. The grey-haired u/s tech handed me a clipboard & a pencil, and told me to remove my underwear & get on the table, feet in the stirrups. She put a condom on the u/s wand (!), put it inside me, and started dictating numbers (follicle measurements) for me to write down as I lay there, trying to see what she was seeing on the screen. (She often had difficulty seeing what was on my left side.) I was in the room for all of about five minutes. When she was done, I wiped myself off, put my underwear back on & left the room. She told me to take the piece of paper back to the RE. It was like being on an assembly line.

I got dressed again & met dh in the reception area. I got into the habit of copying down the number of follicles & the range of measurements for my own record before we headed out to Dr. RE's office, several blocks away. V. took my blood (& dh's too, I think?) & said she would call me later with the results, which she did. Everything was looking normal, she said. I was to come back on Friday, day 7 -- same routine. I scurried into the office, late, hoping nobody would notice.

I called Dr. Ob-gyn & asked that the missing test results be sent to Dr. RE.

Back at the u/s clinic Friday morning (day 7), & again on Monday (day 10). Both days, the tech asked me if I was on clomid or hormones. "No," I said. "Perhaps that's the problem," she said. Problem??

Dr. RE, on day 10, told me I wasn't doing very well, that he expected to see some follicles by now. He had finally got some SA results for dh: at 15 million, his count was on the low side, as was the motility. He mentioned he'd like to do an u/s on me himself to determine whether I truly did have a bicornuate uterus (but never mentioned it again on subsequent visits).

On day 13, he grudgingly admitted that "you could be having a long cycle & ovulate on day 19 or 21" (which was, in fact, the norm for me). Back on day 17, he seemed surprised that I looked ready to ovulate after all. The next day, the u/s tech told me, "You must have ovulated; the big follicle I was tracking isn't there anymore." Dr. RE confirmed: "You ovulated!" He said my estrogen levels were on the low side, but he felt I would respond well to treatment. He told me to come back in a week for bloodwork only (to measure my progesterone levels).

By day 31, my temperature had dropped & I had started spotting. I went in for my scheduled pregnancy test on day 32 (May 9th). I knew I wasn't pregnant, but I was eager to get on to the next cycle.

Dr. RE discussed the next steps with me on the phone. He said I had had a "normal" cycle & "whatever you are willing to go ahead with." I said we were not comfortable with proceeding straight to IVF (the cost factor in particular was daunting). Dr. RE told us there was statistically little difference between an IUI cycle with clomid and with injectables for 40-something women, although he felt Clomid sometimes had a detrimental effect on the uterine lining, & he also felt the side effects were sometimes worse than with injectables.

He suggested we come in the next day for an ultrasound and bloodwork, & he could provide us with a prescription for Clomid or injectables, depending on what we had decided to do.

*** *** ***

In the middle of my monitored cycle, on April 18th, I was back at Dr. Ob-gyn's to have a repeat Pap exam -- actually a colposcopy, which was a little more involved, but still nothing too bad. He apologized that the test results had slipped through the cracks, for whatever reason. He reassured me that what I had was "mild dysplasia -- this is NOT cancer." He went on to say that this was the beauty of the Pap test -- it caught little problems before they turned into big problems.

It was May 3rd before I discussed the results with Dr. Ob-gyn on the phone. He said there was a very tiny area that was showing some very low-grade irregular cells -- "if it was any lower, we wouldn't be having this conversation." He said it was nothing that should preclude me from getting pregnant, or trying to get pregnant. He told me that sometimes, these things reversed themselves without intervention, & asked me to come back in another six months for another check.

I remembered that one of my girlfriends who also went to Dr. Ob-gyn had gone through something similar, so I called her up. She said he'd been monitoring her for more than five years (!) & that he'd actually noted some recent improvement. A friend of hers, also a patient of Dr. Ob-gyn's, had actually had a procedure to laser off the abnormal tissue, but had pronounced it as "nothing" & had been fine since then. That made me feel a little better.

*** *** ***

Dh & I had signed up for an Alpha course at our church that spring, and on May 4, I wrote that the subject had been "How & why to read the Bible." Both the speaker in the video and my small group leader said that often, at critical times, certain passages in the Bible would leap off the page and "speak" to you. We all flipped through the Bible to see what we came up with -- and while my first venture landed on the story of Daniel, a subsequent dive into the book came up with the story of Elizabeth -- old, barren Elizabeth, Mary's cousin, who conceived a baby who became John the Baptist.

