This crazy beautiful thing that happened

Flashback: the week of Christmas, 2014. Work drama per usual, running around like mad, getting ready for work while mentally compiling the list of gifts to finish wrapping and the final things to do before driving to NC for the holiday. A pregnancy test, just taken, was tallying its result. Not that the chances were great it'd be positive - after three years and seemingly endless interventions to get pregnant with Hazel, this was the very first month we were officially trying to have #2. So there I was again, temping and charting, even though we both admitted to each other that the sound of my basal body thermometer's beeps in the morning gave us PTSD reactions. I figured I'd rather know the result alone in our house than during the rest of the week's craziness, when we'd be spending two days in NC followed by two days in CT. By the time I started showering I'd actually sort of forgotten about the test, my mind was so full of things to do that day. I reached for the body wash and happened to look over. My heart nearly leapt out of my chest. Was that...? Surely that isn't...? 

But it was. Holy crap, it was positive.

Talk about surreal. So much effort the first time that we didn't dare wait a second longer than necessary to try for #2, in case we were in for another three-year journey of outrageously costly medical hell. So no, we didn't dare wait... but that didn't mean we really had hope, either.

We told our families right away, later that week, toasting to our Christmas miracle. We were cautiously optimistic that everything would be okay at that first ultrasound. Having had sad news at a previous ultrasound, we steeled ourselves for the worst. We told ourselves that even if this pregnancy wasn't viable, at least we knew we could get pregnant on our own - that simple knowledge felt absolutely revolutionary to us, after all we'd been through. Everything looked great, though. A tiny little bean with a great heartbeat. Each time we checked in, that bean grew bigger and was doing more tricks. Sucking a thumb, spinning around, kicking. A happy camper with a due date of August 28.

We knew from the start that we'd find out the sex. I'm too much of a planner to wait to know - I need the information yesterday. I didn't have an instinct one way or another this time, but found myself thinking more about a boy than a girl as time went on. At the end of February those boy thoughts panned out - our bean (whom we'd taken to calling "Dos") was a he! A little brother for Hazel - too, too good.

Two kids has been our number for a long time, and knowing that #2 is a boy helps cement that thought for us. We'll be a family of four, with a boy and a girl 21.5 months apart. Life is going to be crazy and wonderful and beautiful, and when I stop to catch my breath and consider that, I can't stop smiling.

There's more

A few days after our positive blood test, we were back at the clinic for an ultrasound to take a look at the action inside. I'd been in that chair with those nurses on what felt like a thousand mornings before that day, but none quite like this. T was with me, the nurses were excited, I was grinning, and we let the wand show us the goods. What it showed was twice as much as we'd expected... TWINS!

Both transferred blastocysts had implanted, and we were absolutely giddy with the news. We maintained composure until we left the office, but out in the hallway it was a completely different scene. Hysterical laughter, lots of holy craps, hysterical laughter again, hugs so tight I was in danger of breaking, the works. A week later, we went back to see each of their heartbeats beating away inside me, tiny but strong.

Our biggest reaction at the news of twins - even more than happiness or nervousness about TWO of everything - was relief. We'd never have to go through infertility struggles again. No more IVF. No more drugs. No more countless clinic visits. We'd always said two and through, and now we had them in one punch. The news felt like such a gift.

True to form, I flew into twins research mode. I read three twin books before the month was up, I launched into research of what you need two of versus what you only need one of, I looked into local multiples clubs, and I started upping my protein intake dramatically, per the Dr. Luke diet for moms of multiples. We'd had a sure-thing girls name picked out for years, and had recently come around to two sure-thing boy names, so we launched into figuring out what we'd name a second girl if need be. Although a boy and a girl would be ideal, I had a sneaking suspicion that I had two girls cookin' inside. T - big brother to two sisters and big fan of girls in general - was happy with that scenario, too. We knew we were doing the Maternit21 genetic test at ten weeks, so we'd be able to find out the sexes early, but even that short wait felt too long. I wanted to know basically the minute we were sure we were pregnant.

After we saw our ferocious heartbeats, I became an official "graduate" of the IVF clinic and was transferred to an OB. I chose an OB at the same hospital who specializes in births of multiples, but had such mixed feelings leaving the close confines of the IVF clinic. For better or worse, those IVF clinics become an extension of family if you're a patient long enough. We'd been there for almost a year and a half, sometimes visiting multiple days per week. I also came to appreciate - after the fact - how much I'd come to rely on the very close monitoring the clinic provided. Think about it - I was used to near-daily ultrasounds, and an average pregnancy these days has maybe three of them... total. I was desperate to see the tiny beans again. In hindsight, I really wish my clinic had some sort of transition guide to help steel my expectations about the level of monitoring I'd receive with an OB, or an exit interview of some sort where they could warn me.

For some reason I was sure we'd have an ultrasound at the first OB appointment, but nope. The doctor felt my uterus and said it was larger than a normal pregnancy at that stage, thus indicative of twins, but that was it. I was definitely showing far earlier than a singleton pregnancy (it was there if you were looking by 9 weeks, and pretty obvious by 11), so it seemed like an obvious statement. I did the most "me" thing I could thing of to avoid focusing on how anxious I was about not seeing them - I kept very busy. There was workworkwork, there were weddings, there was always more twin research to do, and there was also resolving the difference in my head between my ideal birth and the realities of a twin birth... quite a gulf there.

