herveryown

Flat Arc

This is not the entertaining part of the story.  No countdowns, no cliff-hangers, no drama, unless you count the most boring trip to the Emergency Room ever, and I don't.  I will, of course, fill you in on the (non) gory details so that nobody worries.  I was running a low grade fever and feeling wretched and dizzy and the nurse on call told me to go downtown to be seen as soon as was humanly possible. 

If this were an episode of ER, a hot doctor would make witty remarks while annoying mood music played in the background and some promising young intern would diagnose me with something exotic at the last minute and then the intern would sleep with another intern, a hot doctor, or a patient.  Possibly all three at once.  A helicopter might fall on someone.

This was not an episode of ER.  The doctor knew nothing about IVF and looked at my conveniently printed out timeline of dates and betas and symptoms like a dog looks at the Periodic Table.  She asked a lot of questions and did a pelvic and had a nurse repeatedly check my blood pressure in different positions and told me that I was not only anemic, but wickedly dehydrated, and that I needed to work on that unless I wanted to end up on IV fluids. 

I don't know why my attempts at reproduction always end with "...and drink plenty of Gatorade." 

I am back on birth control pills, since having another period after back to back miscarriages just seems like a spectacularly bad idea.

Sam's karyotype came back fine, so we're waiting for mine.  We're also waiting to see how the results look together to see if we have what we call The Peanut Butter Cup Problem:  Rather than 'two great tastes that taste great together', might we be 'two not-so-hot people who produce really shitty embryos together'?

I am deeply ambivalent about continuing.  If I could, I would start another cycle tomorrow, or yesterday for that matter, but clearly, I am too sick.  On the other hand, I don't really want to do any of this again.  OHSS was not fun.  Neither was miscarrying.  One (if not both) of those things is almost guaranteed to happen again, and you know what?  I don't feel like it.  Sure, drama makes for an interesting story, but I don't want to be an interesting story.  I just want to have a goddamned baby.  I want to skip to the end of this story and see how it comes out, because I want to know if I'm making the right choices.

But I can't.

Fun Things To Do While Miscarrying

Guess which of the following things I did during Better Embryo's express trip to The Abundante MaxiPad In The Sky:

• posed for family pictures
• took family pictures
• created a superspecial summer scrapbook for ABC
• took ABC to see the Greenlake bunnies (because really, what's more fun than watching mangy, fleabitten fertility symbols cavort on the lawn while an embryo rehearses the final scene from MacBeth in your uterus?)
• started drinking before noon
• didn't go to work when I probably should have
• went to work when I probably shouldn't have
• answered the throwaway question of "How are you?" with "Horrible, and how are you?"
• continued to take prenatal vitamins
• argued with an HMO doctor about whether or not I was ever pregnant in the first place
• won

If you guessed 'all of the above,' you're right, I'm a fucking idiot.

I learned a lot from this miscarriage.  One of the things I learned was that the reason it's inadvisable to start drinking before noon is that then you sober up around 2:30, and really, what the hell else are you going to do with the rest of the day?  When I explained this to Sam, he said "I think the general idea is that you keep drinking."  "Oh.  Yeah, but see, I was bored and tired of getting out of bed to pee."

The helpful miscarriage information handout that the HMO doctor printed for me said that I should contact my doctor if I "feel depressed or not able to function."  Do you think I should call them and tell them that I'm too listless to keep slurping beer out of a sippy cup all day, or is that not really what they meant?

I shouldn't knock the doctor too much.  I mean, she did write me a "get out of work free" card, and that's never bad.  On the other hand, she did say (after staring suspiciously at my Official Evil Insurance Company, Inc Negative Pregnancy Test from the 26th) "Why do you think you were pregnant?"

Ha!  Hahaha!

Yeah.  I didn't even punch her.

I did get a little snotty and say "Well, because we did a Frozen Embryo Transfer on...let's see, the 15th?  And because my Reproductive Endocrinologist confirmed it by blood."  I also helpfully pointed out that their peesticks weren't that hot.  I might have used the term "suck," but I'm not sure because I was busy rifling through my purse for the exact dates and numbers (down to the fucking decimal) of my betas. 

