herveryown

Day Ten

My next scan isn't until tomorrow, so let's talk about something else, shall we?

Every so often, something happens that makes me want to yell "Won't someone think of the children?" like Reverend Lovejoy's wife on the Simpson's.  It doesn't happen with any great frequency because a), I don't actually have children and b), everyone knows that women undergoing IVF are just selfish bitches who think only of themselves, but it does crop up on occasion, and darned if today isn't one of those occasions.

The sextuplets. 

Now, before I go any further, I would just like to say that everything I could possibly say about High Order Multiples has already been said so much better by Julie in one of my favorite posts ever.  Also, I would like to put forth the idea that any doctor or ultrasonographer who can't tell the difference between 'two' and 'ten' should probably put the training wheels back on their wands before they do this to some other unsuspecting couple.

Surprisingly, amidst the articles that lump all Reproductive Endocrinologists in with the cowboys who do this shit and all ART patients in with the parents of the sextuplets, there have been a couple of good articles.  This one talked extensively about Selective Reduction, including its benefits and the risk of total pregnancy loss, and included a quote from an RE that I just loved.

When news circulated about the June 10 delivery of the Morrison sextuplets, "my initial response was 'Who the hell did that?' " said Dr. Theodore Nagel, a fertility specialist with the Reproductive Medicine Center in Minneapolis.

Dude, me too!

It was this article, however, that prompted me to open my big fat yap, although perhaps not for the reason you'd think.

After she found out she was pregnant she, her husband and their 8-year-old son went for her first ultrasound. There were four little heartbeats. "My 8-year-old started cheering..."

I'm sorry, what?

At 45, you brought your eight year old to your first ultrasound after an IUI?  And you thought that was a good idea?  Seriously?  What if you had decided to Selectively Reduce?  What if it had been ectopic?  What if you'd lost all or some of the heartbeats by the second ultrasound?  Call me nutty, but I've heard ugly rumors about that very thing happening.  Are these really events that an eight year old needs to be included in?

We started ART when my stepdaughter, ABC, was eight years old.  At the time, I would have done my own retrieval with a spork before involving her in it.  I did not feel remotely confident in our miscarriage odds, a hunch that turned out to be totally justified, and did not want to expose her to a string of losses.

Now, part of this was a kneejerk reaction ("She's too young, and I don't want her to have to deal with this shit yet."), but part of it was a very personal decision based on my experience and ABC's temperament.  She's a very sweet child, and empathetic to an almost worrisome degree.  She is very attuned to the feelings of others, to the point of frequently putting those feelings above her own (something we look out for).  She wants us to have a baby very badly.  Because of all these things, I felt that it would be cruel to expose her to the repeated miscarriages of her siblings. 

Let's face it, this is not exactly a fucking cakewalk for adults, is it?

ABC is ten now, and nothing has changed.  She is still a sensitive, thoughtful child.  I'm not using 'sensitive' as code for 'big whiny tittybaby,' either.  As an example, when we told her that I threw my back out during the second FET, she would come running at me, wound up and gleeful, when I'd come home from work and then pause just before impact.  "Mom, how is your back?" she would ask solicitously.  "Good enough for a big hug, honey.  Come here," I would say, and only then would she hug me, ever so gently.  She helped around the house even more than usual.  She was considerate of my feelings and my physical wellbeing.  She worried about me.

Now, let's change Mom Threw Out Her Back to Mom's Uterus Is Currently Slaughtering another Embryo, shall we?  No.  Hell no, I will not involve her in this, or at least not now.  When she is older, when we're strolling through fields of daisies having those woman-to-woman talks that always lead to feminine hygiene products in the commercials, I will tell her.  If I ever get pregnant again for more than a couple of weeks, I have no intention of telling ABC until she starts asking why Mom's so damned fat (a question that, due to her impeccable manners, she may never ask) or until we pass some other significant milestone.