9 weeks pregnant, at a wedding

10 weeks pregnant, at a work event

Our second OB appointment was on May 2, and I was sure I'd have an ultrasound this time. It was the day after that hard hat picture above was taken; I was a day shy of 11 weeks pregnant. I dragged T out of work again, but the appointment proceeded much like the first. When it was clear it was wrapping up and there was no talk of putting the babies on the big screen, I finally lost it. The OB called the sonographer and fit me in right away, and at last we were in a mini-movie theater of sorts, darkened and ready for the show.

What followed was one of the strangest experiences of my life, the most dramatic mix I'd ever experienced of terrible and joyous news combined. The terrible is this: there was only one baby inside, and one empty sac. Baby #2 had lasted well after we heard heartbeats, because it was significantly larger than what we'd last seen. The sac was completely empty, though - a blessing, really, since it meant no action on our part was required. The joyous news is this: the baby that was still inside was not just there but thriving. The sonographer burst out laughing at how much the baby was moving. We saw flips and waves and spins and kicks - pretty amazing for how early it was. We had lost one of our little ones, but the one we still had was there tenfold.

A rare still moment from our singleton, a day shy of 11 weeks

I think it took me a week to get over the worst of the emotions. I'd become so attached to the idea of two - and frankly, twins solved so many of our problems - that the loss cut deeply. Even acknowledging how much easier a singleton pregnancy and birth would be - not to mention having only one baby to handle at a time - didn't help that much, not at first. My biggest fear was that losing the twin meant we'd only ever have one child. Because siblings are so important to both of us, I felt like I was already robbing our baby of something important. I just didn't know if I could give her what I wanted for her, and that acknowledgement was searingly painful. Time heals most wounds, though. Today, we're... actually, this post is long enough, yes? I'll bring us up to date next time.

Third time's the charm

After strike one and strike two, we had decisions to make. We'd always said if we weren't pregnant by the New Year, we'd start looking into adoption. And we did, sort of... enough to quickly see that the process was every bit as expensive as IVF with ten times the wait. For whatever reason, the idea of going through the adoption process never really stuck. I think if we'd been anything but "Unexplained Infertility," had any reason besides our history to believe that we couldn't get pregnant on our own, we might have been more serious about it. But something in me couldn't give up the dream of the wavy-haired kid with light eyes that I wanted us to create. Most adoption firms require applicants to pledge not to pursue assisted reproductive technology while pursuing an adoption, but that felt like giving up to me. Not that I wanted to go through IVF again, mind you - the thought made me instantly tear up. But there we were at the end of January, in our doctor's office, telling him we were ready to try again. In some ways it was easier to put our heads down and forge ahead than to think about the big, sad picture of being back there again, so we actively tried not to be big-picture about the choice. It just was what it was.

The conversation at post-IVF debriefs with the doctor is basically "what did we learn and what will we do differently?" This time our doctor wanted to use higher doses of stimulation medications and do a 5-day transfer instead of a 3-day transfer. The 5-day transfer felt particularly hopeful to me. On IVF boards this debate can get pretty heated, but the basic idea is this: by spending more time in the lab and giving the embryos the chance to develop into blastocysts, you're increasing the odds that what you transfer back inside the uterus is as viable as possible. Some people also like to point out that the uterus is the natural home of blastocysts, whereas embryos are still in fallopian tubes at Day 3 during natural conception, so you're making a more biologically sound choice with a 5-day blastocyst transfer. Here's the downside: waiting five days in the lab means more of your embryos will die off, embryos that you might have otherwise implanted if you weren't doing a 5-day transfer. Now I'd argue that I'd rather know up front that these embryos weren't going to make it before transferring them, but others think each one has a shot, so you should give them a shot. To each her own. The bottom line with 5-day transfers is that you need more eggs to begin with, because fewer will make it to the blastocyst stage than they would the embryo stage.

Blastocyst or exotic flower?

Despite the huge amount of dread I felt going into this cycle, the stimulation drugs in February (even with the mega-high doses) didn't grind life to a halt. Sure, I had a huge belly ringed with bruises. Sure, I collapsed at the end of each day... hard. Sure, I was sick to death of needles. But like everything, you get through it. For me personally, being busy in times like these is a blessing. I worked a million hours and ran a huge public meeting while looking like I was pregnant and took the elevator a lot, but I made it. I looked up and it was March 1. Retrieval day. I donated twelve eggs to a really good cause. We breathlessly awaited lab reports, and by March 6, we had two perfect blastocysts ready to transfer and one left to freeze.

Some funny things about our March 6 transfer day: DC had a freak snowstorm that morning - gorgeous, hard-falling winter snow to make our way through to get to the hospital. We were placed in a different part of the clinic than ever before - something felt new and positive about that. We were both laughing a lot that morning. I remember that I was wearing green. The transfer was a breeze (always so simple compared with retrieval), and before I knew it, we were on our way home. The blood test was in nine days.

I don't know that I felt different that time. Symptom-wise, I felt the same as always - still bloated, still sore, still not quite myself. I held out as long as I could to take a home pregnancy test. On March 11, just five days after the blastocyst transfer, I saw something. Not a line, mind you, but a shadow of a line. By the next day there was no denying it - we had something real cookin'.

That's "6 days past 5-day transfer," for those of you who don't speak IVF

We got our blood test results Friday morning. By that afternoon we were en route to the Outer Banks to see my family, calling T's family on the way. It was completely, insanely surreal - we were three months shy of a full three years since we'd hoped to hear that news. We were giddy.

