Bionic Mamas

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


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Items Gestational, For The Nonce

Dateline: 38 weeks, 4 days.

Item: I am still pregnant.

Item: I wonder if that will be true for much longer.

PicsArt.com
The view from now

Item: Had a nice visit at the OB’s yesterday. Sweetly enthusiastic u/s tech kept enthusing during my BPP, making me feel a bit jaded in comparison. (Partly, I’ve been spoiled by the image quality at the high-risk place I go for growth scans.). She really was adorable, taking care to point out specific bones, to enthuse over how Jackalope was practicing breathing, “which they don’t do all the time so we don’t always get to see it!” Apparently both placenta and fluid levels are fantastic, or words to that effect.

After a rather too-lengthy wait for the OB portion of the visit (not because anyone was late but because there are few slots for BPPs, and this was the best we could do), a punchy and overtired Bean accompanied me back to the exam rooms, where he roll on the floor. Blood pressure up a bit, which I suspected as I’ve been having these darling little panic attacks, but not enough to worry anyone; weight down a bit. “Undress from the waist down,” said the nurse, and I said no, I’d wait to talk to the doctor before setting myself up for cervix rummaging, thank you. I do not remember that fondly at all, and have decided I am not submitting myself to painful procedures without good reason.

This, it transpired, was perfectly fine with Dr. White*, who came in wearing yet another pair of hip glasses. (Between my previous visit with her, this one, and my doula’s report of meeting her at a delivery, no repeat frames yet.) She agreed that there wasn’t much to do with the information except satisfy general curiosity and encourage me to go to the hospital quickly when labor starts if it happens that I am secretly already fairly dilated. “But,” she said, “that is already what you are planning to do, so it doesn’t matter.”

* Who is, point of order, not white. But I am into using fairly obvious nicknames this time around (why have I been protecting Dr. Russian and pals?) and the other obvious ways to alter her name are not nice.

I really like her. She was so encouraging about everything, saying she really thought everything was going to go well and I would do great and my birth plan looks good, too. She talked to me for a long time, wanting to hear again a bunch of details from my labor with the Bean, and here, gentle reader, is where she really won me over. I was describing the Horrible Cab Ride, and how even though it was Horrible, I was apparently at 4 cm both before and afterwards (leading to my point about how much better and faster everything went after the epidural, not matter what the books say). “It sounds like you were in transition,” she said.

Internets, I was floored. YES, that is exactly what I thought at the time. Everything about how I was feeling and acting was exactly how transition is described, except supposedly I wasn’t because transition is said to happen from 8-10cm. (This led to some real shock at the hospital when the resident said, brightly, “you’re at 4 cm!” not realizing I had been told the same four hours of agony previously. “WHAT??” I said, or perhaps roared. “Um, maybe four and a half,” she said, in a frankly adorable attempt to mollify me.)

When I told my mother about the transition confusion, she said the same thing (minus the cab) had happened to her when I was born, and that moreover, when she was in med school, they were taught that transition was a kind of labor, not a particular point in dilation. (In other words, maybe many people experience transitional labor in the 8-10 cm range, but that doesn’t mean the two are synonymous). Until Dr. White’s comment, I have never heard anyone with more recent training agree with that concept, and I can’t tell you how relieving it was to hear that maybe I am not crazy, and that did happen. Redeeming, that’s the word.

Anyway, yay, Dr. White. On the basis of nothing except our chat (which included how I’d thought I was going into labor last Thursday and then not and then that being able to walk to a restaurant two blocks away for my date (!) with Sugar on Monday made me think I was having a pre-labor burst of energy and then how I could barely sleep that night from pain because in fact I was not up to that walk and how I’ve been having these panic attacks, sometimes without even consciously thinking about anything that worries me), anyway, on the basis of that long parenthetical, she mentioned cheerfully several times how if I happened to go into labor in the next couple days, she would be on call. “Go ahead and make an appointment for next week, just in case,” she said. She almost rolled her eyes when I asked about their induction date policy. (It’s 41 weeks. I never bothered to ask before because I never expected this pregnancy to last longer than the Bean’s. But here I am, still knocked up.)

