Tuesday, December 30, 2008

Spoke Too Soon (Or, Why My Girl Parts Deserve a Caribbean Vacation)

You know how in my last post I made it sound like the miso*prostol was not as bad as you might think? How it seemed like the process was more or less over and I was feeling relatively fine physically?

When am I going to learn to keep my mouth shut?

Miscarriage is definitely one of those things that you really can't go into detail about in any kind of social situation. Some might call it bathroom talk. So, despite knowing that readers of this blog would have a higher threshold for hearing about it (at this point, it takes a lot to gross me out), I will spare you the specifics. Suffice it to say I've been up all night with some of the worst pain I've ever experienced. I don't even think you can call what I had "cramps" -- I think what I felt was in some sort of new category. And I sincerely feared bleeding to death in my sleep.

I think my reproductive organs have decided to go on strike. They can't take it anymore. And I don't blame them. They deserve a break, and so do I. My husband and I were considering booking a last-minute (warm weather) vacation later this week, but the way things are going it's now out of the question. I feel like crap and I don't want to be far away from doctors and medical facilities that I know and trust.

It's not fair. Such a juvenile, simple-minded protest, but I keep going back to it. It's not fair that my body is doing all of this work to get rid of something dead instead of bringing something to life. It's not fair that this miscarriage is happening in two parts -- the failed pregnancy with no end in sight. It's not fair that my husband and I have this rare and much-needed opportunity to get away and recuperate, but the miscarriage won't let us.

It's not fair. The girl parts and I, we need a break.

Sunday, December 28, 2008

In with the New

Christmas always seems to me a time of renewal. Of course the purest symbolism of the holiday is about hope and better things to come. And I think there's something about bringing in new things that always makes me want to clean out my closets, recycle old magazines, make bags of donations to charity and start fresh. This Christmas, with all of its complication and sadness and upheaval, is no exception. I long for a clean slate, to say goodbye to what's been and look forward to possibilities ahead.

It's been quite a journey from the shock of my first "bad" ultrasound to here. First, I had to endure a second ultrasound to confirm what we already knew. Unfortunately, through this experience I also learned what my due date would have been -- knowledge I had been trying desperately to avoid. I have no need for such a specific trigger for suffering. But now I know, and rather than share it here I am just going to try to commit it to that part of the brain where old algebra equations and what you ate for dinner last Monday go to disappear. Try.

Once we had this confirmation, I realized how ready I was for this process to be over. There was something so deeply sad about feeling pregnancy symptoms because my body still had not clued into the failure of this pregnancy -- and I wanted to release it from its duty as soon as possible. So I called my clinic and asked for the medication they use to enduce miscarriage. I thought they would just call in the prescription to the pharmacy. Not sure why I thought this would be this simple when nothing in this process ever is, but once again I was wrong.

Apparently because the drug is also used for voluntary termination of pregnancy, I had to go in and see a doctor to get it. And because there were no doctors that day at the local clinic where I'm usually seen, I had to go to the big hospital downtown. This created a few problems. One, I had no idea where I was going within the endless halls of that place, since the only other times I've been there were for my retrieval and transfer, in a different wing. So my husband and I proceeded to get very lost. That, combined with my alarm over taking this medication and my empty stomach (note to self: eat lunch before dealing with major life events), led to a massive anxiety attack. I was sure that I would become the first patient to require care in both the IF clinic and the cardiac care unit on the same day. But I recovered with some Sun Chips and deep breaths outside, and after a few minutes felt ready to go back in. When we finally found the right elevator for the clinic, the security guard stopped us. The floors above were on "lockdown," and I overheard his security guard friend on the radio say that someone had a nurse pinned against the wall. Perfect.

Once we were allowed upstairs, after an hour wait we saw a 12-year-old doctor (husband's assessment) for the prescription. I asked a ton of questions, and then waited some more while she went and got another doctor and the printed prescriptions. Apparently, because my doctor wasn't in, one of her senior colleagues was supposed to come in and make sure I wasn't overly depressed or confused or something. Unfortunately, the doctor available to do this was the one in the practice who missed bedside manner training day, and he proceeded to tell me that I still might need a d&c after taking this medicine. Thanks, buddy. That's great news, because clearly I'm looking for all the torture I can get, and more to worry about until then.

The next morning, Christmas Eve, I woke up and, hands shaking, took the miso*prostol, anti-nausea medicine and 800 mg of Motrin and settled in on the couch, prepared for the worst. What started happening six hours later was not pretty or painless, and I definitely wouldn't recommend this drug for recreational use or anything, but for me it turned out to be a very good alternative to surgery (note to anyone considering taking it: DO NOT read the horror stories available out there via Dr. Google). It was more or less over by Christmas morning, and an ultrasound on Friday showed that I'm now clear to just wait for my period to come (I have been assured it will once the hcg drops to zero) or the follow-up visit with my doctor scheduled for Jan. 12, whichever comes first.

There is so much I could say about a Christmas Eve spent on the couch having a medically induced miscarriage while my incredible husband baked pies (yes, you read that right) in the kitchen for my family get-togethers. About the exhausting effort of wearing a brave smile on Christmas so I wouldn't dissolve into a tearful heap over what might have been that day. It was deeply sad and painful in all the ways you can imagine.

But it happened -- for whatever reason, this miscarriage on Christmas has become part of my story -- and somehow, I survived. Crying more tears and feeling more anger over the unfairness of it all will not change this, and though the tears and the anger will still continue to come (they did today with surprising force), my overwhelming desire now is to move forward, out of this time and place. I want to feel hopeful once again that what's ahead is better than what I've left behind. I have to believe that. It's the only way I can keep going.

Thursday, December 18, 2008

A Big Misconception

I got an email from Joe Biden today. Well, me and millions of other people. I was sitting at my desk (Yes, you read that right: my desk. Somehow, for the past two days, I have hauled my sadsack self to the office. I don't know if the effort has been worth it, to be honest. I'm exhausted.) when I noticed the flashing red light of my BlackBerry signaling a new message to my webmail account. Since Monday, whenever that happens it feels like a beam from my own personal lighthouse. A lifeline, a message of comfort from a friend who knows what's going on. Something to hold onto. Something to help me breathe. But when I opened the message, it turned out to be from the VP-elect. The subject? "A Big Misconception."

Indeed.

This week has been like one of those disturbing, vivid dreams where people, places and events that shouldn't go together are suddenly intertwined, nothing makes sense and you can't wait to wake up. Except I can't. I feel doomed to spend the rest of my days in this time and place, mourning something too early to be a real baby but too late to be just another failed cycle. I am a zombie, a shell, a shadow that walks and talks and eats and types but doesn't really register feeling unless I'm crying or talking about my miscarriage.

And yet, it still hasn't really happened. One of the things you do not know until you go through this (because, really, they're not going to describe this to you when they tell you you're pregnant -- although, with miscarriage rates what they are, I'm thinking they'd be better off doing just that) is that the options you have when they discover that your fetus is not developing ("fetal demise" is what the report on the table in front of my doctor on Monday so delicately called it -- one of the many things I am sorry I saw that day) absolutely, horrifically suck. You can either stop your progesterone and wait for it to happen naturally, take a pill that essentially puts you into a violent form of labor to expel the pregnancy or have surgery in which they suck it out of you. Oh yeah, awesome choices. Just the kind of thing I wanted to be weighing this holiday season. Mistletoe, chestnuts roasting on an open fire and how to terminate a non-viable pregnancy.

The problem, I am learning, with conception is that it can end in misconception. And that feels so much heavier to bear, so much harder to ever get over, than no conception at all.

Monday, December 15, 2008

Too Good to Be True

I just knew that if I dared to think for even a second that this might work out, that this positive pregnancy test and good initial scan might lead to a second good ultrasound and -- imagine -- a real live baby, that something would happen to prove that hope foolish. That I would then be left not just with a broken heart, but with a broken heart and vivid images in my head of those moments of hope, doomed to play over and over and over until I feel like I can't breathe.

Today was going to be either one of the best days of my life, or one of the worst. As the ultrasound tech started the scan that would seal the fate of this day and this pregnancy, my heart hammered in my chest and I struggled to catch my breath. I yearned for her to turn the screen toward me, to reassure me that there was a live baby growing in there. But she didn't. I looked at my husband, who raised his eyebrows and looked hopefully at the screen. I thought it was a good sign -- he looked positive -- but I later learned it was because he wasn't sure what he was looking at and thought the sighting of the sac was good news. Nothing -- nothing -- could have prepared me for what I heard next: that there was still a gestational sac, but nothing inside. No heartbeat. No baby. Nothing. Turns out, today was going to be one of the worst days of my life.

