There’s a baby on the way

I have a baby on the way. And for the last two weeks, this baby has given me insomnia and made me feel like I could throw up at any moment. Okay, no. I’m not pregnant. I’ve decided to leave my full-time writing and creative directing job to start a freelance writing business. It’s been a long-time coming, since I’ve always dreamed of doing this. But I just never had the balls to do it.

But I think this whole miscarriage-not getting pregnant thing has given me the courage. It’s taught me that there are a million what if’s, who knows and things I generally can’t control. And I can spend all my time being angry and confused about those things. Or I can get to work on the things I CAN control. And derive my happiness from that.

And frankly, it’s been an incredibly welcome distraction from all the baby-making business. For the first time in a long while, I’m really excited about something.

Unfortunately, all this scheming and networking and almost throwing upping has taken me away from my blogging duties for a few weeks. But once my full time job is finished and I am on my own, I’ll have more time to write the stuff I really want to write. So get ready world. This little dream of mine’s about to get birthed.

Oh hi there, I’m high.

There are two kinds of doctors in the infertility world. Those who prescribe oral progesterone supplements. And those who want you to put progesterone up your hooha. Okay, so there are actually waaaay more kinds of doctors than that in the infertility world. But roll with me here for a moment.

I have previously seen the second kind of doctor. The pill-up-the-hooha kind. But lately, I’ve been instructed to take my progesterone supplements orally since it acts as a natural anti-inflammatory, and my immune system is a blazing, sweltering fire that won’t go out.

Throw progesterone up your hooha, and the side effects are pretty minimal. Sure, there’s extreme constipation and a constant wet and nasty discharge in the underpants. But compared to all the other side effects of drugs us reproductively challenged ladies have to deal with (um, extreme hot flashes, stabbing ovaries, and a condition that’s actually called moon face) it’s a walk in the barren park.

Taking progesterone orally is a slightly different story. The bottle says “may cause dizziness or drowsiness. Do not operate heavy machinery.” However, what it should say is “this is going to make you higher than that one crazy night out on your college dorm balcony. Do not attempt conversation within four hours of taking.”

In short, oral progesterone makes me high. I mean bat shit crazy, elephants on the ceiling, wonderfully high. A high unlike any high I’ve ever had. Not that I’ve had very many, because I’m a good girl, people. For about 45 minutes, I feel like the prettiest, most intellectually stimulating person in the long, dark tunnel we’re all suddenly floating down. And it’s awesome.

I never know quite when it is going to hit me. Sometimes it’s 30 minutes after a dose. Sometimes it’s not until 3 hours after a dose. And every luteal phase, I take two doses a day. Which makes mornings at work interesting.

Especially one particular morning two weeks ago when I was getting ready to present to a room full of 60 people, right as the progesterone kicked in.

My colleagues and I were pitching a new and large account for our advertising agency, and I had a significant portion of the presentation to talk through creative strategy and branding. Typically, this is the sort of thing that I can pretty much wing once I think through a few talking points. But typically, I’m also not high.

Right as my colleague introduced me and handed me the clip-on microphone and clicker, I started to feel that oh so familiar feeling floating through my body. Okay, I thought, so…this is happening. Or did I say it? Was that how I just opened up my section of the presentation? I wasn’t 100% sure. But I kept going.

Next came the challenge of talking while clipping the microphone to the collar of my dress while also managing not to drop the clicker or a stray f-bomb. And…I nailed it. Again, I have no idea if I said that I nailed it. Or just thought it.

My voice boomed; in the microphone, through my head, it was crawling up the walls and enveloping the room in a giant shriek. Quick, I thought, I need to re-clip this microphone closer to my boob so I’m not all blare-y. Again, coulda thought it. Coulda said it. To this day, I just don’t know.

The rest was a sort of out-of-body experience. I said stuff, I clicked, I pointed to visuals on slides. I stood upright. I kept my clothes on. These are the things I know. Everything else, I couldn’t tell you.