And then I went home. And then I lay on the bed in various kinds of back pain and contraction exhaustion for several hours, while the Bean covered me with stuffed animals and trucks. And then I lost a great deal of sleep last night in the same way, unisom notwithstanding, and had a pretty rough morning, to boot. And I am starting to wonder if she might be onto something.

At least we have made it to the lunar new year. The Bean and Sugar are both rabbits, you see, and I have been secretly hoping for a little horse, like me.

Oh, and post-scriptural Item: Thank you for your many kind and encouraging comments on the birth plan. I do want to clarify that many of the things you thought it was horrible to have to request are, in fact, standard at this hospital. I know from being there all but plan-less with the Bean that they always hurl the newborn onto your chest and assume you will all room together. (In fact, the dumb tour guide we had last time said that was mandatory, which sounded intimidating. That was only one of many things she was wrong about. The LCs at that place…I don’t have much good to say about the two I encountered last time. I plan to skip the whole business this time and just see the good one I eventually found in Brooklyn if needed. And my insurance will pay! Thanks, Obama!) As far as I know, non-gestational parents can hang with the baby post-caesarean. Nor do I think anyone’s penis gets automatically docked in the absence of a specified desired to leave the thing alone.

The yelling and so on — well, I certainly hope none of my providers would do such a thing. It’s just that I’ve been so wrong on that count before, and felt so helpless to do anything about it (or even, for a long time, to admit it had happened). Really, putting all that in was mostly an exercise in showing myself I could be an advocate for myself, taking control and all that.

I really do like and trust the OBs in this practice, as much as my twice-shy self can trust anyone. Even Dr. Smarm I think is probably okay, despite not being my favorite: she gets very good reviews online, and Dr. Ready seemed genuine when she assured me that, weird appointment or no, she would not do the things I fear. I feel a bit defensive on this point, partly because of my own history, but also because I often feel sort of demographically pressured to believe I should see midwives instead of OBs. I like midwives, in the abstract, but sometimes the praise of them necessitates a villain in a way I find problematic. Point of order, I have good reason to have chosen OB care, both times. I really like this hospital, and no midwives deliver there. The local midwifery practice everyone loves delivers at a hospital I do not love. The hospital with the fancy birth center and therefore more midwives is farther from our house, and the present cab ride is sufficiently long. In particular during my last pregnancy, I was thought to be at increased risk of needing a c-section, and I thought on the whole I preferred to know the person performing it.

This is part of a longer rant on the problems of birth activism’s concerning itself with abandoning medical systems in favor of options (midwives, home births) that may be great for many people but require, among other things, “good” health. Midwifery has a problem, in my ever humble etc., if hospital-based practices risk out patients for things like gestational diabetes. More to my point, it is not ultimately appropriate to advocate that “healthy” people abandon hospital care en mass as a primary response to problems in that care, inasmuch as removing the most privileged (in health but also, statistically, in race, class, and education) from the system, leaving those less well positioned to advocate for themselves stuck in a system activists would do better to improve. (Mind you, I am talking about activist rhetoric here; a given individual’s decision to have a home birth I have no ideological argument against.)

But meanwhile, my back hurts. I am going to take a bath.


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Happy Hour Items

Greetings, internets, from a local trendy bar that turns out to be more than capable of turning out something “fun and non-alcoholic,” if requested. I thought this order might reassure the woman giving me side-eye as I, well, bellied up to the bar, but it turns out that is just how she holds her face.

Nevertheless, I am looking rather fecund at present, even in the tent-dresses that are all I can tolerate wearing at present. I haven’t had much of the stretching and cramping and so on I had in early Bean-pregnancy since the first couple of weeks, but lately anything putting even nominal pressure on my uterus makes me sore and dizzy and nauseated. An ultrasound probe, for instance. I tried a belt for twenty seconds this week and was off all afternoon, and even my maternity jeans, which felt fine at first, caused trouble after an hour. Sure hope this sorts itself out before the weather turns.

The nuchal scan went well, I’m into the lowest risk zone for miscarriage, and my body is rapidly outing itself, but Sugar is interviewing for a new position at work, so we are in the odd position of telling people in real life but not on Facebook, where Sugar’s colleagues will see it, lest the idea of her taking time off in, say, February, make another candidate look more appealing. (Her job does not give “paternity” leave — or indeed maternity leave beyond six weeks of disability (stay classy, academia) — but she took unpaid FMLA leave when the Bean was born. Besides giving them invaluable bonding time, the leave was frankly necessary for my health, as I was in no condition to be left alone with an infant, being among other things rather deficient in the hemoglobin department.)

