13 week and 5 days. Dragging along.

I wish I could say this pregnancy is going quickly, but it isn't. I had expected to be able to post the results of my CVS by now, but the procedure had to be halted because my cervix and uterus are, for lack of a better descriptive, deflicted. I have a short (or was it long?) and crooked cervix, a tipped uterus, and a cervical polyp. I feel so special. Not. Actually, I was so traumatized by the procedure that it has taken me three weeks to write about it.

I bled. I passed clots. I was told the bleeding, clotting and subsequent spotting were due to the polyp and an "irritated" cervix. I'll have to say that my cervix was not irritated, it was pissed. Really, really pissed. And your cervix would be likewise unhappy if someone attached the clamp below (a tenaculum) to it and then tried to snake a catheter up it. A bit of advice: If you ever see one of these puppies coming at your cervix, run away. Fast. Don't say I didn't warn you. Honestly, this was probably the most uncomfortable procedure I have ever had.



This leaves me in a funk. I had hoped by now to have questions of genetic abnormalities answered and any tough decisions behind me. We've rescheduled an amnio for March 1, but we won't have the results until I am 17 weeks. At age 37 there is a 1.5% chance of chromosomal abnormalities. I realize this leaves us with a 98.5% chance of the baby being fine. But still. It would have been nice to know sooner.

Questions about baby's health are just part of my pregnancy funk. Anxiety about miscarrying has also contributed to my blues. I've had cramping on and off since I tested BFP. I haven't had any more bleeding, but the cramping can be intense at times. Rationally, I realize that it is probably just due to the stretching and growing going on down there, but it is worrisome. I think it was gone by this point when I was pregnant with E. Maybe not, but if I did, I am now blocking it out.

Finally, I have so much fear. This is probably compounded by good old fashioned Catholic guilt. I have the gnawing sense that I got here by cheating. My dear cyber friend, Chris, is being put through hell by her REs, others are dealing with too many losses, and here I am on a natural cycle of all things. I feel like the other shoe may drop at any moment.

On the bright side, I have seen the baby at each visit. I've seen the baby at 7 weeks, at 9 weeks, at 10 weeks, at 11 weeks and at 13 weeks. And the little bean is beautiful. Just like its big sister.

For J, who really deserves higher than a C-

I know you read this. Happy Anniversary and Happy Valentine's Day. I love you because:

• You always love me back.
• You are a better father than I could have hoped for.
• You always know how to make me laugh.
• You are excited about another baby.
• You aren't afraid of a pile of laundry.
• You aren't afraid of Palmetto bugs.
• You are afraid of miscarriage and something happening to the baby.
• You share my political views.
• You tolerate my parents.
• You are a good uncle.
• You are my comfort.

Does it seem like 13 years? Already? I hope we have 50 more.

Pregancy 2.0

I have shamefully ripped off the title for this post from Lindy. Sorry, Lindy. I am feeling so very uncreative tonight.

I know this post is long overdue, but the news is good so far. I visited my regular OB on the 20th and was able to see the baby again. The baby had grown appropriately and had a nice heartbeat. My OB proclaimed it a "healthy pregnancy" thus far. She also arranged for me to have CVS this week which is the earliest form of genetic screening available to me. With Baby E, I waited for amniocentesis which was done at 16 weeks. This time, I think we are willing to trade the slightly higher risk of miscarriage for the earlier reassurance (or not) of CVS. The test can detect the trisomies and a range of other diseases, but it cannot detect neural tube defects. Later blood tests and later ultrasounds can detect these.

Unlike my first pregnancy, J did not accompany me to the OB appointment. We knew he would likely miss another ultrasound, but we were both OK with it. Because he is an experienced expectant father, he couldn't think of any questions for the doctor. The solo first appointment made me ponder what else is different this pregnancy. Here is what I have come up with so far:

• Fatigue. I know I was tired with Baby E, but I am exhausted this time around. I don't know if it is the difference between 35 and 37 or just the added bonus of caring for a toddler and trying to keep the house in order, but I am dragging. When does that second trimester wave of energy hit?
• Feeling less special. I don't want to give J a hard time, but he earns a C- so far on the expectant dad bit. I am, of course, grading him against his prior performance. He was so sweet and attentive when I was pregnant with E. This time, I think he forgets I am gestating. At least he forgets that gestating is WORK. Hard, hard work. Baby E has had a rough sleep week with night waking, early morning wake ups and short naps. Last Wednesday morning, I started crying out of shear fatigue and frustration and J snapped, "Well, I'm tired, too." Damn.
• Showing, but not showing. I have hit the awkward clothing stage much earlier this time. My body hasn't taken that pregnancy shape yet. My regular clothes are a bit too tight, but maternity wear looks ridiculous. Sadly, I just look bloated and thick. Tonight I ordered some transitional pants and skirts from Old Navy. They are supposed to have hidden elastic bands and I hope they arrive soon.
• Gas and constipation. Yes, this is too much information, but good grief, what is up with this? I know I wasn't this bloated with E, and I am sure the constipation started much later.
• Baby Beat is a wonderful thing. I am so glad that we ordered the doppler. I had it last time, too, but this time, it has kept me grounded. The baby can be hard to find, but we've always found the heartbeat. Lovely, lovely sound.