At this point she was very apologetic and kind and stopped looking at me like I was a hysterical twit with a phantom pregnancy, and I kind of gave her one of those tightlipped "I know that you know that I know that you're an ass" smiles. 

They ran bloodwork because I've been feeling like shit lately (go figure) and after watching the Bloodzapalooza in my underpants over the weekend, I'd started wondering if perhaps two miscarriages in three months might have had a detrimental effect on my overall health and packed cell volume.  Imagine our combined surprise when I popped up "not anemic" and in fact, "less anemic than I was before the first miscarriage."  I have no idea how I pulled that one off, frankly. 

"Feeling run down?  Have tired blood?  Try our exciting new product, Repeated Pregnancy Loss, and you'll be hale and hearty in no time!"

Or something.

Putting In An Early Bid For WWM

One of the best things about cycling on the heels of a miscarriage is that when you immediately have another miscarriage, you can economize.  Save time and kleenex!  Feel the pain of both losses simultaneously!

Like I said before, I am nothing if not efficient.

After abruptly stopping the progesterone and estrogen, the hormonal crash decided to look for emotional reinforcements and triggered my Manic Depression.   If you guessed it triggered the "Depressive" aspect, you win a cookie, but I'm sorry, you're going to have to bake it yourself, because I'm really fucking tired over here. 

I'm also angry.

The bleeding started a while ago.  And continued.  And continued.  And continued.  And Dr. Google can seriously kiss my ass.  I no longer believe that your uterus is the size of your fist (unless you're HellBoy), because I absolutely could not hold this much blood in either of my fists.

The reason that I'm angry is completely irrational.  Every time I rip into another Pampers-esque 'Abundante Flow' maxipad, I think "God, what a fucking waste.  Now I see what the Wandmonkey meant when she said I had an excellent lining," and then I get pissed off at Better Embryo for not sticking around, for letting all this go to waste, as if s/he were a rebellious kid who refused to eat the rest of the peas, rather than a little wad of cells that dropped dead.

It's kind of like the way I kept wandering around the house after GE died, yelling "Goddamnit, Good Embryo, I DRANK V8 FOR YOU!"  I loathe and detest V8, but I used to chug it when I'd accidentally shorted myself on my recommended daily allowance of vegetables.  It would activate my gag reflex something fierce and I would stand at the kitchen counter with one eye open and one eye squinched shut, willing it to stay down because it was (pardon my laughter) good for the baaaaybee.  Yep.  I bet I had the healthiest dead embryo in town.

Late at night, when I wonder how far I'm willing to go to have children, it's never about "Would I do IVF again?" because of course I would, will, and am going to.  It's more along the lines of "Would I shotgun another V8?  Because that shit was nasty."

Pardon Me While I Trip Over This Ottoman

Dear Universe,

My goodness, aren't we feeling funny these days?  I mean funny ha ha, not funny strange.

First of all, that whole positive-and-then-not-so-much thing?  That was a fucking laff riot.  Don't ever let anyone tell you that chemical pregnancy isn't hilarious, because hooboy, I just could not stop laughing.  Or crying hysterically.  One of the two.  They sound about the same, so I can't be sure.

Second, I have to say that your use of props in comedy is inspired.  Having that hugely pregnant woman waddle over and sit at the table directly across from me, so close that I could almost reach over and rub her belly while Nurse Sweetie called and gave me the shit news?  Pure genius.

Third, your comic timing is exquisite.  Most people would have let the whole Better Embryo joke stand on its own, but you, Universe, you went all out and made my car break down immediately afterwards.  I stand in awe of your wit.

Also, hey, fuck you.

Sincerely,
Akeeyu Buttmansion

Raise Thumbs, Begin Twiddling

*updated*

"No, really, Pins, the miscarriage is one situation in which being Manic Depressive is incredibly helpful,"  I told my sister.
"How?"
"Because you and I, we have a high tolerance for emotional pain.  We know that eventually, it will go away, or at least get better.  Having a miscarriage is like being forced to run a triple marathon through hell, and the Manic Depression meant that I was already in pretty good shape for the run."