The not-telling has me a little blue, it turns out. I don’t mind waiting a little longer, but I sure hope they hire somebody before February. That concern would not seem silly if you knew how long it’s taken them to schedule interviews. Meanwhile, why does a group email seem so much more intrusive than a social media announcement? Thank heavens for you all.

(Speaking of, have I mentioned how over the moon I am to be pregnant at the same time as our beloved May? I am in danger of leaving orbit.)

Meanwhile, the nuchal. It went well! Despite my anxiety-fueled delusions of intuition, risks of trisomy 13, 18, and 21 are as low as the statisticians are willing to concede. (I gather that in some circles it is poor form to admit happiness at this news, but I am not in those circles. I would not bear a grudge against anyone happy to find she didn’t have the diseases I have, for one thing. For another, my father’s line of work leaves me without certain protective illusions.) Because I was too deep in denial to schedule childcare and because the timing of the appointment interfered with prime toddler napping hours, the Bean joined us. He was not exactly an advertisement for bringing a toddler to such an event, but with Sugar there to wrangle his truck beads, he did okay. We have not, to answer gwinne’s long-ago question, told him the score, but he clearly suspects something, though I don’t know what. There have been several pointed questions lately along the lines of, “What’s in YOUR belly?” (I equivocate. “Lots of amazing things, just like in your belly.” “My belly!!!” Fin.)

We had the same super-nice doctor go over the results as last time. His southernness relaxes me. I find myself stifling the thought that if only I did have a high-risk pregnancy, I could see him. We talked for a while about my peculiar mix of normal and anomalous reproductive anatomy, and get this, he actually apologized at one point for asking too many personal questions! I told him that particular bar had been set rather low by the doctor who invited his receptionist in to see my vaginal septum, and he appreciated my stories about the look on the same doctor’s face when, after he told a fully-clothed me he was sure I didn’t have a septum, I replied, “I can put two fingers inside and they don’t touch.” (This diagnosis is not rocket science. Necessary equipment is two fingers and a functioning brain.)

ANYWAY, this doctor, who is not a condescending nitwit, delivered the happy news that not only were the ultrasound findings good, but this time, in contrast to last time, my blood count numbers were also all good. I find it cheering that my body or the placenta or whatever is in charge of whatever PAPP-A even is, is doing so much better this time (to the tune of about 85 percentiles higher than last time). Low PAPP-A is associated with a host of unpleasantries I was watched closely for last time, including pre-eclampsia and also IUGR, pre-term labor, and placental insufficiency, all of which also go along with mullerian anomalies.

I asked whether I should still be considered at increased risk for the MA complications, or whether my delivery of a normal-weight, full-term baby (albeit one at the low end of normal on both counts) meant my future risk was lower than MA baseline. I was pleased by the caution of his answer, which amounts to that it would mean that, if I had a more typical MA combination, but that my rara avis status means that there are no relevant statistics. (I found one case report of someone like me in the journals I searched, and the dominant theory of fetal development says I am impossible.). He is therefore recommending to my OB practice that I still have cervix-length checks and regular growth scans. I know some people find that sort of thing intrusive, but I find it very reassuring. Meanwhile, in a surprisingly decent move on my psyche’s part, I simultaneously feel much more confident than last time that things will work out, because they did once.

Yeah, I don’t know who I am anymore, either.

I am supposed to be using my time away from the house to work on another writing project, so I will have to tell you about the midwife at the OB office another time. Meanwhile, a picture, because pictures!

12 weeks 1 day

ETA: I just realized these aren’t even items. You must feel so cheated!


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It’s Alive!

That’s about what I have the wherewithal for at the moment. It seems that I don’t respond any better to having blood drawn on an empty stomach than I ever did. But that’s the important part, anyway.

Thank you for all the hand-holding. I can’t tell you how it helped me. A very great deal.

Our wonderful friends insisted on taking the Bean after all, and he clearly had a great time, including his first non-mom co-bathing experience. I wish I could have been there — they are a very appealing pair — but I suppose it’s good for him to have some adventures without me. Even if they are adorable adventures.

