This weekend i read "sweet grapes" by Jean and Michael Carter, a book on...well, how to stop living life as an infertile, mainly.  After many years struggling with infertility during the 80s and 90s, they finally made the decision to live a childfree life.  and this book is about how they left behind the misery of infertility, eventually finding great contentment in a life without children.

It was so hard to read.  All the anger that I've been feeling towards my RE suddenly turned on this book.  I actually felt anger at this couple for even suggesting that I don't have children - which is really, not what they were doing, but I was angry anyway.  But I persevered and eventually was able to learn, I think, a bit about myself in the process.  And here’s what that was.

I’m infertile. I’ve known it a while of course,  but I’m just realizing how much a part of me it has become.  I don’t know that even with a child I will ever be “cured” of this.  I don’t mean to say that infertility defines me.  I mean, these days at times it certainly does and I should definitely work on that.  But it’s more than a label.  Part of me wants to scream and rage, and another part of me is totally, morbidly fascinated by the emotions and desires that I’ve struggled with these past 4 years.

I can’t do it another four.  That is to say, continue along in the same psychologically fragile and emotionally high strung state that I’m in now.  I can’t put my husband through that and I don’t know that I would survive it anyway.  But I still want a child and I don’t want to make that go away.  So, how does one find harmony here?

It’s not a trick.  I’m not trying to get one over on the fertility gods, by playing the “I’m not trying anymore” card.  I just want to find some contentment in my life.  I don’t want to live a life on hold anymore. 

I would appreciate any advice or thoughts on this.  I don’t know where to go from here.  So far my plan is: keep your eyes open and don’t hide from the world.  That’s about as far as I’ve gotten.

Any ideas?

A week has passed since my negative beta result.  I already started AF, a horrid one actually, and am waiting for my next RE confrontation, I mean appointment.  I'm incredibly nervous.

She doesn't scare me, but the language barrier becomes a huge problem when i get nervous and she gets smug, which she does..often.  Smug and condescending.  I feel likes she's patting me on the head.  In fact, sometimes it's accompanied by "You're still very young, most of my patients are in their 40s".  I hate that.  I mean, I'm 30, but is that really young.  Okay there is an increasing population of older moms these days using fertility treatments like DE, but honestly MOST women do have children around my age and before.  So i can't stand that attitude.  Plus she is annoyingly tight lipped about everything and on the days i push her for details I get comments like "Are you studying to be a doctor?"  She thinks that's a joke.  I don't find it funny at all.

Christ if i could only speak Spanish fluently.  I would never put up with this in an American clinic...i don't think. 

And then sometimes I wonder if it's the language barrier or just my general fear and anxiety about the whole thing.  How do I take control of this situation?

First off, i'm making a list of questions for my appointment tomorrow.  I'm going to ask everything.  I will post what i asked and what her response what.  I'm curious to know if I'm being the nut here or if she's just really that annoyingly uncooperative.  I just can't believe that of all the infertile women she deals with none have made a big deal about wanting to know more information.  One of my big questions will be "Why did she do a 2 day transfer?" 

I feel the anxiety setting in.  Any advice on how to deal with a difficult RE would be greatly appreciated!  

there's sadly no good news to report. i've been unable to post...emotionally unable (?) i guess.  Unwilling to face it all or something.  At first it was an effort to remain calm and these past few days, though I've needed to write, I've been bottled up.  Thank you Mel and Josh at The Town Criers for all your infertility videos, which really have broken through my depression.   (Uterninus' Law, My Aunt Jane Knows More Than My RE, and What the Gardener Knows)

The DE cycle had it's ups and downs.  My lining was as uncooperative as ever but I ended up with 9mm on transfer day.  9 eggs were retrieved, not so good, and 4 made it to day 2.  On Day 2, we transferred 2 "exceptional" ones and left the other exceptional and it's mediocre relation to freeze. 

So, anyway, 2 hpt- and i'm currently waiting on the beta results from this morning, though I know I'm NOT pregnant.  I am a little worried that I will get that fantastic "not so clear" response, of like 30, that will then ever so slowly dwindle down to 0 over the next few months...or something.  You know that story, right?  where I spend days and weeks agonizing over "wanting this to be over!" and some days completely irrational hope.  Better than I miscarriage, yes, but still very sucky.  A

So there's this other one and his mediocre friend left.  My RE used the phrase "mediocre" by the way.  I didn't get number or cell counts or anything.  I can't even start on that rant about how much I HATE my RE right now.  Or if not hate, really, severely distrust.  A 2 Day transfer?!!  WHY?