I still miss Good Embryo.  I miss him/her every single day.  I told Sam that miscarriage is the gift that keeps on taking, because while some things get easier, some parts just get harder.  This week, I would have passed into my second trimester.  I remember that without trying to, without wanting to.  It's just there.  Sometimes, when I'm in the mood for a strange food and am trying to justify a late night twenty minute trip with Sam to procure said food, I still have to catch myself before I say "Yeah, well, Good Embryo wants..."  Oh, wait.  Nevermind.

Sometimes for just a moment in the morning, in that hazy stage between asleep and awake, I forget and think I'm still pregnant.  That pretty much sucks.

Somebody at work giddily announced her pregnancy while clutching a handful of blurry ultrasound pictures.  Her due date is three weeks after mine.  I looked at those tiny black and white pictures out of the corner of my eye and wanted to say "Hey, I have those, too!  And then it died!" but I didn't.

Mostly, I am doing okay, though.  Ever since I got The Best Little Cancer In The World, I have regained my ability to smile sincerely.  For example, I can now look at cute little fuzzy baby geese without immediately glaring at the big geese and thinking "God, everybody has babies but meeeeeeeeeeeeee!  Stupid fertile bitch goose.  You know she didn't have to do IVF."  Now I just smile and say "Look, cute little fuzzy baby geese!" and Sam says "They're called goslings," and I say "I know," (an exchange we go through every single time) and then their parents waddle over, hissing quietly, and we scoot away before they peck us in delicate areas.

So, you know, that's an improvement.

The Metformin has been very interesting.  I find that I can still eat fried foods, dairy, snorf up carbs and drink alcohol, but I consume everything in much smaller quantities.  The mad dashes for the bathroom now only happen in the two days after I up my dosage.  Also, I must confess that I have been cheating just a little.  The day I started the Met, I also started to take iron supplements with Dr. DoesNotSuck's blessing (as I constantly skate on the edge of anemia).  The extra iron backs things up, the Met speeds things up, so most days I stay comfortably in the middle.

I've lost five pounds in three weeks, and I'm not really trying.  It's just stunning, the difference a little normal blood sugar makes.  I used to read articles promoting this diet or that regimen, and I'd think "But none of that will work.  I can't possibly diet, because I need to eat every two hours, or I'm not functional."  I did my damnedest to chose healthy snacks every two hours, but it was still annoying.  Since the blood sugar problems had come up gradually, it just never occurred to me that there was anything abnormal about them.  I just thought that other people had significantly better self control than I did, that having low blood sugar didn't bother them as much, that they were stronger.

Nope.  Turns out, I was just sick.  And the Metformin makes me better.

Well, okay, except for this one little thing, and it's really bugging the shit out of me.  Ladies?  Ladies who are on Met?  Help me out again, here?  I have suddenly and dramatically lost my taste for chocolate.  What the fuck is that about?  It's not that I dislike it, it's just that I never really feel like having it anymore.  My house is full of TastyKakes and Lindt Truffles and Reese's Peanut Butter Cups, and I'm barely nibbling them.  I cannot find "You will lose your gastronomic mind and become apathetic towards The Food of the Gods" listed anywhere under Metformin side effects, and it's just freaky.  So.  Chocolate indifference?  Anyone else?

Update:  So, a couple of commenters wondered about a link between Bipolar and PCOS/metabolic issues, and it reminded me of an article I read a while ago.   In it, a psychiatrist from Oregon talked about treating Bipolar patients with Metformin to try to counteract the chubbifying effects of the psychiatric drugs, but what really caught my eye was this: a link to an article discussing whether or not Depakote causes PCOS.  Interesting reading.  Depakote is frequently used to treat Manic Depression, and I took it for about a year back in college.  All the other kids were smoking pot and doing shrooms, I took Depakote.  Man, I got robbed.

Last week's beta was kind of a disappointment.  Dr. DoesNotSuck said it was good, but going from 30 to 12 in seven days?  Let's see.  If it's supposed to halve every 48 hours, and mine dropped by slightly more than half in...168 hours?  What?  So, I worry.  Then, of course, I feel like I'm obsessing (I am), splitting hairs (maybe), worrying over nothing (we'll see).  My next beta is tomorrow, so we'll know more then.