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.

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?

A new day + a new life

Today's our anniversay. Number four, in fact. Four! Do you remember our anniversary last year? I flew away to New Orleans with my love to eat, drink, and be merry in one of our favorite cities. A year ago today I also confessed something close to my heart here, something buried and raw: our long struggle to conceive.

In so many ways it was a beginning, although I didn't know it at the time. The beginning of being more open about a problem so many couples experience yet so few discuss. The beginning to seeking more advanced treatment. The beginning to handling a new level of disappointment. The beginning of a new kind of dedication to having a family. A year later I'm more vulnerable, but I'm fuller, too.

The truth is, my heart is so full these days I feel like it might explode. It's time (once again) to let it all hang out.

(adventures in horrid office bathroom lighting!)

(omggetthatgirlahaircut)

It took us nearly three years and almost everything our doctors could think of, but today I'm 14 weeks pregnant with a little girl! It's surreal to see that in print, still. I'll share all the details soon - the how (unlike most pregnancy announcements, I suppose mine does warrant a "how"!), the ups and downs, and the now. But first, I have a date with an airplane headed once more to New Orleans, where my love and I will eat (oh yes), drink(ish), and be very, very merry.

I'm getting all teary writing this - the journey has just been so... much. For everyone reaading this who's still in the trenches, please know that you have an eternal sister in me. My path toward pregnancy changed me; it's absolutely a part of who I am today. No smug preggo here - just an eternally thankful one, without complaint and with a lot of humility and love. I wish I could hug each one of you in person, right in the trenches where you are. If I could lift you out myself, I'd do it in a heartbeat.

More soon. After the beignets and the shrimp etouffee.

xoxo

The worst and the best of it.

People ask: what's the worst thing about IVF? Well...

1. The cost. I already complained about this one. Holy CRAP, the cost. It's absolutely debilitating. Enough said.
2. The side effects. If I was one to post photos of my stomach online, I could show you. I'd show you the span of bruises, a range of sizes and colors, ringing my entire abdomen. I'd show you how pregnant I look before an egg retrieval, belly as full and round as I imagine it might look in happier times. Baseball-size ovaries feel just like you think they would, actually. And the fatigue is a new level of fatigue, of a body doing things it's not meant to and continually asking you why. Everything hurts... a lot. 
3. The alienation. An IVF cycle takes over your life. There's really no other way to put it. You can't leave town. You have to show up to the clinic nearly every day. You have to stay off your feet and can't do anything remotely active at all. You are an incubator, plain and simple. The only way to feel more normal through it all is to try and pretend that it's not taking over your life, pretend to be normal. And so you try to be normal with people who don't understand what's happening and you fail miserably. Faking normality is painful. And then you just give in and let it take over your life for real. You become a hermit.
4. The reaction. Is there a worse feeling than trying desperately to be happy for someone else's good fortune, but failing? IVF girls know what I mean here, and it's heartbreaking. Feeling like a bad friend is the worst feeling of all. I'm so very happy for your pregnancy conceived after one month of trying... now please let me shut myself away for the next three days. It only gets harder over time.
5. The "What If?" What if we go through all of this again, and it still doesn't work? How many times can we try? How old will I be then? How broke? When do we switch to Plan B? What is Plan B?

And now, let's do something that used to come much more naturally to me. What's the best thing about IVF?

1. The science. Without a doubt, the science of IVF is some cool shit. I'm not a science girl, either, and this stuff amazes me. Our bodies are amazing on their own. But the ways brilliant people have devised to help biology along? Astounding. Growing dozens more eggs at a time than our bodies normally produce in a cycle is painful as hell, but the fact that we can even do that at all, then mate them in a lab and insert them back into the right environment, all of it manipulated precisely? It's crazy. For the first time ever, I can honestly say I think it'd be cool if my kids became scientists.
2. The ownership. One thing I've learned waiting in countless morning monitoring lines is this: IVF gives women choices. Nothing makes me happier for my gender than choice. I've been in line with women freezing just in case, women starting a family with their wives, women with a second chance on life and love... all kinds of women. IVF is a tool that gives all of us dramatically better chances than we've ever had before, and we make all the decisions - whether to go through this at all, how to go through it, how many embryos to implant, how many to freeze, whether to use or destroy them. We choose. That's a beautiful thing.
3. The hope. Few jump into IVF first - our roads there are usually long and littered with frustration and grief and even tragedy. With other assisted reproduction techniques, insurance typically covers several procedures, so there's not as much risk or sacrifice involved. With IVF, we put everything on the line because it's the end of the road, because we believe, and that kind of hope is intoxicating. It makes the failures all the more heartbreaking - oh god the heartbreak - but I think it might make the successes more exhilarating, too.

One other note, in case someone you love is going through IVF. You might feel weird sometimes, and that's okay - we feel weird, too. Being there is all you need to do - you don't need to know the right questions to ask or anything at all about this crazy-science-magic. You just need to keep knowing us, and that's enough. With any luck (and some of that hot science, too), one day it won't be so weird anymore.

"Hey handsome... what do you say we slip out of here and inject a trigger shot in that fancy hotel bathroom we passed?"

A new chapter.

So. Life has been... full.

