Adventures in making and raising our test-tube babies

Saturday, September 27, 2008

Blessing 4: The Outer Trappings

As I am an expert in all things reproduction, I can tell you definitively that there are two realms of pregnancy: the biological and the cultural. We'll call them the inner and the outer. You'd think the inner would be more important, since it really is where the baby-making happens, but to someone who has suffered infertility, the zingers really come with the outer.

Several years ago I finally got the chance to try to make a baby, something I'd wanted viscerally for over a decade. So I launched into things blindly, based simply on my gynecologist's advice that I was most fertile 14 days before my period. Up until then, I really didn't know timing had anything to do with it.

And so began a journey of peeing on sticks (two kinds; both expensive), acrobatic maneuvers, charting basal body temperature, and being disappointed once a month. Then came a little more reading about hormones and body infrastructure, the details of the menstrual cycle, and some oral medication. From there we proceeded to invasive testing on both of us, then learning how to get a baby going from outside you. There are shots to the belly and butt (self-administered or husband-administered), reconstituting powdered medication, screwing with your body's own endocrine system, going to get your blood tested and your uterus ultrasounded every day, and finally leaving it up to Dr. Frankenstein to make it happen in a lab.

And that, because I was lucky, was only the beginning. What I thought was going to be a downhill slide from IVF turned out to be a very difficult trek through the desert. I won't say it's been an uphill battle, but it's no waterslide. Pregnancy can mess with your hormones as effectively as hormone shots. And the bundles of joy inside you can make you a constant threat for projectile vomit. In my case, as they subvert all my energy and nutrients, I've been left almost bedridden for months. For my trouble (and the trouble of my caretakers), we've gotten to see them move and develop on the ultrasound, watch my belly grow, and dream about our growing family.

The inner part is a dream come true.

But it's the outer part that I've actually been dreaming of since I was 25. And bizarrely enough, that's the part that feels much more real.

Out there in life, in the grocery store, in the airport, and among your friends, you see pregnancies and babies happen all the time. And for the most part, nobody is talking about the inner realm of pregnancy. Not to me. Certainly not the strangers in the airport.

For over ten years, ever since I felt a tingle in my hand walking down the street in New Orleans and knew that a toddler's hand should be inside mine, I have looked at pregnant ladies with awe and envy. Here's what I knew about them:

  • Pregnant ladies get to buy clothes in maternity stores.
  • Pregnant ladies get to have ultrasounds with the wand on top of their bellies instead of inside their bodies.
  • Pregnant ladies get baby showers.
  • Strangers put their hands on pregnant ladies' swelling abdomens.
  • Strangers ask pregnant ladies, "When are you due?"
As you can see, I developed a very comprehensive understanding of the pregnant experience.

Because I was a girl who didn't really know what ovulation was until 2006, I wasn't expecting any of the inner stuff. But the outer stuff was a different story.

When I learned that I was pregnant, I could barely believe it. I heard it in a roundabout way from the pharmacist, so the news came as more of a puzzle than a declaration. I have thought and said that learning I was having twins, on the ultrasound table holding James's hand, was the happiest day of my life. But truthfully, I think the happiest day of my life was the day I finally had enough strength (barely) to go to the Motherhood Maternity clothing store in the mall.

I had literally been on the outside, looking in, to the maternity clothes shops in malls for years and years. I went in once, very briefly, feeling like a fraud, and quickly walked out again. Lots of times, I stood outside the window, looked at the clothes, and had to fight back tears. When I finally got to go to one legitimately, I squeezed James's hand again. As we got closer to the entrance my nauseated self started hopping with excitement. When we got inside among the racks of clothes, I could barely breathe. I looked around at the other shoppers, with bellies the same as or bigger than mine. I belonged. I wasn't a fraud. I was buying maternity clothes for myself because I was pregnant! (In the end, James bought them for me because I felt woozy and had to go sit outside and eat a granola bar).

Several weeks ago we ventured out of the house to go to an orchard outside of the metro area. We've picked apples there before, but this time we went to just go buy some. Actually, we went just for the drive. When we got out of the car, I was wearing one of my Motherhood Maternity outfits -- the kind that leaves no doubt in the viewer's mind that the wearer is pregnant. The woman selling the apples said, "Oh, when are you due!?" I reeled. I told her March, and she looked surprised. I was so big! I explained that it was twins. She was delighted. I was way more delighted.

