Sunday, June 23, 2013

Strike one and two

It's hard to describe the utter despair when IVF doesn't work. There's the hollow feeling you're already used to, the one that's come at the end of every single month... for years. That hollow feeling you're already used to came even after the medications and interventions and procedures designed to prevent it. And it came again, and again, and again. Relentless emptiness, with each IUI, with each "maybe it'll work naturally after all" last hope. That's the feeling that leads you to try IVF in the first place, despite the extreme cost and the extreme toll on your body. So when you finally jump into IVF and at the end of the cycle - after a month of down-cycling, after weeks of stimulation and monitoring, after egg retrieval, and after embryo transfer - you're still not pregnant? It feels like everything you know - the floor of your universe - has just crumbled beneath you.

The floor of our universe crumbled twice.

Our first IVF cycle was in September. We hadn't planned on doing it then, actually, but our original doctor moved and our new doctor thought we should jump in. T gets a quarterly bonus that was coming that week, which helped us piece together the funding and make the unexpected - almost impulsive, really - decision to go for it. We were 100% out of pocket for IVF - zero insurance coverage, like a large portion of IVF patients. Because of that, timing the cycles are a financial decision as much as a health or scheduling decision. You've seen what all the meds look like for an IVF cycle, which represent one portion of the cost. The others are fees for ongoing monitoring, the retrieval procedure (which involves anesthesia), time in the lab while the eggs become embryos, the ultimate transfer back inside the body, and then the freezing of any leftover embryos. Understatement of the year: these costs add up quickly. The cycle itself was manageable - although learning to mix the shots was new (the fancy - and easy - injectable pens I'd always had with IUIs are more expensive than mixing the medications yourself, and since we were paying out of pocket I had little choice this time but to beef up my chemistry skills). I had dear friends visit and a big work event to plan while I was stimming, but I managed. By retrieval day, I was ready - I could barely walk I was so bloated from the medications and engorged ovaries. I was knocked out for the retrieval, in which a needle punctures the ovaries and sucks out the fluid containing all the eggs you've harvested. When I woke up I realized I was telling the nurse about our new puppy Eleanor. They write how many eggs they retrieved on your hand for you, so you can see it when you wake up (since you likely won't remember when they tell you). Here was my hand that day:

Of the nine eggs they retrieved, five stopped progressing over the next three days and four were deemed usable (results that are about average, by the way). By transfer day - which was also T's birthday - we transferred two embryos and had two more to freeze. We were happy with the results. I had to work a large outdoor event the entire next day (dubious decision, even though I had my doctor's permission). I was to go back in ten days for a blood test, but we started testing at home after about a week. Because IVF was new for us, I didn't know what my symptoms might mean. Just like many of you might have experienced, when a possible pregnancy symptom could also just be your period starting, IVF symptoms are an exaggerated version of "normal" events. You're also still on medications that make you feel tender/swollen/ouchy, so it's really impossible to know anything based on symptoms alone, and you can truly drive yourself crazy trying to interpret them. We got a hint of a positive one day in those ten days, but it was gone the next. Blood test: decidedly negative. Doctor's orders: take a month off to rest my body and decide what we want to do.

By November, we knew we were ready to use our frozen embryos. A frozen cycle is much easier physically than a fresh cycle, for the simple reason that you don't need to stimulate the production of eggs. It's a lot cheaper for that reason, too (finally!). My body would be rested and ready for the "frosties," we told ourselves... maybe the lower stress from a rested, umstimulated body would do the trick. We were pretty peppy throughout the entire cycle, actually - busy enough not to be counting down the days, which helped a lot. Our transfer was in mid-December, and our spirits remained sky-high. It was Christmas, we were trying something new, my body felt great on only one medication, and everything seemed rosy. I had tons of symptoms - symptoms that again could be either a period coming or a medication side effect, but they were something, and I felt different than I had during our fresh IVF cycle. We waited and celebrated the holidays with family. Despite the daily negative home tests, we  were still sure this was it. The day before Christmas Eve, though, my temperature plummeted, and I knew we were done. That realization was twice as hard as September's... probably the lowest point in our entire process. When I went in to the clinic on Christmas Eve morning, I knew it was a lost cause. Another negative blood test. Merry Christmas to us... I was emotionally numb for weeks.

Our drive-by of the Washington Monument on Christmas Eve morning, en route for another negative blood test. (By the way, all my scenic National Mall Instagrams over the last year, always early in the morning? Always a doctor's appointment.)

I came down with an awful cold/flu between Christmas and New Year's. Maybe I was so heartsick, my body decided it would join in, too. We'd had enough. 2012 was our hardest year together or apart... just nothing we wanted to repeat again. We rang in the New Year on the couch watching a movie, holding on to each other as if we were all we had. On New Year's Day, we did every good luck superstition we could think of. 2013 just had to be better, we kept telling ourselves... it had to.

Do I sound mechanical writing this now, a little numb? If so, it doesn't surprise me. I think our only way to survive was to shut down some of it. I wish now I had written my way through it, but I also know that was more than I was capable of at the time. Getting through each day, having a career, having the semblance of a social life (even it was painful to go through the motions)... after all of that, I didn't have anything left at the end of the day. Thinking back now, I may be forgetting just how raw everything was. The one thing I do know, though - more important than our eventual good news, actually - is that we survived. But I don't wish it on anyone.

Tuesday, June 18, 2013

The journey continues

Oh hi. I'm here. I know, I know... too quiet. Life is a little crazy again (always?). First the death cold, which clocked in at a solid twelve days of misery, then workworkwork, plus T doing workworkwork, plus a million other things, and you have me coming home from the office too tired to craft a sentence. I also just swallowed a cherry pit as I typed this, so maybe I'm too tired even to eat cherries?

At any rate... I feel like I should say a few words about why I'm not screaming pregnancy details from the blogging rooftops. It's not that I plan on keeping everything private, it's just that I want to tell our story in a particular way, and I haven't had time to do it properly. It's important to me to write from the beginning, no matter how fun it might be to skip to the good stuff. Maybe I'm overcompensating for the onslaught of shiny awesome perfection we see in so many other packaged glimpses of life online, but I don't want to be shiny. I want to dig in a little bit and be real about why I might actually, it's true, feel like the happiest person in the world right now, fatigue and all. But being real about my current giddiness includes the whole package - the bottoming-out, the waiting, the trying again (and again and again), the keeping hope alive. For anyone reading this who's still in that godawful cycle, they know what I mean, and it's a discredit to everyone who struggles with infertility to jump ahead to the "this week my baby is the size of a..." stuff. I don't want to gloss over the journey in my eagerness to celebrate the finish line. Doing so feels dishonest. And lame.

So for everyone hoping for the happy ending stories already, keep waiting. They're coming, and I'm smiling and feeling great, truly, but I don't feel like a finish-liner yet. Maybe I never will. That's partly humility, sure, but I'd be lying if I said it wasn't also partly the journey speaking. So instead I'm feeling lucky. Really, really lucky, and really, really grateful. As for happy endings, I was always more interested in what happened to the couple after the credits rolled, anyway. Know what I mean?

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