I was thrilled. I wrote in my journal: "Maybe not this cycle -- maybe yes -- but I took hope from that little "coincidence" -- I WILL get pregnant again. I WILL have another child someday."

Friday, May 20, 2011

The Treatment Diaries: First steps, August 1998 - February 2000

Dr. Ob-gyn had barely walked into my hospital room that sad day after I delivered Katie in August 1998 when I had asked him, "When can I try again?" I was 37 years old, we had been trying 2 & 1/2 years on our own before I finally got pregnant. I knew the clock was ticking & there was no time to waste. At the same time, I figured we hadn't been particularly strategic in our approach to getting pregnant until now. Surely if I read a few books and educated myself on fertility issues, tried a few simple things, we could slash that time considerably. Couldn't we?

We used rudimentary birth control until we'd hit the three-month mark, to give my body a chance to heal. I was home on leave for about 10 weeks, & I had lots of time to read, research and reflect. I hit the Internet with a vengeance, & joined a private e-mail list for subsequent pregnancy after a loss, which included women in pursuit of a subsequent pregnancy as well as those already subsequently pregnant. I remember buying a basal thermometer (& the first of many, many boxes of ovulation predictor tests), and a copy of "Taking Charge of Your Fertility" by Toni Weschler. I ripped the chart at the back out of the book & (lacking access to my office photocopier) on the September day I went to see Dr. Ob-gyn for my six-week postpartum checkup I took it to a Kinkos office near the hospital & had a dozen copies made. Hopefully, I wouldn't need them all...

Over time (even while in infertility treatment), I tried other "home remedies" I'd heard about (although I didn't go to quite the extent I've read some people doing). I bought a saliva microscope (which was essentially a waste of money). I guzzled Robitussin by the gallon, watching drugstore flyers for sales & stocking up. I kept taking prenatal vitamins, with their extra dose of folic acid, as a pre-emptive measure.

But as the one-year anniversary of Katie's stillbirth arrived, I could feel my anxiety mounting. I was 38, with 39 fast approaching, & dh was 42. We'd been trying for 10 months, with no success. Maybe there was some simple issue preventing me from getting pregnant that could be easily fixed. Didn't we owe it to ourselvces to investigate, to at least find out what the problem(s) might be, see what our options were?

Dh, like many husbands in our situation, was less enthusiastic than I was to press the matter, but agreed we should probably look into it. And so, on September 20th, 1999, I made The Call to Dr. Ob-gyn's office. (As a reporter, I've long been in the habit of planning my phone calls & writing down all the points & questions I want to cover before picking up the phone, as well as taking notes during the conversation, & my notes are transcribed into my diary.) I reminded his receptionist who I was, explained that it had taken me 22 cycles to achieve my first pregnancy, & I was now on cycle 10 and 38 years old. "I'm not sure how far we want to take this," I said, "but we'd like to have some fertility testing done to uncover any issues and find out what our options are."

The next available appointment was in six weeks. Six weeks??! Oh well. I took it.

It was a Thursday morning, October 28, 1999, when I finally got to see Dr. Ob-gyn again. I brought copies of my charts, but he barely looked at them. He did a Pap test (surprise!), and suggested we start with an HSG next week (Nov. 3), & that dh arrange to have a sperm analysis done through our family doctor.

After consulting my Internets, I took a couple of ibuprofen a few hours before the HSG, and also some amoxicillin, in deference to my very mild heart murmur. I had an "OW" moment when the clamp was placed on my cervix, & the liquid dye injected inside me felt cold, and I had some very mild cramping later, but otherwise, it really wasn't that bad. I watched in fascination as my bicornuate uterus -- which had been detected mid-pregnancy with Katie -- gradually popped into view. It looked like a Y or a slingshot. The dr concluded that the left tube was blocked -- although at our next meeting, he said that after looking at it again, it was actually fine (!). (This was not the first nor the last time that one of my drs said one thing one time and another thing the next, which I found incredibly maddening & frustrating.) He told me to call if/when I got my period & we'd try another test next cycle.

That was Nov. 22, & I dutifully called the office. The next step, I was told, would be a post-coital test, which we scheduled for Dec. 6. No sex for two days, then sex precisely two to four hours prior to my 10:15 a.m. appointment. Since our usual commute is 60-90 minutes, the logistics took a little thinking through, but I dutifully reported to the office on time.