Recently my neighbor Wendy came over with her new roommate to visit the pregnant invalid next door (me). She was so excited for me that she asked if she could touch my belly. I welcomed it. She spoke to the babies inside. The experience spoke to my heart.

I was going to wrap up here with my conclusion that -- for all I've wanted an actual baby (or babies!) on the inside -- what really makes me happy is the outer trappings. Those have been what I've known for much longer, and wished for for much longer.

But then, two minutes ago, at 4:42 a.m., I was sitting back, contemplating what to write next, and I had my hands on my belly. I have been concentrating recently, trying to feel the babies move around. Up until now, I haven't felt anything other than my pulse. But this time, I wonder. Maybe it was the glass of water that I just drank. But maybe it was my children.

I'll be damned. They're on the inside.

They really are!

Monday, September 22, 2008

Blessing 3: Loss of Loss of Hope


This picture is of me at a baby's birthday party. And I look happy, don't I? We had a grand time, with me lying down for most of it at the end. A good friend kicked a bottle of beer so it spilled in my hair. It was a beautiful day in the park for a beer hair-wash. We had cake and counted strollers. I broke the twin news loudly and proudly.


The last time I went to a one-year-old's birthday party, I left in tears. That was almost exactly 5 years ago, before I knew I was infertile, before I had even met James. There is nothing like a party full of happy babies and parents to make you feel sad.


I had a few experiences this weekend that involved cooing at cute children. I went to the grocery store with James on Saturday but lacked the strength to go into the actual store. I stayed in the car and people-watched outside a string of family restaurants at the strip mall. There was a little girl who was tired of holding her bunny, so the dad tucked its pink head into its back pocket, and they preceded with the bunny's anthropomorphic, decapitated-looking body flopping against his rear end. Another daddy showed a little girl a balloon that had floated way into the sky. They speculated that it would go to outerspace, and maybe Curious George could get it while he was up there. I saw mothers who had not gotten their figures back, walking by with brand-new babies in brand-new strollers.


And my reaction to all of this was, "Awww."


Pregnancy has innoculated me against the pain of the outside world. It has been years since I have seen all these sights and not bristled and shrunk. It has been years since I have not felt, every day, like I am being left behind. Now seeing multiple generations of people together doesn't instill a fear in me that I will never have children. It just reminds me what's good.


I am so, so thankful.


Wednesday, September 17, 2008

And the sexes ARE...




Indeterminate.
When we went for our monthly sonogram yesterday, they said it was too soon to tell. It's a shame, because last time they told us they'd tell us this time. Doh. How can we know whether we'll love our children?


(You must know I'm kidding).


As usual, Baby A gave us some trouble in the photography department. Like during the last ultrasound, when it refused to show us its neck so we could have it measured for abnormalities, this time it eschewed the camera's lense again. It turned its back on us and when we begged, finally turned right to stare us in the face with its skeletal little stare. That little kid is a handful.


We love Baby A.


We also love Baby B. Baby B, it should be noted, is very cooperative and poses like a champ. See its sweet little profile?


Fetal development is fun. The babies are starting to look like babies, even though they weigh only 4 and 5 ounces each. Their bodies, from head to rump, are about six inches long, and their heads are about 3 cm in diameter.


I think they are about the size of baby talapoin monkeys, the monkeys in the New Orleans Zoo that struck me as genetic mixtures of squirrels and humans. When I pointed them out to my great aunt Dotty and asked if she thought they looked human, she said, "Not anybody I know." Apparently her social circle is limited.


Me, my social circle is open and looking to grow. I can't wait to meet these little humanoids. Five and a half months and counting...


Blessing 2: Time Off

I'm disabled. I don't mean differently abled; I mean incapacitated. I have lost capacity. It's not something I'm used to.

Within a week of learning that I was pregnant, at the end of June, I started to get woozy whenever I stood up. A week after that, the feeling turned to nausea. If I were lying down (and not hungry), I was fine. If I sat up, or God forbid tried to walk somewhere, the nausea would come back. The way I understand it, I was subject to low blood pressure (the babies were taking my blood from me) and low blood sugar (they were taking my sugar, too).

