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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A Confession, A Rant, and The Rest

I keep thinking that if I wait, all these things in my head will coalesce into a real post, but it isn’t happening. So here comes a big mess. If you’d prefer not to see a bunch of mental clutter, here is an alternate post for you:

What should we be registering for that we’ve forgotten? Discuss.

Still here?

Okay then.

First, the confession part. It concerns birth stories. Yours and yours and yours and probably yours, too. Your amazing, beautiful, dramatic, powerful birth stories that you put so much care into and that I never comment on, even though I read them again and again and again. Even though I can see page after page of comments making it perfectly clear that all I have to do is say, “Amazing! Beautiful! Congratulations! Thank you!” and my work will be done, I don’t write a thing and (if you think about it at all) you must assume I don’t read them, since half the time I’m writing a novel in your comment box. I hope that doesn’t hurt your feelings.

The truth is that I don’t comment because your stories scare the ever-loving crap out of me. Half the time I have to have a little meltdown after reading them. The other half the time, I have the meltdown while reading them, to save time. I know enough to know that I shouldn’t say *that* in your comment box — I am hopelessly self-centered, but I am aware, in a conceptual way, of manners — and for some reason I can’t bring myself to say anything else.

So now you know. I read your story — and yours and yours and yours — probably more than once. And I was glad it was there to read, because I am an emotional over-packer, and I know that stories help me. So please accept my inadequate thanks for writing yours.

Two, the rant part.

Dr. Sears, please go fuck yourself sideways on something pointy.

Ahem.

Maybe I should start by talking about Wednesday’s birth class instead. This week was “Interventions and Things that Can Go Wrong,” and I have never been happier that we picked this class over the others we were considering. Although most of the class (at least the ones that talk about it) seem to be planning for unmedicated births — at least half of them in the local birth center rather than a hospital — and although the previous three classes have been all about non-medical ways to deal with contractions and so forth, both teachers were calm and even-handed when talking about monitors and epidurals and all that. One even went so far as to suggest that even though lots of people love The Business of Being Born, that possibly it had gone a tad far in its excoriation of pitocin. [Holy Moly — I just went to youtube and watched that part, since I’ve never seen the movie. Heart now racing. Talk about your scare tactics! What the hell is up with that cartoon?] Our favorite teacher talked about a patient of hers who had apologized to her when requesting an epidural and told us in no uncertain terms that she did not disapprove of that decision. The only editorializing — and it was announced as such — was a plea to please not ask for an induction for a frivolous reason, which seems pretty sound.

When we were shopping around for birth classes, I wrote to various teachers and explained that, due to the double-cervix situation, I am at a higher-than-average risk of needing a c-section, and that it was important to me not to set myself up to think of a vaginal birth as successful and a c-section as a failure. One of the major reasons we chose this class is because I felt good about the teacher’s response, and last night bore that out. The whole course has been about letting your body do its thing, asking doctors and midwives for all the options, etc. Our classmates are not the elective c-section type — if they were, they wouldn’t be in this particular class. But who can predict what will happen in labor? I loved that the screen of notes on c-sections began with “C-Section: An amazing, life-saving procedure” (or words to that effect).

None of that stopped me from weeping through the discussion of how emergency c-sections worked, of course. Possibly I have a little hangover from all the furious speed of egg retrieval day. We learned that, in the event of an emergency, the surgical team would work efficiently and fast, “just like NASCAR.” I can only hope the OR isn’t covered in logos for Laughing Clown Malt Liquor.

The whole evening, I was impressed with how calm and open the teachers were, talking about things that probably weren’t on their ideal birth list when they decided to become midwives. I’m sure they knew that the Other Pregnant Lesbian and I have been comparing notes on epidural policies at the hospital we’re both going to, because I have a nasty habit of being that person still shouting as the room goes quiet after break, but neither had anything especially bad to say about epidurals during that section of the class. They passed around an epidural catheter so we could see how slender it is and explained how to keep changing positions even with one in. It’s almost as if they meant it when their response to my email said their goal was,

“to offer childbirth education that focuses on making your birth experience a satisfying and joyful entrance into parenthood, no matter what twists and turns and challenges you face, no matter what your personal desires and goals.”