I don't believe in sugarcoating a lot of things.  When the cat died, we didn't tell her that it ran away.  When my father was diagnosed with cancer, we told her he was sick.  When it became apparent that no cure was waiting in the wings, we gently explained about cancer.  When they said he was dying, we put our heads together with her mother and stepfather and formulated a plan to let her know so that she could talk to him and say her goodbyes.  Given that I don't believe in sheltering ABC from death, the miscarriage thing may seem trivial, but I still think we're making the right decision for our family.

After thinking about this, however, I became insanely curious about your decisions.

If you are undergoing ART and have children or stepchildren, what did you tell them and when?  Ages?  Reasons?  Outcomes?  I'm dying to know.

Running Out

I believe this is what they call a twofer.

My paternal grandfather died last night.  Since my employer offers paid bereavement leave, I am going to be paid to stay home and mourn on Mother's Day this year.

What do you call this, exactly?  Deplarious?  Hipressing? 

I was a little confused when I heard that he'd died.  My grandfather had severe Alzheimers and had suffered several strokes over the last ten years, so his death wasn't a surprise by any means, but I was a little disturbed at how well I took it.  It took a couple of hours to figure out that I wasn't indifferent to the situation, just still a little numb from my father's death.  It's a pretty tough measuring stick, you know?  "Let's see.  Situation X is wretched, but is it better or worse than Dad dying?"  Since so few things rise (or descend) to the level of parental demise, this has made me seem both alarmingly callous and annoyingly resiliant in rough situations.

I'm not sure why it cheered me up, but for a good hour or two I was quite relieved that my father had preceded my grandfather in death.  In this way, my father was saved from experiencing the death of his own father.

My grandfather, whose name was Samuel, was a good man.  He served his country, loved his family and worshipped his wife.  He was endlessly classy and bore more than a passing resemblance to Gene Kelly.  He taught me things like driving and painting, dignity and tact.  He saved my life.

Grandpa, I'm sorry that you're gone, but I'm not sorry that you're not suffering anymore.  I'm glad that you could never remember that your son had died.

The Husband of Tomorrow, Today!

Sam and I have a long held tradition of celebrating crappy things, not because we enjoy them, but because hey, what the hell else are you going to do?  On the way to urgent care after the car accident, I was already flipping through our restaurant guide, picking where we'd be going later.  The evening of the failed baseline appointment found us at Happy Hour (your happiness may vary), snorfing up half-priced garlic fries.

"Hey, Sam, you know the joke that starts off with the woman asking her husband if he would remarry if she died?"
"Yes."
"I just want you to know that if you died, not only would I get remarried, I'd marry a man with a crappy sperm count or something.  I'm really tired of this shit being my fault all the time."
"I thought we were happy about my good semen analysis results."
"We were.  We would just like someone else to pin this on, because every problem always comes back to me, and I'm sick of it."

Well, ask and you shall recieve.

After Sam's volume, concentration, motility and speed all came back picture perfect, his morphology came back kind of crappy (23% instead of 30%), and we've been bumped to ISCI, something Dr. BrightEyes had apparently been considering since our last cycle when our fertilization rate was noted as being 'slightly less than normal'.

Huh.

Next time I wish for something, I think I'll just keep it something simple, like pie.

Mmm, pie.

Ten Days To Go

Dear friends and family,

2006 has been an unforgettable year for the Buttmansions!  Please join us as we take a leisurely stroll down memory lane.

In January, little Samuel Jr. did not try out for the Olympic Llama Stacking Team, partly because there is no Olympic Llama Stacking Team (thanks to those bastards on the Olympic Committee and their narrowminded definition of the word 'sport') and partly because there is no Samuel Jr., either.  Akeeyu got severe OHSS and Sam got a front row seat to the most debilitating pain he'd ever seen.  The fresh transfer was canceled, and the month was nicely rounded out by the death of the most beloved cat ever.  The Cancer Trifecta was now in play.

In February, little Mitzi Jean did not win the spelling bee, having been disqualified on the grounds of not existing.  Akeeyu still had OHSS and weighed more than she ever had in her life.  It was then that she discovered how wickedly difficult it is to lose weight in between bouts of depression eating.  The cat was still dead.

In March, the Buttmansions did not have to worry about being the asshole with the baby in the RE's waiting room because they didn't have one.  A single frozen embryo transfer worked, and there was much rejoicing.  Sam was unemployed.  There was much less rejoicing.

