Bionic Mamas

you're not losing a vagina, you're gaining a son


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Items From Our Catalog

Hi, Internets.  I wrote you such a post yesterday!  Well, we can all believe it was wonderful, because the WP iPad app ate it, and only the good die young, right?  In the interest of posting something, anything, here are some items:

Current Events

  • Sugar did not get the promotion/new job she has been waiting to hear about since, oh, February-ish.  (The actual interview was in August, but that’s around when she started the application process.)  Waiting to hear has been a stressful situation for our family, and this news is, of course, even more stressful.  The job would have meant more money and the kind of title and responsibilities that make it easier to move to another good job elsewhere, so that sucks.  Then there’s the part where she is a great employee who has been in this small department for eight years, doing the work of this better job for most of a year, and generally feels pretty damn shafted right now.  “We sure hope you won’t take this as a reflection on how much we value your [tireless, underpaid-even-for-this-department, grant-money-attracting] work in your current position,” says her boss, who can eat ALL THE BAGS OF DICKS, as far as I am concerned.
  • Her boss gave her this news following a big meeting about how there would be a lot of work for the department in February.  She stayed after to tell him that he might need to assign extra staff to those projects, since we are expecting a baby at that time.  Nothing like getting additional rejection immediately after saying things like “I might need to take time off if it’s like last time, because my wife almost died.”
  • No, I don’t think that influenced his decision.  He is not a quick decider, just an asshole.
  • She isn’t getting fired, but it feels a little like that, because if they aren’t willing to promote her to management after eight years, yeah, it’s time to move on.
  • There has literally never been a better time to convince us to come be your neighbors!  Seriously, if you have connections in educational technology and/or public health, be in touch, huh?  We are open to leaving the city.  Probably not — full disclosure — for Indiana.
  • Sugar left early this morning to visit her parents for the weekend, so we get to be apart while processing all this.  Whee.

Democracy In Action

  • We voted in the NYC primary this week.  Sugar tried to weasel out of it by saying she wasn’t registered to a political party (required for primaries in this state), but ha ha, turns out there’s a website to check that kind of thing.  The Bean was putting up a fuss about going, but the return of the old voting machines (with LEVERS!) and the advent of never-seen-here-before STICKERS may have won him over for life.
  • I kind of can’t believe that in a field that included a lesbian and black man, I checked the box by yet another straight white guy’s name.  But, hey, at least he’s married to a lesbian.  And I’m married to a lesbian, myself!

Obstetrics and Midwifery

  • My appointment last week went well.  I saw the midwife again, and I wish she were an OB.  This practice has two CNMs who work with OB patients, but only the OBs deliver.  I’m not sure why this is the system, but I wish I could see this MW more often.  If nothing else, it was a nice break from grilling everyone about whether they are competent/emotionally stable, since I’ve already told her my deal.
  • I had told her about the postpartum anemia last time I saw her, but I hadn’t known for sure it was because of hemorrhage (as opposed to general pregnancy anemia).  I told her the numbers from the hospital records, and she said they would definitely have offered a transfusion.  That is reassuring, vis-a-vis hoping to not be that sick again.
  • She noted in my chart that I had had a postpartum hemorrhage, but said she thinks it is unlikely to recur, since it was probably mostly the septum doing the bleeding.  If a septum includes an artery, she says, “those things can really pump.”  I guess that explains why the doctors used up all the gauze in the room and the supply closet both, stuffing my vagina full of it and pulling it out again.  (Which hurt a surprising amount.)
  • I made a supposedly off-hand comment about how maybe none of this will matter anyway, if the placenta doesn’t move, since I’d end up with an automatic c-section.  She waved her hand, as if dismissing a joke.  “Please.  It’s marginal at sixteen weeks.  It will move.”  I think she is likely to be right, but this was still a nice antidote to my mother’s gloom on the subject.  (My mother generally seems to think I don’t take bad news sufficiently seriously, and so takes pains to impress upon me that bad news is bad.  I’m not sure where she got the impression that I am an optimist.)
  • The most surprising aspect of the appointment is that we did not have a fight or even a lengthy discussion about my plan to refuse the glucose tolerance screening this time around.  I told her how sick I had gotten last time, confirmed that I had eaten beforehand and still was neurologically wrecked for three days, and mentioned my low risk factors for gestational diabetes.  (I restrained myself from opening with what BS I think most of the things written about GD are, at least when it comes to bad outcomes among patients without pre-existing insulin resistance.  And since when is an episiotomy in the same category of outcome as a c-section, anyway?)  I was all set to argue, with data and citations and everything (thanks to Dr. J. F. Scientist and my mother), but she said, “We had a patient like you really recently.  Are you willing to do some monitoring at home?” I am — what’s a few more self-inflicted stab wounds for a fertility clinic veteran, am I right?  “I’ll bring it up at the OB meeting this week, but I’m sure it’s fine.  You’ll have to get a meter.”  And then she got out the doppler and we listened to Jackalope’s galloping heart.
  • I feel surprised, relieved, and perversely thwarted.  I have data, damn it!  Don’t you want to even look at it?  Please?
  • In general, the visit was reassuring on the “have I once again chosen insane care providers” front.