I wish there was something someone could do or say to take this searing pain away. Some medication they could give me to let me leave this head and the raw sadness for just a while. I want to box up all of these feelings and send it away somewhere so I never have to know them again. I don't even want to write this post, these words, because someday when it doesn't hurt so much I don't even want to remember how it feels to be me at this particular moment. I'm afraid of muscle memory, afraid this sorrow is leaving some indelible mark on me that might never fully disappear.

I was handled well today -- they did everything right and my amazing doctor said all the right things. She just couldn't say the words I most wanted to hear. No one can. And I literally don't know how to live with this kind of pain.

Tuesday, December 09, 2008

All in

On Friday, we upped the ante. My favorite ultrasound technician (never an unsolicited comment, always the right amount of small talk) called my name in the waiting room at my clinic, and this time my husband went in with me. Because instead of looking at ovaries and follicles, we were looking for a developing baby. And before I even had time to get nervous, she found one: there, on the fuzzy black and white ultrasound screen, was the loveliest black blob I've ever seen in my life. I found out later, when the nurse called, that everything about this splotch/blob/black hole (as my husband so delicately called it) was 100% normal for this stage. Which means I should be able to relax a little, right? Wrong. So wrong.

That ultrasound raised the stakes. We're no longer talking about the success or failure of a cycle. We're talking about a real pregnancy. A real developing baby, albeit a sesame-seed sized one, that I saw with my own eyes on a fuzzy screen. And all the hope and the early plans that go along with it, that I've dared to make mentally for this developing being in my rare moments of sheer optimism.

I'm all in on this. And there's nothing left to do but wait and see what the next hand looks like next Monday, when we peer at that screen again, this time hoping, praying that we see a heartbeat.

Tuesday, December 02, 2008

Bye-Bye Betas

Today's result: 1,236. I've crossed the finish line on betas, and the bruise on my hand from the first one has finally, finally healed. Thank you, God. And goodbye to all that.

Next up: a 3-D form of terror. First ultrasound scheduled for Friday morning. I'm bracing myself, though I'm also trying to exhale a bit since the next two days will be free from any kind of check on whether I'm still pregnant, and becoming more so. I need to seize the opportunity to stop being in a constant state of alarm, if only for 48 hours.

So far, pregnancy doesn't feel like pregnancy at all -- or at least not what I anticipated it would feel like when I thought about it the thousands of times that I did. The symptoms I've had so far have been subtle and not at all pointing undeniably to a bun in the oven. So the only proof I have are these numbers which mercifully have done exactly what they're supposed to do. Here's hoping the ultrasounds follow suit, and that I can start to feel something more tangible about this pregnancy, something to hold on to, something that makes it feel more real. Something that gives me permission to believe in it and -- imagine this -- enjoy it. (Just please let this something not be violent morning sickness as I loathe, and actually deeply fear, throwing up.)

Monday, December 01, 2008

Test. Worry. Repeat.

Some early pregnancies go like this: blood test, yay! we're pregnant, let's start planning the nursery. Mine, so far, has gone like this: blood test, euphoria, anxiety. Repeat. Repeat. Repeat.

Still, I am encouraged by yesterday's result: 622, again nearly doubling from two days before. Apparently I need to keep going in until I reach a beta of over 1,000, at which point we can do an early ultrasound. So hopefully, hopefully with tomorrow's beta I can officially be done with this every-other-day blood draw exercise. Fingers crossed.

Friday, November 28, 2008

Today's Forecast: Mostly Sunny

Pregnancy is starting to feel like the weather in New England: You never quite know what will happen next, which makes trying to plan anything a challenge. And no matter how much of an "instinct" you think you have about what's coming, you quickly realize it's totally beyond your understanding or control.

This morning I went to the clinic for my third beta, my sense of dread having become an all-too-familiar sidekick as I entered the office. The nurses were even more understanding and sympathetic than usual about the difficulties of waiting, assuring me that this was all beyond my control, that they're looking for data points on what's happening and that's all we can do. They promised to walk my blood downstairs right away and call as soon as humanly possible. I left exhausted, my body and mind heavy with the consuming worry of the past two days. Once again, I was ready for the sad call. Every instinct in me said this was not going to turn out well.

Once again, I was wrong. They called, mercifully, within an hour. And once again, instead of the dreaded words I expected to hear, I heard reassuring news: my hcg has nearly doubled in two days, increasing from 183 to 337. They are "happy" with this result. It reflects an upward trend, well within the range they like to see.

They want me to come back on Sunday morning to check it again. I so wish I could be a "normal" pregnant person now, free from these betas as a reminder of how tenuous everything seems when you've tried so hard to get here and are desperate for it to work out. Free to just relax and enjoy it, without any concrete reason to think it won't turn out well. I wish I could feel 100% optimistic right now, instead of just strongly encouraged. But for the next two days I am going to try and tell myself that the forecast from here looks mostly sunny. It's all I can do.

Thursday, November 27, 2008

Numbed by Numbers

I'd been told that the angst of infertility doesn't end with a positive pregnancy test. But I guess I thought once I heard about mine I'd be able to let go of some of the worry and pessimism that had set in after so many failed treatment cycles and let myself enjoy it. I was wrong.

Yesterday's beta showed an hcg level of 183, which is about a 60% increase over my level of 112 on Monday. I could look at this two different ways.

If I had known nothing about hcg levels in early pregnancy when I finally got the call from the nurse at 2 p.m. yesterday afternoon (having mentally concocted worse and worse scenarios the longer I waited), I probably wouldn't be that worried. She said a 60% increase is "fine" and that they wanted to see me back on Friday morning "just to make sure everything is on track." Not so bad, right? A consult with Dr. Google (Yes, I admit it: I could not resist the urge. I am weak.) confirmed that in a normal pregnancy beta hcg levels double every 48-72 hours, and an increase of 60% or above over 48 hours is still considered normal.

My husband says I should focus on all of this. It did increase, and it increased within a range that could mean everything is a-ok.

And I've tried. I've tried to repeat those things in my mind, to focus on the fact that, for this moment, I am still pregnant. That I even can type those words is completely amazing to me.

But that's what scares me the most. These stakes are the highest yet. And that is why I can't shake this horrible feeling. Can't stop remembering that originally they'd said they wanted to see that number double in 48 hours. Can't imagine what will happen to me if something happens to this pregnancy. Can't understand how I am supposed to survive the next 24 hours until the next beta.

Monday, November 24, 2008

Pins and Needles

This morning, after a sleepless night (and two weeks of nonstop anxiety and obsession), I walked, still symptomless, into the infertility clinic for my pregnancy test, my sense of impending doom growing with every step. I dreaded the day ahead, the call, the tears.

My name was called by the one medical assistant in the practice who can never, ever find my veins, which only darkened my mood. She asked me if I felt any symptoms. Not a one, I said. No sore boobs? she asked (really). Nope. This is just a guess, but maybe if she spent more energy focused on my veins and less trying to "diagnose" me, she may not have had to do what she did next: use my hand. If you've never had this experience, don't start anytime soon. Because let me tell you something about the top of your hand: It doesn't like to be stuck with needles. It hurts. Also, it's gross. It may have been the only time I've ever felt lightheaded about giving blood.

By the time I got back to my car, I was a sobbing mess. My blood -- the answer -- had been left behind and all I could do now was drive away and wait. The stinging in my hand felt like insult on injury and I decided, right there, that if there was ever a day to work from home this was it. Crying hysterically at work may not be career suicide but it sure doesn't help anything.

I settled into my spot on the couch and tried to remain calm. My husband, home waiting to go to his late-morning doctor's appointment, was in full keep-her-happy mode, making me a snack and doing pretty much anything I asked him to. He was sitting with me on the couch when the phone rang, much earlier than I'd expected. As my hands trembled and my mind braced for the bad news I thought I'd hear, I answered it -- and instead heard three words that I truly thought would never, ever be used in reference to me: Congratulations. You're pregnant.

Some (not nearly all) of the shock has worn off. I am now a whirlwind of conflicting emotion. There are many, many steps in front of us, I know. Many miles to go before we sleep. And yet, there is this victory. After a year of gut-wrenching, mind-spinning, heartbreaking effort with little to cheer us on, no incremental wins, just the head-down, blinders-on quest for a positive pregnancy test, we finally got one. I'm going to sit here for a minute and soak it in. And thank those reading this for every one of your words of encouragement, which mean more than you know.

