Bionic Mamas

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


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Post-Ovulatory Items

Sshhh, internets, the Bean is sleeping. Finally. I should be in the other room, using this time to finish my semester grading, but the Bean is also sick, and if I move, nap over. So how’s about some items, since I’m here for the foreseeable?

Item: for those following along at home, I was finally deemed worthy of triggering on Saturday. Transfer day is Friday. Cross your fingers, if you don’t mind, for an easy transfer and a conclusive beta to follow. Of course, I’d prefer a conclusively high beta, but what I’m most focused on at the moment is numbers that mean I get to go on our planned summer trip of friends and family and beautiful, quiet places in the north woods of Michigan. When I ran this idea past Dr. BF, he said it was all fine as long as they were satisfied nothing ectopic was happening. No one wants to risk a rupture that far from a hospital, not even me.

Item: There will be Valium at the transfer, and don’t think I haven’t made mention of that to every warm body I can find at the Baby Factory. (I know some clinics always use Valium — and I find their logic of reducing uterine contractions convincing — but mine doesn’t.) Look, I know things have changed in the down-there department, post-Bean, and it’s wholly reasonable to suspect at least one of those pesky cervices is a little easier to navigate now that six pounds of baby has gone through it, but I don’t care to test that theory for no good reason. A tiny part of me is holding out hope that Valium plus baby plus lack of septum (and therefore more space for the hand that rocks the speculum) might mean no tenaculum, even. A girl can dream.

Item: I mentioned this to the nurse who took my blood on Tuesday (progesterone check), and she asked if my inseminations had always been difficult. They were, I said, but less bad with the Valium. I think the first one, with no Valium, was traumatic for everyone, not just me, and for me it was downright ghastly. (To say nothing of the pressure I felt to think warm, welcoming thoughts for a baby, while I was getting stabbed and prodded to the point of tears.) Yes, she said, I think I was there.

And you know what, I feel downright comforted to know that she remembers. The Baby Factory is a big place, with a lot of patients, and this was some time ago. I just looked back at the post I wrote at the time, which in no way captures the horror — no doubt I was imagining some future baby reading about his beginnings and didn’t want to scare the mite (guess who hasn’t filled in the birth story page of her son’s baby book?). We don’t need to go back over such old wounds as that, but suffice it to say that directed coughing in no way distracts from the pain of having yet another cervix stabbed with pointed tongs yet another time, and that seeing the doctor break a sweat isn’t very calming. No one said anything much about it at the time — and what could they have said that would have done anything but worry me? — but I am relieved to know that my impression of the day wasn’t crazy.

Item: That the transfer is on Friday means a doctor I haven’t met before (I think. Unless she was at the aforementioned IUI of nightmares.) will be on duty. And thank heavens for that. Had it been Thursday, we could have had the same guy who did the Bean’s ET, which has a cute aspect to it and all, but also has the less winning quality of requiring me to spend more time pants-less with a paternalistic asshole.

Seriously, I don’t know what this guy’s deal is, but it certainly could use a slightly more robust idea of his patients’ bodily autonomy. I found myself in stirrups with him again last week. He looked at my chart and said, in a disbelieving tone, “natural FET cycle? Why would you do that?”

You know that thing when some guy asks you some supposedly neutral question, like what your name is or why you look a certain way (usually: not thrilled just to be near him), and you just know that no matter what you say, you’re about to get hit on/told you are misbehaving/both? (And okay, I’m sure there are instances of women doing this, but stick with me here.) And you seem, in that moment, to have a choice about how to respond — to take the question at face value or to address its obvious subtext by ignoring him/ rolling your eyes/ telling him off — but really, there is no choice, because either you are going to walk right into the condescension (by being nice), in which case you aren’t allowed to complain about it, or you are going to socially overreact, which means you get called a bitch? Anyway, Dr. Paternalistic (who shares a name with a city in California, if you are local and curious) is like that. There’s no right answer. Except instead of his being a stranger on the street, he is the only one in the room wearing pants, and he’s holding an ultrasonic baton.