Addled Brain, My

  • I am somewhat bemused to report that the one thing that would have irritated me about that appointment, in other times, namely the MW referring to the amount of weight I’ve gained as “not bad,” didn’t bother me at all, except in an impersonal, cultural-political kind of way.  Huh.  I realized that I never gave them the “please don’t bug me about eating/my weight” talk that led Dr. Russian’s practice to label me as an active anorexic (and therefore interrogate me about my diet at every opportunity, FAIL), partly because they have never told me anything dumb like some imaginary, ideal amount of weight to program my animatronic body to gain without exceeding.  Funny, how not setting a person up to think her weight in under surveilance is helpful in the not-feeling-under-surveillance department.
  • However.
  • I am not doing so very well in the “putting that birth behind me” category (the one comment from my last appointment with this MW that, while meant kindly, did in fact rub me the wrong way).
  • And so.
  • I have decided to look for a therapist.
  • I have very mixed feelings about that.
  • Bunny mentioned in a comment a few posts ago that she wasn’t sure of my feelings about therapy except that I had been utterly enraged by the Baby Factory’s requirement that we see their counselor.  For the sake of clarity, my feelings about Our Dumb Appointment are not my feelings about therapy in general, but are more to do with the screening-for-parental-fitness nature of that requirement.  Eugenics is so pre-war, darling.
  • That’s not to say I have no issues with the idea of going into therapy, many of which are conveniently wrapped up in my feelings about my mother, who is a psychiatrist.
  1. I prefer the convenience of boring and annoying my family, friends, and readership.
  2. My previous experience with therapy (in college) was deeply pointless.  I now realize that might have had more to do with my therapist being a 22-year-old intern from Alma Mater’s social work school than with therapy as a whole.
  3. A lot of therapists, however, are tremendous flakes.  I imagine it’s not a majority, but admit it: it’s a visible group.
  4. Therapy is the town pastime here, in a way that makes me feel ooky.  Woody Allen is much closer to a documentarian than I had realized when living elsewhere.  I am not interested in a lifetime commitment, let alone such an expensive one.
  5. While I think SSRIs and the like are very useful in some cases, I am unconvinced they are all they are cracked up to be for many people.  No, I don’t think you should stop taking yours, but I don’t want to start taking them, either.
  • However, I have to admit that while all the processing I’ve done here and elsewhere has been tremendously helpful (and you have been, you really, really have), I’m getting to a point where I could use some more help.  As much as it feels like heresy to claim this about a vaginal birth that brought me a healthy baby, I am beginning to think that the initials P, T, S, and D are not entirely inappropriate here.  I look at diagnostic checklists, and it’s increasingly difficult to deny that a lot of those boxes have x’s.
  • Thinking of this as PTSD and therefore a cognitive issue rather than only my special snowflake feeeelings makes me think that maybe I should talk to someone who has actually studied this stuff. Which brings me to more sub-bullets!  Criteria:
  1. No generalized wading into my feelings in a global sense.  I am not interested in analyzing my whole life and my relationship to food and my mother and the military-industrial complex.  I have a goal (not completely losing my shit as I approach my due date) and a deadline (my due date).  No quagmires.
  2. No support groups.  I have those, in a virtual sense (Hi!), and in-person ones I think will only feed my sense that what happened to me was not bad enough to feel bad about.
  3. No well-meaning idiots.  Or, as a friend put it, “you mean you don’t think talking to someone with no idea about how birth works and what you were going through will help you deal with feeling traumatized be being surrounded by people who seemed to have no idea how birth works and what was going on for you?”
  4. No “natural”-birth fanatics.  None of what happened was the fault of the epidural or modern obstetrics as a whole, and furthermore, I am planning to go back to the hospital, so I will thank you not to freak me out about that.
  5. Here’s the deal-breaker: takes my insurance.  This is hard enough without feeling I am spending money we don’t have on such a self-indulgent project.
  • So far, I’ve called one person, who has an opening at a difficult time for childcare.  Contrary to my desire, I did not spend the rest of the day hiding under the covers, but lordy, this is harder than I thought.  I can’t believe so many people do it.

And now it is past time to run off to the hippie food coop and cut the cheese for a few hours.  I’m going to publish this anyway.  Verisimilitude, all that.  Links later.


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Bloody Business

Before I begin, I want to just say, in a small voice, how crushed I feel by May’s latest news, by the utter un-rightness of it, by how badly the universe is flubbing its lines. This is not how the story is supposed to go, dammit. I know we talk a lot about how unfair all of this business is, but sometimes the unfairness is just so fucking unfair. It is not the only thing that has been Not Right lately; that doesn’t make it any less wrong.

I am wondering if any of you happens to know what counts as a normal postpartum drop in hemoglobin and what doesn’t. Imagine you have this patient who, after two days of fairly heavy vaginal bleeding, arrives at a hospital in labor. Her hemoglobin at that point is 13; her hematocrit is 37.8. Following a vaginal delivery, her numbers are 7.3 and 21.7, a drop in the neighborhood of 44%.