Two a.m. and I am wide-awake

It is one of those nights. It was all I could do to stay awake until 10:00 when I surrendered and went to bed. So what am I doing wide-awake? I’m too tired to attempt a coherent narrative so here is a bullet update of my life since I last posted.

• Nurse Joy kissed me. I didn’t see it coming or I would have ducked. Or run. It happened after my second ultrasound last Friday. The scan went well. We saw four limbs (pods, really), a strong heartbeat, and a residual tail (which made me wonder if I am bearing a tadpole). Dr. Negative had a medical student come and meet us and told her, “Here is why we don’t say 0% chance of conceiving to high FSH women.” I had to be a smart-ass and say, “No, they give us so much hope with that less than 1% forecast.” Dr. Negative said I should stay on the progesterone for another week and released me to my OB. Ultrasound in hand, I went to the window to pay for the visit and Nurse Joy came running up and planted one on my cheek. BLECK!

• My toddler may have a split personality. One day, she is all sunshine; smiling, laughing, affectionate, trying all her baby signs, fun. The next, she is stormy weather; whining, crying, screaming, not even attempting to communicate, anti-fun. We are sharing the sitters with another family three days a week. Their little girl EJ is six months old and is a good baby. My E seems at times to be thrilled with the baby, cooing at her, smiling and patting her back “gently.” Other times, she seems insanely jealous. Last week she had a tantrum. Yesterday she chomped on the sitter’s leg as the sitter attended to the baby. Sitter wants detailed instructions on how to handle this, but to be honest, I have no idea what to tell her. Obviously, I want to discourage this behavior, but I’m not entirely certain of what to do.

• I can’t get rid of this book contract. I told my publisher about the pregnancy hoping they might drop me, but they are making accommodations and being nicer than usual. I guess the only solution is to buckle down and get the whole thing written pronto because I do not want this hanging over my head after the baby comes. I will never do another text. Too boring. Too tedious.

•J finally got a CPAP machine. He has sleep apnea and we hadn’t slept in the same room in about a year. I just couldn’t sleep through that anymore and he could sleep through my kicking him, poking him and complaining. But now he has the machine and it is wonderful. He looks like the elephant man getting geared up, but there is virtually no noise. We are back in the same room, which is an adjustment. Normally, if I were up in middle of the night I would read in bed, but it seems impolite to turn on the lights when he is sleeping soundly. Also, I think we need a larger bed. We both learned to take up more space while sleeping apart so we are having some small skirmishes over whose half of the bed we are on.

• We roadtripped and told our families about the pregnancy this weekend. We told J’s family at breakfast by adding ultrasound photos to E’s little scrapbook. She pulled the scrapbook out of her pack and we told her to show her grandparents her pictures. When she got to the last page we said, “And E is going to be a big sister.” We told my family at my nephew’s 5th birthday dinner. We made a gift certificate that said, “The bearer of this certificate is entitled to one cousin redeemable on or about August 22, 2006.” We brought the house down.

• I am trying to work on my worry. I am still constantly stressed about the what ifs of early pregnancy, but I’m trying to focus on the good news and stay positive. I should get a BabyBeat heart monitor in the mail tomorrow. I’ll try to remind myself that nine weeks may be too early to find a heartbeat with it, but I know we’ll try.

• My classes are going well. I have one bozo in my social issues class who believes we should invade North Korea and “take care of things.” He also thinks the homeless guy who was beaten to death in Florida deserved it because he was bugging people by panhandling. Fortunately, the other students seem like a good bunch. My two quantitative practicum sections are off to a good start.

Night!

Chronicles of Nannia

I returned to work one year ago this week when Baby E was three months old. I told myself that I was lucky to have been able to be home for three months. I told myself that E was lucky to be able to stay home with sitters. I told myself we would all survive. I dressed carefully that first day-- pressed khakis, black shirt, coordinating jewelry, and matching bag and shoes-- I thought it would give me confidence to keep going. As I was walking out the door, I embraced E one last time before I left maternity leave and joined the legions of working moms.* She promptly spit up all over me.