Puppy licks. Interspecies interaction. Neighborhood strolls. Showers hosted. Work events. So much support from my loved ones that I walk around in a constant state of humble gratitude. Because life has also been... weird.

Hospital visits. Anesthesia. So.many.injections. Ultrasounds. Side effects galore. Crazy-science-magic. The weight of my own body on itself only barely equalling the emotions of it all.

Right. I haven't mentioned it here yet.

We started IVF.

And because the best place to begin is probably the most surreal place, I'll offer the following:

This is what $3,743 worth of medication looks like.

That's a lot to put in your body over the course of a month. And when the docs later realize they forgot something and tell you it'll be another $380, you don't even bat an eye, because that's actually cheap compared to the stuff piled on that table.

IVF is a lot like IUI, actually... on steroids. And we should know, after three IUI failures. The promise of IVF is bigger, though. There's more certainty, more knowledge, and yep, more money. Lots more.

A dear friend of mine asked me what I felt like the worst part of IVF was. Did it represent a failure, a scary next step, the feeling of wasting time, the amount of medication, or was it the money that got to me most? And without skipping a beat, I said money. Our health insurance is fantastic for everything except this. We are 100% out of pocket for IVF, which is how we ended up spending $4k in meds. Add on the actual cost of treatment, monitoring, procedures, and high-tech lab work? We basically bought a car at our fertility clinic.

The bottom line, though, is what we'd rather have in our lives more than a child. The answer, of course, is nothing. Not a new deck, a landscaped yard, less student loan debt, or more savings. Not any of that. Yet still, it burns. I wonder why our cost to conceive is so high, when other people's is, say, the cost of a wine cooler. In my worst moments I whine about the inequities. Especially since even now, after doctors have watched T's sperm successfully fertilize my eggs in a lab, we don't have any more answers than we did before. "Unexplained Infertility," still.

So these days we're laying low. We're eating at home, playing with the puppy, watching baseball, and reading books. Outside of the side effects, it's not a bad place to be, really. Our days are quieter than before, but in a nesting way rather than an empty way. We're full of hope, because our chances are better than ever.

Is hope worth the cost of my beloved old Subaru Forester? I doubt it. But is a child? Absolutely.

To be continued.

Soothe me.

I'm under (several) doctors' orders to decrease my stress level. Nothing decreases stress like being told you must decrease your stress level, right?

This summer I've made a concerted effort to unclutter my calendar and eliminate travel, which I know has historically been one of my biggest stress-inducers, one that I bring completely onto myself. ("yes I would looooove to come and visit you! yes let's please go out twice next week! yes I will do that huge thing for you! yesyesyesyes!") In other words, I'm trying to get better about saying no.

So far this August, I've only spent one night outside of DC. That's improvement. I cancelled my annual trip to New Mexico, and my lovely girlfriends out there decided they'll come visit me over Labor Day instead. More improvement. I've never tried harder to do as little as possible. It doesn't feel like me, though, all this saying no. (I am my mother's daughter in this respect... hi Mom!)

There are overarching stress factors in my life, I know. There's time: not feeling like I have enough of it, even as I try desperately to empty my calendar. There's work: working too much for my own good, and dealing with work drama that requires more of my involvement than I'd like. There's also money: ummmm, yeah. But isn't it funny how the same things that can de-stress us can also backfire in our heads? For example:

• Animals. I love animals and instantly feel better when I'm around them. We've been trying to adopt a dog for ages (long story). But wait, when is the exact right time to adopt a dog and how should that be coordinated with life-planning and what about the costs of dog-walking and doggie daycare etc? I'd like to volunteer at the Washington Animal Rescue League, too, but wait, what about the time and can I really take on a new commitment?
• Reading. Books soothe me. (Read this and this, by the way, not this.) You know what I hate lately, though? Magazines. Unread magazines are piled up all over my home and do nothing but advertise to me the fact that I don't have enough leisure time to flip through their pages. Oh great, the third issue of Coastal Living to add to the pile of magazines still wrapped in plastic? Yet another Food & Wine? Awesome.
• Food. I love cooking. But not when I don't have time to care about it. See unread issues of Food & Wine, above.
• Friends and Family. My loved ones make me happy, but I'm less happy about my travel lockdown that hampers my ability to visit them. This is a biggie for me, a constant guilt cycle.
• Facials/Massages/etc. Traditionally my favorite indulgence has been a Triple Oxygen Facial at Bliss. T keeps trying to book me massages to relax. But no on both counts. I imagine myself lying there doing nothing but counting the dollars that could've been spent on, say, embryo freezing, and getting even more worked up than I was when I arrived. Sigh.
• Exercise. Like many of you, I love the high of exercise once I'm in the zone, and let's be honest - I could use the endorphins. Getting in the zone, though, is like pulling teeth. And only being allowed to engage in high-impact activities one week of the month? Not helpful. Not enough time to get in the zone.
• Water. Specifically, the ocean. My perennial happy place and the best way to clear my head. But there is no ocean in DC, and fertility clinic scheduling means I can't travel anyway. So.
• Writing. If only I had the time/energy to do it right.

Here's my question: how do you relax? Can we lose our ability to relax over time? Should I just be buying lottery tickets to try to eliminate my work/financial concerns and shut up already? Without said lottery winnings, do I even have a shot?

And let's agree that I'll never again write a post as whiny as this one, okay? Pinkie swear.