Question one: Is that normal? If not, how abnormal?

Question two: Are there causes of postpartum decreases in hemoglobin other than blood loss? Does the placenta itself (or the baby) in some way count towards the starting number?

Question three: Do you do anything about those numbers, beyond suggesting an iron supplement? Do you do anything if the patient calls three weeks later complaining of continued extreme fatigue, dizziness, breathlessness, etc.?

Question four: Supposing a patient with this history is pregnant again. One likely source of postpartum bleeding (vaginal septum) is gone, though possibly the vaginal wall where it attached has scar tissue. Is postpartum hemorrhage in such a case likely to recur? Do you do anything in particular to lessen the chances of her feeling terrible for months again? Is there anything you can say to her to help her feel less frightened?

Question five: Is this patient a good home birth candidate? Just kidding.

My hospital records — the short version only — from the Bean’s birth arrived this week. I’d put off ordering them for a couple of years, which I guess is good, considering that I find myself a little taken aback anyway. This is just the abstract — test results and some nonsense from the lactation consultant, an extremely silly person. There are errors: I am listed as having a didelphic uterus (nope, not that normal), and hemoglobin and hematocrit are reversed in one place. (I flatter myself that a hematocrit of seven might have been more worthy of note.)

Also this week, I finally tracked down a picture I didn’t know existed until recently, of Sugar cutting the Bean’s umbilical cord. That is to say, it’s a picture of my crotch, post delivery but prior to the arrival of the placenta. I thought it might feel sort of empowering to see that, since I was scared to look at that part of my body for weeks after birth, not wanting to see all the stitches. Maybe it would have been, but I found it hard to pay much attention to my flesh, finding the pool of blood I was apparently lying in rather visually distracting. When I say pool, understand, I mean pool. I don’t mean the bed was a mess. I mean liquid. I mean depth. I mean volume.

I thought I was done finding new things to feel angry and scared about, regarding the Bean’s birth, but I guess I was wrong.

I haven’t written in much detail about how sick I was after the Bean was born, partly because at the time, I was filled with confusing hormones, alternately elated and distraught, and, well, sick. I’d been pretty thoroughly conditioned to believe that only people with (unplanned) c-sections were allowed to feel sick or sad after birth, anyway; the websites said I should be exulting in my all-powerful womynhood and resuming my exercise routine while teaching the baby French. All that matters, as you know, is that the baby is healthy. The vessel has done its job.

So, here: I was pretty sick after the Bean was born. For the first week or so, I had an annoying tendency to black out every time I tried to nurse him. The nurse I asked about it told me that was “oxytocin, filling your body with feelings of well being.” Later I realized that was the only time I wasn’t lying flat. I couldn’t hold him during the lactation class and was grateful that lesbian privilege meant I alone among the women there had someone to help. (Men weren’t allowed.) We left early because I couldn’t sit up anymore.

For the endless rounds of pediatrician visits for weight checks in the first few weeks, I took cabs. One day Sugar had a work meeting, and I couldn’t carry the Bean in his carseat. I could barely carry the car seat. We tried to take the subway once. Sugar carried the baby while I shuffled behind her, hips still entirely disconnected, like a troll aunt of some kind. (Sugar got lots of congratulations for her new baby in those days. She deserved them, but my own invisibility beside this gorgeous, healthy, thin woman and her perfect baby was sometimes hard to take. “Don’t worry, honey,” one woman said, “you’re next!”) Sugar went to the store for a different kind of iron supplement for me while I took the dwindling Bean to a lactation group. I remember feeling such utter hatred for the other woman there, so pink and healthy with her fat, pink baby, who was younger than the Bean. While Sugar was gone, I started shaking convulsively. I was losing my vision, trying to figure out how I was going to get myself onto the floor without dropping the baby, who was so, so heavy. Sugar arrived just in time, and held him while I lay my head on the desk and shook. No one asked if I was okay. I took a cab home.

It’s hard to write this without feeling I am exaggerating things, but this happened. Other things happened, too, many of them good. I stayed conscious for the ride home from the hospital, even if I did have to go immediately to bed and so missed the cats greeting the Bean. Friends came over, and I sat and talked with them. But it was months before I could walk around the neighborhood normally. Going up the gentle incline of the train station left me breathless, my vision blotchy. I feel existentially queasy looking at pictures of me with the Bean in the early weeks, because I am so very grey.

I got better. The human body really does have amazing powers of restoration. But does the patient’s recovery mean the treatment regime was wisely chosen? The heroic medicine doctors, the bleeders and purgers and givers of mercury, thought their treatments worked because their patients often survived, when the truth is those patients recovered in spite of the medicine. Regardless of whether I should have had different treatment in objective terms — and I gather from google that sources differ on the guidelines for iron infusions and blood transfusions and so on — I feel sure the other aspects of treatment could have been better. Only one nurse, when I was already in the process of being discharged, mentioned my hematocrit drop and asked if I really felt okay. (Desperate to leave, I said yes.) The nurse practitioner at my OB office told me I should expect to feel tired when I described my trouble breathing while walking. At the infamous postpartum appointment, Dr. Russian didn’t know my hematocrit levels and dismissed my questions on the topic. None of that was helpful, even if it was the case that the best course of action was waiting for my body to rebuild itself. It’s a kind of gaslighting, I think, not to tell a patient that how she feels is not in her head or her weak moral constitution.