Dr. Ob-gyn looked at my sample & said he detected some movement but "not quite as much as thought there would be." Dh had been procrastinating on getting tested, & Dr. Ob-gyn recommended he do so ASAP, "before we hammer you over the head with anything more." He was going away between Dec. 18 & 28th, & we were going to my parents' for Christmas, so we agreed that I would call him when I got my period (or got pregnant) in the New Year & figure out our next steps.

I called on Jan. 4th (2000). Dh (still) hadn't been tested, but my journal notes say he had PROMISED me he would do so that week or the next. If memory serves me correctly, he wound up taking an entire day off & getting it done on my birthday (!).

To be fair to him, it wasn't (just) squeamishness on his part. Trying to figure out the logistics of just how to do this was challenging, and actually somewhat ridiculous. When you're under the care of an RE & fertility clinic, everything is laid out for you, but we were pretty much on our own. I had asked whether he could do it at the hospital where Dr. Ob-gyn practiced but for some reason, that option was not deemed do-able. He got a sample bottle from our family dr, & I called around to a couple of medical labs close to where we lived to find one that would do the analysis, looking at clinic hours & figuring out how long it would take him to drive there with his precious cargo, keeping it at body temperature in our sub-zero temperatures.

On Jan. 20th, about a week after the deed was (finally) done (and I had totally forgotten about this until I went back to re-read these diaries), our dr's receptionist called us. She had the results from the lab -- but all the envelope contained was a blank piece of paper (!). I told her what I knew, & she promised to call me back. I couldn't believe it -- was dh going to have to through this whole rigamorole AGAIN??

She called me back later in the day: they finally faxed her some results, but now the dr would have to look at it. Four days later (!), I called to find out what was going on: the dr STILL hadn't had a look at the results -- & probably wouldn't for a few days, since he was heading out of town.

Meanwhile, I was scheduled for an endometrial biopsy on Jan. 25th. By Feb. 4th, I still hadn't received any results, so I called Dr. Ob-gyn's office. I was told the results were fine, & the next step would be to start clomid when my next cycle began.

My notes indicate that I talked to Dr. Ob-gyn himself later that day. He said he could put me on clomid & we could try that for a few months, "but I'm not sure there's any value in that. Or," he continued, "I could send you to one of my buddies in the infertility field."

I was 39 years old, & had been puttering around with testing for almost five months now. My biological clock wasn't just ticking, I could hear the alarm ringing. I had been on enough Internet forums to know I didn't have any more time to waste, & that an RE was the way to go. I asked for a referral. His secretary called me back later that day with a name, address, phone number and date: Feb. 24th at 1 p.m.

"Keep trying," Dr. Ob-byn said. "If nothing happens, you still have the appointment."

Monday, May 16, 2011

Blogger ate my post & comments :(

I know I'm not the only one who was affected by Blogger's problems over the weekend. :( Two of my posts, & the comments posted on them, went missing. :( And I notice the "publish" button still isn't working?? (Anyone else have this problem? It's only my home PC, not at work. I recently had my browser upgraded to IE9 & I am wondering whether that has anything to do with it??)
BUT (...anyway!)-- fortunately:
  • My most recent post was originally lost, but then retrieved from the depths of Bloggerdom (although I lost a few comments along the way).
  • Another, earlier post was NOT reposted by Blogger & is presumably lost :( -- BUT, I could still read it (& copy it!) from my Google Reader. : )
  • I still have the e-mail notifications of all my comments. : )

So here, for posterity's sake, is the missing post, along with the lovely comments I received:

*** *** ***

TGIO (i.e., Thank Goodness It's Over)
(originally posted on May 11, 2011)

I knew I should have avoided FB on The Day That Shall Not Be Named. One status update/meme I read: "In honor of Mother's Day, post the name & birth weight of your children as your status if you're a proud mom." I had to bite my cybertongue to resist posting "Kathleen Maria, 125 grams." I'm willing to bet the silence in response to that one would have been deafening.

Couldn't find a movie I wanted to see, so we spent a lazy day at home, with a brief outing to Dairy Queen where I drowned my sorrows & frustrations in a Skor Bar Blizzard. : )

And how was your weekend?