I was quite taken aback when I came into the office, as it has been severely renovated since my last visit, to the extent of replacing most of the drippier naked lady paintings with aggressively green poppy wallpaper and adding an additional floor. Then came all the rigmarole about being out of my insurance network, the end result of which was my charging an astronomical amount to my credit card, 80% of which I very much hope will be coming back to me (although even 20% is significant). I have made peace within myself about this problem, but lord if every new receptionist and billing person doesn’t have to process with me about it.

The doctor was nice enough. I’m not sure I love her, but that is more a once-burned situation than anything I can pin on her. I imagine I will come to like her fine. She said the right things and didn’t rush us, she just also didn’t emote at me the way my main doctor here did when I told her about my adventures with Dr. Russian. On the other hand, I also wasn’t crying, shaking, or refusing to make eye contact. So her response was fine for the situation. Sugar does not seem concerned, and she is a better judge of this sort of thing.

The blood draw was for the nuchal business, which is coming up very soon. That scan will be at the high-risk place with the fancy machine. Assuming all goes well (and I am too relieved right now not to enjoy that assumption for a bit), perhaps we will get a better picture than today’s. Well, maybe better isn’t the word. Limb-ier. The critter does seem to have limbs and even to be able to wave them about, but that view was not committed to ink and paper. I suppose we will just have to actually remember it, imagine that.

PicsArt.com


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All’s Well

Dateline: Northeast Corridor, aboard Amtrak regional train.

The Bean and I are presently riding the rails southwards, which means, yes, the “where’s embryo?” scan went well. Three cheers for that! It was indeed to early for a heartbeat, but we saw a sac with a little yolk sac in it, in my uterus. “With numbers like these, where else would it be?” Asked Dr. Paternalistic. I know he is right, but I have had too many friends have ectopic pregnancies to truly believe they are as rare as the statistics say.

Yes, Dr. Paternalistic did the scan. I did ask a nurse if we could have someone else, but no dice. He was fine this time, which almost irritates me, since Sugar cannot therefore back me up about his ickiness. Well, he did awkwardly rip the ultrasound pictures out of the printer while still holding the probe in me, which was unsettlingly jiggly, but I think he was just eager to give us a picture. Here it is, by the way:

PicsArt.com

Not as good a picture as if I’d scanned it, but there really is not much to see. And this way you get verisimilitude!

So. Off we go on our adventures. I am requested to organize a progesterone blood test while in Little Rock, but that’s it. No ultrasounds, for instance, until July 15th at the OB’s. A month! And no one seems to have any problem with that! It’s like being a fertile person, except for the huge amount of luggage space devoted to crinone.


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Interim Items

Gosh, internets, thank you for all the love and enthusiasm. Warms the cockles, I tell you what.

I keep thinking I’ll pull together the mental wherewithal to organize a proper post, but I’ve been spending all my wherewithal talking to insurance companies and billing offices. Herewith, the Insurance Items:

Background Item: Since the Bean was born, I have been on Sugar’s health insurance (Aetna), first because I wasn’t working and then because I wasn’t working in the right place to have my own. However, that insurance doesn’t have the kind of gold-plated fertility coverage I require, so this spring I accepted two night classes with a wretched commute in order to return to my old insurance (Empire Plan) long enough for an FET or two. This coverage ends in late August, at which point I will be back on Sugar’s plan.

Item: I screwed my courage but good and called the office of the nice OB — you know, the one who said four hours of pushing didn’t mean I wasn’t trying and used the word “horrified” more than once as I quivered on her exam table, trying to explain why coming in for a Pap smear had me so anxious. I like her a good deal and trust her about as much as I’m currently able to trust any member of her profession (midwives included, I’m afraid), and even so, I was quite dizzy with nerves as I waited on hold. (This bodes well for the coming months, eh?) I finally made it out of the holding tank and then through the nine million questions necessary to schedule early pregnancy appointments (knock wood, practice belief, knock wood), at which I point I casually mentioned that my insurance had changed since my last visit.

Guess who doesn’t take my current insurance, only six or so plans with remarkably similar names?

Cue panic attack.