Besides angry, I feel a bit scared by these new documents, in particular the picture. My septum is gone and presumably won’t break and bleed again. I expect it caused some of the trouble, in addition to other tears. The midwife at my new clinic says that didelphic cervices can bleed a lot, and suggested they might try rectal cytotec in addition to pitocin if it seems necessary. (I haven’t talked numbers with her, just my experience of being anemic.) If the pre-labor bleeding was a placental abruption — and we’ll never know, since the head of the OB practice didn’t see fit to take it seriously — there’s a chance that won’t happen again, and a 100% chance I won’t let it be ignored this time. I have the reassurance that I did survive, however sick I got. But there is still that nauseating feeling of almost having been run down by a bus, not realizing it was even there until it passed.


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CD 1 Eve

Hi, internets. You awake? I am, and I’m blaming my new, thrilling PMS symptom of intractable insomnia on the day prior to my period’s arrival. I could be wrong: I’ve been thinking my period imminent for several days, what with cramping and spotting and weeping on the floor at the end of our final (I promise, Starrhillgirl) attempt at toddler yoga, about which more another time. (WTF, spotting? Granted, the volume in question is probably <1% of the pre-hysteroscopy volume, but I thought I was supposed to be done with this, Oh, uterus, you old tease.) This could be just the prednisone, I suppose.

Yes, prednisone again. I returned to the ENT this Thursday, having finished a fourteen-day course of augmentin (which began with six days of prednisone), feeling very, very much improved, expecting to be declared well and sent on my way. 'twas not to be, alas. One aerosolized cocktail of novocaine and decongestant and a scope up the nose later, the doctor declared himself pleased but not pleased enough. So. Ten more days of augmentin, four more of prednisone, come back in a week. I'm beginning to feel I'm getting to know that office too well, rather as one does with the baby factory. And I definitely prefer a dildocam to a nostrilscope.

Still, I am much, much better — practically human now! Thank you for your sympathy on my last post.

The prednisone means no drinking or NSAIDs, still. Clean living! You can imagine, I'm sure, how pleased I was to hear that, given the cyclical date and all. Part of why I am hoping tomorrow is indeed CD 1 is that it's the weekend, which means Sugar can watch the Bean if I need to take Percocet in the daytime as well as at night.

CD 1, those of you following along at home may remember, also means Return to Dildocam Island, aka Baby Factory: The Musical: The Sequel. About this I feel…strangely cold-blooded. Every new stage of TTC the first time around, from deciding to begin, to making appointments with new doctors, even upping the treatment ante, felt exciting (among other things). Just starting the process, let alone having the actual baby, felt like the realization of close to a lifetime's worth of dreaming about having a baby, dreaming that, what with the endometriosis and the relative poverty and the lesbianism, often felt very unlikely to come true. Trying again just doesn't feel like that.

For one thing, those lifelong dreams always included at least one child, but the number was sometimes only one. I spent an enormous amount of time imagining what it would feel like to hold a child of mine on my chest (and feeling the terrible lightness of that child's absence), but I don't have a similarly visceral sense of what holding two children of mine might feel like.

More to the point, I think, is the fact that I am straight-up terrified of going through infancy again. I am just so very much better at this toddler gig, and I don't think it's only a case of being a more experienced mother now, in which case the second iteration of the larval need-bag stage could be reasonably expected to go better than the last. I think it's more to do with coping very poorly with serious sleep deprivation, not being particularly well-treated by breastfeeding hormones (Do I have a mild case of Dysphoric Milk Ejection Reflex? Maybe.), and, well, being the kind of person who would even think of calling a gurgling bundle of sour-milk-scented joy a larva.

You, of course, know the other thing I’m afraid of: birth, and that whole nightmare roller coaster again. See: everything tagged Dr. Russian. It is entirely possible that much of my feeling distant about the whole TTC business is just protecting myself from thinking seriously about the prospect of facing all that beyond the safe confines of this space. That I started weeping while looking at positive reviews from women who had delivered with my new doctor suggests there could be something to that notion. Throw in a soupçon’s fear of TTC not working, and you have a fine recipe for an aloof Bionic.

It isn’t, I am almost certain, that I don’t want to have another child. I keep asking myself if that’s it, of course, because we are still at a stage where backing out is possible. But no, it’s not that. I do want a sibling for the Bean — and another one of these critters for my own, selfish reasons. I wish I could capture in writing the wry smile the Bean had tonight when Sugar asked if he’d like a fish stick and, champion re-director that he is, he laced his fingers together, leaned across the table like a talkshow host, and said, “ooooor, maybe chocolate?” And did I tell you about the “turtle” he “drew” this week? What’s the turtle’s name, I asked. The Bean uses a kind of movie-Italian speech pattern sometimes now. “It’s-a called Penis,” he said, “It’s a big one.” I think Penis is a weird name for a turtle (maybe it was a skinny baby?), but the point is, this is a pretty great gig.