But I do know that in the last two weeks, nobody at work has said a word to me about that presentation. Which is probably a good thing, as it was hopefully just like any other presentation I’ve given. Or, it’s a bad thing, because they’re all secretly whispering about that time I stood up and let out monotone humming sounds for 15 minutes straight.

And there is one other thing I know for sure. Along this crazy road of injections and infusions and inseminations and negative pregnancy tests and stabbing ovaries and things called moon face, I’ll take all the little highs I can get.

Minivans are for other people

I drove a minivan in high school. The kind with the fake wood paneling on the side. It was old and wreaked of stale McDonald’s cheesburgers, cigarettes and the bad strawberry air freshener that was working just a little too hard to try and cover up the cigarettes. It had a busted taillight from the time I let Nacho, the foreign exchange student from Mexico back it out of the driveway at a Halloween party. It was ugly as shit. But it was perfect. I could fit half the drill team in the back of that thing to cruise around town with our pom poms and Natty Lite. And I loved how at only 95 pounds, I felt like I ruled the road.

I always assumed there would come a stage in life when I’d drive a minivan again.

But minivans aren’t for people like me.

They’re for my sister-in-law who is about to have her (whoopsie) fourth baby, any hour now. That phone call is a-coming. They’re for those friends of mine who once rode in the back of my own minivan. Even the ones who swore back then they’d never drive one themselves. They’re for the woman in the elevator at my doctor’s office on the day I found out that this cycle, too, had failed. She had an adorable little girl and an equally-adorable 8-month bump and politely looked away as I struggled to hold back my tears.

Today will be my last appointment with the Dragon Lady. For a while at least. Not necessarily because she got my hopes up this time, only to be dashed again – though I’d be lying if I said that wasn’t a small part of it. But because it’s starting to look like this ever-building mound of medical bills, prescription payments and IVIG infusion costs isn’t going away any time soon. And on top of that, it looks like we may need to throw on a round of self-funded IVF. And so something has to give.

So, no, minivans, they are not for me. At least not any time soon.

The Dragon Lady analyzes my belly

Tuesday, I visited the Dragon Lady for what should have been my pre-IUI #3 acupuncture session, where she would have hooked me up to an electronic contraption and sent power to my uterus like a car battery. Yes, that actually happened before IUI #2. And yes, I really need to write a post about that.

But back to this month. My body, wanting to perpetuate this whole hard-to-get game with pregnancy, decided to ovulate a week early. Luckily, I caught it in time to move the IUI up to last Friday. But that meant that this week’s session with the Dragon Lady was just a normal session in which she told me about all the problems of all the girls down the hall while placing needles in my legs only. “No belly today! Could be baby in there!”

Yes. Just a normal session. But then, at the end of the session she ordered,

“let me see belly!”

After 8 months of the Dragon Lady putting needles in the most random places and observing different parts of my body, this seemed pretty normal. So I lifted my shirt.

“Your belly huge!”

Um, okay. So maybe I ate a little more this weekend, I tried to explain. I guess I’m a little bloated. And yeah, I ate 4 oreos on Labor Day. Damn, nothing gets past this woman!

“It so huge!”

Getting a little defensive, I looked down and put my hands on my stomach. I just couldn’t see what it was she was talking about.

“Look how big belly is. I see it. There more than one baby in there!”

Whoa, slow down woman. I told her how the IUI was just four days before. It would be a while before I would even know if this one worked. Besides, it’s not like implantation could have even happened yet. Trust me, I’ve googled this shit about 9 thousand times.

To which, she gave me a look that said, “you silly white girl. Don’t question me.” To which I gave her a look that said, “Don’t you dare get my hopes up, Dragon Lady, unless you know what the hell you’re talking about.” To which, she said,

“This not crazy talk!!!! I know!!! I know all these girls!”

She pointed to a photo of newborn triplets on her wall.

“She come in. 43 year old. IUI with own eggs. I first one say “There more than one baby in there” she go to doctor. Three! Three baby in there!”