After a lot of phone calls and mental math, I decided that the cost of seeing the good practice for a couple of out-of-network visits before returning to their accepted Aetna plan (three, I’m guessing) is lower than the cost of patching my mental health back together if I have to find a new practice, even just for a couple of months. I have a few hundred dollars of deductible to cover, after which my insurance will pay 80% of “reasonable and customary” charges; someone from billing is supposed to call me back this week, but she sounded like she thought they would likely work with me to charge amounts my insurance finds acceptable. This will still end up costing us quite a bit more than seeing someone in network, but therapy ain’t free, either. Especially at a time when I can’t avail myself of the kind sold in fifths of a gallon.

And anyway, that deductible has nearly take care of itself already, because…

Item: I am suddenly outside the bounds of my coverage at the Baby Factory, despite not being released as a patient yet.

My insurance considers the Baby Factory in-network for fertility care only, not for pregnancy care. This seems like no big deal, since the Baby Factory doesn’t do OB, but it did cause me some stress three years ago, when I started bleeding after they had released me but before I’d found an OB. At that point, Empire Plan considered a heartbeat on ultrasound as the boundary between fertility and obstetrics; I had a first beta, a second one week later, saw a heartbeat two weeks after that, and was sent on my way. It all seemed perfectly reasonable. We know too well that a positive first beta does not mean a Real Live Baby, but the rate of miscarriage drops significantly after a heartbeat.

Imagine my surprise, then, when having been relieved of yet another vial of blood this Sunday, I was handed a bill for the second beta (and progesterone and estradiol just for fun, I guess), to the tune of $300 and change. We can send it out to a lab your insurance pays for, said the lady in billing, but you won’t get results quickly. My cheapness fought my anxiety; cheapness is strong, but anxiety has throwing stars. So even though I had a sinking suspicion I wasn’t pregnant anymore, I decided to bet on good fortune and pay the bill, hoping that money would count against the deductible I’d spend at the OB’s anyway, assuming I got there.

So far, so good. Which brings us to…

Item: Ultrasound.

My father’s family has been going to this particular place on the shore of Lake Superior for a bit more than hundred years; there’s a gathering of cousins there planned for the end of June. We go there rarely, and I so want the Bean to see it. It is so beautiful, I won’t even pretend to do it justice in a rushed blog post except to say that it is what I picture when I think about heaven. And I’m not really a cold weather girl. It is also quite remote. The only telephone is several miles from where the cabins are; the nearest hospital certainly over an hour. It is sublime, but it would be a hell of a place to have an ectopic rupture.

I asked Dr. BF back in March what he thought of our going the on the heels of a May cycle. As long as your betas are unambiguous, he said. If they look potentially ectopic, I might have to tell you to stay home. Fair enough, I agreed. Just because this place is like heaven doesn’t mean I want to die there.

All this time, I’ve been refusing to quite believe that this trip will happen as planned, but the plan is to leave on Friday. (We are going to a wedding in DC, then to Sugar’s parents’ in lower Michigan, then to the UP, then home (Sugar) and Arkansas (the Bean and me, to see my mother). It’s quite the odyssey, even by our standards.) So after the first beta, I called Dr. BF to remind him of our deal, and that this means we will not be in town for their preferred viability ultrasound at something like 10 days past the second beta.

“You’re leaving Friday? Just come in Thursday morning for a scan. We won’t be able to see much, but as long as we can see something in your uterus, you can go.”

The first problem with this plan is the “Thursday” part. Thursday is Dr. Paternalistic’s shift. I do not want to get bad news from his mouth. I’m not even sure he’s capable of giving me good news without being an ass. But all my scheming about whether I could convince a babysitter to wait in a playground with the Bean (and our luggage?) so that I could go on Friday instead, on our way to the train (pause to appreciate the crazy scheme), was displaced on Sunday by fretting over the cost of the ultrasound without insurance. (Both, of course, a form of distraction from the more obvious anxieties attending such a scan.)

Happily, many phone calls later, it transpires that the prices of everything except the progesterone test are within the bounds of “reasonable and customary.” I confess shock that the blood tests are, frankly, and suspect this has less to do with chemistry than lab monopolies, but whatever, not my (immediate, individual) problem.