Last time around, every move we made to get to the Bean was driven by passion, and it’s just different this time. It’s less like I need to have a baby NOW, and more like, I know what I’d like our lives to look like in several years, and this is the time it makes sense to start building that future. I gather more rational people have experiences like this a lot, you know, and plan their lives in an orderly fashion and so on. But it’s a disorienting sensation for an impulsive creature like me. So. Off I go to the clinic, faking it ’til I make it.


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News From the Front

The bottom of the front, specifically. The front bottom, if you will.

The appointment went well. Dr. Baby Factory did not, after all, yell at me, you will be relieved to hear, though as always, he had that sad look that Sugar reminds me is mostly just how his eyebrows are shaped. His hair’s gotten a bit shaggy, as if the four years since we’ve met (is that all?) have taken him from being the 11-year-old star of the piano recital (as I always thought of him after seeing the picture in his office of him sitting ramrod straight up on one of the Today Show’s couches) to a 15-year-old with a garage band and a penchant for eschaton.

Dr. BF is who first suggested I go to Dr. Russian’s practice for OB, although in fairness he specifically recommended Dr. Robot, who left the practice in my first trimester.  Nevertheless, I decided I would tell him to rethink recommending them, if not for Dr. Russian’s appalling manner (which I know you all believe me about, but which could sound like the whining of a delicate flower) then for the way Dr. Skinny, the head of the practice, dismissed out of hand my was-that-an-abruption bleeding in the days before labor.  It is with deep pleasure that I report to you that he already has a call into Dr. Skinny, because he keeps having her patients come to him, get pregnant, and then refuse to return to her practice.  (Smart women!) So I guess it’s not just me.

While we’re on the subject of Dr. BF, can I just say what an absolute artist that man is at a pelvic exam? Seriously, he is the only person ever whose haven’t hurt; even his double pap smears don’t hurt. (Yes, I am a special snowflake and regularly cry over medical messing about in my lady business(es).  My cervices are on the inside for a reason.) I have to say that here because, 1) it is worthy of praise, and 2) there is no non-creepy way to express this sentiment in the moment.

So, the various bottom lines:

  • I will be making a lot more “bottom” jokes around here in the coming months.  Enjoy.
  • My CD 2 numbers are, I think without digging for my old notebook of data, the best they have ever been.  (FSH 5.6, E2 a shockingly low-for-me 39.)
  • My famous endometriomas (aka, “chocolate cycts,” if you are into ruining your ability to enjoy chocolate forever, which I am not) have apparently disappeared (?) (!).  Is this even possible?  I have noticed less back pain in the past few months, but I certainly felt plenty in cycles since being pregnant.  I am befuddled.  I’ll work on being glad, but right now I’m too confused.  At any rate, the dildo-camming didn’t give me the usual sensation that a smoldering rat is trying to scramble out of my lower back, which was a nice change.
  • We have lots of embryos, and Dr. BF seems optimistic about our chances, or as optimistic as his eyebrows will allow.

Scheduling is a bit of a annoyance, more so than I had anticipated.  I have the good insurance for six months, March-August.  I naively assumed this meant time for several cycles, but I had forgotten that the Baby Factory closes for IVF and like matters three months of the year, and two of those months are April and August.  When the scheduler explained that an April cycle, which was what I had begun to imagine, wasn’t going to happen, I felt bathed in adrenaline.  March?  March?!?  That’s so soon! But waiting doesn’t make a lot of sense, under the circumstances, so March it is.  Then I drank the warm apple juice she’d brought when I got woozy missing the half-gallon of blood they’d siphoned off for still more tests.  When a few molecules of sugar reached my brain, I remembered that I can’t do March, because Dr. BF wants me to come back early next cycle to see if a polyp is what’s making me spot so much before my period or if it’s just my good buddy endometriosis.

So May it is.  I am not entirely sorry to wait, though I had gotten myself slightly excited about Just Doing It.  I am worried that between the possible polyp and the closures, my six months of insurance just became three (and that’s assuming there’s no polyp or that it can come out quick-like in April).  However, billing had a surprise for us: the less-good insurance (under whose begrudging, code-careful auspices we had this consult) actually covers quite a bit more than we had thought.  Doing a cycle with them would still be more expensive than with the good insurance, but it sounds at the moment like it wouldn’t be impossible, especially if we planned ahead and got the drugs while I’m still on the good plan.

May gives me time for a few more visits to the favorite cocktail bar I am just now falling back in love with.  It also gives me some time to get worked up about various parts of this whole gig I wasn’t expecting.