Go figure.

And then there’s Dr. Sears.

An old friend sent us a box of baby-related hand-me-downs recently, including the Sears’ Pregnancy and Birth books. I tend to agree with Dr. Sears on about 80-90% of things, and find the other 10-20% hopelessly nutso, but I decided to take a look. In a bookshop, early in the pregnancy, I’d been very impressed with how calmly and thoroughly he dealt with first trimester bleeding — most books just say “well, it might not be a miscarriage, but PROBABLY IT IS” which is silly considering how common it is — and rather turned off by his section on weight gain, which took the usual tack of assuming you are just itching for an excuse to become morbidly obese and added the nicely tuned guilt trip of “plus you are making your baby fat, you lazy cow.” But free is free, so what the heck. I turned to the birth stories section.

The stories themselves are what they are. Only one of them makes me actively gaggy. It is an induction story, and the second paragraph begins, “Dad likes having a baby this way.” (I’m all for having both partners involved and everything, but I’ve already told Sugar that any statements like that of the father Dr. Sears praises for saying “we had a vaginal exam” are…unwelcome. Unless she’s up for hopping in the stirrups alongside me for moral support.) Okay, I also want to do a consciousness-raising session with the author of “I Witnessed Myself Become A Woman — VBAC Water Birth,” but whatever.

Dr. Sears is a proponent of “natural” childbirth, by which he means no drugs. (I hate that term, personally — it’s a bit of an emotionally loaded dichotomy for my taste — but whatever.) I’m a proponent of letting women decide for themselves what they do and don’t want to be part of their birth. This is where we diverge. I expected that, but I didn’t expect quite the level of paternalistic bullshit found in the commentary on the birth story of the Woman Who Dared Ask For An Epidural.

“A Medically Managed Birth” is about a woman whose doctor tells her to go the hospital when her water breaks. Ten hours later, she gets some pitocin. Some time after that, things get intense and painful, and she starts to feel hopeless. She can’t concentrate on the baby, only the next contraction. She requests and gets an epidural, feels confident again, promptly dilates to 10, pushes the baby out — able to concentrate on it again, rather than pain — and feels happy about it.

How dare she! Incredulous, Dr. Sears, et al., “interviewed her about whether or not this style of birth [“American”] left her “less fulfilled” as a woman.” Rude much? She says no, on the contrary, she feels great about it. “

There was no doubt in her mind that she gave birth, and the fact that she didn’t experience the intense sensation of a drug-free birth did not lessen her fulfillment.”

Mother gives birth to healthy baby, isn’t hung up about it; everybody wins, right? Wrong. Dr. Sears goes on to remind us that she didn’t have the chance to have natural, gradual contractions — okay, fair enough. Everyone says pitocin sucks like that. It’s the closing that pisses me off:

“We wonder whether her Lamaze instructor mentioned the importance of taking the contractions one at a time […] thinking of the baby, not the next contraction.”

I’m going to go out on a limb and guess the instructor did mention that, since the mother mentions the loss of her ability to do that after…chronology is a little unclear, but at least 12 hours, probably quite a bit longer. Maybe, just maybe, she was trying to do that and it was too damn hard. So she should have what, tried harder? What is the big fucking problem with an adult making a decision to use a very safe drug to lessen pain? Labor pain may be “pain with a purpose” or whatever, but so is the pain of passing a kidney stone, and no one talks about how virtuous people enjoy that.

I in no way mean to denigrate women who choose to give birth without painkillers. I really, really don’t. But I think that the important thing is that the laboring woman — not some moralizing jackass judging her story later — makes that decision. There’s so much B.S. out there about epidurals — most of which was either never true or hasn’t been true in 25 years — that the last thing I consider acceptable is telling a woman with no negative feelings about how her birth went down that she should feel bad.

