6w3d and 160 bpm

Just a quick update to say I am measuring in the target range and the heart rate was strong. Dr. Negative morphed into Dr. Positive today. He has dropped my chances of miscarriage to less than 5 %. Nurse Joy was not in the vicinity so it was a good day all around. We have one more ultrasound with Dr. Negative in two weeks and then I will be released to my OB.

Can I exhale now?

Ultrasound is tomorrow morning

Nerves. I have a case of them and it isn't pretty. I frequent several boards and have been witness to a rash of recent miscarriages. The saddest of these boards is the high FSH pregnancy board. The women who make it that far have overcome great odds and for a pregnancy to fail just seems colossally unfair. So I wonder where this pregnancy is going. The internal debate goes something like this:

My morning sickness is getting worse.
But the Mayo Clinic web site said it was possible to have rising hCGs and a blighted ovum.

My boobs hurt.
But I'm taking progesterone.

But I'm taking it up my you-know-what and that isn't supposed to raise serum progesterone levels by much.
But I'm still supplementing.

Dr. F. at SIRM said a 30-40 percent chance of miscarriage.
Yes, but Dr. Negative said less than 1% chance of pregnancy and here I am.

The doubling time for my betas slowed way down.
Yes, but they slowed down nearly that much with Baby E.

Blah, blah, blah.
Blah, blah, blah.


To up the intensity and angst, J's parents just called and announced they are coming here tomorrow. Hellooooo. Tomorrow's a big day. Plus the baby is sick. and running a fever of 102 F. Do we really want my in-laws here if we get bad news? They have no idea that we are expecting.

J said I am being a bitch because I am telegraphing that I don't want them to come tomorrow. Telegraphing? I TOLD them that Saturday would be better because we tomorrow have appointments and a sick child. Besides, J's mom flatly rejected the Saturday offer for a full day and said they will "just stay a little while." So J and I are totally pissed at each other. He is mad that I don't care for his parents and I am mad that he won't say no to them.

He is right about one thing: I can't say that I have ever loved them (but I think the same can be said of Js feelings toward my family), but I respect them and try to get along. Now they are here every other weekend and it drives me crazy. Plus, they are very indecisive which leads to unpredictable behavior like arriving on adult children's doorsteps with less than 24 hour notice. J said he never objects to my parents' visits which is mostly true, except that they have only been here once in the last five months. I guarantee that if my mom were to start coming every other weekend, he would object. I know I would.

For my part, it makes me crazy how hard J tries to please his parents. Still. And I hate to say it, but I think he is looking for a form of approval that has never been there. Especially from his mom.* I think she approves, but I just don't know that he feels it. There is an odd dynamic at work in his family. They are extremely cerebral, but things never feel warm much less hot (I can't imagine voices ever being raised in that home). They don't speak of emotions, but they debate for hours on end at the dinner table -- competitive dining-- but never with pounding of fists or voices cracking in anguish.**

So that is where I am tonight. And I'm tired (a good sign, right?). And cranky (another good sign?). Think I'll head to bed and try to think happy thoughts.

*A retired child psychologist whose parenting style was self-described as "benign neglect."
**My family, on the other hand, is anti-intellectual and extremely emotional. NOT the best combination, I shall admit.

37

That isn't a beta. That is my age in a few hours. Lucky J to have married someone for whom he only needs to worry about gifts at Christmas and Valentine's.* I'm not depressed about turning 37. Sure, my butt is sagging and I plucked a loooong hair from my chin tonight**, but I'm OK with the whole "another year older" thing. I suspect the hormones may be helping.

Because I am more superstitious than I would like to admit, I feel it necessary to keep a tradition started on my birthday when I was a kid. First, I recap my year, then I share my hopes for the next year. It is fun and sometimes sad to go back through a few years later. For instance, I never made good on my wish at 17 wish to be John M's girlfriend, but I did finish my dissertation (28) and run a couple of marathons (32 and 33).

Recap
December 2004: Turned 36. Baby E slept through the night for the first time on Christmas granting me the best gift ever.
January 2005: Started back to work. Cried a lot. Hired one great sitter and one OK sitter.
February 2005: Was summoned before the tenure and promotion committee to provide "more information" about my tenure case. This was a very bad thing as the only people who get called in are those in danger of being denied. The call came on Friday, and my meeting wasn't until Monday. Cried for two days, then got pissed. Attended meeting, provided information, and received tenure.
March 2005: Did not get a spring break because publisher wanted that time to work on exercises. Still resentful.
April 2005: This month is a black hole for me. I remember nothing.
May 2005: Survived the semester. Had to look for summer sitter because my wonderful sitter found a nanny position in Colorado. This is the start of sitter hell. AF finally showed up. Started ttc #2.
June 2005: Hired a sitter who neglected to tell me she would be having knee surgery and could not pick up a baby. A few of her friends covered some of her hours, but it was not optimal.
July 2005: Required surgical revision of my tears from E's birth. Truly hellish surgery, but things are 100% better. Down there.
August 2005: Started taking E to another mom. It looked promising at first.
September 2005: Other mom takes last minute vacation to Costa Rica with her unvaccinated infant. To make things really fun, this happened during the week J was in Denver on business. I had to scramble to find childcare and I pissed lots of people off.
October 2005: Hateful month. High FSH discovery and visit from publisher. Stopped taking E to other mom's house.
November 2005: Three nannies, one feud, Thanksgiving with the in-laws, preseed, OPKs, getting ready for exams.
December 2005: BFP. Hope.