For instance: more shots.  When I was first contemplating IVF, I decided I could deal with the little needles for stims but not the big ones for progesterone-in-oil, and Dr. BF agreed that I could use coochie bullets — excuse me, vaginal suppositories; excuse me, non-American readers, pessaries — instead.  They were messy and sort of annoying, but I was never sorry to be missing the intra-muscular missile to the butt I’d read about on other blogs, still less the bruises and lumps and lingering scar tissue.  But I guess now I get to learn for myself what all the fuss is about, because Dr. BF says (and, I regret to say, that the study I found on the topic agrees) that the delivery method really does make a difference in FET cycles.  Dr. BF says that during my IVF cycle, I was making some progesterone on my own, but that during a medicated FET, I won’t, which means that small differences in efficacy can mean big differences in results.

So one thing I guess I could use about now is some PIO pep-talking, should you have any on hand.  I’m not upset by needles per se, but I am no great fan of personal pain, especially deliberately inflicted, in my own home, every day for three months.  Call me crazy.  However, I also realize that a miscarriage I would always fear I could have prevented is worse.  Great choices, these are.

Okay, I know there are worse choices, I KNOW.  I know that, as subfertile lesbians go, I am sitting very pretty, what with the good clinic and the good insurance and the bewildering array of embryos.  It’s just…I had forgotten what this part, when fear and uncertainty loom so very large, feels like.  Frankly, I thought I got to skip it this time.

Mel asked the other day, after my first return to the Baby Factory for CD 2 blood work, whether I found that some of being back was much easier and some was ten times harder.  Yes.  That is exactly how I found it.  At first, I was giddy, almost, being back in such a powerful place without the dread and exhaustion I remember from the last time around.  This is a cinch, I thought, walking right up to the check-in computer to type my name.  The first time I came in, I stood awkwardly in front of the receptionist’s desk for some time before a woman in a pompadour, whom I did not yet know was nosy as the day is long and none too quick on the uptake, informed me in one of those New York lady klaxon voices that still startle me that I was doing everything wrong, as though it weren’t understandable that a person might imagine their office worked like every other office on Earth.  This time, the receptionists were new and muscle memory guided my hands through the menus as surely as if they were ticket machines at Grand Central.  Bam! I thought, jabbing the CD2 bloodwork button, my doctor’s name, my insurance carrier.  I got this.  I even made a self-deprecating joke about sperm to the guy ahead of me in line.  (Sorry, sir.  I should probably not be allowed in public alone, at least not while giddy.)

As I waited for my name to be called, a strange nausea crept over me.  I hadn’t, I realized, been comparing my present-day self with the me who had first come to the Baby Factory at all; I’d been comparing myself to my memory of that person, a memory colored by knowing that my first visit was only the beginning, that there were miles to go, disappointments and fears and more than a few crying jags.  In fact, that very first me, the one the receptionist startled, was a lot like this me: happy, excited, hopeful.  I had mainly wanted to go to an RE because of my mysterious lady-part arrangement and because my insurance covered it and the Gyn I’d gone to was a dick, so why not?  I imagined we’d leave with a plan, buy some sperm for home use, and have a baby in less than a year. Although our story ended happily, that original me sure had another think coming.

The PIO surprise was like a bucket of cold water to the face in part because I thought this time was going to be so easy.  Aren’t FETs supposed to be so simple compared to a fresh cycle?  I suppose it is simpler, in that I don’t have to come to the office much and won’t get OHSS this time, but I had forgotten that simpler isn’t the same as easy.  I know what to expect from an IVF cycle, but an FET is nevertheless new to me, bringing with it all the anxiety that attends medical novelty.  That I know how to get to the clinic and where to buy a coke after they exsanguinate me for science does not mean I know anything about what’s going to happen, and worse, it doesn’t mean I have any control over the results. I know I’m a lucky subfertile lesbian, but dammit, why can’t I just be a fertile one?  I thought skipping the rounds of IUI this time would make me feel fertile, but that fantasy is crumbling now that I remember that this “fertility” still involves doctors and needles and tenacula and fear.  I never really believed this when we were trying to conceive the first time, but it turns out this secondary infertility jazz is, to paraphrase Smarshy’s memorable image, just a different bag of ass.


7 Comments

I Figured It Out

OH!

The reason I am a staticky ball of anxiety — like, if you turned off the light, I’m sure you could see little lightning flashes around me — isn’t that I am having cold feet about returning to the Baby Factory, per se.

It’s PTSD from that horrible postpartum appointment with Dr. Russian. I was just like this before my last lady-parts doctor’s visit too, even though nothing terrible was on the agenda. Maybe I will always be like this from now on. Fun times for my lucky readers!

I realized talking to Sugar just now that the reason I wasn’t worried about my bloodwork visit the other day but I am scared to see Dr. Baby Factory himself is that I have in my mind that he will somehow yell at me about something. What he’d have to yell at me about, I don’t know, but then, I wouldn’t have thought there was a lot it made sense to ream out a limping, anemic mother of a six-week-old for, either.

In my actual brain, I know that Dr. BF is a kind, gentle man who will may even be happy to see us and want to see a picture or two of the Bean, seeing as how he was rather small last time they were in a room together. We’ll see if I can get my viciously tense body to listen to reason, but at least my brain feels better.