In April, there was even less rejoicing in the Buttmansion abode as the embryo, previously seen to have a nice strong heartbeat and all those fancy things, dropped dead unexpectedly.  The miscarriage continued well into May, dragging on and on (and on), robbing Akeeyu of her ability to make even the cheesiest of jokes about children she doesn't have.

In May, Akeeyu was diagnosed with basal cell carcinoma, causing Sam to edge slowly away from her, muttering "Jesus fucking Christ, woman, what's next?  Lightning?"  Akeeyu said "Oh, kids, your father's such a card!  Now, don't forget to slather on the suncreen before you go to soccer practice.  Kids?  Kids?  Oh, right."

In June, somebody in the Buttmansion household decided to get cute and acquire a resistant staph infection.  We don't like to name names, but it wasn't Sam and it wasn't the dead embryo.

The Buttmansions, having learned a thing or three about efficiency from the previous miscarriage, managed to squeeze another frozen embryo transfer and a miscarriage into the month of July, which led to Akeeyu's bouncing bundle of new diagnosis in August: Repeated Pregnancy Loss.

In September, Akeeyu's father's doctor completed the Cancer Trifecta by saying "No, we really mean it this time, he's dying."  Akeeyu gathered up the grandchildren and headed to his bedside.  No, wait.  Scratch the grandchildren part.  Shit.

In October, Akeeyu's thyroid crapped out.  Again, Sam said "I love you, but I think I should stay the hell away from you because you have the worst medical luck in the world, and I'm afraid if I get too close to you my peener will drop off."  Akeeyu said "Well, the last thing we need is another cause of infertility in this family."

In November, Akeeyu's father, Giggles, was hospitalized.  It was a motherfucking nightmare.  For weeks afterwards, angry family members would hurl the word "NURSE" at eachother as the ultimate insult.

December marked the due date of the April miscarriage, which Sam and Akeeyu spent apart.  Sam mostly played nerdy games online while Akeeyu drank heavily.  Several of the family's beloved appliances broke.  Mother Nature got super pissed at most of western Washington for reasons known only to herself (although I suspect somebody might have forgotten her birthday). 

To round out the year, Akeeyu's father finally died right before Christmas.

It's been such a fun year that we hardly know how we'll ever top it!  All we know for sure is that 2006 will be over in ten days, and we never have to do it again.

If I Were A Guest, I'd Kick Myself Out

When people visit a dying person, a large number of them want to talk about death.  On the one hand I understand this urge and think it's perfectly natural and on the other hand, good God, people, change the fucking subject.  The dying person's family members and caregivers are just about up to here with the morbid chatter, and I know for a fact that this topic has crossed the mind of the person in question about 56,000 times since June.  So no, we don't want to hear about your dying (or dead) relative, we don't want to hear your theories on the afterlife, and we really don't want to hear about your elderly relative's recent brush with cancer (or whatever), because that intense look on our faces doesn't mean we're thinking "Wow, I'm sure glad so-and-so survived that nasty infected hangnail," it means we're doing the math in our head and figuring out how much older your elderly relative is than our not-so-elderly relative will ever be and resenting it.  A lot.*

Incidentally, I am totally not talking about any of the sweet comments and/or emails y'all have sent, which have been wonderful and kind and supportive.  I'm talking about the people who stood in my father's kitchen for fortyfive minutes waxing poetic about mortality while I stood there, nodding politely and thinking about the laundry I could have been folding and the lunch I should have been preparing.

The death-related assvice is intense.  "My (insert family member) had that, and is fine now."  "Have you tried...?"  "You should..."  "If you just think positive..."  Wait, come to think of it, a lot of it sounds oddly like infertility assvice.  Huh.

I feel suffused with death and I would desperately like to talk about something else, but at this point I'm having a hard time focusing on anything else for very long.  It's a bit like that old story about stirring porridge for five minutes without thinking about little green monkeys, and am I the only one who remembers that story?  Apparently the Internet has no recollection of it, and neither does my mother.