My hopes for the next year:

That this pregnancy is healthy.
That Baby E thrives despite the problems we have had with childcare.
That Baby E gets a spot at a good center by May.
That I summon the strength and discipline to finish the text.
That I succeed in getting family leave and sabbatical next year.
That I be a good mother to my daughter and a good wife to my husband.
That there are fewer natural disasters to fret over.
That I remember others have it much worse.
That I keep writing in this space for therapy.
That fewer hairs show up on my chin.
That Karl Rove is indicted and Cheney is forced to resign.
That Dems take over in midterm elections.
That there is peace.

Merry Christmas, Happy Hanuka, or Happy Holidays to you. I'll be away for a few days (because I so love spending my birthday with my in-laws).

*We were married Valentine's weekend, not because we were all into the hearts and cupids, but because the priest wouldn't marry during Lent which started the next week. A spring wedding was not a good option because the church was being renovated and had no AC, a must for large gatherings in the South. See how defensive I am about the whole thing? I've had way too many people go, "Awww, that is so romantic to get married Valentine's Day weekend." Gag.

**Please, if I ever spend any time in a coma, you must promise me that my brows will be waxes and stray facial hairs plucked. I would do the same for you.

Double, double toil and trouble

The doubling times for my beta have slowed way down. New number 2681 . It is now taking 60 hours for the betas to double. Last week, it only took 30 hours. I know there isn't much I can do and that I will just have to worry for another 9 days until my December 30 ultrasound. My fear ,of course, is that the baby has stopped growing and we were catching the beta on its way down. I know there isn't much I can do except to try and remain stress-free, take my prenatals and stay on the progesterone.

The vitamins and progesterone I can handle. Stress free? I don't know. I have nanny issues again. The latest to give me a headache is Nanny M.

One way that I keep up with E is by keeping a daily log. The nannies make note of her daily activities, moods, naps, food consumption, and poopy diaper output. I leave notes for them and they leave me notes. I depend on an accurate record.

Nanny M is an exercise addict and part-time model and takes E for walks most days. Yesterday she let E sleep for an hour during the walk, but that threw off the nap which threw off the night schedule which just made teething hell* worse. Today I left a note asking the Nanny M to avoid letting E catnap this morning even if it meant cutting the walk early. I asked nicely. With a smiley face even.

Because J has the rest of the week off, we only asked Nanny M to come in from 9-12 today. I ended up coming home an hour early because I finished my errands, didn't care to be out in this traffic any longer, and wanted to check beta calculators. So I arrived a few minutes before 11:00 instead of 12:00. I was not expected. When I arrived home, Nanny M and E they were out walking so I peaked at the log to see what the morning had been like thus far.

I was startled to see that the log was filled out through 11:45 (45 minutes in the future). It said: "Took walk from 10:30-11:30. E slept for about 10 minutes, but I managed to keep her awake most of the time." It also said she had been great ALL morning and was happy.

So, Nanny M filled the log in ahead of time and E had that dazed, sweet just woken look when they came in. She didn't want to go down for a nap at her regular time. I'm pretty sure that Nanny M let her sleep for the whole nap. I would not be pleased with that, but the untruthful log gets me. What else is she lying about? Maybe I should get a nanny cam.

*E has been teething this week and has been up at night.

Waiting. . .Still Waiting

I've been thinking about Tom Cruise and Katie Holmes. Well, not too much. That would be icky. But some. Specifically, I have been thinking about their well-publicized purchase of an ultrasound machine. I get it, I think. I understand the reasoning leading to this acquisition.

Now my "sympathize with Tom and Katie" ship sailed when he went on his PPD rant. Asshole. Or maybe it was when he jumped on the sofa. Contrived. It could have been the whole silent birth thing that pushed me over. Freaky. Weird. Basically, he is a turd and she is tainted by mere association.

Even so, I totally get why they bought the ultrasound machine. THEY JUST WANT TO SEE THE BABY. Is that a crime?* It is the first thing that I have understood about them. If I were a multimillion dollar actor and could afford one as easily as a box of tissue, I probably might consider it.

But since I can't afford an ultrasound, I did the next best thing and bought even more more sticks to pee on**. I know this is truly borderline OCD, but it helps with the anxiety. Now that my hCG must be getting up there even the cheap tests turn dark pretty quickly. I do have symptoms. Sore breasts, passing nausea, lightheadedness. But I need more. I need proof.

I haven't been obsessing every moment. Here are other things that have filled my time:

• Grading. Why I gave my methods students a three hour written exam, I'll never know, but grading it was hell.
• Writing reports. I served as interim program director this term. It taught me that administrative duties should be avoided at all cost.
• Shopping and wrapping gifts. I need to put some photos of the girl in frames for grandparents, but I am basically done. This shall be known as the year of the Gullah basket.
• Nanny 911. I'm a wuss and didn't fire them. Help is hard to find. Nanny S has been sentenced to pretrial intervention and anger management. Nanny M was threatening to quit unless I fired Nanny S, but I wasn't willing to let her call the shots. She didn't quit. So far, so good.
• Ultrasound scan of my throat. I finally got to see why the doctors won't declare me disease free. There is a largish lymph node (we think) wrapped around my carotid artery. Its position and size are a little odd which means I get to keep having follow-ups to make sure it isn't growing. They can't biopsy it because they could go through the carotid which would be very bad. I'm not worried.
• The text. Neglected as always, but I promise to return to it tomorrow after commencement.
• Caring for Baby E who is learning body parts. Today she learned to find her belly button. So cute to see her lift her shirt and search very seriously to make sure it is still there.

My next beta is four days away. Hoping it goes quickly.

*And the answer, apparently, is yes. They had to donate it. If he would just stop talking.
**Getting worried about the growing stash of tests I am hiding in the medicine closet. It seems so wrong to toss them aside. The Christmas ornament idea is sounding good. Maybe I'll just make one for J. Shall I post a pic here?