Saturday, November 22, 2008

Holding out Hope

This two-week wait has been a rough road peppered with land mines. The end of it is near, and I'm not sure I like where it leads. Right now, all signs -- or lack thereof -- point to nowhere good. Still, I'm trying to keep my eyes on the road and pressing on, because I guess I know somewhere deep down (and therefore not always accessible by my overactive mind) that even if I'm not there yet, I may be headed in the right direction.

Two weeks after they put real, live, fully-formed embryos in my uterus, I feel absolutely nothing. Nada. I have heard countless women tell me that they, too, had no symptoms and dreaded the call from the nurse after their test -- but turned out to be pregnant. I have saved those friends' emails and read them obsessively, poring over every word like a heartsick teenager with a text-messaged love confession from her crush. But these messages from real people who have achieved real pregnancies do nothing to appease my growing sense of doom. Logically, I hear what they're saying. But logic can never shut the other part -- the worrying part -- of my brain up. Did they really not have one little inkling that something was going on? Couldn't I just have a sore boob for good measure? A little nausea for hope's sake?

Along the way, it appears I've been tested by the infertility imps just looking for a poor sucker to prey upon. That cute gifts catalogue I thought would be filled with unique holiday ideas? Also contained a baby onesie that read, "I was worth the wait." After I recovered from that hysterical crying jag I went into my office to search for something and found, instead, the stuffed dinosaur I bought when I thought this would be easy, because it was the softest toy in the land and I thought my baby should own it. Apparently, nowhere is safe for the infertile anymore -- not even her own house.

Another thing that was not helpful was my co-worker bursting into the cubicle where I was talking with a colleague and waving around the card she got for the birth of her granddaughter, which featured a disturbing photo of a baby's head being held by two hands, taken from the top of the head (Note to everyone I know: If I ever find myself holding a baby that is mine and am lucky enough to get a congratulations card from you, please do not pick the one featuring one or more babies in unnatural or vaguely humiliating positions or outfits. This includes being dressed up like flowers or animals. This practice is not okay and to my mind should be banned by law.). I'm not sure what her point was in showing this to us, although my sensitive/vaguely human side does see that one might be excited about a granddaughter. But still. I just really, really do not need to be reminded about my infertility while I'm at work trying to forget about it. Can we all agree to that? Yeah, thanks.

The other award for unhelpfulness goes to Dr. Google. Sure, doctor, you are always there -- 24/7 I know I can count on you when I want to fulfill my sick urges to search for "no symptoms after IVF" or "can you push out your embryos by coughing." You tell me what I want to hear, but my friends have told me you're unreliable. They question where your ivy league diploma is. So I'm quitting you. For now.

So here I am, somewhat exhausted by these two weeks and, in a way, just thankful that the wait will soon be over. On Monday morning, I will find out whether my first IVF, the thing that was supposed to be the holy grail, my golden ticket to motherhood, worked. So much depends on a positive beta. I don't know what life looks like beyond a negative, and I don't want to know. I don't know what there will be to hold on to. So for now -- for tonight and tomorrow -- I am holding out hope.

Saturday, November 15, 2008

Classifieds: Womb for Rent


Available
:

One-room womb. Cozy accommodations. All board, including meals, provided with 9-month lease. Monthly rent is free. Plenty of room for one or two. Well-appointed and super deluxe. Environment particularly supportive of personal development and growth. A gem!

House rules: no wild parties. Must agree to an uneventful, painless eviction when lease expires.

Must be at least six cells to apply. Interested? Move right in and make yourself at home. (Please.)

Monday, November 10, 2008

Buns in the Oven

I was a bit of a late bloomer myself. My first bona fide boyfriend arrived on the scene at about 16, and I didn't start getting really good grades until college. So it comes as no surprise that the two embryos they transferred yesterday are slow growers -- six cells each, to be exact. But you know, those embies are 6 cells going on 6000. I can just feel it. I hope to confirm this with my pregnancy test on the 24th (let me just reiterate my call for more advanced technology allowing for earlier post-fertility treatment pregnancy tests...come on, genius scientists across the world). In the meantime, all I can do is wait. And obsess (Can I go to the bathroom? Cough? Laugh? Are they still in there?). And obsess some more.

There are a number of ways I can look at this. The doctor who did my transfer yesterday did not seem concerned by the slow growth, and cited a couple of times the "excellent" pregnancy rates the clinic has for my age group. And I have heard and read several times now the fact that perfect looking embryos do not always produce babies and by the same token, imperfect looking embryos often do. No one seems to be at all gloom and doom about this news -- but me.

The problem is, we now have a photo. Before I got over my mental and physical stumbling blocks and did this IVF cycle, it felt like I had nothing but a wing and a prayer going into the two-week wait and, when those cycles failed, dashed hopes and despair for the intangible loss. But now, there is a photo. I can see what they've put inside of me, and it is real. And if it/they do not stick, it will mean the loss of that something real.

It's not that I wish I had refused the photo. The realness of it also means that the opportunity here -- the chance for something real to develop from all of this effort -- is that much greater. Plus, don't tell me you don't think it would be cool to show future children what they looked like in a petri dish. It brings a whole new dimension to parental guilt trips ("I have been looking after your wellbeing since you were just six cells!"), doesn't it?

So the wait has begun. Some moments I think it seems like an eternity; others, not so bad. Some moments bring hope; others, pessimism. And while I can look at the photo of my little six-cell slow bloomers for inspiration, I can also look at my post-embryo transfer discharge sheet for some comic relief:

"Progesterone: Crinone - one application per vagina tonight. Tomorrow change to morning administration."

(I don't know about you, but one is about all I can handle these days.)

Saturday, November 08, 2008

We Came, We Saw, We Fertilized

I did it. All it took was countless words of reassurance from my husband, friends, doctors and nurses, two IV attempts, some really strong anti-anxiety medicine, and my unyielding desire for a baby. Oh, and conquering a long-held phobia of anesthesia.

It got off to a rocky start. First, a nurse came out to the waiting area and told me they were running about an hour behind. Nothing like an extra hour to sit still with your belly empty and your mind full of worst-case scenarios. By the time they finally called me back for the pre-op stuff I was an absolute basket case. Their two long attempts at getting an IV in me didn't help. What finally did help was whatever brilliant anti-anxiety medication they put in the successfully placed IV. Thank you, Mr./Ms. Scientist who made that stuff! And goodnight everyone! My husband knew it was working when I asked him, not quietly, if he thought my surgical hair bonnet was "sexy." It was like gulping down five consecutive glasses of Veuve Clicquot on an empty stomach. From there, I remember being wheeled into the OR, looking up at all of the faces around me and trying but failing to form a coherent sentence, and my legs being placed in the crazy hanging stirrups. That's it.

Next thing I knew, they were telling me it was done and I was wheeled back to the recovery area, where my husband soon arrived (directly from the "men's lounge"). I asked the nurses repeatedly whether they were sure they had really done it (I give them major credit for not telling me to shut up). I was quite groggy and in a lot of pain, but mostly I felt this tremendous relief and gratitude that it was over. The embryologist came out and told me they had indeed gotten 18 eggs. I smiled, and after a short recovery got dressed, came home (I'd be lying if I said I didn't enjoy the wheelchair ride to the car -- in my groggy state I felt like Ms. America of the hospital), had a few bites of soup and went straight to bed by 7:30 p.m.

Yesterday came the call that I'd dreamed of receiving when we started IVF and before I was sure I would get through the egg retrieval: the fertilization report. Out of 18 eggs, 9 fertilized. In a dish somewhere in the IVF suite at a nearby academic medical center, we have nine fertilized eggs. For the first (known) time, we've actually put egg and sperm together -- and something (nine somethings) is developing from it. I probably shouldn't be this excited about it -- after all, it's the first of many, many hurdles to climb before I am holding a baby. But when your quest for a baby goes back several years and the past twelve months have been filled with pills and shots and ultrasounds and bad news, the positive movement toward a real developing baby is something of a thrill.

To get here, I've had to climb perhaps the biggest hurdle of all: fear. The egg retrieval was a bravery test, a question of whether my will to have a baby could win over the convincing strength of a childhood phobia. I passed this one, and we have nine developing embryos to prove it. One or two of the best looking ones will be transferred tomorrow. Let's hope the trend continues.

(Thank you again to all of you for rooting me on throughout this process!)