Anyway, in light of my total lack of focus and the fact that I may have gone completely crackers and invented an old story about porridge and little green monkeys, I think I'm going to drag a few old posts out of mothballs and air them out, if you don't mind.  Like all things pulled out of the back of the closet, they may be a bit out of fashion or have a hem in the wrong place, but I think they may still have some wear left in them.  We'll see.

*The best thing to talk about at somebody's bedside, other than whatever the hell the person in bed wants to talk about, is your warm regards for them, your favorite tales from the good old days and any ways in which the person in question has influenced or improved your life.  This melts everybody like a pocketed candy bar in the summer, leaving the same sweet aftertaste.

No Partum Depression

My due date has been ticking down relentlessly like an overused plot device in an action movie.  The significant difference is that it won't be stopped at 00:03.  There won't be a deux ex machina.  Nobody is going to save Good Embryo at the last minute.

My due date is going to come and go, and in the space of twentyfour hours I will be changed from a woman who was supposed to be pregnant right now to a woman who was supposed to have a baby right now.  But I don't.

My mom, who is very kind, always tells me that I am a good mother.  She has been doing this since we started IVF, regardless of how things have been going.  I'm not going to call my mom a liar, but I don't feel like a mother.  'Mother' implies 'child.'

Just to make it entertaining, I've spent almost my entire Imaginary Third Trimester knowing that my father was dying (shortly), so every twinge or spasm of grief I've had for Good Embryo (or Better Embryo) has been overshadowed by the accompanying feeling of "Don't be an asshole.  He's dying right in front of you, this whole real person that you love very much, and you're crying over somebody who was never even born?  Over somebody who isn't even 'somebody'?"

It's been, to put it mildly, a little trying.  I'm performing dimestore alchemy on my own heart, transforming grief into guilt effortlessly.  Rumplestiltskin need not apply.

Because I am away from home and caring for my father, I am also away from Sam.  In case you're wondering what it's like to spend your Imaginary Third Trimester 750 miles away from your partner in reproductive crime, the only other person in the world who feels the same loss you do, your husband and the person you desperately want to see at the end of the day, every day...look, it's fucking rough. 

I have no idea how much easier this might be if I were home and Sam could hold me every night and of course I never will, because there's no undoing the situation.  I am choosing to be here.

When you lose a person, you don't lose what you had, you lose what you didn't have yet.

Every experience I had with my father is still mine to keep and I feel very lucky in that my relationship with my father didn't have many 'If only's except for the big one.  Good Embryo, by contrast, is markedly short on haves and interminably long on didn't haves.  My relationship with Good Embryo consisted largely of wandmonkeys and horrible news and being very, very ill.  Here is a short list of things I did not get to do with or for Good Embryo: Give birth, breast or bottlefeed, change an awe (and insipid post) inspiring diaper, dress him in anything cute or funny, show him to my parents, put him in school, embarrass him in front of friends, hold his hand, hold him at all.

It's not the actual embryo I am mourning, but all the things, both great and terrible, that that embryo was supposed to become (and never will).

People in my life frequently tell me that everything will be okay once we have a baby.  I, of course, always mentally convert 'baby' to 'baby that lives', and remain deeply skeptical (and somewhat offended).

"If your dog dies, get another."

Good Embryo wasn't a dog. 

In all fairness, I do think it would have been better if Better Embryo hadn't been chemical.  If Better Embryo had been on the way to being a bouncing baby anything, Good Embryo's absence wouldn't be as glaring, but s/he isn't, and it is.

"If your dog dies, get another."

This grief, instead of being arrested by another baby, by another cycle or a success or anything positive, has simply been compounded by death and illness and the way time can stretch out in the most uncomfortable ways when left to its own devices.

This grief has come full term.

O Dark Thirty

It is called the Activities Room, but as everyone on this wing is either chronically or terminally ill (or both) or the family members of the chronically or terminally ill, I wonder what kind of Activities they are expecting.  Dancing?  Will there be bingo later?

The room is full of glider rockers.  Comfortable, but they remind me of the sort of thing given at baby showers.  I involuntarily imagine them housing a flotilla of pregnant women and wince.