128 is so yesterday (or two days ago)

A quick post as final grades are due in less time than it will take for my betas to double! I am oddly unmotivated.

My new favorite number: 376. Now that is a nice number! I realized as soon as Nurse Joy said "Congratulations!" that I was still in the game as 376 was obviously more than double 128. It wasn't until this evening when I was surfing that I realized my betas had almost tripled. Wow.

So far, I don't have many symptoms. I am very tired, but I am chasing a toddler around and working fulltime. The first wave of nausea hit tonight. It isn't bad, just a mild queasiness that is somewhat reassuring. My breasts don't hurt at all which is both worrisome and nice. When I was pregnant the first time, my breasts hated me. I hated them back: they went from a perky 34Cs to pendulous 36-38DDs-bastards.

Here is a bonus: just like when I was pregnant with E, my back spasms* are better. My back started feeling a little better about a week ago. Now I know why. When I was ttc the first time, I was terrified of not being able to take anything during the first trimester but the hormonal cocktail agreed with me. I'm glad it seems to be helping again.

So what is next? My next beta is in a week. If that goes up appropriately, I will have an ultrasound the first week of January.


*Back of a 70 year old according to my surgeon.

128

I think it is my new favorite number.

While I love 128, I'm still scared witless. I vacillate between pure, unadulterated joy and worry and doubt. It is hard not to doubt and impossible to relax. This was too easy; I feel as if I cheated and didn't pay my fare. Will the conductor track me down and tell me to stay on the train until my stop, MUCH further down the road?

I made it through the weekend by testing. Compulsive testing, if you must know. I bought quite a few HPTs, certainly enough for a Christmas gift or two. In fact, I have enough HPTs to make Christmas ornaments for all the family and neighbors*. [Oh! The thought of my cold, aloof MIL opening her HPT ornament and frowning at the knowledge I have peed on it!]

If peeing on sticks were introduced as an Olympic sport, I would medal. She is totally dedicated to her sport, the press would say. My need to POAS was so out of hand over the weekend that I had to make sure that I went to different cashiers at Target. They raise their eyebrows when you buy three boxes of tests at once, but to do that three days in a row? That's just sad.

Still. I needed reassurance. So I squinted, held the tests up to the light, and attempted to divine the meaning of varying shades of pink and thickness of lines. Sure, the digital test was sexy, signaling PREGNANT with no hesitation, and no ambiguity. But was I just a little pregnant or was I a lot pregnant? That, friends, is what I needed and still need to know.

Where does this leave me? With a bad case of niggling doubts. With a gorgeous first number. With a beautiful image of two children holding hands as they skip on the beach. With two more tests. Just enough to get me through to the next beautiful number.


*My first crafty idea ever. Also earth-friendly.

Proof

Since I last posted, I have taken an additional 5 tests (at least!) to be sure. And I am happy to report that I am really pregnant and that I am still pregnant. Nurse Joy's warnings have haunted me and sent me running to the bathroom every five minutes to check for blood. (The sensation of Prometrium suppositories oozing and the start of AF are more similar than dissimilar. Very unfortunate, IMHO). Every cramp, every twinge makes me wonder if this is it.

I emailed Dr. F at SIRM. He was quite kind to email back on a Saturday (do you think Dr. Negative would do that?). Dr. F puts the odds of losing this pregnancy "for someone with your medical history" at 30-40%. He reminded me that this leaves a 60-70% chance of a successful pregnancy. Please, when I am freaking, remind me that this is so much better than a less than 1 % chance.

The plan right now is a beta on Monday followed by a second beta 48 hours later. I don't know how long this will last--another day? another 8 months?--but I reserve the right to obsess and worry. On a mothers' board I frequent, there has been a rash of miscarriages lately and these weigh heavily on my mind.

If the betas go well, there will be more tests and more worry. To be honest, I never quit worrying while pregnant with E. Just when I thought I had made it through all the potential hazards--betas, ultrasound, amnio, level two ultrasound--I would hear another horror story which would jolt me out of my comfortable place. Even now, as she sleeps safely in her crib, I worry over her.

So, I will wait. I will worry. I will vent (I have to interact with Nurse Joy on Monday, after all). And I will keep Dr. F on speed dial. Just in case.

The Urge to Test

Two nights ago, I dreamed that my SIL was pregnant. For some reason, it seemed perfectly natural that I was carrying around her positive pregnancy test with its two pink lines signaling SUCESS! FERTILE! I woke up sure it was a premonition and certain that she must be pregnant again. I guess we'll learn that at Christmas. All I'm saying is that pregnancy testing and babies were on my brain all day yesterday. . .

We have decided to go ahead with injections/iui for my next cycle. One last chance before traveling, you know? I woke up this morning convinced that AF would show today (cramping like a mad woman and my temps dropped slightly) so I decided to call the center and have Nurse Joy order my stims. However, just before I was going to call, I decided "What the heck. I'll test just to be sure I'm not pregnant because it would suck to order meds and not need them." This was just my rationalization for POAS; I didn't believe it would be anything more exciting than a BFN. I've become quite the masochist with pregnancy tests.

So I tested. And then something odd happened. A faint, faint second line showed up. I was not impressed. Evaporation line, I told myself. I took the test to J. "Is there a second line?" I asked. He squinted, but confirmed there was a second line. "What color is it?" I asked. More squinting. Kinda pink, he decided. Whoa. Could it be?

Still not excited, I decided to try a second test. Another faint line. Another conference with dh. I called Nurse Joy for a beta.