You are all such clever people that you no doubt figured out 20,000 words ago what this post is really about: my fear that you’ll think less of me if/when I get an epidural. Even that “if” was a pretty big lie — birth is unpredictable, but the epi is in the plan, for sure. I’ve done my research, and I feel good about it from a scientific perspective: one reason I’m happy we’re going to Kips Bay Mega Hospital is that their epi policies are excellent. (OB anesthesiologist on 24/7. Standard use is light-dose, patient-controlled, which all the studies agree is the way to go in terms of pain relief and side effects if you have the staff. The intent at least is to keep the dose light enough that patients can go to the bathroom themselves. No “window” — you can have one whenever you want and the OB thinks is okay; Dr. Russian says I can have one now as far as she’s concerned.) If the cervices don’t behave and I need a c-section, I’d just as soon already have the epi in, and if not, I’d rather not be feeling every bit of my septum breaking, which it may well. Even without those special circumstances, useful as they are for shutting down any “your birth will be fine because mine was” stuff, I think I’d be leaning this way. I’ve experienced plenty of severe pain in my life, what with the migraines and the endo/GI situation, and I haven’t noticed anyone giving me a medal for the times I’ve done so without painkillers. Other people have had worse pain than I have and make other decisions; that’s okay. I’m okay with being a wimp on this one…

…as long as y’all will still be friends with me.


22 Comments

It’s time

I’ve been in stirrups so many times in the past week that I’ve started wearing skirts to the clinic, just to save the trouble of taking my pants on and off. I take my shoes off anyway, because not doing so seems somehow inappropriate, even though there’s no real need.

I went into the Baby Factory for blood work and ultrasound this morning, as I have for the past seven consecutive days. First stop: blood draw room. There are lots of nurses, most wonderful, and I hadn’t had this one before. She said something sympathetic about how much time I’ve been spending there — both arms are pretty bruised at this point — and I said I didn’t mind, that I appreciated being watched so closely, that it helps me worry less. And anyway, I like having more data.
Oh, she asked, do you work in medicine?
This question comes up a lot. I don’t work in medicine, but I was raised by two doctors in an area where hospitals and labs are major employers. Medicine is my mother tongue.
So I told her no, that my parents were doctors, though. And then she said what easily fifty percent of people do after that revelation:
“Aren’t they disappointed that you’re not a doctor?”
Now I ask you, what kind of small talk is that? To tell you the truth, I’m not entirely convinced they’re not disappointed, though they never say so. Heck, sometimes I’m disappointed in myself for not being a doctor — I’m pretty sure I’d be good at it — and I never wanted to be one. But is this really a conversation I need to have with a stranger first thing in the morning? Public Service Announcement: If you find yourself about to ask someone who is not a very close friend whether her parents are disappointed in her, JUST DON’T.
Onward to ultrasound.
At the Baby Factory, all IVF patients on a given day are seen by the same doctor, no matter who your regular doctor is. Each day of the week has a doctor assigned to it; Dr. Baby Factory, for instance, is Dr. Monday. Ultrasounds are done by one of a trio of lovely fellows — all women, just to complicate the nomenclature — or by the doc of the day. Today I met Dr. Thursday, a jovial, paternalistic jackass.
First of all, I appreciate it when folks introduce themselves before sticking anything up my privates. Call it a quirk of my Southern upbringing. Second, when I tell you, since I’m not counting on your having read the details of my chart, that I have a vaginal septum and that you should aim to the right with that dildocam, the preferred response is, “thank you for telling me.” Not:
“Why didn’t somebody take that out?”
Luckily, my pre-cycle anxiety dreams had prepared me for this moment (only with more knives), so instead of blubbering I managed,
“Because it belongs to me.”
The examine continued in that vein. Dr. Thursday is the only one of the docs I’ve seen who didn’t adjust the u/s screen so I could see it, and I bet he wouldn’t have told me the follicle measurements I’d asked for if he hadn’t had to call them out to the resident in the corner. He ended the session with a pat on my knee and a “Good job” that made me feel like livestock.
So now I know why they want you barefoot in the stirrups: a kick to the face is bound to hurt less that way.
ONWARD.
I am triggering tonight. Ten minutes to midnight, which my sweet, strictly diurnal Sugar is bound to hate. I’m nervous as heck about the shot and mostly about the retrieval and continue to appreciate your reassurances and general support.
Biggest follicle is about 19.5 mm. Dr. Thursday said about 10 on each side. So now I’m nervous about OHSS, too. E2 is 3364. Talked to Dr. Baby Factory, and he sounds a little nervous, too, but not nervous enough to have me trigger with Lupron. So I guess we just hope for the best and stock up on gatorade.
Retrieval is Saturday.
Which means a 5-day transfer would fall on…Dr. Thursday’s shift. Awesome Sauce.