Cooterally Speaking

My uterus is still laughing at the Misoprostol.  My colon, however, is not at all amused, and would like to request that I stop taking this shit, like, yesterday.  I don't know what to say.  I've got so much of this garbage in my system that you'd kind of expect The Mystery to have been ejected at high velocity hours ago, accompanied by that 'p-twang' sound that bullets used to make on Bonanza.

I must confess that I was less than encouraged by the additional dosing recommendation that Dr. BrightEyes gave me, the one that was too long to fit on the prescription label: "You'll want to take this every four hours for three days, or until you start bleeding, or until you just can't stand it anymore."  I appreciate that he doesn't sugarcoat things for me, but I keep thinking that this is a situation where having a high tolerance for pain isn't really helpful.  If I were a bigger sissy, I would have stopped several pills ago.

There was (naturally) a small speedbump when I picked up my prescription.  Dr. BrightEyes and I had discussed a higher dose, administered vaginally, and the label on the bottle indicated a lower dose, taken orally.  Hmm.  Since I was determined to make a sincere effort to dispose of The Mystery by Friday, I promptly called Nurse Sweetie to clarify.

"Hey, the prescription doesn't quite jive with what I recall from the visit.  Which dose is correct, and am I taking these by mouth or by cooter?"

When Nurse Sweetie called back, she was still laughing.  "By cooter?  I can't believe you still have a sense of humor at a time like this.  I went and asked Dr. BrightEyes if this should be administered orally or cooterally, and he said cooterally."  She wished me luck and called the pharmacist to straighten things out.  With the confusion cleared up, I crammed some more Misoprostol up my already put-upon hooha and went about my day. 

I considered the many weird and uncomfortable things I've already done to my dainty girly parts during the last six months and all the things I'll be putting them through in the near future and thought "To heck with 'vagina'.  Sure, it's an okay term for medical illustrations and tampon directions, but after everything I've been through with mine, after the needles, the pills, the endless rides on the Wandmonkey Express, it seems a little, well, formal. I think my cooter and I are currently on a first name basis."

I think that the best thing about taking Misoprostol every four hours (other than the fact that those things really fucking burn in a place where you never want to experience a burning sensation) is the chance to shove small white tablets up your cha cha in a squalid public bathroom.  Repeatedly.  Because that's always fun. 

No, wait, you know what's really the best part?  The fact that those tablets don't really dissolve up there like the literature says they do, or at least not completely, so that every time you insert another one, you encounter the crumbly remnants of the last one and start wondering if all the grit and debris up there will start to function as a rudimentary rock tumbler and polish The Mystery to a glossy sheen before ejecting it.

No, no, hold the phone, I was wrong.  The best part is actually that although the Misoprostol is causing considerable discomfort (and when I say 'discomfort', I mean it in the way that doctors do when they say "You may experience some mild discomfort during this procedure") and a large number of side effects, it doesn't seem to be doing its damned job yet.

Timing is Everything

Boy, I'm sure glad I didn't have a miscarriage right before some emotionally loaded holiday like, say, Mother's Day.  Because that would totally suck.

I finished my last Rice Krispy Treat this morning.  I am finding little comfort in comfort foods.  I think part of the problem is that when I was pregnant, I was eating every two hours in a futile effort to make the morning Every Waking Minute Sickness tolerable, and it kind of killed my appetite.  I always felt sick when I ate, and I almost never felt hungry, but there I was, shovelling in carefully chosen nutritious meals and snacks on a schedule.  If I didn't eat, the nausea and dizziness became unbearable.

Now, I can not eat if I don't feel like it, and all I get is hungry.

After my first Beta, I called my mother and said "You know what?  Even if the second Beta is no good, even if I lose Good Embryo later, I'm glad I'm pregnant now.  I love Good Embryo now.  I'm somebody's mother now."  Every morning, I woke up tired and sick and miserable, and I was so happy because I had Good Embryo. 

Now I don't, and physically I feel a lot better, which is horrible.  I wake up and I'm not sick anymore, so I feel guilty because I feel better.  Shouldn't I feel worse?  Shouldn't something on the outside be as broken as I feel?