It would have been okay if I had been able to remain in bed, but I couldn't. I wasn't working. I had no responsibilities outside the house and few inside it. But I started getting hungry at least once an hour. Desperately hungry. Hunger made me nauseous too.

And so at least once an hour I had to plan out in my head something that I could grab quickly and eat in bed. According to my "anti-nausea diet and lifestyle" instructions from my doctor, I was to have both sugar and protein in every snack to stabilize my blood sugar. So I would get a plan (apple and peanut butter, say), then dash out of bed to go realize it. I would slosh some water over the apple. I would grab the peanut butter, a knife, and a paper towel. If I were unlucky enough to be thirsty, I would start filling a cup with water and hope I could keep standing long enough for the cup to be filled. And then with superhuman speed I would sprint back to the couch or bed, lie flat on my back, practice deep breathing, and hope that my system would equalize before I had to throw up.

It was glamorous, to say the least.

All of my meals and snacks, for a full two months, were eaten lying on my back. I became devoted to straws and napkins. I have spilled yogurt on the neck of every garment I own. Once I burned the back of my neck and shoulder with a little chunk of chicken and a noodle from some soup. That was nice.

Confident that I would get better soon, I made a few plans. One by one, I cancelled them. I counted the days till the end of the first trimester, when I would definitely be better.

I am now about a month in to the second trimester, the time when some women feel exhilarated, better than ever. I am not feeling exhilarated; I'm not feeling better than ever. Fortunately, I have reduced my vomiting significantly, and I am much better able to stand up -- sometimes for an hour at a time! But I am beat.

Except for my utter fatigue, every other one of my symptoms lines up exactly with my pregnancy book. Expanding ribcage? Check. Stronger fingernails? Check. Nasal congestion? Check. Never has such a bizarre, new, weird condition in my body been so by-the-book.

But what about the fatigue? What about the fact that I've been waiting for months to be able to go back to work? What about the 15-minute errands that do me in for the rest of the day? My OB tested me for anemia and other conditions, my bloodwork came back fine, and she said I was just pregnant with twins, so I should listen to my body. I asked my high-risk maternal-fetal specialist whether I should be concerned about my desperately tired state. He said it was normal in pregnant women, and especially women pregnant with multiple babies.

That was yesterday. I came back home from that appointment and went to sleep for a long time. As usual. When I woke up, I saw that a book I ordered from Amazon.com had arrived: When You're Expecting Twins, Triplets, or Quadruplets. And it all made sense.

Turns out, pregnancy with twins+ is significantly different from pregnancy with a single baby. Supported by loads of data, the book made the case that nothing is more important in the health of newborns than time in the womb. How to prevent premature labor and other complications that would force multiple babies out? LIE DOWN. The book recommends that expectant mothers in this situation stop working and traveling at 24 weeks (that's 8 more weeks for me) and take three naps a day, plus a full night's sleep. Up until then, the more time we can rest rather than work, the better. Ten to twenty hours of work a week should be the upper limit.

Finally, something legitimized my need to rest!

Two days ago, when I attempted ONE task in the whole day (buying cat food at the pet supply store), I found myself inevitably thwarted. Seeing three whole aisles of catfood, I sat down on a big bag of dogfood and called James. It would be impossible to walk through three aisles. I thought about poor Central American women who had to walk miles and miles of tough mountain terrain every day to get a bucket of water for their homes. How could they do it when they were pregnant? What would happen to women who didn't have the cushy life I had? I wonder how the human race has gone on for so long.

I have been blessed, BLESSED, with the ability to take time off from work. And my mom has come over almost every day for months to do laundry, wash dishes, and feed me. James has done a double share of grocery shopping, errand-running, and invalid-attending. My whole family has been very doting. When I wondered aloud what women would do if they didn't have this support, if their normal duties continued as usual, my cousin Ashley said, "they just do what they have to do." The very thought makes me tired.

How have I gotten so lucky?

Monday, September 8, 2008

How to Tell Your Infertile Friends You're Pregnant

In the last few days, I've found out about two pregnancies. James confessed one evening that he'd been keeping something from me: two friends of his had a baby last year. He didn't tell me. I have to say I was glad. It would have been hard to take back then.