*** *** ***

Kind comments received (thank you!)

From Lisa in SK: Lori...you should have posted on FB...far too many "forget". Next year...post it. You are forever a momma and deserve some credit. Glad you got through the day. Take care...

From Colleen: Over the years, I have gone from not being able to handle the day that shall not be named (I love that....). But over the last couple years that has changed. I think that is because I have had several friends and coworkers lose their children over the last couple of years. It has been so heartbreaking. I spent part of Mother's Day writing them messages on FB because I am sure the day was not easy for them. I guess maybe I should have sent them a card or called but I was thinking it is not always easy to sign in to FB so maybe a message would make it 100% easier. I never can feel bad for myself because I am thinking about them. You are included in that. Katie is super special.

Our priest this year and last included me in his blessing too as women who are not able to have children. I thought that was super special. My DH even said when we left that he is such a IF oriented priest. Few and far between. I just wish he was 30 years old instead of 85 years old! He is such an amazing man who made my day. :)

From One-Hit Wonder: Oh man, I think you definitely should've posted Katie's name. She was a real person and you are her mother - a mom to a saint in heaven - and you deserve to be honoured as such.

I always think of my niece and nephew who were stillborn and, if my SIL posted a similar comment about them, I'd be happy to acknowledge it. I never forget about them. But that's just me.

Anyway, I'm remembering Katie with you.

From Mrs. Spit: It passed. I saw that same status. Saw it from a woman whose first baby had died. She didn't include her first, which surprised me.

Wednesday, May 11, 2011

Introducing: The Treatment Diaries


Earlier this year, I wrote about how I found the journals I kept during my infertility treatment days, and thought there might be fodder in there for some retrospective posts, a la my "1998 Memories" series of posts from a 10-years-later perspective.

I'm fast approaching the "10 years later" mark for my last round of IUIs -- and our decision to remain childless/free -- so I figured I'd better get writing!

Here's a photo of my journals -- two of them, alike (although the second one is only about 1/3 full). The journal itself was made by Antioch Publishing, featuring artwok by an artist named Joyce Birkenstock. You can immediately see why it appealed to me, as the mother of one angel in heaven, hoping to have another with her here on this earth. : ) The journal came with a matching bookmark with a Bible verse: "We know that in all things God works for the good of those who love Him, who have been called according to His purpose." (Romans 8:28). There are other Bible verses on the pages throughout.

On the inside front cover, I wrote my name, the date(s), and a title: "Babyquest." (!) Journal #1 covered September 1999 to June 2001 (which is actually the full span of our fertility workup & treatments). Diary #2 is dated June 2001, but the last entry is dated Oct. 16, 2001.

Below that, I wrote the names, addresses & contact information of my family dr, Dr. Ob-gyn, Dr. RE & the infertility counsellor we consulted. The next inside page was a sort of combination calendar/chart I drew up. Cycle #s ran across the top, cycle days down the side, & on various dates, I've written numbers & size ranges of follicles. IUI dates are circled & marked with a star.

I've also pulled out my datebooks from that time period to help me remember.

Here goes...! More to come soon...

Saturday, May 7, 2011

Book: Shania Twain: "From This Moment On"

I couldn't resist picking up Shania Twain's new memoir the other day. It was 30% off, 40% with my discount card. I'm not a HUGE fan, but I do like some of her stuff, & of course I am proud that she is Canadian. ; ) I know a bit about her personal story, of course -- I grew up in a couple of small northern towns myself (Manitoba & Saskatchewan, not Ontario), so I can relate in some ways -- I've been to Deerhurst Resort, where she sang in the cabaret show. She hasn't experienced infertility or pregnancy loss (that I know about, anyway), but she's not had an easy life in many respects, & I admire that she has worked so hard for everything she has.

One of my friends from our support group said she couldn't listen to "It Only Hurts When I'm Breathing" after the loss of her daughter -- it just hit too close to home. Whenever she was listening to the CD in her car, she would skip over that song. She didn't think anyone noticed, but nope, her two other kids did & asked her why! I can't remember what she told them, but I do remember that story.

I haven't read the book yet -- trying to resist until I finish the book I'm currently reading (a bad habit I have...!) -- but of course I couldn't resist flipping through a few pages. Would you believe, when the story opens with her birth, the doctors thought she was stillborn, because she came out blue & not breathing??