Item: The plan. Scan Thursday, very early so that Sugar can come before work. Probably too early to see a heartbeat, so we’ll try not to think about that part. I will see if I can sweet talk a nurse into jiggering the schedule so that we get the fellow I like instead of Dr. Paternalistic. If not, I guess I’ll live. On the other hand, this might be my last chance to kick him from the stirrups….

Item: this post is absurdly long. Sorry.

Item: I think that today I entered the part of pregnancy when I can’t have coffee anymore without feeling really sick. This lasted for the duration last time, and boy, is caffeine a more important part of my life with an early-rising toddler than it was pre-Bean.

Item: This morning also marked the first convincing nausea of this process (doxycycline excepted). Not so bad, as these things go, but still not my favorite.

Item: I’m not sure if this quite rises to the level of a craving yet, but holy Moses, is beef all I want to eat in the whole world. I could have wept for joy at the sight of hamburgers grilling at Sunday’s pool party.

Item: this post is absurdly unstructured. Sorry.

Item: I will leave you with some Bean cultural anthropology, inspired by his asking after the whereabouts of our local ice cream truck at six or seven on Saturday morning:

ME: Many people do not consider ice cream a breakfast food.

BEAN (thoughtful, serious): Maybe some do.

(And then, in the spirit of self-fulfilling prophecy, he fell backwards off a picnic bench while we were out to brunch with a friend, smacked his head on the concrete patio, acquiring in the process a magnificent goose egg and a free gelato from a sympathetic waiter. How is it so many people survive being toddlers?)


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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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Notes from Week 36

Item: Thank you for the nice comments on Sugar’s painting. The likeness is a tad off, but the boobs are exactly accurate. Um, Sugar? My face is up here.

Item: We had our last growth scan on Monday, and all is well. As Sweet Sonographer covered my midriff (sounds too cute…mid-raft?) with icy glop, I said lightly that she ought to make them buy her a fancy glop-warmer, like they have over at the high-risk place down the block. “Oh, I do have one. It’s over on the counter.”

I still love Sweet Sonographer, and it was cute that she tried so hard to find something adorable for us to see at this scan (we settled for hiccups, since the Bean’s face/dragon snout was obscured by its low position in my pelvis), but I must admit that her halo is a bit tarnished by this revelation.

Item: According to the u/s, which I understand has a remarkably enormous margin of error, the Bean weighs in at a respectable 5lbs. 7oz. at 36 weeks, which means it’s been listening to my chanting “over 6, under 9” at it. Good Bean.

Item: It has recently come to my attention that “0-3 month” size clothes (of which we have a respectable number) are not the same as “newborn” size clothes (of which we have none). What the hell is 0 months if not newborn? Do we need newborn clothes? How in the hell is a person supposed to figure these things out, anyway? And what hope have I of managing the actual work of raising not killing a baby if my limited brain power is being wasted on stupid clothing sizes?

Item: Thanks to Schroedinger, there are at least some diapers in the house. Lord knows if they’re the right size, but diapers I know where to buy.

Item: Group B Strep test was also Monday. The GBS test involves a vaginal and anal “swab,” which caused me much worry on Sunday, as Sugar had celebrated Valentine’s Day early by giving me the GI bug she’d had on Saturday. (Sub-Item 1: despite what you may have assumed, bouts of diarrhea are emphatically not improved by having someone kick at your intestines throughout. Sub-Item 2: Nor by things-we-are-not-calling-hemorrhoids.) I needn’t have worried. I scarcely noticed the butt part, so distracting was the vaginal aspect. “Swab” might be better described as “vigorous scrubbing with what appears to be an old mascara brush.” “Just wait until the cervix checks,” said Dr. Russian, with an evil grin.

Item: Dr. Russian loves shoes. On Monday, she was wearing black patent leather platform stilettos with wide ankle straps. They did complement the mood, I must say.

Item: I will not be in pretty shoes any time soon, as it’s all I can do to waddle around in clogs. Speak to me not of stairs, either. I am even taking what elevators (not enough!) exist in subway stations, despite the aromas inherent in that process. Today, an old lady cut me in line for one, forcing me to wait for the next round. It was a blatant cut, too, no simple misunderstanding. Those hooligans think they can do whatever they please, all tricked out and speedy with their canes.