I had to make a quick change into an outfit that left me feeling less together and more bereft. I cried on my way to the campus and looked terrible by the time for my first class. Is there a moral to this story? I can’t think of one. I think, instead, that it served as an omen of things to come. My plans, however carefully laid, never seem to come to fruition when it comes to childcare. It is as if I am off from the rest of the band by a half beat. I think other women manage this better than me and I am at a loss as to how I went so wrong.

You’ll probably want to nominate me for the worst mom EVER award when you hear this: Over the last year, Baby E has had nine caretakers. That is right. Nine caretakers in 12 months. Bad mommy. Bad.

Here is the list:

Nanny L (four months): An undergraduate who watched Baby E two days a week last spring. She wasn’t a natural, but she only missed one day due to illness and she tried her best. Baby E wouldn’t nap for Nanny L (who was incapable of letting her fuss), but this really seems like a small issue now. Nanny L left after final exams.

Nanny J (Three months): The best. She was here until last May when she got nanny position in Colorado. The oldest of seven children, she was a natural. She sat for us 2-3 days a week in the spring. I would have kept her forever, but some rich Winter Park family can pay her more.

D (Two-three weeks): Notice I don’t call her a nanny. She started the job and then told me that she needed knee surgery and wouldn’t be able to lift the baby “for a while.” She went home to recover and never came back.

S (Eight weeks): This is one of D’s friends. She did very well with E, but could only sit for a month.

C (Eight weeks): Another friend of D. Pretty good with the baby, but she left after the first summer session.

Mommy J (Three months): A mom with a baby two months younger than E. An attachment parent.** I thought the attachment parent thing was a huge plus because E would get attention and not be lefy to cry, but it turned out that watching two children was too difficult and stressful. Mommy J was still waking four times a night to nurse and was completely exhausted. She couldn’t get her daughter to nap during the day without lying down with her, which was a problem with a second baby in the house. E started coming home dirty, stressed, and unhappy. We ended that in October. Mommy J is currently seeking employment outside the home.

Nanny M (Two months): Found her on Craig’s List. I didn’t get a good or bad gut feeling about her, but her references were excellent. She didn’t want to work fulltime so she brought her (then) friends Nanny S and Nanny J on board. I fired Nanny M two weeks ago after coming home early and discovering that she wasn’t being truthful.

Nanny S (Two months and counting): Almost fired her when she went to jail for slugging Nanny M, but I’m glad I gave her another try.

Nanny J2 (Two months and counting): Right now, I am not pleased with her but I’m trying to be understanding because I need her. She called today to say that she is A) Stuck in the Midwest with a useless Independence Air*** ticket and is B) “really sick”. Nanny J2 is supposed to be sitting this entire week because Nanny S has her parents in town. However, we are scrambling again because if she is still sick when she finds a return flight on another carrier, I don’t want her infecting Baby E who is recovering from a bad cold and ear infection. So J is checking his schedule, I’m trying to figure out exactly how much time I have between my 10:40 and 4:00 Tuesday classes.

You’ll notice that there are no daycares in this scenario. That is because when I was pregnant the first time and idealistic, I thought that daycares were impersonal and not good enough for my baby. I did not investigate centers. I did not sign Baby E up. I’ve changed my mind on daycare. I am still wary of most centers and my children will never go to Kisti’z Krazy Kidz Kottage, but I see advantages to daycare now. First, while I know daycares have turnover, I don’t think they can top my turnover rate. Second, there is more socialization at daycare. E is an extremely outgoing child so this would be good for her, I think. Third, there would be more oversight. No more coming home early to discover a nanny behaving badly. Forth, there would be a backup system. If one caregiver were ill, there would be another. Finally, the cost would be less of a financial burden. Not that I would let econ0mics alone determine childcare arrangements, but it says something that we spend more on nanny pay than we do on our house payment. We need to be saving.

Baby E is on the waiting lists at two good centers (the only two I could stomach) and it looks like we should have a spot this summer. I’ve already signed little brother or sister up for next January. I know I’ll have second thoughts, but I’ll try to remember the Chronicles of Nannia and go through with it.


*What does this mean, anyway? I worked my ass off those first few months.

**I’m not an attachment parent myself as I am very much into gentle scheduling and very much not into co-sleeping, but I don’t have a problem with it. I think a good parent is one who is at ease with her parenting philosophy of choice.

***How could she be unaware that they were no longer flying? Have I really hired someone who does not read a newspaper, listen to the radio, or have any idea of what is going on in national, regional or local news?

Happy New Year

Peace, prosperity and happiness to you. May your fondest wishes come true this year.

Now can someone please tell my pyromaniac, firework-obsessed neighbors enough already?

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.