16 Comments

Back In The Saddle

…or the stirrups, anyway.

No, no, not in the TTC sort of way, not yet anyway. I won’t spring that on you without some high-octane angst first, promise.

But I did go to the OB/Gyn, for the first time since my postpartum appointment, which some of you may recall ended with me wandering the avenues of Midtown, weeping so hard people were forced to break the NYC taboo on talking to crying people and the one on stopping strangers in the street. (In case you’re wondering, it does take some doing, especially in the blocks around Grand Central.) I was, erm, a little nervous. Related: what is it about filling out those medical history forms that makes me afraid I’ve forgotten my own name, let alone whether I have kidney disease?

You will not be surprised to hear that I did not return to Dr. Russian, as punching her in the face would open me up to more court and jail time than fits my schedule. I stacked the deck a bit by going to Sugar’s doctor, whom I have met before. (In fact, I tried to go to her practice when I got knocked up, but they weren’t taking new OB patients.) Nevertheless, I was feeling pretty shaky as I sat there on the table waiting, gripping my notebook of questions. I fetched my journal out of my purse, for the sense of enhanced safety only another book can provide.

And…she was wonderful. She listened to my slightly quavery explanation of why I was switching practices and said it all sounded pretty traumatic. She said that lots of women push for four hours with a first baby and that it doesn’t mean they aren’t trying, and that they give nifedipine if they even suspect Reynaud’s in the nipples of a breastfeeding mother, because Reynaud’s is so awful and nifedipine is so safe. (See here and here for contrast.)

I haven’t written about this, but one part of labor that I have felt increasingly upset about in recent months is the part where I was bleeding heavily for days at home and Dr. Skinny said it was nothing and then was such a bitch about my calling back when it hadn’t stopped, twelve hours or more after my first call. I’ve talked to many, many women since then about their experiences of labor, and I have yet to hear anything that reassures me it was normal. I suppose it’s possible that it really was just a particularly determined (and large — this was a lot of blood) broken vessel in my cervix, but it’s also possible it was a placental abruption, and there is no way Dr. Skinny could have known it wasn’t via phone. I didn’t think it seemed normal at the time, and I shouldn’t have let her intimidate me out of that. Things turned out okay for me and the Bean, of course, but it’s not a comfortable feeling, thinking that I could have let my baby die — oh, and potentially died myself — because I was too chicken to argue with a doctor. I told the new doctor that, and she looked very serious. That does not sound normal, she said, and no one at this practice would have let you stay at home if you called bleeding that much. That will not happen to you here.

Ultimately, she said that while she couldn’t ethically say things about Dr. Russian to a patient, she was — I think the word was “horrified” — by what I had told her. Then she said so again.

So. Maybe it wasn’t just me.

If this doctor has a fault I am aware of, it is that I find her a little happy to cut, as surgeons tend to be. On the other hand, as much as I don’t want to have surgery for the endometriosis I’ve thus far fail to cure with denial or pregnancy, I’m not sure she’s wrong that I should have it. Things are getting worse, and most months I now spend three out of ever four or five weeks in some amount of pain. In particular, pain in the week before my period is getting out of hand, such that I’ve been dipping into my hoarded Percocet stash to sleep. Nothing else does a thing. The question in my mind is whether surgery is worth the pain of recovery, given that it doesn’t always help with endo. Somehow I didn’t get that question in, but I am being sent back to Dr. Demure, the man who did a transvaginal ultrasound without so much as seeing my legs, to see how my garden of ovarian cysts grows. Well, I imagine, from the way my back feels half the month. I’m also to see a rehab specialist about the way my hip joints fall to pieces and leave me so weak once a month, though she seems unconvinced that isn’t somehow also endo.

If I am going to try to get pregnant again in the spring or summer, I’m not keen to have surgery first. I’m hard-pressed to come up with a rational excuse for that — besides that I have no idea what I would do with the Bean for two weeks if my recovery were anything like Sugar’s — but she said it did not sound crazy. Should have asked her why not. In the meantime, I have a legitimate prescription for Percocet now, though she said several times that we couldn’t just carry on like this until menopause. Other than pain medication and surgery that might not help, there is no treatment. Birth control pills help some people, but are a bad idea for people like me, who get migraine with aura and don’t like the idea of having a stroke.

The pelvic exam itself was not much fun, though I think she was as gentle as possible while hunting around for cervix number two. Righty seems to have done the job at delivery, for those who were wondering. The worst part, though, was the groping around for uterus and ovaries and such like. I was doubled-over after and am still in a fair bit of pain, though some sangria left over from our party on Sunday did take the edge off last night. She may have a point about this situation not being tenable.

So! On balance, a win yesterday, I think. Let us hope for another one tomorrow, when I have a job interview at a college in Staten Island. I am hoping that my scanty publication record’s including a book about a forgotten corner of our most ignored borough will give me an edge.


8 Comments

What Was That All About?