There is a truly bizarre library along one wall.  Maybe library is the wrong word.  There are several tall shelves of books.  Both the selection and the arrangement are completely haphazard and inappropriately hilarious.

A row of bibles, their matching spines neatly printed "Holy Bible," "Holy Bible," "Holy Bible," "Holy Bible," and then a fifth bible, off to the side, upside down, and pushed away from the others.  What is it, the unHoly Bible?

A military novel entitled "My Dying Breath."  Actually, we're trying not to think about that particular subject.

A copy of a textbook labelled "Infectious Disease."  No, thank you.  We don't need any of those here.

"Eating Hints for Cancer Patients."  I don't think cancer patients would be very good to eat.  They'd probably be pretty tough and stringy, to say nothing of the chemical contamination of the meat.  Given a choice, I'd recommend going for the depression patients, as they are likely to be nice and tender from all the listless apathy and ice cream.  You know, like soylent veal.

I am a little annoyed to see that there are five bibles and not a single box of Kleenex.  I will understand why later.

Finally, I find a book that seems appropriately placed: an ancient nursing textbook on caring for the terminally ill.  I leaf through it listlessly.  "Many nurses avoid dealing with dying patients," I read (unable to even feign surprise), "even to the point of ignoring them when they call."

By this time, I've figured that out on my own.

Let's Talk About Something Else

It's not what people think.  There is an enduring image of starched shirtwaists, sunlight streaming through white curtained windows, benevolent hand holding, Florence Nightengale shit.  It's not that.  It's laundry at midnight and dishes when you're tired and wet paper towels for the vomit and the gradual emergence of prominent bones that changes the shape of the most familiar face. 

I'm still here, and so is he.  There is a sense of postponing the inevitable, which of course we are, and I think we all know it.  Most of the time I don't think about it.  Most of the time I just think about what is directly in front of me at the moment.

It's funny, but the thing they don't really tell you (other than that the Florence Nightengale thing is a crock) is that you won't be miserable the whole time.  There will be a period when you feel nothing but pain and taste nothing but cardboard, when you can't think or remember what's in your hands, when you accidentally throw your keys in the garbage and get lost on familiar streets, when you cry not out of grief but sheer exhaustion, when you put facial soap in your hair and forget to brush your teeth for disturbingly long periods of time,* but that will go away.  Eventually, you will be less than miserable.  At first you will feel guilty every time you start to crack a smile, but after a while it's okay.

I am okay.  People call and ask how things are.  I say "Fine, thank you," and the person on the other end of the phone sounds politely horrified and says "Really?  Fine?  But...?" and I say "Well, he still has terminal cancer, of course, but it's a good day.  It's fine," and I can tell they don't really get it.  I know I sound callous, but I've stopped worrying about how I sound or look (and on certain unfortunate days, I haven't worried about how I smelled, either, and for that, I feel that perhaps I should apologize to the neighbors, and possibly the dog).

I have hit Crapuilibrium.

My long silence has more to do with unreliable Internet connectivity than anything else.  Fear not, I am not curled up in the corner weeping (I can't, as I have too much laundry to do and dinner ain't cooking itself, you know?), and I loved reading all your comments and emails when I regained a connection.  Thank you, thank you, thank you for all your thoughts and prayers.  I told my Dad that half of the Internet was pulling for him, and he thought it was very sweet.

That being said, though, let's talk about something else.  Let's get back to Infertility or Politics or Really Good Chocolate Cake Recipes or something, okay?  I'm kind of up to my asshole in Grief and Death over here, and would love to have a nice bitchfest about the assvice I've been getting lately.

*Speaking of assvice, I am just waiting for somebody to say, when I talk about caregiving and exhaustion, "Boy, sounds just like having a baby," because then I will say "Really?  Your baby weighed 200 pounds and had terminal cancer and was in constant intractable pain, even while on enough morphine to kill a Clydesdale?  That's terrible!  You poor thing!  I hope you weren't surrounded by fuckwits saying stupid things, because that part really sucks."