Then yesterday some other friends of ours whom we hadn't seen in a while called to congratulate us on our pregnancy, and tell us that they're expecting again this winter. They hadn't wanted to broach the topic. Again, I have to say I was glad I hadn't found out before, before I got pregnant myself.

The nicest thing the world could do for infertile couples is to stop reproducing. That would be a really kind gesture. Too bad it's insane. And impossible. The next to nicest thing would be for people to wait until the infertile couple is pregnant to break the news, start showing, or have their babies. But the same problems apply here, too.

As I discussed when I first started this blog, infertile people -- particularly infertile women -- are of two minds about other people's pregnancies. On the one hand, they're probably genuinely happy that their friends or family are having a baby. On the other, no matter what, they are at least equally sad to be reminded they they're not having a baby themselves. And while it's easier not to tell the infertile couple about successful pregnancies at all, it's gotta be done eventually. Worse than having to shoulder the bad good news is an infertile woman's feeling left out of her friends' lives. Yeah, it's complicated.

I want to tell you the story of how one couple did everything exactly right. That's my brother and sister-in-law.

They found out they were pregnant this spring, and were ready to tell the world in May, right when James and I were waiting to see if our second IVF had worked. They waited a few days and hoped we would find out good news before they broke theirs. My brother wrote me an email that week, saying he thought I was the "Greatest American Hero," not to be confused with the 1980s series. I thought that was really sweet.

It was a Wednesday when we found out our bad news. We told our families. Everybody was sad, but I felt eerily okay. As a student of my own psyche, I knew I was in a state of denial. I kept saying, "Yeah, of course it was negative: isn't it always?" I knew that a shoe would fall at some point and I would collapse into sobs. Probably in public, because I seem to like public crying.

On Sunday we had plans for a family gathering, a celebration of multiple birthdays. The day before it, I got a call from my brother. He sounded nervous. I listened. "We have some news. It's news about Erin..." I knew what was coming. "And the news is that she's pregnant." He didn't apologize exactly, but it was clear he knew he was telling us bad news. He said he wanted to tell me before we saw each other the next day at my mom's. He wanted to give us time to get used to the idea. I was grateful. Very grateful. I told him genuinely that I was happy they'd had an easy time getting pregnant; they didn't need the kind of drama that we had had. I told him I would take some time and get used to the idea and see them later.

But what happened was that I got off the phone and started crying. I wasn't crying about their pregnancy; I was crying about my own. The shoe had dropped. Boy, did I blubber. The next day, I couldn't go to the birthday party because I couldn't stop crying. It wasn't that I didn't want to see my beautiful pregnant SIL; it was that I knew that my teary waterfall wasn't exactly going to make her feel comfortable. Nobody wanted me to be sad, and they would hate to see it, so I took the time to grieve. My family is wonderful, and they all understood.

From that point, it took only about two more months for me to get pregnant. We had the pregnant couple over once in the meantime. After not talking for a while about the elephant (sorry, Erin) in the room, I asked her some questions about how she was feeling, how the pregnancy was going. I told her I was so sorry that her happy pregnancy came at the same time as pregnancy-related sadness for me. I was sorry it couldn't just be all happy. She said she knew; she was sorry too. And then we rubbed bellies so her baby-dust could rub off on me. It ended up being pretty fun and funny. And I think it might have been just the thing we needed.

Within a month, I was pregnant. And now it's really fun to hang out and compare bellies (see the picture post below). I couldn't have planned it any better at all.

I thank my brother and sister-in-law for caring about me so much, for being so kind and sensitive towards us. I thank them for giving us advance warning before we saw them, and for being brave enough to tell us, and thoughtful enough not to tell us in person. I thank them for understanding when we had to be sad, even in the midst of our happiness for them. And I thank them for letting us set the pace for how much we saw them, and how much talking about baby stuff we did NOT do when it was such a sore subject.

Now if their baby comes a month late and ours come a month and a half early, we could still beat 'em.

So here's a review, for use in your life. When you have to tell an infertile friend that you're pregnant, here are some tips:

- Don't do it in person. Your friend will need to be sad for herself even while she is happy for you. It's hard for her to make her face look happy when she's so conflicted. Let her get her bearings before you see her in person. Email is a very good method.