Needles (and what's inside them)

I occasionally write about my struggle with infertility. It's good for me, and maybe good for some of you out there, too. Feel free to skip if you're not interested. If you are, you can read more from me here and find resources to help you or your loved ones here.

"How bad are the needles?"

That's what everyone wants to know about my infertility injections. How large they are, how painful they are, how weird it is to stab yourself as if it's no big deal.

Answer: it's pretty weird.


The lovely Mia Wallace demonstrating a fair but frowned-upon reaction to a syringe

The thing is, though - you get used to it. Like anything else.

For my first IUI, I couldn't get over the hilarity of the presentation. Imagine this: a large cooler arrives at your house filled with high-tech ice packs and boxes of syringe "pens." Sketchiness meets high-tech, right on your doorstop. Accoutrements include dozens of alcohol wipes and just what you've always dreamed of owning: your very own Sharps container. This is going to be fun!

The syringe pens go a long way in making this is as easy as possible. Old-school versions of this protocol included a lot more know-how on the part of the patient. But in 2012, I simply dial up my prescribed dose, grab a handful of tummy (not that I have a handful), and go for it.

Inserting the needle never hurts as much as you think it will. Sometimes there's a tiny drop of blood, but not often. Bruises are common, but as I said, you get used to them. If the worst part of this treatment were the actual injections, I'd be a happy girl. Here's what's not the worst part: not the needles, not the near-daily trips to the infertility clinic for "transvaginal" ultrasounds (if those sound familiar you're probably recalling these right-wing idiots), not the insemination itself, and not even the waiting for the positive or negative pregnancy test. The worst part (for me) is what's inside those needles, and how it makes me feel. That's what makes me dread the next injection. The prick and the ensuing bruise are manageable, but the 24-hour rollercoaster each one prompts inside my body is no joke.

Looking at my needle one night, full of dread

Here's the basic schedule: Every night for a week or so, I inject what in (very) layman's terms are basically steroids for my ovaries. This is why I have to have such frequent ultrasounds; the doctors are closely monitoring follicle growth and how the dosage is impacting number and size. Too many follices that are too large, and it's dangerous for me; too few and too small, and they'll increase my dosage. They're looking for way more and way bigger follicles than most of you reading this have in a regular cycle, but not so many that I'm in the hospital or auditioning for a reprisal of "Jon and Kate Plus Eight."

Looking back at my first IUI in January, I can now tell it was going to be a bust because I didn't hurt enough. My dosage was really low; the docs needed a baseline to see how my ovaries would react to the medication. I felt a little tired and crampy, but nothing terrible. By the time my dosage was doubled for my next two IUIs, I'd be flat on my back as much as possible. I become a swollen, aching, sore-to-the-touch patient with zero energy and zero clothes that fit. I try to keep a bra on at all times, because taking it off hurts so badly that it's not worth sleeping like a normal person. The fatigue is so strong I can barely keep my head up after 4 p.m. Concerts, dinners out, meetups with friends, all cancelled. I can barely get to work on the worst days. My sister asked me for a physical equivalent of the pain, and I told her it was like a heated metal corset being slowly cranked tighter... and tighter... and tighter... for a week.

Being weightless in a cold swimming pool over the 4th of July was the best feeling I'd had on the meds since January. I read nearly an entire novel floating in that pool. The minute I stepped out, though, the weight of my own body on itself was crushing. Also crushing: having to grimace and recover when your nephew jumps onto you for a hug; looking pregnant while trying desperately to be pregnant only not being pregnant; overhearing breastfeeding discussions and knowing that, no offense ladies, my boobs hurt about 100 times worse than yours do, only I'm not allowed to talk about them. (Thank goodness for forgiving dresses.) 

But there is an end to it. The "steroid" regimen is never more than ten days. When the doctors think the time is right, I take the "trigger shot" that also arrived in my high-tech yet sketchy cooler to force ovulation in 24-48 hours. The day after the shot, we do the insemination. And then we wait. And my body ever so slowly tries to recover.

And so it began.

The 7 a.m. line for bloodwork and ultrasounds at the fertility clinic feels like a cattle call for tired women. Or a depressing “2012 Babies or Bust” party I never wanted an invitation to in the first place. We’re just days into the New Year, and have dragged ourselves into the clinic bundled up like Eskimos, only to sweat inside and peel off layers en masse while we wait to be seen. Scarves and hats litter the hallway.

It’s my first day here, but the ladies in line with me are old pros. They can sense I’m a newbie, and kindly show me the ropes: we wait for our blood to be drawn, then cross the hallway to the changing rooms, where the doctor will call us in for our ultrasounds one by one. As I wait and watch those ahead of me, the speed of the process astounds me. Women go into the exam rooms at a brisk clip and are back out in no time, fully dressed. How could there possibly be time to undress and get probed by a foreign object at the rate they’re coming out of that room?, I wonder. The mechanization of the process is as comforting as it is disconcerting. I’m just one of dozens of women going through this today, I tell myself… my situation happens all the time and is easily fixed. But wait… I’m special! I’m different! I’m not just a number! Fix me! Back and forth, back and forth.

There are many reasons why we were all in that line together. Some of us might have Polycystic Ovarian Syndrome. Some might have Endometriosis. Some might have a reversed tubal ligation or a partner with a reversed vasectomy. Some might have a partner with male-factor infertility. Some might have a female partner, or might not have a partner at all. Some others might be like me, with that (in my selfish mind) most maddening diagnosis: Unexplained Infertility. Sometimes I think I’d rather have something specific to prevail over, like a blocked ovary, rather than this mystery nonsense. I know that’s not fair. I also know that in the big head game that is infertility, unfair thoughts abound.