Thursday, November 06, 2008

Numbers Game

Egg retrieval: 2:15 p.m. today

Level of anxiety: astronomical

# of follicles (estimated): 18-20

# of irritable people in my house doing the IM trigger shot at 2:15 a.m. yesterday: 2

# of expletives flying around during the process: 15

# of asses in pain as a result: 1

# of times I screamed into my pillow after the phone call in which my mother said, "I didn't realize it [infertility] affected so many things" in reference to my decision to leave candy on the porch rather than answering the door for trick-or-treaters: 10

# of ACLs torn by my husband playing soccer last week, in case I didn't have enough to worry about: 1

# of weeks until his surgery: 4-5

# of times I've thought of calling off the egg retrieval due to severe anxiety over anesthesia: 200

# of times I've realized that is not an option: 200

# of hours I need to go without food before the retrieval: 14

# of fattening, indulgent foods I will eat as reward for making it through: 5-10

# of times I've felt immensely grateful for all of the supportive calls, emails and comments from good friends and fellow bloggers: countless

Wednesday, October 29, 2008

Fear and Bitterness in IF Land

A lot has happened in the last week, the sum total of which is a general feeling of yuckyness and funk from which I am not sure how to recover. Suggestions are welcome.

First, my brother got married. Typing that as a negative makes me feel like a special kind of selfish and evil -- who sees her brother's wedding as a reason for bitterness? -- but there it is. Weddings, frankly, are not friendly to the IF crowd. All that talk about building their own family, looking forward to children, yadda yadda. It is all just so hopeful, it brings my back to my own wedding day when I was fresh faced and optimistic. And of course it now feels like there is this imaginary race toward birthing the first grandchildren. The multitude of questions I got from family and old friends about our "family plans" (this will never cease to amaze me) were also not helpful to my mood.

As Sunday night approached, with Monday morning's baseline -- the official start of my first IVF cycle -- hanging out there ominously, I grew more and more restless and less and less tolerable. You might think that by 32 I'd have learned how to manage my emotions and how not to convert anxiety over significant life events into virtual meltdowns over things like a missing sweater or a show that didn't TiVo, but you'd be wrong. And my husband (who, miraculously, still lives with me) would be the first to explain to you just how wrong you were.

Here's what did not do anything to improve things: waiting all afternoon to get the call with my baseline results, finally calling them in a panic at 4 p.m. when I still hadn't heard, finally getting a voicemail back at 4:25 when I really thought they'd forgotten about me, and having their message be different from my original instruction sheet (the Menopur that was on the original sheet was not in their verbal instructions). After several calls including a first-time-ever page to the on-call doctor and much hand-wringing over the confusion ("Is this the thing I'll look back on -- why did I not press the issue on the Menopur? What if it was the thing that would have made it work?"), I learned that it was simple human error. Apparently the order was never in my doctor's notes, and the nurse who wrote the instructions had included it completely inadvertently. Which makes me feel both better and worse, but I'm trying to move on.

All of this other angst is only aggravating my elephant-in-the-room anxiety over the impending egg retrieval. I simply cannot will myself to stop obsessing about it. It is the fear of the unknown -- I had the same consuming fears about my HSG test nearly a year ago, which turned out to be a breeze for me -- that is my worst enemy. I have learned to feel brave about everything else, from taking shots to all the morning ultrasounds and blood draws to the nurses telling me I'm not pregnant to relatives' voices asking me when I will be. I need to find a way to be brave about this part too.

Saturday, October 18, 2008

Dear Infertile Friend (You'll Never Believe What My Kid Did!)

So I'm sitting at my desk on Friday, minding my business and writing remarks for our upcoming fundraising dinner, when my little Outlook window shows I have a new message. One look at the subject and the bottom falls out of my stomach. It's just one word, the name of the daughter of a friend of mine (let's call her Kylie). Though every instinct tells me to ignore it -- even delete it, send it to a cyberspace black hole filed under "emails about children insensitively sent to infertile people" -- I open it. It's a story, sent to about five friends of this friend including me, about Kylie. I will spare you the details (I already shared them with two IF friends and subsequently felt huge guilt for subjecting them to it -- I should not spread the suffering around on this one), but generally, it's a saccharine story involving Kylie and her discovery of the moon the evening before.

I had several thoughts at once. First, I will give my friend the benefit of the doubt. Though I distinctly recall a get-together with another friend in which I alluded to there being "challenges" in my reproductive department (And honestly, I have been married for eight years. Eight years! She has known me since junior high and knows I love children. Is sensing that I am infertile such a leap? Maybe I should wear a button or a t-shirt.), I have never had a frank discussion with her about what I'm going through. Though I would love the comfort of confiding in her, her mother is known as our hometown's gossip and the risk that it could slip out and get to her (and the loss of control over my story that would ensue) is not worth the reward. So I will assume that it never occurred to her that it could hurt me, her friend who is scared senseless about going through her first IVF cycle.

Still, why would I get this email at all? Having never been pregnant, I have never even come close to being inducted into "the club," so maybe someone can explain it to me. What happens to you where you think this kind of story will be appreciated by others who do not answer when this child says "mommy?" What makes you think it will be entertaining for them?

Playing devil's advocate, I can hear critics of this post say that I am cold, that we're talking about a child, that it's human nature to find children adorable and entertaining. And I say that is BS. Do I find it awe-inspiring that my friends have these kids who are walking and talking little versions of them? Absolutely. Am I so happy for them and the family lives they've been able to create? You betcha. Am I going to find every excruciating detail of said family lives interesting? Not any more than they would find a play-by-play of my 2 p.m. meeting interesting. But somehow, when you're talking about a child, it makes it okay to tell these stories, even to those who might be hurt by them. The implication seems to be that we should just grin and bear it. That to protest is to seem like a kind of misanthrope, a cold-hearted grinch.

There are baby and pregnancy references everywhere -- ours is a baby-obsessed culture. You can do your best to shield yourself from them, but short of never watching TV, reading a magazine or book, or going to the mall (Can somebody tell me how many more fancy baby clothes stores this planet needs?), you can't hide completely from them. But when it comes to your friends, don't you have the right to expect that they'll spare you the kind of cyber hand grenade that was the email I got on Friday?

I'm tired of trying to be brave, of swallowing the tears. Tired of bearing the burden. Part of me wants to play the infertile card, to tell these friends that I'm going through it and ask that they leave me off these emails (The snarky side of me wants to email back one word: "Unsubscribe."). But I am still fiercely protective of my story, and the vulnerability I know I will feel after delivering such a response always keeps me from hitting send. And I guess there is some self-critical part of me that thinks it's a little selfish to ask them not to talk about their kids while I don't have them -- will it be okay for them to do so when I do? If I don't have a summer home, is it not okay for my friend to talk about her beach house?

The fact is, I do have friends with kids who talk about them in a way that does not stir this kind of angst (I can think of a few who read this blog, and it's important to me that they know this is not a blanket criticism of any friend of mine ever uttering a word about their offspring). I don't know if it's their general sensitivity to my condition, their restraint when it comes to the frequency of these comments, or the way in which they communicate these details (no "e-bombs," and often a question first about whether I am in a mood to hear them), but the combined effect is that it is okay -- in fact, it gives me hope that someday I will be sitting in their shoes, listening to some child of mine yammer on about what the opposite of "raining cats and dogs" is. But I promise, if and when that day comes, I will not share whatever cute thing s/he says with you unless I sense that you really, really want to know.

(How do you handle babygrams from friends?)

Wednesday, October 15, 2008

Someone to Watch over Me

When I was little, I loved to fall asleep in the living room with the TV on and others still watching. It was comforting and cozy to think that life was still going on -- and that it would still be there when I woke up. That I would open my eyes and find not a dark, empty room but life and warmth. In the same way, I love hearing the silken voice of the announcer on the soft rock station (guilty pleasure) say, "Continuous soft rock all through the night," and (stay with me) waking up to the stock reports from Asian markets. It gives me the reassuring sense that the world is turning as planned, that others are keeping watch by night, that the sun will keep setting and rising on schedule. That, when I am just starting my Monday, people in Asia are already wrapping it up. Monday came and went on the other side of the world, and nothing catastrophic happened. They led the way and lived to tell about it. They were keeping watch.

I have never longed for this feeling more than now. I want someone to keep watch, to make sure my world keeps turning even when it feels like it's about to stop. To somehow keep me on course, to lead the way as I fumble in the dark.