"When did you ovulate?" she asked. I told her fertility friend is being moody, but I could be 13 dpo or I could be 10 dpo. Just depends on the setting. She was not amused.

"We tell our patients not to test until 17 days past iui to avoid false positives," she told me. "You tested too soon." She said no to the beta. Told me to call next week if AF doesn't show. "But it probably will."

I think there is something going on. I understand it may well turn out to be a chemical pregnancy, but I don't think that the tests lines turn in the absence of hCG. So let's not call this "false," OK? I may be in the clinic next week for a follicle count and instructions on injecting hormones into my butt, but until AF arrives, let me call this hope. Is that too much to ask?

Oh yeah. If you need me early tomorrow morning, I'll be peeing on more sticks. I bought two more boxes this morning.

A (not so) Welcome Distraction from Fertility Obsessing: Paging Jerry Springer

It would be nice to win tonight's Powerball drawing. Oh, I know, there are tons of people far more needy and deserving than me, but winning would still be swell. It would mean that I wouldn't have to choose between IVF and sending E to a decent school. It would mean that I could get off this publish or perish treadmill.* It would mean that the news that Nanny S spent last night in a jail cell seem less consequential. Heck, it might even seem funny.

That is right. Nanny S spent last night in jail. It wasn't for DUI, it wasn't for possession, it wasn't for failure to pay insurance. These things I might have handled more easily. It was for --deep breath now--assault.

But wait, there's more! This was not only assault, but it was the assault of Nanny M. That is right, cyberfriends. My nannies have been feuding, and last night the shit hit the fan and Nanny S beat the crap out of Nanny M.

A little background is in order, I suppose. I met Nanny M first. She models part-time and is away from here odd weeks. She doesn't make so much money from modeling that she can afford not to work so she thought a part-time nanny spot would be good. She had two friends, Nanny S and Nanny J who would split the position. Thus far, Nanny J has really been the backup if Nanny S and Nanny M are both busy. Everyone's references checked out, so I decided to go for it. Having more than one nanny seemed like a good idea at the time. If one was sick, another could fill in. If one's fiance got transferred or called up (they are pro athletes in the minor leagues), two more would be available. They were only looking to work through May when the season ends which is when my semester ends. It may sound kooky now, but it sounded like a great idea at the time.

Trouble started brewing a few weeks ago when I received a rather distraught email from Nanny S saying that she and Nanny J had learned some things about Nanny M. Nanny S said she didn't think Nanny M was a "good" person and was scared that Nanny M would try to cut her out of the childcare arrangement. She said that Nanny M had severed ties with Nanny S and Nanny J and she was worried that Nanny M might do something bad like lie about her. I assumed this was just girl trash going on and told Nanny S that her position was safe. I assured her that Nanny M had not said a word, and that unless this was something that would affect E's care that I would prefer to remain Switzerland and not get involved. "Well-handled!" I told myself.

I heard no more until this morning when Nanny M called and asked to come over to talk. I knew it couldn't be good, but I did not expect her bombshell news. Nanny M was visibly upset and covered in scratches and bruises. Her left ear was crusty with blood. I didn't notice, but she said that patches of hair had been pulled out. Her story: she and her fiance had gone to the apartment of Nanny S to ask the fiance of Nanny S to ask Nanny S to tone things down and stop putting things on the internet about Nanny M's sexual practices and modeling history. While they were talking, Nanny S came out and a heated argument ensued. Curses were shouted. Names were called. At some point, Nanny S attacked Nanny M. The police were called. Nanny S was led away in handcuffs. Her court date is Tuesday.

J and I sat through this news exchanging nervous glances. Nanny M said that she can't continue working for us if Nanny S does. Well, I haven't heard from Nanny S yet, but assault is a big deal. Impulse control you know? Pretty necessary around toddlers, right? So I doubt her working for us is going to be an issue. We told Nanny M that needed to talk and that we would get back to her soon. I have left messages with Nanny J who may be trying to play Switzerland, too.

J, who has more managerial experience than me and who has the word "administrator" in his degree, made many good points/ observations once Nanny M left. First, there is a chance that the problem will resolve itself because Nanny S is here on a visitor's visa and may get deported. Second, the franchise may decide to trade her fiance because this can't be good for team unity. Third, if Nanny S doesn't leave, we may have to fire all the nannies because what happens if they bring their feud over here? Even if we fire Nanny S, what is to stop her from coming here while Nanny M is on duty? I mean it sounds like this may be a bit of an obsession. I'm thinking Glenn Close minus Michael Douglass** but with the rabbit.

Obviously, we have a mess on our hands and the timing stinks. I will keep trying to call Nanny J to get her take on it. I will also put an ad for a nanny on Craig's List just in case. What I would do for a spot in a good child development center. A winning Powerball ticket would also do.

On the bright side, I have not obsessed about fertility nearly as much today. On the not so bright side, I think Baby E is going to undergo yet another transition. This simply isn't fair to her. I feel so much guilt. Mother's guilt.


*Tooting my own horn here. Had a paper accepted at a very good journal this week. Yahoo!
**What does Katherine Zeta-Jones see in him, anyway? I have never gotten him. It made the fatal attraction ring a bit untrue to me.

My Date with Dr. F

Dr. F finally called me back. I think he likes me. It was two hours late (two weeks and two hours late, but all is forgiven), but worth it: He was optimistic.