Then pointing to another picture, this time of twins,

“She IVF. I see belly, tell her first. More than one baby in there! I know!”

Holy shit, I’m thinking, this Dragon Lady could be right. She’s been right about other things. And my ultrasound this cycle did show four follicles. I could have four babies! All at once! A full house. 2 girls, 2 boys with names that all sound like they go together but that aren’t too cutesy because they’ll have to grown into adults someday. Wham, bam, thank you ma’am. Reproductive shop closed. We’re all good here.

Sensing my changing mood, she looked at my belly one more time and said,

“If you pregnant. There more than one baby in there. Next week, I know for sure.”

IF I’m pregnant. IF. So that gives me two options, and two options only. I’m either not pregnant. Or I need to start pricing out mini vans.

I’m either carrying multiple babies. Or hanging on to the remnants of four oreos.

Thank you, Dragon Lady, for the most hellish two week wait ever.

An alternate universe

Yesterday morning, I went to get my monthly negative blood pregnancy test drawn. I knew it would be negative because I had already started spotting and I could just feel that I wasn’t pregnant. And also because the Dragon Lady had felt my pulse on Monday and said “you start period soon.” And if the Dragon Lady says you’re getting your period, you’re getting your period. Like she ordered it up special for you.

Still, my doctor ordered a blood pregnancy test in order to start letrozole again this cycle, since crazily, letrozole will help get you get pregnant but if you take it while you’re pregnant your baby is guaranteed to come out with four eyes and eight knee caps.

As the new, cheery phlebotomist at my local Quest Diagnostics lab removed the needle from my arm and slapped the bandage on, she innocently wished me a cheery “Good luck!”

“Oh honey,” I wanted to say. “There is no luck here. Just a body that can’t keep a pregnancy going and has now decided it won’t allow a pregnancy to even begin. And there’s the knowledge that this month was yet another failed month. And there’s despair. But luck, there is none of that here.”

I didn’t of course. I politely thanked her and went on my way. But as I drove to work, I allowed myself to wonder what it would be like to be a woman with possible luck in her near future. To just be a woman who missed a period and needed a blood test as she came to wonder, “could I be pregnant?” To be still curiously, optimistically unsure, waiting for my doctor’s office to call that day with possibly life-changing results. I let myself imagine what it would be like…

At 2:30, my phone rings. It’s the nurse practitioner from the fertility clinic, asking how I am feeling. I tell her I feel fine. And she tells me she only asked because my blood pregnancy test came back positive. I tell her she has to be fucking shitting me. And then I apologize for just saying “fuck” and “shit”, but then proceed to say both three more times before hanging up.

I tell my co-workers that something has come up and I have to leave on a personal matter. They assume I have diarrhea. But I don’t even mind as I run home to immediately down the progesterone I stopped taking on Monday and shoot myself up with the blood thinners I also suspended back when I was sure I wasn’t pregnant.

But none of that happened. Not outside my head at least. As expected, the call came through with the negative results. And I sent it to voicemail, knowing it’d be easier on both me and the nurse practitioner if we didn’t have to have another conversation that started with the word “unfortunately.”

I stayed at work that day, a non-cussing, non-diarrhea-having, secretly heartbroken unpregnant worker. To everyone else it looked like any other day. But to me, it was a day where in some alternate universe, some other unlucky version of me was for once getting a little long-awaited luck.

The world according to my nipples

My nipples know things. Good things. Bad things. Things that could change my life. They know. And so every month around this time, I consult them. I ask them for their secrets.

What do you know, nipples? Show me my future. Any little humans growing inside me?

Today’s answer: outlook not so good.

They’re like little bastard children of the magic eight ball clinging to my chest. And they tell lies too. Last month, exactly 7 days after my first IUI, they told me it was THE month. They got big and super tender. And I got excited and super confident.