This longing was sharpened yesterday as I shakily attempted to navigate the complex maze of IVF drugs and instructions. First, there was the realization that today, October 15, coincided with day 21 of my pill pack -- not day 23, as was written on my instruction sheet. Which direction should I follow -- the written date or the written pill pack day? The nurse I spoke with only complicated matters: the most important thing was that I overlap the pill and the Lupron for seven days. Since I was to stop the pill on 10/22, that meant I should start Lupron this morning. I thought that answered that -- until I consulted the calendar and realized that (and since math is not my strong suit, this took a few manual counts of the days) 10/15-10/22 actually equals eight days of medication. I called the nurse back and this time I stumped her. While I usually enjoy impressing with my sharpness -- who doesn't? -- it turns out that when it's a nurse in charge of the process that will create your baby in a lab, it doesn't quite provide the same thrill. She left a message for the original faulty instruction maker (who happens to be my favorite nurse so she gets some slack) to call me back today (I have started the Lupron).

Yesterday, take two: Having noticed the absence of a friendly UPS email telling me enough injectable drugs had arrived on my porch to feed a drug habit for a year, I called the pharmacy. The very earnest gentleman I spoke with looked up my account and assured me that, yes, my medications were just approved by insurance and would be delivered Wednesday afternoon. "Um, yeah, no," I told him. "I told you when I called Friday that I needed them today, as I start the Lupron in the morning." One messenger and one husband pulling into the driveway just in time to sign for it, and I had my medications. But, hello? Where is my infertility secretary and what has she been doing all day? She is so fired.

It's hard to keep up. It's exhausting to be vigilant, to make sure the drugs get into my body when they should. And to be confident that this process will go as intended, that my body will perform and create life out of this. To know that I can be sure and steady when I need to be. I want someone to keep track of the details, to give me comfort through the night. Someone to keep watch.

Friday, October 10, 2008

Falling for Hope

There is something about fall that makes it easier to hope. Something about the crisp in the air that carries a sense of anticipation, a feeling that good things are just on the horizon. It makes me nostalgic for a time when this kind of weather would signal the need for school supplies, for Trapper Keepers and new corduroys and a glossy new lunchbox with the character du jour on the front of it. There was a sense of starting over, of wiping the slate clean, and this weather brings all of those memories rushing back. It makes me want to run out and buy number two pencils.

But it's harder now to think about what's ahead, because the stakes are so much higher. Gone are the days when my biggest problem is that I'm not crazy about my new math teacher. That my BFF isn't in the same homeroom. That my boyfriend is trying out for varsity track this year and may not have time to hang out.

On my drive to work, I look at the throngs of newly arrived students -- when you live in a college town it's impossible to avoid them -- and I just think, You don't know how lucky you are. Not that I would go back. I like being 32 and happily married and knowing now what I didn't know then. But would I escape from this limbo -- this time when I'm no longer a carefree 20-something with no real responsibilities but not yet a 30-something with the children I always knew for sure I would have by now -- if I could? Would I give up the burden of infertility and once again feel what it's like to live with unburdened hope ahead? In a heartbeat.

I don't know what to hope for anymore. As I prepare to start an IVF cycle -- something I swore I wouldn't do when we started this journey, before I felt the sting of failure and the irresistible allure of something bigger and better promising to deliver on my dream -- I am not sure if I dare to trust the better odds, the assurances that this is far superior to everything I've done before. In a way, it feels like I'm starting over, like this is where it might really get good. But I've been fooled into hoping before, and my horizon for hope beyond this is getting shorter and shorter.

I don't know what to hope for. So I'm trying to just enjoy the moments of this season that I adore, savoring the scent of dried leaves and apples and the veil of softer sunlight, and every so often, the sense it brings that something good might be just around the corner.

Sunday, September 28, 2008

Dipping My Toe

What I want to do is fast forward to the part where I get my happy ending. Where it's just me and him and our baby, living our normal life, and the scars of all of this failure and disappointment have faded to the lightest marks that you have to really squint at to see. Because right now, from where I'm sitting, I have nagging doubts about whether I'm cut out to get through what's in between.

Our meeting with Dr. A on Thursday confirmed what I felt after our first meeting: That she is the doctor that was meant to treat me at this time for this condition. Everything she says feels like it's part of the script for the movie, "What to Tell Good Egg to Calm Her Down and Give Her Hope." She told us that this past cycle was exactly what she was looking for (except for the not getting pregnant part). That she could certainly let us continue with injectible/IUI cycles to try to win the numbers game. But that, from a medical perspective, knowing the physical and mental toll this process takes, she would probably advise moving on. Bringing in the big guns. Going to the big show. IVF.

We knew going in that that was probably going to be her advice. And until I was sitting across from her I wasn't sure what my response would be. But as she said it, the failure of this last cycle still stinging, I knew she was right. Sure, we could keep trying the other way, and at some point we might actually get the result we want. But we could also trade in our cell phones for rotary. Sell our cars and get a couple of horses. Throw our iPods out the window and break out some 8-tracks. When there's better technology available to you, you use it. Because it's, well, better. Why should our quest for a baby be any different? I am ready to upgrade.

Still, I am, to put it mildly, apprehensive (some might say freaking out). Several things are overwhelming me at this moment. The first is the long list of instructions and new drugs that will be introduced to my babymaking regimen via this upgrade to IVF. I'd really gotten the injectible routine down, and there seem to be far too many opportunities amid this far more complex protocol for user error to come in to play.

There's also this feeling that I can't believe I'm here. Call me naive, in denial, whatever, but I really never expected to need this kind of intervention. Part of the blame goes to the OB/GYN I had when we first got married, who told me that the fix for my suspected PCOS would be, whenever I was ready, an easy course of "fertility lite" (Clomid) and voila: Pregnancy. Why wouldn't I believe him? Why would I imagine that years later we'd be knocking on the door of our last hope for biological conception? Despite the fact that it's been a long time since I lost that "infertility virginity," I guess part of me still mourns the fact that our baby will be created not on a fun evening with just the two of us and a bottle of wine, but with doctors and chemicals and stirrups. Needing IVF has brought that into sharp focus.

And of course, there's the thing I'd rather not mention but is the elephant in the room, the squeaky wheel in my head. My fear -- my phobia -- of anesthesia. Nothing like being pinned down on an operating table at the age of nine by insensitive doctors armed with a gas mask without having been prepared for said experience to really make a girl want to run screaming from the room whenever the words "surgical procedure" are uttered. Yes, I know they don't use the same general anesthesia they use for major surgery. And that I'm no longer nine years old. And that I'll only be out for 15-20 minutes. Doesn't help.

Still, I've dipped my toe in the IVF pond. And even with these doubts in my head begging me not to, I'm about to jump in.

Tuesday, September 23, 2008

Postcard from the Bell Jar

Greetings from the saddest place I've been. It pretty much sucks and I don't wish you were here -- wouldn't wish this on anyone -- but I have discovered a few perks:

-I can indulge in nonstop emotional eating and still somehow lose weight. Is it nerves? Calories burned by nonstop crying? Who cares?
-My getting ready time in the morning has been cut significantly by my general lack of giving a damn what I look like.
-Similarly, I'm perfecting the whole Mary Kate Olsen vagabond look.
-I am acquiring a newfound understanding of the range of mind-numbing and often disgusting programming options (note to self: avoid the Discovery Channel at all costs) available on cable television.
-In a moment of economic crisis in our country, I am singlehandedly boosting the stock prices of companies that make Kleenex, Aleve, those stick-on headache patch thingys, wine, chocolate and refined (so not PCOS-approved) carb products.

So I guess every cloud really does have a silver lining. Which is good, because I've been here a few days and I don't yet see a way out.

Saturday, September 20, 2008

A Lesson in Heartbreak

I recently heard that when a female giraffe gives birth for the first time, she does so standing up -- and fifty percent of newborn giraffes will not survive the five-foot plummet to earth. So when she feels labor coming on for #2, she does what any concerned mother recalling the horror of losing her first baby would do: She lies down.

In the pursuit of a healthy baby, we all keep trying and looking for lessons and working to get it right. So tell me: What am I supposed to learn from my negative home pregnancy test this morning? Just tell me what it is I'm doing wrong, and I'll fix it. If someone could please just tell me how I can work harder, want it more, prove that I'm worthy, I'll do it. I. Will. Do. Anything.

I've been here before. I've seen this puffy face before, these raw, seared eyes. Felt simultaneously like eating everything in the house and never eating again. Had the odd sensation of being totally disconnected from the world, from life, and yet acutely aware of life's force -- pain, drama, feeling. Wanted to crawl out of this skin, out of this pain, away from this reality which can't be mine. Each time, the shocking sting has worn away. The brightness of each morning has seemed less offensive. Somehow, I have found my way back to hope. To the essential belief that one day I will look back and not only feel that this pain has been worth it, but need to struggle harder and harder to remember what it felt like at all.