Gamely, I said, “why not?” And really, why not? My actual doctor thinks my odds of success are the same this way as in a more medicated cycle. But he didn’t like that answer, because this kind of cycle means I have to come into the office a lot, which, by the way, I haven’t indicated any impatience with, because I don’t actually mind. So I said that I liked that this cycle meant I could avoid the progesterone shots (since my body will make its own, meaning the suppositories are sufficient insurance). This isn’t an insignificant reason, to my mind — a few extra office visits versus stabbing myself in the increasingly lumpy ass for three months? No contest — but he looked unconvinced. “Also,” I said, bracing myself, “I liked the idea of letting my body do its own thing, since there’s no indication of any problem with my hormones.”

“I GUESS,” he replied, with all the self-effacing deference I’d expect from a fourteen year old. And then he stuck a dildocam in my vagina. Because that’s how this game goes. At least there’s no septum for him to make me feel bad about anymore.

Item: I cried on the bus ride to school after that. I’m sure it’s frustrating, as a doctor, when patients don’t make the same decisions you would — hell, I’m frustrated by other people’s decisions all the time — but maybe make a distinction between decisions that actually have anything to do with health outcomes and those that don’t. And then maybe try not to be a jackass, also.

Item: On the other hand, the nurse who gave me my trigger shots (two, because they are subcutaneous now and therefore weaker) on Saturday is in my good books. She, too, noticed and commented on the NATURAL scrawled on my chart. They don’t do many cycles this way, and that note has a lot of highlighter on it. “Good for you! Making your own follicle!” And then she stabbed me in the stomach (because that’s how this game works) and we talked about people eating their placentas. Not our thing, we agreed, but no reason others can’t do it. Imagine that.

Item: For the medical record, the progesterone is different this time. Last time, it was little waxy bullets from a compounding pharmacy, but this time I was given a choice between Crinone twice a day or prometrium thrice. My decisions was entirely based on math: 2<3. So far, the crinone is fine, except for making me crampy and leaving an absolutely revolting substance behind for removal during shower-time spelunking. Still, I will take gross over painful any day of the week.

Item: For the further medical record, following an awful morning of intense nausea, I decided to be pushy and ask if I really needed the doxycycline I'm on, given that I've had no invasive egg retrieval this time, no one thought I needed prophylactic antibiotics for an IUI (which is not essentially different from an embryo transfer), and my stomach is still all ducks and drakes from this sinus adventure. Message relayed via nurse is that I can indeed stop it, and I think I shall. I shall carry on with the methylprednisolone (how much extra do you think my insurance paid for the pre-metabolized version of a cheap, old drug?), as I can see the medical point of that one.

Message goes on to say that I must also stop taking Prilosec and Pepcid post-transfer, which is less good news. (Sinus doctor wants me to stay on both for another month while things heal; they a not presently back to normal.). I remember from last go-round that Dr. BF didn't even want me taking lysine for cold sores while under his wing, so this is hardly surprising. Lysine is an amino acid, for crying out loud; it's in FOOD. Similarly, I was directed to take both Pepcid and Prilosec while pregnant with the Bean, though admittedly later in the process. I guess every drug is suspect except the fertility drugs, which we all know wouldn't hurt a fly. I am at heart a Good Girl, though, so I will try for a bit and cry to my new OB if things get hairy.

Item: I can't believe the Bean is still asleep, but I woke him up prematurely yesterday (following his passing out on the floor in the late afternoon, following heroic meltdown, following utter refusal to nap earlier) and he still didn't go to sleep in a timely manner last night.

Item: Acid reflux and moral purity be damned, Sugar and I are going out for what I hope is a last-gasp cocktail tonight. Which means the Bean will have a babysitter, and sleep, well, that's her problem.


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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.


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Updates and Such

Hey there, internet. It’s been a rather rollercoaster-y day around these parts, so I’m not sure how peppy I can make this.