For the next seven days, I could not stop consulting them. I consulted them in the shower. I consulted them in the bathroom stall at work. I consulted them in the middle of the night when I got up to pee. I consulted them in the car while nobody was watching. I even consulted them in the gluten-free aisle at whole foods. Trick: pretend you have an itch in the middle of your arm, if your scratching arm hits your bra and causes pain, consultation complete!

It got to be where pinching through the outside of my bra just to make sure the tenderness was still there became an automatic reflex. Every 20 minutes, it just had to be done.

And then, little by little, the tenderness went away. I kept pinching though. Nipples, are you sure? Nipples, are you just getting used to the pain? Nipples, have you been lying to me?!

My beta 14 days post IUI confirmed it. My nipples had been lying the whole damn time.

But still….I cannot turn my back to the secret wisdom of the nipples. Now, 8 days past IUI number 2, I still feel they hold all the answers. And sure, they said “no” twenty minutes ago. But excuse me while I touch my boobs again.

Yep, still “no.” Those little fucking shits.

Excuse me while I freak out a little bit.

What do you get when you add two shitty ovaries, 987 autimmune issues, a crapload of medicine, a 3-month window to conceive and two failed cycles? A major freakout by yours truly. So major, I had to drop off the grid for a couple of weeks to lick my wounds in peace. But I am back now to take my freakout to the public. You’re welcome, internet.

Back in May, Dr. Kwak-Kim gave us three months to conceive on her every-drug-under-the-sun, this-just-might-work protocol. Mainly because one of her magic drugs, prednisone, can diminish kidney and ovarian function. And since my ovaries are already about as diminished as ovaries can be without being glued to an old lazy boy recliner eating soggy raisin bran, we need to be straight up knocked up pronto.

And I just watched cycle #2 on her protocol, a paperwork-perfect cycle I felt so incredibly sure was going to work, come and go with no second pink line. How are we supposed to find out if her magic combination of wonder drugs will keep me pregnant if I can’t get pregnant to begin with?

So now, things are looking pretty desperate. I’m desperate, the husband is desperate. Even The Dragon Lady is feeling the desperation. A couple of visits ago, she told me, “I run 500 miles if it make you pregnant.” This, coming from the woman who once yelled at my face, “no more running!”

With only one cycle left, I feel my it-will-all-work-out-in-the-end attitude starting to leave my body.

And I know that this is exactly what the Karate Kid and Mr. Miyagi felt like when they were seconds away from being taken out by that pimply kid Johnny, and had just one last chance to claim their destiny. Assuming, of course, that Ralph Macchio was on all kinds of mood-altering fertility drugs and getting weekly checkups of his uterine lining. And also assuming that Ralph Macchio’s character was a real person with feelings and a future and a family who was counting on him.

So yeah, assuming all those things, right now is that exact moment when I need to find the power for one, single, massively epic crane kick to Johnnie’s face.

If only I weren’t so scared to open my eyes.

Riding in cars with sperm

This morning began with the most precisely timed jack-off in all of history. I was scheduled to be inseminated with the best of my husband’s sperm at 10:15. Which meant our fertility clinic would need his sperm sample at 9:00 so that they could pick the best swimmers. And since my husband just started a new job and couldn’t exactly take the morning off to jack off inside a room at a fertility clinic, we were given a cup and detailed instructions to “collect” at home no earlier than an hour before the 9:00 drop-off.

With traffic, it would be about a 30-minute drive to the clinic. To complicate matters, my husband had an 8:30 meeting. But I was scared of “collecting” too early because my latest google search told me that the ideal window for sperm to be viable is 30 minutes. I was nervously watching the clock.

So, at 8:13, after informing me that his penis is not a spigot that he can turn on and off, my husband retreated to the second floor of our house to masturbate into a cup in peace.

At 8:26, he emerged victorious, handed over custody of his semen, and left for work. I placed the magic cup into the overly inconspicuous white paper bag the clinic provided, strapped it securely into the passenger seat of my car and started the most nerve-wracking drive of my life.

It started out fine, me cautiously turning onto the freeway as I contemplated the fact that I had half of my future baby in the passenger seat. Then, I must have made too sudden a lane change, because I heard the paper bag crumple a bit as the cup flipped onto its side inside it.