This has happened to me every other time I've been here. But how many times do you have in you? What is to say that you can find your way back time and time and time again? How much is too much to bear? And how do you know when it's coming? When you're in it? Because right now, it feels like too much to bear. I am too far gone.

What am I supposed to learn from this?

Saturday, September 13, 2008

Welcome to My World

Ooh, was that a twitch in my uterus? I think I just felt my right boob tingle, too. Let me go read what twoweekwait.com has to say about it. Let's see...okay, so it sounds like if you have any of the following you might be pregnant: afternoon fatigue, morning sluggishness. Pain or cramping anywhere down there. An intense crying jag upon watching a sad movie. A canker sore. Dizziness. Irritability. Hunger. Anything weird happening to your boobs. A stuffy nose. A runny nose. A general feeling of restlessness. Having to pee a lot/badly. A good vibe. A bad vibe. A headache. Anything at all that you happen to notice about your body or the way it functions.

Hmmmm. That was helpful.

The feeling is gone anyway. There's no way I'm pregnant. I am a miserable failure at all things reproduction. I am going to become one of those old ladies who collects cats/old newspaper clippings/knit doilies because she has no children or grandchildren to keep her busy. What a sad, sad existence. I can't believe this is happening to me.

Wait a minute, was that a wave of nausea? I know it's early for that, but let me go see how many people felt it at 6dpIUI.

How, my friends, am I going to survive another 10 days of this?

Monday, September 08, 2008

Spin Me Right Round, Baby

After all of the shots, the trips to the clinic, the ultrasounds and blood draws and phone calls from nurses, it seems incongruous that the final act of an IUI cycle is a five-minute procedure which feels like nothing more than a pap smear, a 15-minute wait on the table and a hurry-on-your-way. Talk about anti-climactic. It's like training for a marathon, running it and then coming home not to a congratulations party with all your friends but to a night of sitting your couch watching PBS while eating dry toast. You think, was that it?

The silence that follows the initial flurry of activity is deafening. Because no matter how stressful it is to anticipate how many follicles will show up on the screen in the morning and what the nurse might say when she calls you in the afternoon, at least you are taking action, doing something. It feels like progress. You can have hope, because your chance is still ahead of you, unmarred by the doubts in your head and the symptoms -- or lack thereof-- in your body. And the idea that in the moments, the hours and the days that follow there is not some definitive sign, some message from the heavens, some clear and unmistakable symptom that tells you whether you are or are not in fact pregnant as a result -- it seems impossibly cruel.

This is what brings you down from the high of finally reaching the end of a cycle, successfully, with two eggs to fertilize, to the angst-filled low of the two-week wait. It's the emotional tail-chasing that really gets to you. In no time at all, I go from a mantra of "I am going to be a mother. This could really work," to waving the white flag, ready to accept the defeat of another failed cycle. The disbelieving voice in my head says that I would feel it in my bones if it had worked. That the IUI was poorly timed, that I should have done two. That the sperm count was too low. That I've been too tense. Too pessimistic. Thought too much about it. Thinking that, I try to push myself back to optimistic -- or at least neutral -- ground. Around and around it goes.

Despite my best efforts, my prayers, my good luck charms, I can't seem to settle into this two-week wait. I know that some women are able to look at the wait as two weeks of assuming, against all odds, that they are pregnant. Seems like an unattainable ideal rife with so much potential disappointment. But maybe if I can find a way to stop my head from spinning I can at least inch a little bit closer to the possibility.

Saturday, September 06, 2008

The Secret Life of an Egg

What do you suppose eggs do between trigger and release? Do you think they put on their finest suits and dresses to get ready for the big show (I think mine go for Armani -- classic, sophisticated, not too trendy)? Do they have one last champagne fete to celebrate their imminent release? Break out maps and compasses and plot their journey from ovary to fallopian tube? Read advice books on the best way to attract a sperm?

I hope mine are doing all of the above. I hope they are type A, overachieving eggs -- the kind that go to class early and always do the extra credit question. I hope that, whatever they are doing right now, they are the kind that get me a baby.

Friday, September 05, 2008

Trigger Happy

After almost a year of fumbling toward pregnancy, the number of times I actually have had a statistically significant shot at it is disproportionately low at just three. It's par for the course when the diagnosis is ovulation-related, I know, but it's a troubling fact when so much effort and angst is poured into every cycle. So when I reach the finish line, when I actually have a chance, when pregnancy feels like more than a pipe dream, it is an important victory.

This cycle turned out to be exactly what my new doctor promised: slow. Only over the past few days did anything finally develop, and my expectation that that would be the case didn't prevent me from feeling discouraged and, yes, bitter (see "Happy Not in Labor Day" for evidence) at times. Still, as compared to previous cycles I was able to maintain a relative sense of calm which, under the circumstances, is a miracle I can only attribute to finally having a doctor I fully trust, who I know is totally familiar with my case and focused on my cycle. It truly has made this cycle feel more "real shot at pregnancy" than "total and complete drunken shot in the dark."

I'm taking that shot -- literally -- tonight when I trigger my two mature follicles (three if you count the 12 mm which may or may not contain an egg), with my IUI scheduled for Sunday morning. Having slowly crossed the finish line on this cycle, I'm just going to sit here a minute and soak in the victory.

Monday, September 01, 2008

Happy Not in Labor Day!

Is it just me, or is the unfortunate moniker of this holiday a kick in the ovaries to the infertile among us? Although I certainly appreciate any day off -- regardless of what they call it -- in my world, right now, it would be more aptly called "Not going into labor now or anytime in the foreseeable future" day. Particularly given what's going on with my ovaries. They are really holding out. Playing hard to get.

In keeping with my fine, fine tradition of dates with the ultrasound wand on all major holidays, I was back at the clinic at 8:15 this morning. You see, when I imagine a whole day off, stretched out in front of me in all its leisurely glory, no activity seems more fitting to get it started than a blood draw and a little spelunking around in my girl parts with a lubed-up probe. And the craptastic news that my lead follicle only grew one -- yes, one -- millimeter (to a grand total of 11 mm) since my last check on Saturday really put me in a holiday spirit. Now I can spend the rest of my day off -- at least until the call from the clinic -- worrying about why, after almost two weeks of stims, I have one follicle that is barely measurable. Good times. This must be what they call a helliday.

Oh, note to my ultrasound tech this weekend? Your vag cam school called: They want you to come back and take the course you missed called "Bedside Manner 101." I hear the prerequisites for the course are sensitivity, common sense and discretion. Required reading includes, "Don't shake your head at the screen and keep repeating, aggressively with a touch of glee, 'They really haven't changed at all since Saturday. Nope, not at all!'" and "Why you shouldn't come out to a crowded waiting room and self-righteously belt out to a patient that the tech from the other day was wrong and no, she did not have a 12 mm follicle -- just a 10!" Oh, and they wanted me to remind you that an ultrasound tech is not, in fact, a doctor. You can call them back at 800-GET-A-CLUE.

Would you, too, like a little bitter in your Labor Day barbeque?

Monday, August 25, 2008

Ask and Ye Shall Receive Snark

In honor of that cherished American tradition of asking others -- without regard to Emily Post, privacy or closeness of friendship -- when they're having kids, I've prepared the following list of ten fabulously snarky comebacks:

1. "How much do you want to know about my girl parts?"

2. "If I could answer that, I'd teach at Harvard Med."

3. "Maybe you can give me some tips, because no baby yet, and we've sure been active upstairs (wink)."

4. "When are you getting your tubes tied?"

5. "Wow, this topic reminds me of the hour I spent weeping in my therapist's office the other day."

6. "I'll ask my ovaries -- I'm seeing them again on Wednesday."

7. "Why would we do that, when infertility is so much fun?"

8. "Speaking of taboo subjects, can you believe Barack finally picked his running mate?"

9. "I was hoping you'd just give me one of yours."

10. "Well, I was wondering the same thing while I was in the stirrups this morning. Here, let me reenact it for you -- could you move the salt and pepper?"

What's on your list?

Tuesday, August 19, 2008

Off to the (Slow) Races

It had been several weeks, and frankly, I missed them. Missed glimpsing those fuzzy black splotches on the screen reminding me that yes, I do in fact have girl parts and yes, they are loaded with eggs just jonesing to make a baby. Missed the morning rendez-vous with the giant wand poking around in there -- well, okay, maybe not that part (definitely not that part). But it was good to see my ovaries on TV again this morning.