I took a ton of notes. Here are the highlights of our conversation:

• He started with "so who decided you have decreased ovarian reserve?" which made me realize he wasn't quite buying it. Hoorah!
• At SIRM, the live birth rate for women in my age group (35-37) is about 30% per cycle. For those who make it to transfer, the live birth rate is higher.
• He considers my infertility "unexplained." Egg quality is probably an issue.
• SIRM doesn't use CCCT. The results are not all that useful except to tell me time is of the essence.
• Nine antral follicles isn't great, but is still enough to qualify me for their Outcome Based Plan. I need to have at least that many at my February baseline.
• My prolactin of 26 is a tad too high and needs further investigation (My OB and Dr. Negative said it was fine, but having milk this long after breastfeeding is kind of freaky-nice to know it may be impacting my fertility, too).
• He would like me to cycle in January, but I can't miss two weeks of school in January. February is the earliest I can go. Sigh.
• He knows my RE, Dr. Negative. Well, he knows of him. He was nice, but he said that Dr. Negative's group is the biggest Egg Donor program in the country which probably explains why they were pushing donor eggs on us at our first visit.
• There is no escaping the BCP because he wants my ovaries to "rest" before IVF.

OK, I need your help. Do I go ahead and try a December round of injections and IUI here with Dr. Negative and Nurse Joy(less). Or do I try on my own until I go on the pill in January? I'm torn.

Pros to trying here:

• Got lucky with injections/IUI before.
• Much, much less expensive than IVF
• Potential to become pregnant sooner.

Cons:

• Lower likelihood of conception
• Dr. Negative and Nurse Joy
• Would I be wearing out my ovaries by stimming?
• Dr. Negative and Nurse Joy.

Help me decide, please.

Semester of Calamity, Semester of Worry

With the exception of the year I took between finishing my undergraduate degree and starting my Ph.D. program, time has been measured semester by semester, paced by the academic calendar and syllabus. My wedding? Spring Break. September 11? Classic social theory. My BFP? Corporate and government power. Another semester has nearly passed. I will forever associate it with hurricanes, earthquakes and infertility. It will be recalled as the semester of calamity and worry.

This is the last week of classes for me and I am worn down. Childcare issues, book deadlines, and infertility have worked their collective misery and it hasn't been easy.

My semester recap:

Childcare. I found a stay-at-home mother who wanted to keep another baby. She lives only blocks from campus, so that was a huge plus. Unfortunately, it did not work out. First, I had an unrealistic expectation of how many hours we would need childcare. I was working into the wee hours trying to keep up with my workload, but the other mom was not willing to increase her hours. Then, during the middle of September, the mom watching Baby E took a vacation the same week J was at a conference in Denver. I think I can pinpoint this as the week things went off the rails. In October, the mom decided she wasn't cut out for childcare. I ended up hiring a nanny. Two, actually. More on that later.

Book woes. In October, my publisher (AKA, the Enforcer) came to town for a working visit. This was a disaster. In addition to my being badly behind on the text, I was doing the Clomid Challenge. Hormones and mixed deadlines do not mix. It was an awful visit that ended in vague threats. More on that later.

High FSH. Two hours after my publisher left, Nurse Joy called with my FSH results. I lost it. Totally lost it. That is how this blog began. It was my attempt to get a handle on things. More on that now.

All things considered, I think I am in a better place than I was two months ago. Perhaps the shock has finally worn off. At any rate, I did not turn to pills or therapy as I threatened.

Childcare. So far the nanny thing is working out. Sure, we are broke (seriously, we are spending more than we earn), but E is sleeping well and is doted on all day*. She is surrounded by her own toys and sleeps in her own crib. I don't have to cart her around so she isn't hostage to my cycle. She is learning baby signs and verbalizing more and more. Then there is the bonus that one of the nannies went to cooking school. J says he think it may be legal in South Carolina for us to marry Nanny S. Hmm. . . I always wanted a wife.

The text. I am still seriously behind schedule, so nothing is new there, but I am less stressed about it. I played the worst-case scenario game and realized I could live with the consequences of failure on this. If I lose the contract, I lose the contract. Sure, it will look bad, but I am tenured and it would take more than this for me to lose my position. For that, I'd have to sleep with a student or something**. I am going to make a good faith effort to get a great deal of work done on the books during the month of December, but I am not going to stress over it. Stress is bad for fertility. Oddly enough, this take-it-or-leave-it attitude seems to be increasing my productivity ever so slightly.

Infertility. This is my single biggest source of stress these days. I spend hours I should be writing instead reading up on FSH, antral follicles, wheat grass, IVF protocols and acupuncture. I read infertility blogs. I read everything that tells me I am not alone in this. My phone consultation with Dr. F had to be rescheduled to this Friday. I can't wait. He is playing hard to get and it makes me want him more.

I feel a spark of hope going into exams. I will finish grading this rather large stack of papers***. I will get through grading exams. I will deal with the sniveling grade-mongers. I will start exercising more regularly. I will eat better. I will take my prenatals. I will dream of babies.

* E has a slot in a good child development center starting in May. I have sabbatical next fall so she won't be in full-time care outside the home until well after her second birthday. I can live with that.
** Shoot. I'm tenured. So sleeping with a student probably wouldn't do it. I'm in the Southeast, a real Red state. I could take dubbya's name in vain. That might do it.
***Should probably NOT be blogging right now.

Damn those OPKs

Have you ever noticed all the vocabulary we infertiles build? I was trying to explain where we are in our attempts to ttc #2 via email to a very fertile friend who has never had to think about getting pregnant. (She is so fertile she once got pregnant on the pill AND then got pregnant while nursing. What a show off.) The original email went something like this:

"We had a BFN last cycle. TTC is depressing, and I'm not pleased with my RE. He thinks my FSH is too high and my DOR makes me a bad candidate for everything except DE. He is willing to try a round of Follistim and IUI, but is not optimistic and will not try IVF. I'm hoping to become a SIRM patient because the A/ACP IVF protocol sounds promising. We are trying on our own this cycle, but it is already cd 20 and I don't think I have O'd based on my bbts. My OPK results have been confusing. A week ago, it appeared that I surged based on the FR and Target brand OPKs. However, I did not get this result with CBE. In fact it was very -. Because my temps did not jump, I bought two more packs of OPKs, CBE and Target. Today the CBE showed a surge and the test line was darker than the control line. However, the Target OPK was -. So we dtd again in case I am really going to O this time. I am praying for a BFP in the near future. In the meantime, damn those OPKs."