I'm already gearing up for my next appointment.  Why do i feel like I'm facing some kind of battle with her?  And how messed up is it that I'm dying, in a very disturbing way, to see what kind of smug or blithe attitude she can give me now. 
Yes, I know it's messed up, I said so didn't I? 

And finally, I've been wondering what is left when hope is gone?  What does hope change into?  How do I find a place to  live with this in the long term?  It's been 4 years now, but it could be another ten.  I need a new mindset to cope.

Things have been moving along smoothly, though slowly, for the past few weeks.  As it turns out I did not have to have the endo biopsy, which was fantastic, as I had recently done a hysteroscopy with my RE and she found that adequate.  Even better, at my last appointment my lining had surpassed 11mm, which is great. I hope it goes as well during the real thing. It’s really all about those patches (Estradiol).  Three times a week and 8mg of the Progynova a day…that will be my regime.

Now it’s time for the real thing.  Well, not quite time.  I’m starting a new cycle.  I got to leave off the hormones for two glorious days, during which I felt about 10 pounds lighter.  Now I’m slowly starting back.  My donor is supposed to start her period on the 8th and then it’s...two weeks? Thereabouts.  Sometime at the end of October.

I’m feeling, in general, pretty calm.  Though I am experiencing moments of panic, alternating between fear of another miscarriage (Should I be on Lovenox?!) to fear of using DE (Was this really the right decision for us?!).  But overall I am pretty calm.  We’re redoing our house and that’s a helpful distraction.  And I’ve just been avoiding all infertility groups, updates, internet contact of any kind.  I really don’t want to stress.  Hence, the blog’s out of date.  It’s true that I’m a terrible procrastinator on the best of days, but I want to believe that this lack of updates has been a subconscious decision to keep myself sane.  Instead I’m learning about Herodotus.

I dare you to find something more removed from ART worries!

As far as I know this is how things will go from here on out:

The clinic will call me when they have more information on the donor’s cycle and advise me when to start increasing my meds (and adding in the patches).  Shortly after this they will begin monitoring my lining more closely.  An ultrasound a week or more perhaps?  Something like this.  Then we’ll get a date after the 8th, I think. 

Not sure what their guidelines will be on rest post-transfer.  I suppose now that I’m allowing myself (limited) access to the internet I will seek advise from the experts (those wise souls who have gone before).

I will get up the nerve soon to write more about my state of mind.  I’m curious as to how many people have developed obsessive/compulsive disorders during the course of ART.   I find myself doing the weirdest, sometimes scary, things, along the lines of “don’t think that way or X will happen” or “if you do that then y will happen”.  It’s some weird self-imposed morality/punishment system, except it’s specific to me and only governs the outcome of the next pregnancy attempt.

And now that I’m clearly completely mad, I’ll sign off.

I hate to be ungrateful, but, honestly, could you give a girl a little warning?!  This is exactly why I want all the information up front, Day 1, so that I can avoid the let down experienced en-stirrup that occurs after I learn that my lining has finally increased and we can now move on to the biopsy of the endometrium.  It was a “YAy-a-a-what?”

No one ever told me.  Which, I think, means I get to be a little bit of baby about it and whine for just a few moments here, since DH is beyond sympathy for me.  (I’m no longer apologizing for my crying spells, so there!)  I was very happy to hear that the estradiol patches did their job and my lining finally jumped up to 8.4 mm.  I just thought that would be the end of it, but apparently I have to have this biopsy thing done, which scares the hell out of me.  It sounds painful, but I was assured that it wasn’t nearly as bad as the HSG.  We will see.

After getting that news I was sent to the lab to have my estrogen levels checked (still waiting on those results) and told to continue current treatment until I hear from them, at which point it’s time to start progesterone. Then next week I have a biopsy and progesterone levels checked and then FINALLY, if all goes well mind you, I’ll be READY TO CYCLE.  Can it really be true?