My first impression of the women at the clinic is that I’m on the younger side of the group. There’s a bit of satisfaction in this, I'm embarrassed to admit to myself. There are a couple of women in their late 20s here, but the majority appear to be older than I am. At 33, I must have a better chance at conceiving than the mostly gray 40-something in front of me, I think. My doctors have never been concerned about my age or my eggs. Yet I can’t help but wonder how many children that 40-something already has. Maybe she has one or two at home, with her heart set on another. Maybe she’s remarried and wants a child with her new partner. Maybe if I’m already having problems this young I’m hopeless. Maybe this isn’t going to happen for me. This is a trick of infertility, by the way: in a second, the game changes inside your head. Pros can flip into cons with the blink of an eye. And why am I trying to “beat” these women anyway?, I ask myself. Her pregnancy doesn’t mean mine’s not coming, and vice versa. We all deserve to be pregnant. We all deserve to be done with this.

Before I know it, I’m in the bloodwork chair, where a friendly nurse tries her best to woo my veins. In the coming months, I’ll get to know her well. I’m here for “baseline testing” that will kick off my very first Intrauterine Insemination (IUI) cycle. They’ll be looking at levels of hormones in my blood, and will use the ultrasound to monitor follicle growth once I begin the injectable medications. I'll be back here two more times that very week alone.

In no time at all I’m in the changing room, wondering why in the world someone can’t make paper sheets wide enough to cover my average-sized hips, when they’re calling me in for my exam. The doctor wields the ultrasound wand with all the efficiency of that line outside. He calls out numbers to the nurse, different ones for the left versus the right ovary. I don’t bother remembering them, knowing that I’ll get a call later that afternoon with a detailed analysis. The exam is over before I know it, and in another minute I’m walking out through the ever-growing line of women who are waiting to do exactly what I just did.

I wonder how many women will go through that line at the clinic that morning. And of those of us here, how many will get pregnant this month? How many of us will ever get pregnant at all? Only time – and a lot more visits to this clinic – will tell.

Family Fourth, beach-style

Despite US Air's best efforts, we made it to Holden Beach last week to meet my nephew Max and enjoy the fam for the 4th. I didn't even bring my work Blackberry. I did, however, bring my puffy, bruised, needle-poked body - the ideal time to wear swimwear, really. But enough of that! A great book, an urgent desire to float in the pool and bop around in waves, and my favorite people all in one place. On to the photos!

Such a sweet guy, this new nephew of mine!

Fourth of July festivities (my family still has approximately 10,000 pieces of our wedding props on hand)

My dad representing the 'hood

My sister-in-law, aka the best-looking "just gave birth nine days ago" woman of all time

HEART EXPLOSIONS.

Pretty.

Game of Thrones set made of sand?

My sis found this enormous dead beetle on the beach, which my nephew Liam named "Shakin' Bacon 48,000," or just "Bacon," if you prefer. He was gorgeous, really. My sis is framing him.

And one more time for those heartstrings.

We had a family portrait session while we were there with the fabulous (and amazingly sweet) Megan of Genie Leigh Photography (see her fab work from my brother's wedding here). Fingers crossed we get some good ones... we can be a motley crew sometimes, after all. And also, there was a diarrhea explosion involved. Gotta love it!

Time to unwind

One of my high-school favorites just stayed with us as he passed through DC (embassy headaches = unexpected visit to my house = the bright side). We talked, we laughed, we speculated, we celebrated, we drank way too much wine... and life is good today. (Much better than this weekend, for example, when fertility drugs made me feel like I was trapped in one of those medieval torture devices that squeezes people to death. Seriously.) But last night and today: better. At last. And so I'm rushing through the day in order to land in another happy moment by night's end, when we'll meet up with my family at the beach.

Stealing from my sister's Instagram photos for a bit (if you like pictures of cute kids and pretty chickens, you might consider following her), let me show you a little of what's waiting for me tonight oceanside:

I'm sure I'll be Instagramming too (it's a sibling obsession), if you want to see more of these cuties. I can't wait to get down there already. Have a fabulous 4th, everyone!

Some bonus red, white, and blue inspiration - ahhhh, memories:

Game Plan

This is the story behind our current story. Statistics are involved. And not many adjectives. But it's how we got here, whether we like it or not.

One of the most unexpectedly difficult things about infertility are the anniversaries. These are the days to which you’d already said your goodbyes. Like that last-gasp Halloween party where you dressed up and acted like a kid again, one last time before you had a kid. Only now it’s Halloween again, and this year you don’t feel like dressing up at all. The Thanksgiving where you smiled at the thought of a baby smaller than next year’s turkey. But a year later, there’s just another turkey. That “last Christmas as just the two of you,” which turns into another Christmas with the same number of stockings hung. (Thank goodness your spoiled cats get stockings, too, or the sight of only two would be too sad to bear.) And then there are the weddings. People announce wedding dates far enough in advance that it’s easy to believe you’ll have a belly by the time the big day rolls around. And then one by one, you toast newlyweds with champagne instead. Time marches on.