Now my sisters in infertility probably would probably understand most of that, but I realized before hitting send that my fertile myrtle friend would not understand a bit of it.

Have you noticed how infertility creates a wall of sorts between the fertiles and infertiles? The lingo is just the start of it. What strikes me is that the infertility subculture, while thriving, is largely hidden. Yeah yeah, I know there is some new dumb-ass television program about an infertility clinic, but I refuse to watch because I already know they probably make the REs seem god-like, the patients seem needy and desperate (OK-maybe they are getting that right) and the nurses seem like saints (and if you have read my previous post, you know how I feel about nurses right now.) And sure, we know Brooke Shields and Julia Roberts both conceived via IVF, but we know more about Brooke's PPD than we know about her infertility journey.

Why are we hidden?

Shame? I publish under a pseudonym for fear of colleagues or students stumbling across my posts and knowing way too much. Not that we should be wearing tee-shirts proclaiming "Natural Cycle- We DTD today!" but what is wrong with sneaking in an "as an infertility patient" into conversation once in a while?

Stigma? Perhaps being infertile calls into question a woman's raison d'etre. We can be very accomplished--a lawyer, a doctor, or a professor--but this still calls into question our self-worth. I grew up next to an older couple who had no children. They were like our surrogate grandparents, but I pitied them for not having children or grandchildren. My mother once told me, "Mrs. S couldn't have babies ." I have felt sorry for Mrs. S ever since. She is 90 and I still feel sorry for her. I have a child so I doubt eight -year-old neighbors will feel sorry for me when I am old, but I do get the feeling my friends look at me and feel pity when fill them in. I don't want pity. I want empathy.

Fear? Discomfort? One of my friends recently told me that I am probably better off with one child because it is easier. She ended that dialogue rather abruptly and we moved on to discuss something inane, but safe, like shoes. Or was it TV? This is one of my most loyal friends, but she is not an infertile and seems uncomfortable talking about what we have been through. Other friends behave the same way. Silent.

I revised my email message: "Things are not going well naturally, but we will start fertility treatment soon with hopes of making E a big sister. How are the kids? Bought any new shoes lately?"

Dr. Negative and Nurse Joy

I had a nice visit with baby Katherine today. She made tiny squawking sounds as she slept in my arms. My friend K was very generous to let me hold her and watch the parade of expressions flick across her face as she slept swaddled and capped in pink. I felt wistfulness to be sure, but ultimately it just felt good to share in K's happiness and marvel at the beauty of life so new.

Oddly enough, the visit was not the emotional landmine I had expected. That honor was reserved for Dr. Negative and Nurse Joy (her real name-I am NOT making that up). I called to say I wanted to try one round of injections and IUI. Nurse Joy called me back and, in the most patronizing tone imaginable, told me the following:

1. Dr. Negative strongly advises against it as it is highly unlikely to work. He has written this in my chart so now it is part of my permanent record. Better for the insurance company to deny coverage.
2. Yes, of course, there are a few women in that lucky 1-5% who succeed with numbers like mine, but there are 95-99% who don't and I should plan to be in that latter group.
3. I had 18 antral follicles that made it to one baby when I conceived two years ago. Now that I only have 9 antrals, what is the point?
4. I should really consider donor eggs. Really.
5. It is too bad that I am not, 15 years old, poor and black. Because I would get pregnant easily then (a racist, classist nurse-Joy!).

So the plan at the moment is to do one cycle of injections and IUI here. Really, I consider this to be a data gathering mission. I want to know how I respond to the stims so I can have the best protocol at SIRM. If I get pregnant during this fact finding mission that will be wonderful; if not, I'll head west to SIRM in the spring. Dr. S at SIRM wrote me a nice note tonight, so I go to bed with hope:

This is incomprehensible to me. At 37 with an FSH on day 3 of 6.7 MIU/ml in association with a low E2 and at least 9 antral follicles, you should have a reasonable chance of a successful IVF in my opinion. You could even be eligible
for the OBP (see below) at SIRM. A single abnormal CCCT change does not alter my opinion.

Baby Lust

A good friend had a baby girl today, almost four weeks ahead of schedule. Mom and baby are doing well and I am thrilled for them. I was, in fact, almost tearful when I learned K had gone into labor because I knew this would be the most important and wondrous day of her life. We talked for a while tonight and she gave me a funny blow-by-blow recap of the unexpected arrival. When K told her husband that her water had broken, he kept asking "What does this mean? What does this mean?" I guess at 5 a.m. impending fatherhood takes a while to compute. By 12:30 p.m. they were parents. What does this mean?

I remember the wonder and joy of Baby E's birth, of sobbing and telling her, "I have waited so long for you, my beautiful girl ." My world was forever changed; and for the better. While trying to conceive Baby E, I was propelled by a vague notion that having a baby would be meaningful and good. But I had no idea. And I want to do it again.

Tomorrow morning, I will visit K and baby in the hospital while my husband gives a crash course in car seat installation. Thursday, I will deliver a Thanksgiving meal. I will hold little Katherine, I will breathe her sweet baby smell, and I will hear her newborn sighs and moans. I know that seeing the baby, holding the baby, and smelling the baby will add fuel to my already burning baby lust. I'm very happy that Chris C. wrote today of the nostalgia and envy that accompany a visit to a newborn because I would feel ugly for expressing this craving and jealousy. Thank you Chris, for helping me realize I am not alone in my feelings.