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Memorial Day

Hello, internets. Welcome back — physically, mentally, whatever — from the holiday weekend.

Sugar and I took a last-minute trip to New Hampshire with Womb Buddy, stayed in the 200-year-old house she moved to after leaving our hometown when we were both little. I visited in the summers for a few years, sliding in the swimming hole under the covered bridge, getting locked in a horse stall full of kittens, and generally living the country life, oblivious to the fact that W.B.’s parents’ marriage was collapsing. (The packet of old photos I found at my parents’ house this Christmas suggests I was oblivious to everything except kittens. One picture of a person in the whole batch: a fuzzy me, holding a kitten.) Until last summer, I’d never been back, though I picture the house and its yard whenever I read Madeline L’Engle’s Wrinkle In Time books, remembering lying on the glacier-scraped granite outcropping to watch the sky as Meg lies on the stargazing rock.

The house is different in some ways, despite its familiar creaking floorboards and narrow stairs. Parts have been remodeled, and its denizens now include W.B.’s step-mother and step-siblings. But the town is old and small and slow to change. There is still no mail delivery to houses, no stop light, no noise or light at night. Its valley of green fields and shuttered houses is still watched over by blue mountains, the postcard-perfect New England town.

On Monday, we walked down the road to visit a woman we met last year, who with her son raises alpacas and shetland sheep for wool. Last year, her fluffy tom cat herded geese away from us as we walked the road towards the swimming hole, and she insisted on taking us out back to meet the animals. We loved it, of course. She’s a single mom, and she explained that this is an inexpensive way for her to keep her son close — the animals themselves were gifts from 4-H. We wondered, a year later, if they’d still be at it, if her son ever was as invested as she, if he might have grown older and started racing dirt bikes or chasing girls.

Thumper and the Bug
W.B. and Thumper, July 2009

We found the shepherdess at work in her front garden, spending her birthday putting in new perennials. She was happy to see us and happier still to usher us back to the barn and pastures, where her son showed off two-day-old lambs with evident pride. The alpacas were overdue for a visit from the shearer, who is behind in his work. Our favorite ram, Thumper, died of bloat over the winter, but nevertheless, the little farm carries on.


Mostly, he looked happier than this, but I chose this picture because OMG I AM HOLDING A LAMB!

We continued down the road, over the covered bridge, and into the old part of the cemetery, where flags marked graves of those who served in wars all the way back to the Revolutionary.

Mill Cemetery, Meriden, NH

The cemetery is beautiful, shaded by ancient maples, in sight of lupin-covered hillsides. It is not so hard to think of spending eternity on the high banks of the fast river there, visited by hikers on their way down from the mountain behind it. We hiked there this weekend, as most of those buried here must have at one point or other. The forest shifts from dark hemlock to brighter groves of beech and maple. Where sun creeps through, forget-me-nots cluster around the path. From the bald on top, you can survey the valley.

View from French's Ledges

Hiking in the eastern mountains this time of year always makes me think of a college housemate of mine, who hiked the Appalachian Trail the summer after she graduated. I remember how excited she was for the trip, and also the quiet confidence that ran under her talking about it, the knowledge that she had the skills for the trip but also the right mindset, that she knew well how to break big projects into steady, determined days.

That attitude was typical of Roselle. She was so steady in every way, like a sturdy tree you know will always be there to be counted on. She was pre-med, and it was clear that she excelled in school not by lucky flashes of brilliance punctuating long weeks of sloth but by day after day of orderly studying. She got her work done without panic, and yet never shook her head over those of us who were grasshoppers to her ant when it came to laying up stores against the coming winters of exams and final projects. Her professors noticed, too:

“Roselle was smarter and more capable than the rest of us, and she held an almost tender benevolence toward others. She did not ask anyone else to work to the high standards she herself was working to achieve. ”

Tender is the word exactly. She paid attention to you in such a quiet way that you could easily miss it, until you sat with her at dinner and discovered she remembered everything about that play you were in, that joke you told once. When I watered her plants while she flew to Texas for a med school interview, she brought me back a packet of bluebell seeds, having remembered a small picture of a blue-blooming field I’d had up on my wall.