Enough was enough. A year and a half after first trying to conceive on our own, we became patients at a fertility clinic. Our reproductive endocrinologist ran new fertility screens on us and came to this unhelpful diagnosis: Unexplained Infertility. Further rounds of poking and prodding and running dye through my fallopian tubes yielded nothing more than confirmation: Unexplained Infertility. I had mixed feelings about this diagnosis. On the one hand, my inner overachiever loved hearing that nothing was wrong with us. On the other hand, something obviously was wrong, or we’d be parents by now. Surely there had to be some answer out there, something specific we could try to correct. But no. We were answering every question correctly, yet still failing the exam.

Our doctor suggested we try Intrauterine Insemination (IUI), which facilitates fertilization by placing sperm directly into the uterus. Although we knew my husband’s guys could already swim and my ladies were ready and willing, the doctor believed a medicated IUI would improve our chances without the additional intervention (and cost) of In-Vitro Fertilization (IVF). We’d try IUI for a few rounds, and if that didn’t work, we’d move on to IVF.

According to our doctor, 85% of all couples trying to conceive have about a 20% chance of getting pregnant each month. For a couple like us, diagnosed with Unexplained Infertility, our au naturel chances are only 2-3% each month. Having an IUI without supplemental medications doesn’t meaningfully increase our chances, nor do medications without an IUI. We agreed with our doctor that an IUI plus medications was the best course for us, but this involved choices of its own.

We could take Clomid, an oral medication, and raise our chances from 2-3% to about 4-6%. Or we could choose an injectable medication and raise our chances to about 6-9% per month. There are pros and cons to both, but I disliked what I’d read and heard about Clomid much more than what I’d read and heard about injectables. Besides the obvious discomfort factor of injecting needles into yourself, the injectable route does come with one big risk: a multiple pregnancy. IUI + Clomid has about a 7% chance of having a multiple pregnancy, but IUI + Injectables has about a 30% chance of a multiple pregnancy. (Head spinning from percentage chances already? Here’s another fun one for you: if IUI doesn’t work for us and we move on to IVF, we’ll have about a 40-45% chance of conceiving each month, and only a 25% chance of a multiple pregnancy, but with 0% insurance coverage.)

If you’re now thinking we’re crazy to go through IUI and injectables for an at-best 9% chance of conceiving each month, which comes with needles and a 30% chance of having a zoo of children, you wouldn’t be alone. We thought that, too, when we first started trying. Now, though… it doesn’t sound so crazy at all.

We’re lucky that our insurance pays for a good percentage of an IUI cycle. The thought of IVF terrifies our bank accounts, so it’s prudent to try every other possibility first. Last December, though, as we faced a year of unknowns and all the pressures that come with that, we did something crazy instead of being prudent: we flew to Paris for Christmas to forget our troubles. We had a game plan for 2012, but we had the City of Lights to explore first. And it was worth it.

Friday I'm in Love

I'm looking forward to a weekend in DC where we shall slooooooooooow down. My plans include tinkering around the house, garden, and neighborhood, hanging out with friends, and booing the Yankees. Sounds pretty perfect to me right now. I hope your weekends are filled with slow goodness, too. Here's three little links from me to wrap up the week. See you on the flip side!

'Grow Your Own' Calendar

 I'm obsessed with this gorgeous planting guide print, available here and discovered here. I'd love it if they would expand their reach and include planting seasons for places other than England. Perhaps my Grandma Jessie Mae can be the planting expert for the Eastern NC calendar... But would I choose that one, or the Mid-Atlantic guide? Hypothetical decisions abound! Regardless, this piece would be perfect hanging in any kitchen or back porch, don't you think?

Bedroom Upgrades

 I recently received a much-deserved (if I do say so myself) promotion and raise, and to celebrate, I ordered a piece of furniture I've been ogling for ages. Actually, I ordered two! These gorgeous Bedford Chests will serve as beefed-up nightstands for us, filling out a wall where we have space for more substantial furniture in what is otherwise wasted by only using small nightstands. I'm so.flipping.pumped that we're about to have more storage in our bedroom. We are ever so slowly getting a vision for what that room can become (only a year and a half after moving in... why does the bedroom always get shortchanged in my world?). I think I might even do some painting this weekend... it's been too long since these hands wielded a brush! The dressers are delivered Saturday... color me excited.

More Belle Boggs

 I know I recommended a Belle Boggs article last week, too, but this one was just too beautiful to go without mention. It was sent to me by my friend Cate (join me in wishing she was blogging again, why don't you?), and with good reason. In this piece (Yearning for Conception: The Art of Waiting), Boggs reminds me of Barbara Kingsolver in my annual spring/summer read Prodigal Summer. There's infertility, sure, but it's woven into the fabric of the NC Zoo, biology, and nature. Gorgeous stuff.

Spirits and Sparks

I may have developed an embarrassing weakness for psychics. Last year, three separate psychics told me that I’d get pregnant that November. I didn’t. You'd think that might have turned me off the fortune-telling game, but no. Just last month I found myself wandering into a New Orleans shop where an aisle of psychics waited for customers behind velvet curtains. "My" psychic told me that he can usually see a pregnancy aura when a spirit has chosen its mother. I do have a slight aura, he confessed, with one big problem – my aura radiates sparks. In other words, me, the woman who has allegedly been trying to get pregnant for two years, is shooting live fire ammunition toward the spirit who might otherwise become my child. 

I’ve long felt that I’m a complicated person, but this? This takes my issues to an entirely new level. 