Luckily,  something happened on Thursday to ease any immediate worries about the next phase: I had my appointment with an English-speaking doctor!  It was...well, if I still smoked I’d have had a cigarette.  Seriously, it was that good and that calm inducing.  She was chubby and blond and smiley and oh-so-reassuring.  She eased my fears about there being another issue in addition to the chromosomal translocation and said that DE looked like just the thing for us.  Which made me feel SO much better, I’ve been doubting my Spanish doctors so much.  DH was, also, visibly relieved to not have to serve as crisis translator.  He told her, “This is the best appointment we’ve ever had.  Thank you! Thank you!”

Even better though was that she also happens to be in charge of picking the donors at my clinic.  I feel like we connected a little and her mom is from the same city as my mom in the States which makes me feel like she’ll use a little extra care picking out my donor.  It’s probably not true and she’s totally objective about that process, but still, I feel a little more connected to it now.  If nothing else, my irrational fears that an angry RE would pick out an ugly donor have been put to rest she looked like my mom at a younger age (she really didn’t), just so she’d know my mom’s a blond, but I thought that was taking it a bit far.

We are in negotiations with my endometrium apparently.  It wants more drugs and perhaps a little romancing too.  If I were in charge (oh how that thought makes me giggle), we’d be strapping it down and force feeding raw estrogen concentrate (while simultaneously scolding it for it’s past crimes).  Unfortunately(?) my RE takes a more “tranquilo” approach, which basically means we gradually increase our oral estrogen intake while  peeking in on it weekly.

Our last “how do you do, miss lining” was Friday and she was just as stubborn as always.  I think we were up .3 mm, which is like…nothing.  I thought for sure my relaxed doctor was going to calmly increase my Progynova to 9mg a day, with nothing but a raised eyebrow and a “relax, we’ll get there.”  Thankfully, I got a little more this time.  I got estradiol patches to stick on my ass.  (Why the ass?)  And we’re to go back next week for another peek.

The reason I’m getting so stressed is that every delay really is delaying the whole procedure. At this point, we’re just waiting on my body to get with the program.  As soon as we get through this mock cycle it’s just a matter of syncing us with the donor, which the clinic claims will take about a month, but every week that passes with my uncooperative lining pushes that date back.

It feels the closer I get the further away I am.  So cliché, but oh so true.  And on a side note my favorite pharmacist who I’ve never talked to about this but has clearly guessed, told me to “relax and it will happen”.  :sigh:

I started back on the progynova this week. I had about three total days of not taking hormones and now I'm back on them. I can already feel it and it seems much worse than last time. Am I imagining things or have I been crying a LOT more in the past few days? I've become a weepy person. I cry at sad movies, dogs in the street, old people and now scary things make me cry too. But the thing that makes me cry the most is when my husband does or says anything.

How long can this go on? How hormonally charged can I become before I snap? I don't know, but it looks like my limits are going to be tested this month.

Since I've started the progynova again and officially embarked upon my last cycle before the donor egg transfer (fingers crossed), I decided I should really bump up my efforts and really give this cycle my ALL. YEAH! LET'S GO! I don't know who I'm cheering on. Me and my endometrium, I guess. Anyway, this means inhaling flax seed with every deep breath. Luckily I have an old habit of holding my breath when on the computer and this gives my digestive system a needed break.

Flax seed and progy,
sittin' in a tree.

Honestly, I don't think the flax seed really works, but I'm doing it anyway.

The next doctor's appointment is Monday. It's a lining check and it's with my regular RE, not the jerk-head-of-clinic-expert-jerk we met last time. Hopefully, all will be well with the triple lining and we'll finally get some more definite news on when exactly the transfer will happen. I'm a bit nervous however, because I intend to discuss with the doctor my worries that the miscarriages might have another cause, in addition to the balanced translocation. I don’t anticipate it going very well, unfortunately. Partly because every attempt at an in-depth look at my medical situation is difficult due to the language barrier and partly because all my doctors seem resistant to looking at multiple causes for the miscarriages. They seem happy to blame it all on the balanced translocation and I’m just not so certain.