We have an appointment, and we also have a plan.  Well, not so much a plan as a theory.  The theory is that worrying about being emotionally ready for the next cycle is pointless.  Studies show that stress has little to no influence on the outcome of IVF cycles.  Waiting is not going to make either of us feel better in the long run, and neither will getting pregnant again.  Having a baby will not erase the loss of one.

The point is, we didn't do IVF to seek emotional balance and enlightenment, we did it to get me pregnant and have a baby, so we're going to keep working on that as soon as possible.

As soon as we're cleared for takeoff again, we're going to go for it, and until then, Sam and I are going to be here, eating, sleeping, crying, falling down, and getting up again.

Alias Not Grace

First of all, I would like to thank everybody who has commented, emailed, IMed, called, shaken angry fists at the cosmos on my behalf, etc.  Thank you.  Sam just said "Can you imagine how shitty this would be if the only sources of information you had about miscarriage were well meaning friends and pregnancy books?  You'd be a basket case."

Of course, I am a basket case, but it's not for lack of caring support.  Incidentally, is anyone expecting me to take this particularly well?  You know, suffer in silence, be a pillar of strength, go through this with style and grace, be a shining beacon, all that crap?

Oh, honey, you've got the wrong blog.  That would NOT be me.

Things I have done in the last three days:

• Eaten three batches of Rice Krispy Treats
• Yelled at Sam for being mean to me in my dreams
• (Mostly) accidentally kicked Sam in a delicate area because he touched my butt
• ...and then I laughed about it
• ...until I couldn't breathe
• Glared at pregnant women
• Cheated at cards
• Made inappropriate jokes before and after the D&C
• Listened to someone gripe about their bad day, laughed at them, and said "Bitch, please"
• Jumped on the bed and screamed at Sam like a fucking banshee because we were arguing about...crap, I don't even remember what it was about anymore, but he wanted to hug and make up, and I didn't
• Driven like a goddamned maniac on the freeway, yelling "Yeah, cut me off!  Come on, I dare you! I literally have nothing to lose at this point!"
• Burst into loud, runnynosed tears approximately every .75 hours
• Become an insta-hermit
• Made a fourth batch of Rice Krispy Treats

I can't say I'm terribly shocked by this, and by that I mean by what happened and the way I'm taking it.  I see people on the pregnancy loss boards say "I never thought this would happen to me," and I wonder why not?  Why not them?  Why not me?  Why not anybody? 

Pregnancy is not a meritocracy. 

Somewhere, some crack smoking Springer guest is currently 8weeks5days pregnant (probably furtively wishing for a miscarriage with the same fevered enthusiasm with which I wished not to have one) and I am not.  Instead of trying to take this well, I am just struggling not to take it personally, because in the grand scheme of things, it's not personal.  It just is what it is, which is shitty.

This is not to say that I'm not completely destroyed by it.  I am.  I'm just not shocked.

Also, I don't believe that the grace with which I accept this has any significance whatsover.  If I smile magnanimously and glow and work my way through the stages of grief in the correct order and at the correct speed, do I get a prize?  Do I get Good Embryo back?

No?  Well, crap.

I was going to have a baby in December, and now I'm not.  That is where I am living right now, and there is no time off from that for good behavior.

Does This Wine Go With Donuts?

Well, this week I've been snorfing up Krispy Kremes, Frango mints, tuna sandwiches, Mad Housewife wine, and beer.  No, not all at the same sitting, although that could be my next move.

Beer is a lot better than I remember it.  I'm starting to wonder what other vices might be equally good.  Should I take up smoking?  Huffing paint?  Peeing on toilet seats?  I'm tempted to drive down to Renton to score some crack or meth or something, if only for the ability to say "Sure, we did IVF, but I think it was the crank that really did the trick" in the unlikely event of (snort) success.

I exhausted my entire supply of faux calm when I was blindsided by the memory of why we're doing this in the first place.  It doesn't take much.  A photograph, a chubby baby grabbing your sleeve, a Tide commercial, and it all comes rushing back: how much you just want to have a damn baby.