I suppose that in the end, this baby lust is what will propel me. It will sustain me through the hormonal assault of fertility treatment, see me through each procedure, and give me strength when the odds seem low.

Things that suck about TTC on our own (that is, without the help of the RE who has given up on us):

1. OPKs. I am close to an LH surge, or maybe I have already surged. Yesterday I took three OPKs. The first, the Answer brand was +, the second, the Target Brand was +, the third, the ClearBlue Easy was -. Normally, I would say two out of three is pretty darned good, but my RE and nurse Joy (really her name) went to great lengths to impress upon me the superiority of the ClearBlue test. Problem is, that test was never close. Upon waking this morning I took the Target brand and it was no longer positive. Argh. Now I'm left wondering whether I caught O or wasted another precious month.

2. Conception Sex. It is bad. Just bad. Foreplay is reduced to "Honey, I think the lines are the same color." Each month I wait in eager anticipation on fertile cm and the LH surge. My chart stands by ready to document the rise in temps that follows ovulation. But. . . I don't want to have sex. Not for fun. Not for conception. Oh. I'll take one for the team on that less than one percent chance that I'll conceive, but there is no joy in Mudville. This is, I think, a cruel infertility trick, an inverse law of need and want--the more you need to have sex, the less you want to have sex.

3. No monitoring. Don't get me wrong. I do not enjoy the condom wrapped ultrasound probe any more than the next girl. However, I like scientific evidence that something is happening in there. I like seeing my follicles grow. Now that I am not being monitored, I have no idea what is going on. Is there a follie? Is it big enough? Has my lining recovered from last month's Clomid challenge? Are there any malicious cysts? How is that fibroid doing?

Well that blows. It really was like a date: I was stood up.

There was a SNAFU and Dr. F. did not know he was supposed to call me. I sat by the phone for 83 minutes and finally called the patient coordinator. She was very nice and apologetic. My name was on the master schedule and my chart was ready. Somehow that information just didn't make it down the hall. Unfortunately Dr. F is going on vacation and can't talk with me until December 2. Two weeks. Two long weeks.

That would be bad enough, but today was my annual exam. My goal was to be an OB patient by the time we needed to check my cervix and tits. But no, I was just a regular old gyn patient. The heartbeat doppler sat lonely on the counter of the exam room reminding me of what might have been.

My OB/GYN asked about the fertility front and when I filled her in she said, "but you have a beautiful little girl," as if that should be enough to make everything better. When I told her that Dr. Negative instructed me not to bother with IVF or to "chase" other doctors, I expected a little grrrl empathy ("don't listen to that-you know what is right for you"). Instead, she told me that, "he's an excellent doctor and acting in your best interest." That's what I needed: more medical paternalism.

I am unbelievably sad right now. Inappropriately sad, I think. I feel like hope keeps slipping away.

He hates me. He was supposed to call 53 minutes ago. What's a girl to do?

My phone consultation with Dr. F. is set for this Friday evening. Dr. F. has a great reputation among the high FSH crowd. Actually, he has groupies which I'll take as a good sign.

My records should be there by now--I requested that they be sent after last week's disappointing visit with my local RE. I'm curious if the local RE, Dr. Negative, wrote his "less than one percent" pronouncement in there. I wonder if he wrote that I "shouldn't go chasing other clinics because they play with their numbers." I wonder if he wrote that "you don't need IVF because you ovulate."

I'm excited and nervous about the consult with Dr. F. It has been 15 years since my last first date, but this feels like one. Will he like me? Will I like him? Will he like my records? Will I like his success rates? Will he push me too far, too fast? Will I sound too needy? Will he get me pregnant?

I have questions, so many questions:

• Is it possible that my cd 10 FSH was high two years ago when we were trying for Baby E?
• Is having normal FSH on CD3 promising or is the high cd 10 FSH more important?
• Will IVF give me a better chance than IUI?
• How much will this cost?
• What is this clinic's success rate for other woman who are the same age and have a similar FSH as me?
• What made my ovaries old?
• What protocol is used for high FSH women? How is this different from other clinics?
• Is there any way to avoid BCP before IVF (it makes me crazy)?

That is it so far. I would love suggestions for other things I should ask from anyone who knows more about this.

It was a small step to be sure.

I faxed my new patient questionnaire to SIRM. I am proud of myself for getting it done. Why proud of such a small accomplishment? I'm proud--self satisfied at least-- because it is my first babystep (no pun intended) away from my RE, Dr. Negative.

Normally, I would have used the fax at work, but the thought of being discovered sending fertility papers out was just too much for me. So yesterday I bought a plain paper fax for $29.99 after rebate (bargain!). I hooked it up and hit send.

Poof. My history, my hopes, my fears are on a desk somewhere waiting for a second opinion.

On the bright side, I love our nanny.

While the last few weeks have been difficult, and I am continuing to struggle with the concept of potentially never having another child, I feel it is worth mentioning a bright spot, Nanny S.

We have tried a number of childcare arrangements, some more disastrous than others. A few weeks ago, a bad situation came to a head, and I had to scramble to find care. Our current arrangement seems to be working. Breaking the bank. But working.

[Honestly, we don't earn enough for a nanny. However, I did not know to register Baby E. for a reputable child development center when she was just two lines on a stick. We have a spot for May 2006. Until then, we shall continue to pretend to be members of the bourgeoisie.]