And my baseline ultrasound was delightfully uneventful. The girls weren't growing cysts or talking smack or plotting their escape. They were just quietly hanging out, awaiting their next instructions. So dear ovaries, if you're listening, here they are: Grow two follicles. Just two. Don't go showing off. I know you can grow way more than that -- I remember your 25-follicle extravaganza back in February. That was nice and all (if you enjoy the feeling that your ovaries will violently explode every time you sit down, which I do not), but let's dial it back this time. Think more quality than quantity. More tortoise than hare: Slow and steady wins the race. Let's go for a healthy singleton, not a scary litter.

And on the other hand, can you step it up just a bit from the last cycle? That one follicle barely crossed the finish line. (I don't mean to be critical, dear ovaries, but if you can't be honest with your own reproductive organs....)

Here were my instructions today: Take 37.5 IU of Gonal-F for four nights, and return on Saturday for monitoring. I can follow those instructions. We'll see after a couple of weeks of "low and slow" FSH injections whether my ovaries can follow theirs.

Thursday, August 14, 2008

Shit-Colored Glasses

The thing about infertility is that it is all-consuming. The thing is, it makes you feel like it's the only thing you can handle.

That's why this other medical symptom I'm having is driving me so insane. I don't even want to get into what it is because a) it all sounds so melodramatic and b) so far, after a few tests, the signs are pointing away from "serious, life-threatening medical issue" and toward "girl, you are stressed OUT!" Which is just really, really embarrassing. I hate to be one of *those* people. Especially since it started right when I got back from vacation. Although I could see my body going into a bit of shock -- I mean, really, when was the last time I actually relaxed?

Like 3-D glasses at the movies, infertility seems to hand you shit-colored ones at the time of diagnosis. The things about your life that used to seem pretty rosy now look, well, all murky and dark. Infertility takes the pep from your step and the joie de vivre right out of your spirit. And it makes any other problems that may pop up appear impossible to manage. It takes away your power to cope.

I hope the medical student who looked at me, smug smile on her lips, and inferred that the cause of my symptom is likely stress -- I hope she is right. (Is it wrong, by the way, that I was giddy inside when my doctor came in and told said smug med student that she "wouldn't have mentioned to the patient" the typo in my test report that said "serious abnormalities" instead of "no serious abnormalities" as it would cause "needless worry"?) Although it would be another item on the growing list of inconveniences and side effects infertility has wreaked on my life, at least it would be one less thing to deal with right now.

Sunday, August 10, 2008

Gold Medal in Peeing on a Stick

As I sit motionless on my couch in front of the TV watching people run, throw, swim and contort their bodies into all sorts of inhumane positions in their quests for gold or silver (Does anyone really want bronze? Isn't it a bit like picking the wrong Let's Make a Deal curtain and going home with the goat?), I'm wondering what sort of competitions would be held at the Infertility Olympics. I have a few ideas and would welcome your input before I go ahead and write the IOC.

Opening Ceremony -- I'm thinking rows and rows of women in johnnies marching with flags of ovaries, uteruses, follicles and sperm. And someone would of course sing our anthem to start the games:

O say can you see by the speculum light
All the broken girl parts that are causing my plight

Who's the tool who asked me when I'll have a baby --
Don't they know they risk wrath from my hormone-pumped body?

And the follicle wait
Do I have one or eight?

Gives proof everywhere
That life isn't fair

O say does that egg and sperm banner yet wave
For the infertile girls, so determined and brave

Toilet to stirrups sprint -- Who will set the world record for shortest time from the pre-ultrasound "bladder empty" to assuming the position in the stirrups?

The stick pee -- How many OPK and HPT sticks can you cover in one stream?

Verbal fencing -- Gold medalist will produce the snarkiest comeback for "When are you having a baby," or "You know, having kids will really change your life for the better."

Needle sticking -- Who can do it without flinching, whining or drawing blood?

Specimen Dash -- A men's event: Winners are the fastest to get sperm in a cup. Gold medalist will have high counts, good motility. Pants down! Grab your porn! Go!

Two-week Wait Distraction -- Top performers will fill up every minute of the two-week wait with busy work and meaningless activity.

I'm starting training later this week. I'm thinking I want a gold in the marathon to my baby.

Wednesday, August 06, 2008

The Best Laid Plans

I remembered something on the drive to work this morning that made me laugh out loud.

A few years ago, when I naively thought the only people who would be in the room when I got pregnant would be my husband and I, we decided that I would go off the pill in the spring. Why? Well, it would be very inconvenient, I thought, to be hugely pregnant in the summer months. It's too hot and I didn't want a giant belly making it even hotter. This way, I would get the early stuff out of the way in the summer (because according to my plan I would definitely be knocked up in two months, maybe three at the most) and be waddling around during my favorite season, fall. I could dress up as a pregnant lady for Halloween!

Oh, you dear girl. Such a quaint little plan!

Over the course of trying and trying and treatments and more treatments, this carefully crafted, time-sensitive plan has devolved to this: I would take a pregnancy in the heat of hell.

In the cold of the arctic.

Inside, outside, upside down.

In a boat. With a goat.

I have decided to think of this minor setback in my plans as an opportunity to learn to be flexible and nimble as preparation for excellent parenting. For example, I won't miss a beat when confronted with a spontaneous projectile vomiting episode in the back of the car when I'm running late for a meeting. And I will handle nuclear-level meltdowns in Target with the greatest of ease.

Meanwhile, I have been tagged by Res Cogitatae to do this meme. I'm clueless and don't even know what a meme means but it seems fun so, since I have no vomit to clean up or meltdowns to attend to, here goes:

Rules: Answer each question with one word and tag four others to play.

1. Where is your cell phone? bag
2. Your significant other? R.
3. Your hair? blondish
4. Your mother? creative
5. Your father? kind
6. Your favorite thing? learning
7. Your dream last night? forgettable
8. Your favorite drink? wine
9. Your dream/goal? contentment
10. The room you’re in? living
11. Your hobby? reading
12. Your fear? failure
13. Where do you want to be in 6 years? vacation
14. What you’re not? patient
15. Muffins? wheat
16. One of your wish list items? dog
17. Where you grew up? Massachusetts
18. The last thing you did? pedicure
19. What are you wearing? sweats
20. Favorite Gadget? blackberry
21. Your pet? cats
22. Your computer? frustrating
23. Your mood? optimistic
24. Missing someone? grandmothers
25. Your car? hybrid
26. Something you are not wearing? maternity
27. Favorite Store? many
28. Like someone? husband
29. Your favorite colour? orange
30. When is the last time you laughed? laughing
31. Last time you cried? days

In keeping with the rules, I'm tagging egg dance, Maybe I Will Have a Glass, Family of Two and Fractured Rainbows. If you feel like it (it's fun in a middle school sort of way, a la MASH).

Monday, August 04, 2008

Greener Pastures

This one goes out to the 25 screaming kids (I wish I were kidding) and parents (who were screaming too) who descended on the tranquil al fresco breakfast my husband and I were trying to enjoy the second morning of our vacation last week. You almost made me consider trading in my FSH-laden syringes for some Ortho-Cyclen. Almost.

Lest you think I've returned from said vacation still heavy with bitterness, rest assured: The only heaviness I brought back is from butter-drenched seafood dishes, an array of fine cheeses and glass upon glass of Chardonnay and Sauvignon Blanc. My mind, spirit and stomach are happier than they've been in a long, long time. Almost as soon as we got to our rented condo, I felt so much of the tension of the past few months evaporate. I would be lying if I said I didn't think about infertility (and I know you'd see right through it anyway). But I could almost pretend we were just your average married couple, pre-kids, on a weeklong summer vacation.

Of course, the same things that draw a childfree married couple to a seaside town also draw scores and scores of fertile people and their spawn. The stroller-to-people ratio felt like 3:1 at times. And nothing makes a barren girl feel more barren than watching a cherubic little face devouring an ice cream cone as his or her adoring parents look on.

As I observed all of this and started to slip away from my blissed-out vacation mode back into sad, stressed-out territory, something occurred to me which, though it might be supremely obvious to anyone with an objective point of view on the topic, had not previously made its way into my oft-irrational mind. What if those couples I was looking at with such envy as they took up valuable sidewalk real estate with their MacLarens (another topic for another time) were, when I wasn't paying attention, looking wistfully back at me and my husband and our long, leisurely, non-"family style" dinners that never, ever, included the words, "I have to go potty?" What if, someday in the not-too-distant future, I think back to this week we had and wish we could get in a time machine for a visit?