If Roselle was a more diligent student than most of us, she seemed thrilled with the clownish ways we were different from her. If I close my eyes, I can hear her sudden, full-throated laugh, surprised at whatever we living room layabouts had invented to amuse ourselves while she studied in the dining room, somehow untroubled by the cacophony we regularly raised. And we all loved her. Of all the women I lived with those four years, Roselle is the only one I can think of no one’s complaints about (unless you count her old roommate’s assertion that she closed her dresser drawers too loudly in the early mornings). There simply wasn’t anything to complain about.

Roselle died in Iraq in 2007. She was an Army doctor, and had volunteered for overseas duty because others in her group had small children. She was by all accounts tender and devoted as ever.

The news of her death was a shock. When another housemate forwarded me the email she’d received, I thought the dead Smithie in the subject line must be Madeline L’Engle, who died close to the same time. I didn’t expect it to be someone I really knew — but why not? Exactly how naive am I, that I expected to go without losing a friend with our country at war for so long? Did I think that the pins I’d worn (paltry activism), the letters I’d written (never enough) would somehow protect me? Did I think this was all just an intellectual debate? (Answer: of course not. Knowing how our volunteer army works, I instead counted on my race and class to insulate me.)

Soon, nausea set in. The Army would not release the details of Roselle’s death, only that she’d died in Kirkuk not long after arriving there with her unit, that her death was not combat-related. Another soldier in her unit, a man, died the same day. I hate what I know of what women are too often subject to in our military. I hate that they are often raped, hurt, killed by their fellow soldiers, that the military doesn’t seem to care enough rid itself of its old habits of misogyny (that seems too weak a word). Rape is twice as common in the military as in civilian life, a statistic all the more disgusting because the Army purports to teach unit cohesion, to protect one another. I hate that the only big name who ever seems to talk about this publicly, to admit that it exists, that it’s not just isolated incident after isolated incident, is Garry Trudeau. Shouldn’t we be reading about this outside of the comics section?

I didn’t know that’s what happened to Roselle, of course. I knew it could have been anything. A munitions accident in a warehouse somewhere. A car crash. A fall down a flight of stairs. But knowing that it was far from outlandish to imagine her attacked by a comrade is unacceptable.

The Army has since released its report. They say that she was overwhelmed, unprepared. That a senior officer berated her, that she told a fellow officer that she couldn’t do it anymore. That she returned to her barracks and shot herself.

I can’t tell you how difficult I find it to square this story with the Roselle I knew, who seems just like the one described by medical school classmates and hospital colleagues who wrote messages of condolence after she died. Yes, I know that suicide is often an impulsive act, that there is no “type” of person who attempts it, that it can happen out of the blue. Maybe she was sent overseas without proper training, a less awful negligence on the Army’s behalf. Maybe she was that thrown by whatever was said to her, though that’s hard to imagine. I keep trying to build a version of Roselle in my head that allows me to believe this story, but it hasn’t worked yet.

Instead, I am left with doubt and with anger at an Army that promises to take care of its own. At an Army I can’t trust to tell the truth, when it has tried so hard to cover up or ignore other problems. At a war we had no business starting, made possible by jingoism and racism and calculated lies. It’s not politic, I realize, to say such things on Memorial Day. We are to wave the flag and believe sacrifice makes every cause noble. We are to “Support the Troops,” which means ignoring the kinds of support the troops may actually need, if the real circumstances of their service don’t lend themselves to blockbuster movies. But Roselle didn’t heroically give her life to keep us free and I refuse to forget her that way.

We college housemates, classmates, teammates, and friends of Roselle pooled money to have a tree planted on campus in her honor, a Cladrastis lutea “Rosea” — pink-flowered Yellowwood. Sugar and I saw the young tree this month, growing on the street where we all lived together. It takes several years to begin blooming, but when it does, it sends out surprising, wisteria-like clusters of pink. I hope it will stand watch on our street for many years, steady and lovely and sometimes laughing with flowers.