Let’s start with good things:

  • We now have two dozen fertilized eggs. Obviously 24 is too many to put back, but luckily vitrification and FET means we can have two, reasonable pregnancies of 12 each….
  • The red gatorade isn’t so bad if it’s really cold.
  • After no percocet overnight, I felt great this morning. Better than in a week, in fact.
…that’s all I can come up with.
Less good things:
  • Stopping the percocet was stupid, stupid, stupid. Midmorning, I was suddenly in so much abdominal pain that I freaked out. Luckily, I did the responsible thing and called the Baby Factory. The doc on call there said she wasn’t a bit surprised, given my age, battery-hen-style egg production, and extensive endometriosis. She told me to get back on the percocet and stay the heck in bed. Although it took several hours for the percocet to get back to its former level of effectiveness (because it always works better if you don’t let the pain get away from you), I am basically okay now. I am also still in pajamas, which now have gatorade stains. Classy.
  • Way too sick to go to acupuncture, even if I hadn’t been forbidden to leave the bed.
  • The nurse who called with the fert report announced that I would be having anesthesia for my ET, per the doctor who did the ER (Dr. Saturday, not Dr. Baby Factory), who never introduced himself in the OR and put my IV in badly so it hurt like hell the whole time.
Dr. Baby Factory and I had already talked about ET procedures, as he knows my ornery cervices better than anybody, and he did mention that anesthesia was a possibility. He mentioned it in a “in case you think *you’d* like this” kind of a way, just as information. We decided that valium was enough. Now some guy I don’t even know has just announced that my care is changing, because he feels like it. I feel out of control and angry.
I also feel really, really sad about the idea of not being conscious for the ET. So much of the IVF experience is so distant from what I want the conception of our child to be like. I am grateful that I have the opportunity to use IVF, grateful that it may save us from infertility. But the experience is not without loss, you know? I’ve read so many IVF blogs, and ET day seems for so many couples like the day it becomes personal again, as they watch the embryo on the screen, hold hands as it goes in. I want that.
Doctor On-Call wants me to come in tomorrow anyway, to get checked for OHSS and so on. Since Dr. Baby Factory is also Dr. Monday, I hope to talk to him about it. I just hope I can keep from crying. Because crying hurts my belly so much right now.
Oh, I forgot one other good thing: a big shout out to my wonderful acupuncturist, who wrote to check in on me and is just generally a blessing.


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Bullet-y Roundup

Hey gang. There’s been way too little about hoo-has on this blog lately, no? Sorry about that. We’re in a period of hoo-ha dormancy at the moment, ending soon. To whit:

  • We’ve been on TTC break, but IVF commences in round about 2 weeks. (This protocol begins on CD2, and all signs point to my ovulating about now.) I’m excited and totally freaked out. I am trying not to take my lunacy out on Sugar, but dreaming of needles every night is getting old (and tiring).
  • Speaking of needles, I have been going to acupuncture every week for some time now. I really like the practice, Brooklyn Acupuncture Project. It’s clean and nice and cheap. The practitioners are friendly and no one’s tried to talk me into changing my diet. (I have a history of disordered eating and know from experience that even small, reasonable changes lead me directly to the place of hypercontrol, which leads directly to the place of not eating. Which can’t be a good move, health-wise.) I’m not sure how much it’s helping with my chief complaint, anxiety (see dreams above). It does chill me out on the day of the appointment, and I suppose I am moderately less crazy than I was in April, so that’s something. What I don’t like about acupuncture is how it wears me out for the whole day. Do others of you have this?
  • Have any of you done IVF at NYU? Know any bloggers who have? Since it looks like Nicole will have to wait a few months, I’ve lost my cycle buddy — and I was selfishly hoping she’d go first and give me the lay of the land.
  • I’ve ordered the meds. Still need to sort out whether Dr. Baby Factory will stick to his statement that he’ll let me try the progesterone coochie bullets, since the shots freak me out.
  • We need to order more sperm. This week, yo.
  • We found a church hall to have our wedding party in! Now we just need to get some food and invite people….
  • A veritable bevy of my aunts is in town. My mother, too. This has led me to blurting out things about my vaginae, cervices, and so on many times in the past few days. Since living in New York means living in public, said blurting has occurred in inappropriate places: the check-out line at the food coop, a busy sidewalk on 35th street.
  • My mother and her sisters are all deaf to varying degrees, so said inappropriate blurting has also been very loud. And repeated. Continuing to do my bit to keep city life interesting.