Oh shit, my half baby!

I reached over and placed the cup right-side-up, and then I remembered something. My sister – who has done several inseminations and transported several cups of her husband’s sperm – once told me that the sperm are more likely to survive the trip if you hold the cup between your breasts. Because it keeps everything at body temperature.

Looking down at the two tiny lumps on my chest that I sometimes call boobs, I knew that wasn’t going work. The last thing they successfully held together was the plastic front clasp on my 6th grade (okay 8th grade) training bra. So I came up with a plan B. Between the legs. Fortunately, I happened to be wearing a long cotton skirt, which meant that with a quick lift of fabric, I could get those little swimmers even closer to their final destination. So that’s exactly what I did. Cup, meet crotch.

It was weird. And it made it a little hard to drive, but it was working. So I pushed my foot down even harder on the pedal and soared on down the highway. Outta my way, people, I’ve got live sperm here! And it’s gotta survive until it gets inside my cooter!

Of course, I neglected to pay attention to the fact that I was driving through a construction zone, where the speed limit was only 55mph. I was going 68. Crap. I slowed down and looked around. All clear. No harm no foul. But two minutes later a police car switched into my lane, directly behind me.

Crappity crap, had he clocked me going 68 back there? Was he about to pull me over? Would he ask where on earth I was headed at that speed? What would I tell him? “I have a cup of my husband’s semen in my crotch and I have to get it to the fertility clinic so they can put it up inside me?“ Would he think I had made up the lyingest lie of all time to get out of a speeding ticket? Would I actually have to show him the cup and the semen? Would he confiscate it and take away my half baby?

We both pulled off the highway at the exit to the clinic. But luckily, he turned the opposite direction as me. I, and the semen cup in my crotch, was saved.

Once in the parking lot, I returned the cup of sperm to its white paper bag, and carried it across the lot to the doors, through the lobby, up the elevator, around the corner and finally to the door of the clinic with everyone looking and thinking, “that girl has a cup of semen in there.”

Finally inside the clinic, I delicately placed the white bag on the check-in counter like it was the world’s richest most breakable jewel, checked in with the receptionist, and looked on nervously as a lab tech nonchalantly opened the bag, pulled out the cup and then took my half baby away.

I turned around and saw an Asian man sitting in the waiting room. He looked at me knowingly. Like he was about to produce a cup just like that, but in the safety of the clinic. Where no traffic, police officers, or road construction could do its contents any harm.

I sat, relieved that the hardest part of the morning was over. But the relief soon left me, as I imagined nine months into the future: My husband and I are in the delivery room, exhausted but bursting with joy as we look down to finally get a peek at our long awaited baby. Who’s half Asian.

Chief Project Manager of Reproduction

I have three sets of reproductive doctors: Dr. Kwak-Kim and her Nurse Practitioners, My Reproductive Endocrinologist – or I should just say, his nurses, since I’ve only gotten to actually speak to him once in 9 months, and my perinatologist who is on-call, ready to go when this extremely high-risk uterus of mine lands a baby. That’s right, for those following along, I’m still un-knocked up. Damn you, you smugly right pee sticks.

All three doctors offices are supposedly working together to impregnate the great medical mystery that is me. But as I’ve come to find out “working together” means they occasionally allow me to make mention of the other doctors and their recommendations without balking.

So it means I’ve taken another job. No, don’t be confused, I still have my regular 8-5 job. But this other job, well it’s more demanding with the not-so-guaranteed possibility of someday being rewarding.

I am now Chief Project Manager of Reproduction.

What exactly does Chief Project Manager of Reproduction do? It’s a medical position. But the fact that I have absolutely no medical experience is of no concern to anyone involved. Key responsibilities include communicating and interpreting lab results, medical prognoses and cycle recommendations between doctors, nurses, schedulers, insurance companies, pharmacists, lab technicians and one acupuncturist.