One of the new nannies (they split the week) went to cooking school. Somehow while Baby E naps for two hours, Nanny S. manages to cook entire meals using things she finds in our refrigerator and pantry. I looked at the pantry and fridge this morning and thought, "Ah well, there is truly nothing she can fix this time." Wrong! She made corn chowder, cornbread (with a hint of cheddar), and shortbread cookies with strawberry glaze. Did I mention she used ingredients we already had? This is like the best party trick ever. I can't cook a meal unless I make a special trip to the store-- and even then I forget key ingredients and resort to cereal. Again.

For the record, she is not required to cook or clean. She said she gets bored waiting for Baby E to get up. Who am I to let her get bored?

Did I mention that she folded the laundry that I left running in the dryer today? This is almost like having a wife.

Baby E. likes her too.

It hit me tonight.

Baby E. was up needing a sip of water and a cuddle moment. Normally, I would be a bit annoyed to have my sleep broken up. But tonight as we rocked and she lay quietly in my arms, head on my shoulder, it hit me. I may never have another child. I may never have another child. I may never have another child.

When I was working hard to conceive Baby E, it never occurred to me that infertility, round 2, could cut so deep. My heart and soul are primed. But is my body able?

Moment of truth arrived today. We met with the RE at long last to discuss my dismal test results. He wore a sad smile as if to say, "This is the worst part of my job, not being able to help people." He is of the school of thought that I can't get pregnant (less than 1% chance) with my own eggs. The upshot of the meeting was that we can keep trying on our own, but we would come back to donor eggs eventually. He is willing to try IUI to placate us, but will not try IVF.

Not so fast, buddy. I am getting a second opinion.

My worries:

• Even if we find money for IVF, what if travel costs to a big city are too much.
• Even if we find money for treatment and travel, how can I take off for two weeks in middle of a semester?
• Even if we find money for treatment and travel AND find a way to take off in middle of a semester, what if it doesn't work?
• If it doesn't work, will I always regret having used money for treatment that could have been used for adoption?
• If I decide on adoption, will I regret not having tried with my own eggs?
• What if autoimmune disease catches up with my pancreas next? Or my pituitary? What else can it get?

I feel so. . . Shriveled. . . Used up. . .Old.

Warning to the next person who tells me of someone who got pregnant:

• as soon as the doctor said she couldn't
• as soon as she relaxed
• as soon as she ate organic wheat germ grown in her own yard
• as soon as she stopped stressing
• as soon as she made a big purchase and accrued debt
• as soon as she used cough syrup
• as soon as she adopted/ chose a surrogate/ gave up ttc
• as soon as she gave up her job

I will punch you. Zip it.

Haven't cried in two days; must be getting a handle on things. That or clomid side effects are wearing off. For the record, it is cruel business to tell someone in the grips of Clomid that she has failed the clomid challenge test and therefore has less a chance of becoming pregnant than Terri Schiavo had of running a marathon. Making her wait three weeks for a follow-up is plain wrong.

Fortunately:

• My women friends are wonderful. This is particularly true of the women I met while ttc and while pregnant with Baby E.
• I've corresponded with three REs who were not put off by my day 10 FSH (freaking stupid hormone) levels. I may need to travel great distance at great expense, but they will accept me for IVF.
• I am going to hire a nanny tomorrow. Actually, I'll hire two who alternate so they don't get Baby E burnout. It is expensive, but necessary, as current arrangement is not working.
• Colds don't last forever. Right? Baby E caught one, has passed it to me, and now her father may be the first man to die of the common cold.
• All this stress is leading to loss of appetite and weight loss. I'll be back to my trim summer weight in no time. How I have put on four pounds since August, I have no idea.

Have decided that therapy and pills are worth a go and intend to contact someone soon. How does one go about this anyway? Have also decided to "take my fertility into own hands" which sounds very feminist and affirmative.

Things I am thinking about now:

• Can I love a donor egg baby the way I love my daughter?
• Is acupuncture just a bunch of hooey? Worth a try for fertility?
• Can I ditch my book contract without incurring legal wrath and financial pain inflicted by publisher?
• What can be done with a Ph.D. in a social science that doesn't involve teaching?
• When did I start to hate teaching? Or maybe it is just the publish or perish I hate. Yes, that may be it.
• Why can't I sleep?
• What jackpot did I win to have cancer, spinal surgery and chronic pain, and infertility all in my 30s? Do bad things happen to good people, or am I a bad person?

Welcome to my little corner of cyberdom. The worst day ever seems like a good day to start a blog. It also seems like a good day to start therapy or pills, but this is cheaper.

My day:

1) Did not win Powerball. This, despite loyal weekly contribution to state’s Education Lottery (which is practically like paying self since I am an educator-woo hoo).
2) Was intimidated by my publisher who reminded me my text was due a year ago. No longer want to write text, talk about text, think about text. Must turn in eight chapters in four months. Or else.
3) Childcare for E not working out. Looking for nanny who approaches Mary Poppins in experience and demeanor but who will work for less that $10 an hour. Still praying for non-scary (e.g. Krista's Krazy Kid Kare) daycare opening.
4) Found out it is highly likely that E will be an only child. Was ready to start trying for baby two, but failed Clomid Challenge. Badly. For those of you who stumble across this and are unfamiliar with the gritty reality of infertility, failing Clomid Challenge is akin to failing one’s boards.
5) Canceled class because it is pretty uncool to teach while crying over bad FSH (magic fertility) levels.
6) Realized I hate my job as college professor. Students are needy and sniveling grademongers. I already have a baby, thank you.

7) Have not talked to husband for more than a few minutes since Sunday because publisher (AKA: The Enforcer) was in town to break my legs. Time to tell him bad baby news.