Thanks to Tom Gill for the picture of a blooming Yellowwood.

Pictures of Roselle’s tree are up here.


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Best Planned Lays

This isn’t going to be one of those well-made blog posts. This is one of those pissy lists. BUT: Before the ranting commences, Hello and Thanks for dropping by! to everyone, but especially to those of you directed here by the lesbian-lovin’ Kymberli. It’s a pleasure having you. If any of the rest of you don’t read Kymberli’s blog, you should certainly head over to read today’s tale of accidental head-shaving.

1. LH surge: I can has one, pls? Still spending my days with legs crossed, still but the palest of lines on the OPK. Not yet out of bounds for my longest cycles, but getting close. Am secretly convinced I don’t make LH.

2. Farewell, Mr. NMEBSI? It turns out he wasn’t screened for a genetic disorder that I only just now got tested for. I won’t know my results for at least another month or so. I had thought that no donors had been screened (so my own results would only be to help us decide about prenatal testing), but it turns out that some have. So we will choose a screened donor for September, at least, and maybe beyond (depending on my results).

(If you think I’m being over-cautious, please keep in mind that my father is a pediatric geneticist, who treats very small, very sick kids. This disorder is common, and although my parents raised me to be independent, he all but asked me to get tested.)

We were pretty upset about this, but we’ve since found some screened donors who also seem like good choices. Which means we have plenty of energy left to be upset that…

3. Dr. Baby Factory will not waive the $450 counseling session, nor will he allow us to see a counselor outside of the practice (who might take our insurance or just charge a little less than $9/minute). There are so many reasons this enrages me (and fills me with hopeless despair, but the anger is more interesting, I imagine) that it’s hard to keep them all straight in my mind. I’ll limit my rant to three. I’m realizing that they mostly come down not to the refusal to waive the counseling but to how it’s been talked about.

a. There’s equal ≠ fair aspect to the whole thing — Dr. Baby Factory cannot or will not (as I find white men of privilege generally can’t or won’t) wrap his mind around the idea that treating all couples using donor-whatever in the same way may be equal but it isn’t fair, in the sense that it is willfully blind to what brings each couple to this place. The best I can come up with is that this is like saying that it’s fair that no employees get Jewish holidays off, when in fact that’s equal but unfair. It bugs me that he won’t acknowledge that our position is different from that of a straight couple using donor-stuff.

b. There’s the giant fuck-you that is their counselors working with NO insurance. I don’t think I’d be half as mad if they worked with some but not ours, though I’d still be pretty tweaked, since we chose this practice because it works with our insurance. But taking no insurance at all? So it’s just an automatic “too bad you aren’t normal” charge? Shitty, shitty, shitty.

c. There’s the way Dr. Baby Factory distinguishes straight couples from us by referring to them as “married”. GAH! I AM TRYING TO BE MARRIED, JERK-FACE. (How I wish we’d already eloped to CT, so I could tell him off properly for that one.)

As I see it, we have three options — but please let me know if you think of any others, wise internet:

1. Suck it up, swallow pride, see if pooped-out pride sells on eBay, and pay for it.
Pros: Path of least resistance (except cost means less sperm means fewer tries before we have to store up money again).
Cons: Money, rage.

2. DIY at home, at least to start. (Assuming Dr. Baby Factory will still sign the home delivery release, as he said he would back at the HSG.) Reevaluate after a month or so.
Pros: No one involved who makes me want to spit nails.
Cons: Lower conception rate than IUI. Inefficient use of money, since we would be buying 2 vials/month and having to get them shipped every month (vs. getting 3 months’ at once and storing at the clinic).

3. Change clinics.
Pros: I have another recommendation that my insurance will cover, with free sperm storage and no seekrit psych fees. Could work on details while trying DIY for a month.
Cons: Starting all over with intake, etc. More prodding of the vages. More theories. Sounds exhausting and like it will take forever.

Stay tuned, internet, to see down which path our heroines next gang agley.