Hey, y’all.  Thank you again and a hundred more times for your comment on my sad post the other day.  One of my blog goals is to start replying to more comments [sidebar: I’ve finally learned that if I reply using WP’s email system, I can also cc the email you used when you left the comment, which means you might actually see my reply, assuming you left a working email]; I’m not sure I’ll manage replies to these ones, only because I feel them very deeply and am having trouble finding words, even after looking under the couch cushions.  But truly, deeply, thank you all.

I’ve been doing some thinking about what made me fall apart so very much just then.  Certainly, the things I mentioned in the post itself — sick, sad Bean; lack of sun and exercise; insomnia (WTF?); cetera — are part of the answer, but a few other things have come to mind, to whit:

  • That pesky anniversary thing.  Several of you have mentioned bad stuff coming up around a year after birth.  For that matter, many of you (too many) have talked about renewed sadness and upset around the anniversaries of losses.  How that part of my mind knows what time of year it is, I don’t know, but I think maybe this is part of what’s going on.  Here’s hoping the outburst at 11 months is somehow protective and that the Bean’s birthday will be only joy.
  • PMS — Okay, I did mention this one, but it makes the list anyway because I’m curious to know whether any of you who have had babies think your PMS has changed.  I think mine has, and I’m hoping it’s partly because of the nursing-related hormone roller coaster and will therefore GTFH eventually.  I’ve always…felt intensely about PMS.  Feeling fat and moaning about same was, given the uncertainties of my cycle, pretty much how I knew it was time to buy pads; some light crying on the last day inevitable; weeping not wholly out of the question.  But it did not used to ravage me so thoroughly.  Crying, yes; sobbing, not so much until now.  (And just in time to try not to scare another creature with unpredictable behavior!)  These days…damn.  Anyone else?
  • Another thing that’s new is the kind and character of my period pain.  It’s been creeping back.  Every month I nurse a little less and I bleed a lot more and things hurt.  I didn’t expect being pregnant to cure my endometriosis any more than it cured my mother’s or than adulthood cured the asthma of anyone in my family, but I can’t help having hoped a little.  At least so far there have been no visitations of the dreaded GI/endo horrors which I positively cannot take care of a child during.  (I remember thinking on the infamous cab ride to the hospital that, while what was happening was very painful, I had been in worse pain many times and survived.  It’s like that.)  I’m not surprised that the pain is coming back, but what I am surprised about is how it has changed.  I’ve always been in pretty bad shape from the sternum down during my period, with belly, hips, back, and legs all hurting in one way or another, but the hip pain in particular has shifted from being something that I mostly noticed when trying to sleep on my side to being constant, beginning even before my period.  It also feels different, like someone is standing behind me, digging curled fingers around the front of my hip bones and then pulling out and back.  My hips and legs also get strangely tired and loose-feeling walking long distances during my period, the way they did at the end of pregnancy and especially after birth. It and the back pain are all-too reminiscent of giving birth, which I think makes me a little panicky and upset even before it’s strong enough that I’m thinking about it consciously.  I’m curious to know whether any of you who’ve given birth and/or been pregnant have noticed anything similar.  (I’m trying not to exclude anyone who’d like to answer but also trying not to be all trigger-y; please forgive inability to find a better way to ask.)  And, you know, whether it ever went away.  Also, pain med suggestions happily accepted.  I was so happy, post the cervix-puncturing HSG, that my pain had gone down so much that I could use Advil instead of Aleve, as Advil takes a week to really tear up my stomach while Aleve only needs two days, but this month I found myself taking half a percocet one night, and taking the other half an hour later.

The other, happier realization I’ve had about all this mess is that it is not strictly true that, as I had been thinking, I’m stuck on this.  It seems that way, but I think what’s really going on is that I’m slow, not stuck.  I wish I were done turning this over in my head, that I had successfully turned the whole story into an empowering narrative of personal triumph and joy and unicorn poop

[pause for unicorn poop cookies.  These Exist.]

…but the fact that I haven’t been able to do that yet, it has finally occurred to me, doesn’t mean I’ve been doing nothing.

It took me six weeks to even begin to accept that I was upset at all; that’s what the hysterical crying that began after Dr. Russian told me off in my post partum visit and continued for another day and a half was all about.  (And that there was some Crying, let me tell you.  People in midtown Manhattan do not stop crying people walking down the street to tell them it will be okay; it is just not done.  But they did me. And then this weird subway con-artist regular manhandled my baby on the 42nd Street shuttle.  Great day.)  Until then, I was fumbling around, wondering why I felt ashamed of myself, assuming who suggested that I had Encountered Assholes was just misunderstanding the situation.  I think that’s called denial.

Since then, I’ve gone through some valleys of despair, it’s true, but I’m starting to look around and think that maybe it’s not all the same valley.  They tend to look the same — being so shadowy and all — but maybe I’m not going in circles but just on a very long walk, one that ends somewhere with unicorn poop cookies.

(Okay, probably not.  But the disco dust part of those cookies isn’t really for eating, and I’d be much happier with a nice red wine and chocolate.)