Giving Away What I Don't Possess

IVF is great practice for being a caregiver.  First of all, it teaches you how to function while your heart is breaking/broken/about to collapse like a wet sugar cube.  Second, after juggling needles and pills and protocols and whatnot, keeping track of a cancer patient's laundry list of medications seems, if not simple, certainly manageable.  Lastly, it increases your emotional stamina and endurance.  This is very important, because as far as I can tell, caring for a dying parent is the emotional equivalent of lifting a VW Bus off a puppy...four times an hour.

My life is very different right now. 

My caregiving day starts at eight in the morning and may go until about eleven at night.  I prepare meals, administer medications, do laundry, run errands, set alarms for pills, make beds, do a little chauffering, keep an eye on the Hospice workers so that they don't screw anything up too badly, and do various odd jobs around the house. 

It sounds a little overwhelming, but strangely, it's not.  I don't do any of these things for fifteen straight hours, but rather work in short bursts, spending my downtime emailing friends and relatives, IMing with Sam at all hours of the day, and killing time on sites like this.

The first couple of days, I relied on shock and denial to get me through, but then I restarted the Lithium and hit a comfortable routine and now I'm relying on something else, something unfamiliar and seemingly inappropriate at a time like this: gratitude.

Don't get me wrong, I am not grateful that my father has cancer.  I am, in fact, pretty goddamned pissed off about that so fucking pissed about it that I can't find words strong enough to fully express my rage, and that's pretty amazing, because I know an awful lot of very vulgar words.

What I am grateful for is that I can spend this time with him, that I am able to help my mother with the daily chores and free up her energy to be spent on him.  I am grateful that my parents taught me how to take care of people.  I am grateful that they trust me and are letting me help them.

Mostly, I am grateful for every single day that he is still alive and in good spirits.

Hide and Go Crazy

There is one nearly universal truth about psychiatric offices: They are ridiculously hard to find.  If they are in a large office complex, they will be underground, in the basement, at the end of the hall, around the corner, possibly behind the janitor's supply closet.  If they are in their own building, they will be at the edge of town, surrounded by one way streets, and/or offer no available parking.  If they are attached to a medical facility, they will be on the very edge of the hospital's campus or sometimes at a separate location altogether, and they will always be incredibly poorly signed.

I don't know why this is true, although sometimes I suspect it's an attempt to weed out the really really fucked up patients, the ones who walk around with tin foil on their heads and have long conversations with their elbows.  All I know is that the elbow people never would have been able to find the office I went to today.

The office's directions were incomplete at best, it was nearly impossible to find street addresses on any of the buildings, and just for fun, signs pointed left when the building was actually on the right.

One of the more entertaining moments was the elevator.  When I walked into the building, a small note said "Patients of InsanelyBusy Psychiatric Services, please take the elevator to the first floor."  Upon stepping into the elevator, I saw that my choices for floors were G, 2, and 3.  No 1.  Since I had entered the building on what appeared to be the ground floor, I was completely mystified.  The doors swished shut, and I just stood there for a while, staring at the buttons with my head cocked.  G, 2, or 3?  "But what the hell am I on?" I muttered, and then answered my own question: "Nothing, dumbass.  That's the problem."

I should probably clarify something.  The post from the other day talking about seeking psychiatric medicine was describing an event that took place quite a long time ago.  It's been a while since I was on Lithium, not because I don't adore the stuff, but because it carries certain risks in the first trimester, bla bla bla.  I have been off of it for a fuck of a long time, and while I can usually just hang onto the world by the skin of my unmedicated teeth, there is a limit and I've hit mine.

We canceled the cycle so that I could stay with my parents for a while, which is what I'm going to be doing.  This is somewhat incredibly stressful, not because of my parents, who are wonderful people, but because one of them is terminally ill, so I decided that I should probably go back on Lithium for the duration. 

This is why I spent today not only trying to get crazy drugs out of an HMO, but trying to get crazy drugs out of an HMO that is currently denying the existance of my coverage.  I am getting better at it, though.  What took several weeks two years ago took just under twenty three hours today.

My father is dying, and nothing can change that or make it better, but the medication will hopefully, as I told my mother, "make me able to be as miserable as a normal person."