- Speak directly to her and acknowledge her pain. This means, don't do it in a mass email. Tell her (or email her alone) before you tell the rest of the world en masse. Go ahead and spit out the news, but don't be overly giddy about it. Tell her you won't forget how hard this is for her, and how you'll always support her efforts and be there for her.

- Let her set the pace. Take your cues from her as to how much you should see each other and talk about anything, especially your pregnancy. She might need a leave of absence from you. Trust that she'll come back to you when she's feeling stronger. Please don't take it personally. Her infertility affects everyone, and that means you, too. You're one of many people whose lives are different because of it.

- Don't ignore her and don't forget her. Even as you give her space, send her notes or call occasionally to check on how she's doing, or to let her know you're thinking of her. Invite her to your baby shower, because being excluded sucks, but let her know that she doesn't have to come if it's too hard.

- Ask her before you put her on your mass mailing list. She doesn't need to see the updated ultrasound pictures that you send out... unless she wants to.

That's all. See: nothing to it!

Boy, infertility sucks.

Friday, September 5, 2008

Blessing 1: Finding Out

While we were waiting to find out if we were pregnant, we took a trip to Rhode Island with my in-laws. I spent a lot of the week under the influence of my continuing IVF shots, sleeping. I also came home a day early, skipping James's drive with his parents back to their house in New York State.

That Monday, June 30, when I was back home alone, I went to the doctor in the early morning for the pregnancy test. They took my blood and I went home and waited. That last day of the Two Week Wait is terrible. There is no way to distract yourself from the anxiety. I'd done been through this wait twice before and it had ended badly both times. I didn't expect this time to be different, but I did hold out that infernal hope. You know, the thing that keeps you hurting because you just can't stop caring, no matter how effective your pessimism.

I expected the phone call around 3:00 or 4:00 that afternoon, because that was the time slot the nurse had for calling patients. But at about 11:30 a.m. my cell phone rang. Caller ID told me it was the specialized pharmacy where I got my IVF drugs. I picked up.

"Ms. Bailey, this is Val at the pharmacy. We were just calling to see when you would like to pick up your Endometrin." Boy, was I surprised. I never heard of Endometrin.

"When did you get this prescription?" I asked. Val said they'd received the prescription from my nurse -- and she said the right name -- earlier that morning.

"Is Endometrin the kind of thing one might take if one were pregnant?" I inquired.

Pause.

"Yes?" she answered tentatively, wondering why I was asking.

"Holy shit," I said.

Pause.

"You're the first person to tell me I'm pregnant. I've been trying for over two years. This is what I've wanted my whole life."

Val got a little worried. "Oh... good!... Um, you might want to call your nurse to confirm, just in case."

Yeah, no kidding. I told her I'd call her back when I sorted this whole thing out. Then I hung up the phone and started the "could this be true" internal dialogue with myself.

On the plus side, when I'd found out I wasn't pregnant the first two times, the nurse told me to "discontinue the medications." There was never an instruction to take something new. That seemed to indicate that I'd be getting a new and different result. Of course, all the pharmacist knew was that she'd gotten a faxed prescription. She didn't actually know my test results, and the person who did -- the nurse -- was the one who could tell me for sure. What if it was a mistake?

I tended to think it wasn't a mistake.

At 1:00 I picked up James from the airport. Instead of popping the trunk and letting him put his suitcase in himself before he got in the passenger seat, I got out to greet him behind the car.

"Hi, Daddy," I said. He smiled, cooed, and then his face changed. He stopped. His eyes got big. They filled up with "are you saying what I think you're saying?" I nodded.

And then we hugged and kissed and laughed and laughed and laughed, right there in the pick-up lane. I dare say we loitered in an area of the airport where they like to keep the traffic flowing. We did the happy dance. We hugged again and laughed laughed laughed.

Later he thought it was prudent to call the nurse, just to be sure. When she didn't pick up, he assured me that I could call the front desk and have her paged. He'd never been aware of a more pressing emergency situation. When we finally found her, she confirmed that it was true: I was pregnant!

In fact, I was "very pregnant." The pregnancy blood test measures the hormone hCG in the system. A positive test is one that comes up with a score of 5 or more. I had a score of something like 1,620. That's greater than 5. That's a whole lot of hormones is what that is. Later I'd find out that it actually represented two concurrent pregnancies in my one body. Twins.