It hurts, you know?

Without further ado, I will now be returning you to your regularly scheduled program of aimless anxiety and crippling depression.

I can generally determine how depressed I am at any given time by taking note of what CDs are in heavy rotation.  As of this week, I have blown through Peter Gabriel's angsty period, skipped Pink Floyd entirely, and have gone straight to Johnny Cash. 

Yes, Johnny Cash.

I am that depressed.

Dropping Acid

Yeah, I'm still depressed.  I'm also having severe migraines and I haven't even started the estrogen yet.  This seems like a bad sign, doesn't it?  I mean, I get those nifty migraines where you're crawling around in a darkened room, clutching your eyes and whimpering and scrabbling uselessly at blister packs of Imitrex and those are just caused by regular old birth control pills.  I can hardly wait to see what those stupid Vivelle Dots do.

This, however, is not my primary concern.  I generally like to keep my obsessive worrying fairly orderly, and as I currently already have something to pointlessly fixate upon, the migraines are just going to have to suck it up and wait their damned turn.

Because of the aforementioned depression, I'm going to take the lazy way out and use an old email thread to explain the current problem.  Observe:

Akeeyu:
"Well, I'm starting Lupron this week. 
After that, it gets weird, because apparently I'm supposed to stop the birth control pills and 'wait for a period'.  Ha.  Fascinating.  I've never had a 'period' during any of the other times they've had me do that, but okay, whatever. 
Then I start pasting these stupid estrogen patches on myself (up to four a day!) and possibly taking additional oral estrogen, and hey, did I mention the migraines?  And of course, estrogen feeds the Endometriosis.  I don't really have a good feeling about this. 
Plus, some time in the next three weeks, we're supposed to decide whether we want to transfer one or two.  Thank God it's not a big, important decision or anything, because that would be like, STRESSFUL!  Ha!
PLUS, I have Spina Bifida Occulta (really really mild symptomless spina bifida that I wouldn't even know about, except that they found it on an MRI while they were looking for something else) and guess what?  Having that greatly raises my chances of having a baby with spina bifida!  So that's my new thing to worry about.  I mean, other than the imaginary period and the migraines and the endo growth.
I'm positive like that.  Oh, yes I am."

Olivia Drab:
"Oh, jeeziz.  Nice way to make you 'relax and not think about it.'   The good thing about the estrogen is it makes a super duper fluffy lining for embies to embed.  You know, just don't think about the migraines and then you'll be fine, right?  HA!  Don't forget your folic acid.  That helps REDUCE the spina bifida chances.  At least that's what that damn WebMD says.  I never know whether to trust them or not these days, after that whole 'Adequate uterus' thing."

Akeeyu:
"Oh yeah, after poking about on spina bifida pages, I thought 'You know, seriously, I pay someone else to do this kind of worrying for me,' and emailed my OB/GYN about it.  She said that instead of taking the usual 400 to 800mcg of folic acid, I should be taking 4000mcg, and that I should get it from supplements, not foods.  Yay!  Easy way out!
It's a good thing, too.  I did the math.  I would have to eat seventyfive cups of spinach a day.
Even Popeye never ate spinach in those quantities."

Olivia Drab:
"Yeah, and you don't want a kid with massively swollen forearms and a cockeye like Popeye, anyhow."

Akeeyu:
"No, wait, that would be kind of cool.
Except for the tiny corn cob pipe.  'Well, Mrs. Buttmansion, your labor seemed to be progressing normally, and then that damned tiny corn cob pipe got stuck on your cervix.  Pity about that'."

Olivia Drab:
"Corn cob pipe, you say?  Hmmmm... *scratches head*  That kinda sounds like endo clots!  So that lends credence to the theory that endo pain and labor are similar...
I just wouldn't want the kid to wind up that arm and punch your kidney or anything, all the while muttering something under his or her breath."

Akeeyu:
"Ha!  I'm cracking up over here, picturing going in for an OB/GYN appointment, having them slap a doppler on my belly to check a heartbeat and listening to 'a-gug-gug-gug' or whatever muttery noise it is that Popeye usually makes.

It's official.  I am crazy."