The psychic who told me about my sparks is a kindly, rounded man who sounds every bit the Cajun that he is. He looks like the nicest kindergarten teacher you could ever have. His theory about the sparks is that I am unkind to myself – my own worst enemy. By improving my sense of self on the inside, he said, the sparks on the outside will disappear, thus allowing the baby spirit inside.

My theories are many, as you might imagine.

Theory 1: The sparks represent the fact that I am openly embarrassed about having a weakness for psychics, and also confused about the fact that I love psychic readings even though I’m not sure I believe a word of them. The sparks, in this theory, are really just evidence that the Cajun Kindergarten Teacher recognized a hostile audience.

Theory 2: The sparks represent the me who is up late writing this blog post, the me who questions and searches and seeks. She’s the one who still wants a PhD. She the one who thought she’d be an accomplished writer/activist/teacher/whathaveyou by now. She listened to cavemen Republicans in Virginia try to mandate vaginal ultrasounds before abortions and decided that on the infertility "plus side," this recent clip of three to four of those very same ultrasounds per week has made me a more informed citizen. She thinks I can do better in several areas of my life. She thinks I’m not trying hard enough. I like to think she makes me better in that way. She makes me want more, because I have the capacity to handle more. She does things that years later cause me to shake my head – how did she do that? – forgetting it was me all along. She is probably what the Cajun Kindergarten Teacher is talking about.

Theory 3: The sparks are just what happens when a non-baby person decides she wants a baby. I was not always a regular on the “TTC” Internet boards, you see. I had girlfriends who set a cutoff date for themselves, a date at which they’d use a sperm donor or be a single mom. They felt they were born to be mothers, whether a partner was involved or not. I always knew that wasn’t the right choice for me. I assumed that my biological clock would start ticking only when I found the right partner, only when the time was right to create someone who’d grow up to split our quirks and features evenly, and who’d be parented by us both. And sure enough, in the whirlwind of meeting my husband, marrying him, and moving around the country together, the idea of a little us went from a charming abstraction to something that we should probably go ahead and make. I didn’t want “a baby,” but my husband’s baby? Who’d have his eyes or hair or smarts or sense of humor? Oh, how I wanted that baby. Yet two years into trying, I’ve only recently felt what I’d describe as baby pangs when I pass a baby on the street or see one at the next table over at brunch (which usually coincides with me ordering another Bloody Mary… hmmm). Does that mean the sparks were even worse before? Or just that it’s taken me two years to get used to the idea that I'm actually ready for a child of my own?

Theories, then, but no answers. Never any answers. Our official diagnosis is Unexplained Infertility, by the way, which infuriates someone like me who likes answers. (Although Unexplained Infertility does leave room for “sparks” to be the underlying cause, I suppose… I wonder what my reproductive endocrinologist would say about that?)

I told the Cajun Kindergarten Teacher that we were a bit beyond the wishing and hoping stage, that our babymaking efforts were serious and clinical enough to preclude even the use of a carefree term like “babymaking.” His response? Keep up what we’re doing, but “invite the baby spirit in.” No matter the theory or the why or the how. Just issue an invitation. My Cajun friend also predicted an RSVP this summer.

Time will tell. Along with many more conversations with the baby spirit, of course.

Friday I'm in Love

I'm so pumped it's Friday today that I'm flashing back to my teen cousins visiting last summer and wishing they were here incessantly singing "Friday" to me. Yep, that annoying song (I'd rather link to Glee boys than the esteemed writer/performer herself - so shoot me). After a hectic work week, I'm off to North Carolina tonight to attend the birthday party of my favorite three-year-old boy and to hang with the rest of the crazy crew sharing my bloodline. I predict lots of laughs, which is a good thing, because I'm ready for them. Here are a few links to round out the week:

Lego Bird Creations

I was a Lego kid, and so is another kid I know. If these cool bird projects were sold by Lego, I absolutely would've snapped one up for his birthday gift. If you vote for this creation, it may well become an official Lego set. And really, who doesn't need the challenge of building something besides yet another fort out of those nubby blocks?

Gentlemen of the Road

I'm already a Mumford & Sons fan, but this tour would tug at my heartstrings even if I wasn't. To quote: "Join us this summer for a series of Gentlemen of the Road Stopovers at handpicked locations around the world. Each Stopover is a day-long event, celebrating the music, food and people of the places we're visiting. We'll be bringing a full lineup of some of our favorite bands from around the world, and curating events that combine a music festival and local gathering into one epic party. We plan to start early, and go late, taking the party from the stage to the town." Boy do they know how to speak my language. My August does have room for a Portland or Bristol trip, now that I think about it...

Infertility Words I Wish I Wrote

Since bursting out of the infertility closet over here, so many of you have e-mailed me saying the equivalent of "I don't know how you must feel, but I'm offering support anyway." This is why you guys are a pretty great crew, by the way. But I thought I'd share this piece today for two reasons: first, this is how it feels. And second, this is also the high level of decision-making taking place in our own house/hearts/minds. For a girl who shrugged her way through science classes her entire life, being fluent in the world of follicles and zygotes and implantation is pretty major for me. It will come as less of a surprise that the online "TTC" world the author describes is something I took to far more quickly than that of near-daily ultrasounds. At any rate, for those interested, have at Visible Life.

And that's all from me this week, folks! I'll check back next week full of kiddo birthday cake... Have a happy weekend!