I’m printing out all kinds of information on lovenox, heparin, metformin and all related disorders, immunological issues, etc.. that might warrant the use of those drugs. I want to make sure we've looked at as many potential causes as we can before we proceed. I plan to get together a massive list this weekend to prep for the big appointment. I’m putting it off till Sunday though, because otherwise I’ll spend the entire weekend with knots in my stomach stressing over EVERYTHING to do with current, no baby, situation. It’s emotionally draining to say the least. Does anyone else find they have to schedule their “thinking about trying to have a baby” time to prevent 24-7 anxiety attacks?

Technorati Tags: DE, infertility, progynova, translocation

I hemmed and hawed about this long enough. I just couldn't decide how to go about introducing myself on my new blog. The problem is it's a flimflam, a carefully constructed ploy to divert potential readers away from the truth.


Wha??!!

I know it doesn't sound like something you should admit to, but despite my current title as Resident DE Deceiver, I really do want to be honest. Which is why I'm telling you upfront about my scam.

My old blog was all about my experiences with trying to have baby. I won't say conceive, because I have conceived, five times, all naturally. I lost each during the first trimester. So, I suppose that’s Fact 1 about me. Perhaps we should start a list.

Fact 1: Trying to have a baby (for four years) with five miscarriages

I'll try not to make the list too depressing, but it's not all sunshine and rainbows here folks. Anyway, my old blog, as I was saying, was great. I was chronicling our past few years of doctor's visits, exams, blood tests, arguments, etc...(all very fascinating stuff) as honestly and accurately (as much as I could remember and regurgitate) as possible. But recently we've run into a sticky problem. We've turned to a new ART (Assisted Reproduction Technology) since our most recent diagnosis.

Fact 2: Recent diagnosis of a Balanced Chromosomal Translocation (that's on my part)

To sum up in an incredibly oversimplified way, this translocation is a genetic abnormality on my part that affects how I pass on chromosomes to my baby. Sometimes the baby gets the abnormal (translocated) chromosomes and it cannot develop normally. In my case, given the exact nature of my translocation, it never seems to live past the first trimester, which is maybe a blessing. Unfortunately, as any of you currently invested in the world of infertility are aware, I'm not even certain that this is my only problem with having a baby. Still, a recommendation has been made and seconded and even fifthed that we should, in light of this information, try to get pregnant with less problematic eggs. As of this past spring we've been on the path to IVF with donor eggs. Our transfer is scheduled for this fall.

Fact 3: Pursuing IVF with Donor Eggs and scheduled for Fall '07 transfer.

So you might see where privacy issues start to come into play. I need a space to talk and share, but I'm not convinced certain members of my immediate (though distant) family could handle this information. I'm not sure they need to know. And the crux of the thing is they have the old blog address.

Now you all know my great deception. What else should you know?

Fact 4: I live in Spain, but don't speak medical Spanish fluently.

That's actually quite important, because, though my husband does speak Spanish (he is Spanish), my inability to fully communicate with my medical care providers has been a major source of frustration and anxiety during the past two years. We used to live in the States, but that was before my third miscarriage, when the doctors were still blowing off my concerns. Most of my serious testing has been done here in Spain. Don't get me wrong! (Hang on to your sombreros you proud Españoles!) I'm not saying that the care is substandard. It's not, but there are conventional differences between the two. Add to that trying to communicate things like "I need a Rh immune globulin shot after the D&C, because I'm Rh-negative." (During that very real moment, I took a detailed printout of the shot into my D&C appointment and pointed at it. I think I said "Necessito este..." or something equally inane) Things become confusing fast.

But I think that's probably the same for most people going through this nightmare of infertility or recurrent miscarriage. Maybe that's Fact 5...

Fact 5: Constantly confused while making life-altering (or so they seem) decisions

And...always waiting. I feel like I'm always in the sala de espera (the doctor's waiting room). It isn't a very nice place to be. There's something quietly unsettling about it, isn't there. I would like to know, as a side note, why fertility doctors think women trying to conceive want to read gossip magazines in the waiting rooms. There's always ten or so on the table with some gorgeous, thin and very pregnant celebrity smiling up at you. I don't feel emboldened by this! I feel envious, honestly, and something closer to fear than hope. Is this just me? I won't make "I'm envious" a fact about myself though, because I'm not, generally, an envious person. Although, give me a few more years with this baby journey and I'm sure I'll get there.

By the way, comments, feedback and advice are greatly appreciated!

Technorati Tags: DE, expat, infertility, IVF, miscarriage