And there's a great quote on the back cover that resonated with me:

"When everything goes without a hitch, where's the challenge, the opportunity to find out what you're made of?"



You-Know-What Day

How is Mother's Day like Lord Voldemort of the Harry Potter books & movies? When you're infertile &/or have lost a baby, it's "The Day That Shall Not Be Named."

Of course, it's pretty difficult to avoid. Everywhere you turn, in stores, on TV, in the newspapers, ads & articles singing the praises of motherhood & Mom (& finding the perfect gift for her, of course). We did go out for dinner tonight, but plan our usual strategy of avoidance tomorrow. Perhaps a movie, if we feel like it. AF has once again decided to keep me company on this weekend (how considerate of her -- not), so I will see how I feel.

I did get a wonderful gift just before this weekend. I recently reconnected with one of my good friends from high school on Facebook. We've drifted apart a bit over the years -- we exchange Christmas cards & have had a few brief visits over coffee, but rarely e-mail, so it's nice to reconnect with her on FB. She resisted its siren call for a long time, concerned about privacy & security, but finally caved (I suspect her new granddaughter -- yes, granddaughter -- might have something to do with it).

Anyway, we exchanged a couple of private messages & at the very end of one, she wrote:
"You and [your dh] were on my mind tonight. [My dh] and I were at a fundraiser for a Crisis Pregnancy Center. Their focus tonight was to honor women/couples who have lost a baby. One couple shared their story. It made me realize how much pain you must have gone through and the long journey to healing. Even now, your heart must long for her. You are in my prayers."

I was at work when I read this & it was all I could do to keep the tears from rolling down my face. It was probably the best gift I could have received just before You-Know-What Day, & I wrote back & told her so. Makes me think there might be hope for humanity yet. ; )

Mother's Day 2010

Pre-MDay 2009

Mother's Day 2009 (Baptism)

Mother's Day 2008

Pre-MDay 2008

Sunday, May 1, 2011

Stuff I've thought about or remembered since my last post ; )

  • I've only seen the Royals once in person -- but four at once, not bad! -- the Queen, Prince Philip, Prince Charles & Princess Anne. It was July 1970 & I was 9 years old. They were touring my home province of Manitoba for the province's centennial (as well as a few other places in Canada) & attended a Sunday morning church service at the grandstand at the fairgrounds in the town of Dauphin, which was about an hour's drive from where we were living at the time. My grandparents came from Minnesota for the occasion, & my sister & I wore the matching knit dresses my mother had had made for our aunt's wedding a few weeks earlier. Mine was lime green with a white scalloped yoke, & my sister's was the same, only in lilac. (It was the '70s.) They left the fairgrounds in open convertibles, & my dad got a wonderful picture -- with our old Kodak box camera, no less -- of the Queen waving, with a white-gloved hand. My grandfather said, "I was close enough to touch her," & we really almost were.
  • Years later, we found a letter from one of my grandfather's aunts, reminiscing about when she & her sister went to Winnipeg to see King George VI & Queen Elizabeth (the present Queen's parents) in 1939. She said the King wasn't much to look at but the Queen was a very handsome woman, lol.
  • As I posted on FB, I realized while watching the wedding that it's been 30 years since I watched Chuck & Di get married. If it takes another 30 years for Will & Kate's son or daughter to marry, I will be EIGHTY. Gulp. (But probably still getting up early to watch. Wherever I am...!)
  • Oh yes, & even before the wedding last week, I saw one of the trashy magazines was already speculating about a royal baby -- specifically suggesting that Kate was a pregnant bride. And that if it was a girl, she would be named Diana, of course. Good grief. Leave the kids alone, will ya???
  • I know the Royals aren't everyone's cup of tea. But I have to admit, I found it kind of funny that Americans -- who founded their country in order to dispose of things like the monarchy -- were probably the most gaga of anyone about the wedding. Much as I love all things royal, even I found all the pre-wedding coverage a little over the top. I switched back & forth between CBC & BBC Canada for coverage of the wedding itself.
  • The Globe & Mail had a great editorial in today's paper about the wedding. I especially loved the last few lines: "It may not matter in the way that the exchange or prime interest rates matter, or the federal election outcome matters, or Japan's nuclear crisis matters. But the monarchy remains central. Moreover, love matters, and so too does the fact of the persistence of something great and noble of the past in our harried world."