I called the pharmacist that afternoon and told her we'd be by to pick up the Endometrin, which turned out to be the new progesterone supplement that I'd be taking for the first 10 weeks. When we got there, I asked for Val and she came to the half-door window. We screamed and hugged. She gave me a book on motherhood, a picture book with cute photos of animals. I told her I'd never forget her my whole entire life. She made me promise to send her a picture of the baby when it was born. Heck, yeah! I almost asked her to be the Godmother. (Oh, did I mention I'd never met Val before?)

From that moment on, everything was different. Thus began my pregnancy. And I've been confused and giddy ever since. It's been a blessing.

Blessings and Survivors' Guilt

I saw a made-for-TV movie about two people who survived a fatal airplane crash. The guy sitting next to one of them was vaporized. The person the other had traded seats with didn't make it.Though they walked away unscathed, their lives disintegrated because they felt so guilty, so unworthy to have made it out.

DailyStrength.org, the online support group that provided me a community of infertile friends to compare and commiserate with, made a new sub-group this year called "Pregnancy after Infertility or Loss." That was to shield the still-tryings from the conversations of the newly-pregnant infertility-busters. It was also an acknowledgement that pregnancy after what we've gone through is different than just regular pregnancy.

We have our own set of issues.

The most notable, which I've felt and which I've seen over and over on Daily Strength, is survivors' guilt. Achievers' guilt. Those of us who finally succeed in getting pregnant are left a little bereft. Our dreams have come true. We've crossed that second pink line. We get to move on to experiences and annoyances that were off-limits to us before. We're going to have BABIES!

And we've become the people that used to make us feel so sad.

We have left our friends behind. We have put them in the position that we used to be in: happy for the newly-pregnant, but devastatingly sad for themselves. It's hard to be around friends who make you cry. It's hard to be reminded that other people get what you want. I know that a lot of people have been pulling for James and me, and by golly, they're ecstatic. So shouldn't we be? Don't we owe it to our still-trying friends to at least enjoy the tremendous luck that we've got?

So don't get me wrong: I'm awfully damned happy. I'm so happy I can't even fathom it. How did such monumental pain just seem to work out in the end? How did I wind up pregnant with twins -- the absolutely most wonderful outcome I could ever have not-dared to wish for? Why does it seem so easy, so meant-to-be now, when it was so, so hard for so, so long?

As my mom said when I told her it freaked me out to feel some foreign object in my abdomen whenever I crossed my legs, "Don't overthink it." I know the same applies here. But remember the 65 postings I wrote before this week. Why stop the overthinking now?

The purpose of this blog, as I recall, was to let my world know about what I was going through, what a big thing infertility is. It was to share the interesting ups and downs of invitro fertilization treatments. And it provided me a forum to get my thoughts down and make sense of them outside of my head.

I don't pretend that we're in the clear now. Lots of things could still go wrong, but in our fifteenth week, the odds are that we'll come home with healthy babies next Spring. In the spirit of playing the odds and erring on the side of hopefulness, we're not going to be talking about infertility for a while, if ever again.

So what's the blog for now?

You don't want to hear about the uncensored ravages of pregnancy, although I'll be happy to tell anyone the gruesome changes a body goes through, if they ask. You may or may not be amused by all my vomiting stories. You might not find it all that fascinating to read "Today I watched some more TV and then had a glass of milk."

Well, tough. This blog's educational outreach function may be done, but I like writing. And I've always thought that the details of my life ought to be of utmost interest to strangers and friends alike. So the "chronicle of the journey towards the light at the end of the birth canal" continues. But to keep things in perspective, to allay some of my survivors' guilt, I plan to frame the adventures in terms of blessings.

Never let it be said that I don't feel lucky to throw up in public. And never let it be said that I don't wish the same thing for my still-trying friends, from the bottom of my heart and stomach. I do. More than anything.

Thursday, September 4, 2008

Pregnancy Pictures




You've waited so patiently all these months, so you deserve some pictures.


The bare-belly picture is a close-up view of what happens at 14 weeks, when twins are "barely showing."


The composite shows my progression from 12 to 14 weeks.


And the last pic is me and my sweet and round sister-in-law, who is exactly twice as pregnant as I am (29 weeks, versus 14.5). Hmmm. And yet only half as pregnant.