I owe you a number of posts, internet. Posts about why I feel guilty moving on to IVF so soon, and about why it is a good idea anyway. Posts about why I’m not taking Dr. Baby Factory’s advice and letting him remove my vaginal septum, even though doing so is on balance the more logical decision. Posts about how I’ve become someone who screams about my vagina in midtown. I’m certain to feel more frantic in the coming weeks, so stay tuned.

And I’ll get a new Come and Eat post up soon. Meanwhile, try playing this game. (Tip o’ the nib to Geek and Lawyer.)


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Red Light, Green Light

I thought it might help to sort out what about IVF I am and am not scared of. Something’s gotta help soon, because I’m sick of waking up at 4:30. (Good news: I found a sliding-scale acupuncture clinic! Gonna call next week, for reals. We’ll deal with what about acupuncture I am and am not afraid of another day….)


What I am scared of:

Big needles. Dr. Baby Factory prefers to use progesterone in oil, but he said he’s okay with coochie bullets. So I don’t need to worry about that one (except for the part of me that’s like “but shouldn’t I use THE VERY BEST THING? WHY DON’T I WANT A BABY???”)


What I am not scared of:

Small needles. I’m a tiny bit weirded out by the thought of the follistim injections, but not in an unmanagable way. I used to watch my dad give himself allergy shots. I think this is one of those times that being a doctors’ kid helps — I don’t have the feeling that medical care is something that doesn’t happen at home, and I’m basically into science experiments. And if it gets that bad, I have a friend with a medical degree who’s already offered to give me the shots. (And if that doesn’t work out, I can always have her 2.5 year old daughter do it. That kid gives me “medicine” with my bbt thermometer every time she’s over, which is often. She has a great bedside manner — comforting but very firm.)

– That follistim and friends will make my ovaries hurt unbearably, given that Cysty Lefty hurts an awful lot of the time as it is. Oh well. I suppose childbearing is a weird goal if I’m interested in avoiding discomfort, huh?

Two-week follicular phase. That sounds like a big improvement over my usual twenty-odd days. I can do anything for two weeks, right?

Egg retrieval. That’s normal, right? How could I not be scared of giant needles in my vagina, right? And how the hell are they going to get around my big-ass cysts? (According to my dream life, I am also afraid of crazy infections that enlarge the lining surrounding my heart. Awake, I am afraid that the Terrible Metaphor part of my mind is taking over. IVF leads to heartache? Real original, brain. MFA in Writing = money well spent.)

IVs. Dr. Baby Factory said he’d want to do my ER with anesthesia — and he thought I’d object! Ha! I’m a big wimp and am all for being knocked out. So I’m telling myself that all I will have to do on ER day is show up and get an IV. Everything that comes afterward…well, I’ll be down for the count. (I hope. Last time I had twilight anesthesia — when I had my wisdom teeth out — I woke up in the middle. On the bright side, I was still too blissed out to be bothered. I remember lying there thinking, “Oh, that crunching sound must mean they’re having to break my tooth to get it out. La la la!”)

Not having any eggs/embryos. Dr. Baby Factory doesn’t think the no-egg thing is likely (since I had a bunch of follicles on the last scan), but really, I suppose there’s only one way to find out.

Twins.

Single Embryo Transfer. Dr. BF thinks this is a great idea for me, given my age and all the rest (like my fear of twins). He thinks it lowers my odds only a little bit, and since my insurance is paying….
But then again, my insurance company wouldn’t be the ones climbing back into the stirrups, not to mention dealing with the emotional fallout not getting pregnant. Okay, it turns out I am a little afraid of this. But I am more afraid of twins in our New York apartment and our loosey-goosey financial situation.

Believing this is a sure thing; losing my mind if it doesn’t work, even if only on the first try.

Never having a child. Always being the-adult-kids-love, with none of my own to sometimes love and sometimes loathe me. Again, only one way to find out.