Side responsibilities include arguing with that guy at the specialty pharmacy who was supposed to ship IVIG medicine before the day it was needed, coordinating scheduling with a home health nurse for bi-weekly infusions, and being able to name the exact size of IV catheter, tubing and equipment needed at my home at any given time.

Despite its many duties, this role does have some major perks. One of them being sex. Lots of sex. Assuming, of course, that there’s a blinking smiley face showing on a stick I just peed on.

And, of course, there’s the valuable experience I am gaining. A year ago, I never would’ve been able to spout off recommended cytokine ratios or which type of tube blood needs to be collected in order to test them. Now, I could teach a course. And I practically do every time I go to the lab to get my blood drawn. Plus I’m getting really good at accurately describing the color and consistency of my period blood to a nurse without blushing.

Of course, for the role of Chief Project Manager of Reproduction, there is no pay. But I figure if I put in enough time here, someday there’ll be the possibility of a promotion to Chief Project Manager of Gestation. And from what I hear, after nine months, that one has a pretty sweet payout.

Eff you, pee sticks

Pregnancy tests hate me. And I hate them. And the fact that I am still so obsessed with peeing on them makes for an even more fucked up relationship between me and those little shitsticks of anxiety. In the 14 months that we’ve been trying to conceive, I must’ve peed on at least 96 of them. And only one, ONE test gave me a positive result. AND I’VE BEEN PREGNANT TWICE! That ONE positive test came a good FOUR days and TEN TESTS after I missed my period the first time. And as luck would cruelly have it, that positive test came the morning before I started bleeding.

The second time I was pregnant, I got all negative results up until four days after I missed my period. Finally, my doctor, who thought I was crazy, ordered a blood test. My HCG level came back at 300 (considered very normal for 4-5 weeks pregnant) yet I still couldn’t get even the faintest of faint pink lines on a home pregnancy test. But, of course, it really didn’t matter then either when my blood HCG fell and I again started bleeding.

I’ve consulted OB’s, REs, nurses, doctor Google and my dog about why in the heck my pregnant pee won’t turn a test strip pink. I’ve dehydrated myself, held my bladder for hours longer than what is healthy, and memorized every word and every pictogram of the little First Response instruction insert. First Response, my ass. And still I’ve gotten nowhere. One nurse had the theory that my body was already destroying the pregnancy, and so that’s why it wouldn’t show up. It sounded like a reasonable explanation. But then why would I still have had such a sturdy blood HCG level?

My pee stick anxiety peaked this week because after my first heavily medicated, heavily monitored, things-all-falling-into-place cycle with Dr. Kwak-Kim, I am under strict instructions to take a home pregnancy test 10 days post ovulation. That’s today. I am told that if the test is positive, I need to double up on many of my medications and injections. But if it’s negative, I need to stop my prometrium, prednisone and lovenox and wait for the next cycle. Simple instructions, if you are a normal person who pregnancy tests don’t lie to. Not so simple if you are me.

What if yet another false negative pregnancy test causes me to stop taking the very drugs that could keep my undetected pregnancy going? Then again, what if my refusal to accept the reality of a negative pregnancy test keeps me holding onto a hope that just shouldn’t be there? What if it’s just delaying the inevitable pain and disappointment I’ve gotten so used to feeling, month after month.

You don’t have to be a genius to guess that this morning’s test was negative. You also don’t have to be a genius to guess that it didn’t stop me peeing on about five of them. I then sent an anxiety-ridden email to Dr. Kwak-Kim’s nurse practitioner requesting orders for a blood test.

I’ve begun to accept the fact that, reproductively, I’m never going to be normal. I’m never going to be able to just have sex and get pregnant. But come on, universe, can’t I at least be a person who turns a pregnancy test positive when in fact, I am pregnant? Why must you make things even more difficult?

Then again, maybe this time, it’s just the universe’s (and science’s) way of telling me “Seriously, you aren’t pregnant. Get over it.”

I guess I’ll know when the phone rings.