Maybe those parents of the 25 kids who invaded our breakfast wished we could take them off their hands for a while. Maybe they wanted to go to the beach and just sit there, reading like me, instead of building sandcastles and "burying" children in the sand. Maybe someday I'll look back on this time, when we hung in the delicate balance between couple and family, between two and three (or four?), when it was still just us with the hope of something more, and, knowing that the pain would eventually stop and the longed-for baby would arrive and all the joy of that was still ahead of me in this moment, feel a certain longing.

Until then, all I can do is pick up the torch again and keep chasing the dream. It starts tomorrow, with bloodwork to confirm I'm not pregnant (insert sarcasm here) or ovulating on my own. Barring that miracle, I'll start Provera and, about a week later, a new injectable/IUI cycle with my fabulous new doctor. As green as the grass may be on this side, I'm not giving up on my search for something greener.

Thursday, July 24, 2008

Holiday

I started infertility treatments eight months ago. In the time that has passed since, I have: taken pills that didn't help me ovulate but did help me become a raving lunatic bitch; injected myself every night for weeks at a time; snuck out of a dinner on a Saturday night to give myself an HCG shot in my car like a desperate drug addict; nearly passed out twice at the shock of getting my period early; experienced the return of teenager-worthy acne thanks to PCOS; gotten intimate with the ultrasound wand too many times to count; had even more blood draws, several of which took many tries thanks to my thin veins and at least one inept medical assistant; nearly had my cycle canceled unnecessarily; found a new doctor (see previous item); and cried too many tears for one person.

The sum total of this? I. Need. A. Vacation. Seriously.

So, I'm taking one. On Sunday, my husband and I are headed for the first weeklong summer vacation we've had in forever. And it couldn't come at a better time. I hope I come back all rested up and ready for more of the above. Because the saga continues in a couple of weeks.

Monday, July 21, 2008

Girl Power

Sometimes I wonder what infertility would feel like if I weren't the "broken" one. Would it be somehow easier without the burden of knowing that my body is the problem? Without having the success of a cycle hinge on my PCOS ovaries' ability to produce just enough -- but not too many -- eggs? Would I feel less pressure if I didn't have this vague feeling of inadequacy at my inability to fulfill this "womanly" role every single time I saw someone else's child?

The irony, of course, is that even with male factor infertility, the woman is often the one to go through treatment. And frankly, although there are days when I would gladly hand the burden over to my husband -- or, really, anyone else -- I think this is for the best. With all due respect to men, their tendency to whimper at the first sign of a cold and avoid the doctor's office at all costs doesn't do much to convince me that they'd be terribly good at handling this stuff. Women are tough, and perhaps no one is tougher -- by necessity -- than a woman going through infertility. We bite the bullet and take the injection. We talk through tears. We subject ourselves to relentless poking and prodding. We chew on our lip when we want to yelp in pain. We keep going and ignore the voice inside that says I can't do it anymore. And sometimes we even manage to look cute doing it. I don't know about you, but some days the only thing that helps me leave the house is a pair of fabulous shoes.

All told, I am amazed at what we all are able to endure. I am reminded of the scene in Sex and the City after Charlotte's miscarriage. She's been sitting by herself, catatonic, for days, when she flips on the E! True Hollywood Story on Elizabeth Taylor, in which Taylor says, "Now is the time for guts and guile." The phrase brings her back to life; soon she is walking into Brady's child-centric birthday party looking flawless and ready to take on the world. How many times has each of us done the same -- returned from that desperate place of grief to brush ourselves off and walk on?

I know we would all do anything to cancel our memberships in this club. But since I'm an official, card-carrying member right now, it's such a relief to know that I'm not alone. You're all out there, surviving, showing me what it means to have guts and guile.

Wednesday, July 16, 2008

Chemistry 101

If you've ever sat down for a consult with a new RE, you know that in many ways it's like dating. You're searching for someone who shares your outlook, someone with whom you have that chemistry, that je ne sais quoi, that (as Carrie Bradshaw called it) za za zu. In this case, of course, I'm looking for someone to fix my broken girl parts. To get in there with speculums and ultrasound wands and medicines and washed sperm and get me knocked up, already. (Sadly, though this kind of dating ends with someone getting in my pants, I'm not even getting a free dinner out of it.) This week, I met with two and I have to say, I'm smitten. With the wrong one.

My search for a new doctor is a long time coming. Since starting treatment in November, I really haven't felt comfortable with my current doc, or confident that he was invested in my case. When he (incorrectly) nearly canceled my last cycle halfway through, the nurses gently suggested that I meet with another doctor in the practice (let's call her Dr. A) if I didn't get pregnant. I eagerly agreed, but secretly thought that this crossroads offered the perfect opportunity to make a fresh start with a different practice. So I also made a second consult appointment at another clinic, and saw the meeting with Dr. A as doing my due diligence, to get another opinion but seal my suspicion that I needed to move on. To stay, I thought, Dr. A was going to have to be fabulous. And, in keeping with the rest of this infertility journey which seems to be full of surprises, she was.

She immediately took charge. She told us she believes in patient education, and proceeded to explain, from the beginning and in detail (with drawings), what was wrong with me, what is happening with my cycles. She said my last cycle was actually ideal, though she would have kept it going until my one follicle was a big larger. She prepared me for "low and slow" injectible cycles (perhaps up to 30 days) if she were to treat me. She said things like, "After you get pregnant we'll put you on the pill until you try for #2." She told me it's likely a question of when, not if. Mostly, she made me feel that if I went with her, she'd want success as much as I did. She was caring, but all business. A girl after my own heart.

Prospect #2 -- Dr. B. -- was a nice, nice man. He had caring eyes and a soft manner. He listened carefully and thought about his answers. But I found myself wanting to get a rise out of him. He put several options on the table without expressing a strong opinion on any one. I realized that I want to go to my friends to chew on things and get tender words and looks of sympathy. From my doctor, I want the bottom line and a strong opinion on how to achieve success. Want someone who plays to win.

I really didn't want to stay in my current clinic. But you have to mesh with your doctor, and you can't force chemistry. When it comes to the journey to my baby -- just as I did in the journey to my husband -- I'm learning to follow my heart. And my heart tells me Dr. A is the perfect match.

Wednesday, July 09, 2008

Make a Wish, Baby

Years ago, my parents had a few super 8 movies made into VHS tapes (which now need to be DVDs...when will it end?). In one, I am a tiny infant in the arms of my dad, who is impossibly young looking, on the brink of becoming the sure-footed dad I know, but for that moment still just a guy in his 20s whose wife just had a baby. The footage is set to "Sunshine of My Life" by Stevie Wonder, which as a result sticks in my head (yes, I know it's schmaltzy) whenever I try to imagine what it must have been like for my parents when I was born, 32 years ago today.

The tape is hard for me to think about right now. My young dad with a baby in his arms, the beginning of a new family, the hopefulness and anxieties of all new parents, since the beginning of time, suspended in the air of those first moments. Me, so vulnerable and unmarred by anything that lay ahead. I want to tell that girl some things. Want to give her fair warning and see if I can remove some of the shock and sting. I want to tell her that it -- life -- sometimes isn't anywhere near what you thought it would be. You will wake up on your 32nd birthday and notice that the kids you'd imagined are missing and your fridge is stocked with injectible FSH.

But sometimes, the gap between what you thought and what turns out is okay. Sometimes there is this unanticipated joy in the discovery of what actually happens. My birthday is tied with Christmas as my favorite day of the year. I am absolutely obnoxious in my excitement over it. When my husband told me he wouldn't be here, I felt this deep disappointment. I immediately pictured myself alone, in tears, still grieving over my negative pregnancy test. Here's what happened instead: My friend, the kind of friend who is family without the baggage, took me out on the town. We shopped. We stuffed ourselves with cheeseburgers and laughed out loud. I couldn't have felt less alone.

And I even had a little birthday party earlier in the day at work. All told I had two desserts today (low carb diet be damned), two candles to blow out. I'll give you two guesses what I wished for.

Sunday, July 06, 2008

Independence Days

Could they please stop making holidays that make me feel more barren? I thought once Christmas -- with the tiny tots and their eyes all aglow -- was behind us I would be safe, at least until next year (but by then, surely I'd be pregnant). I was wrong. There was Easter, with the adorable little ones in their ruffly dresses and miniature suits chasing pastel eggs around lawns across the nation. And then Friday we had Independence Day, the latest holiday that apparently requires kids to celebrate fully. There are parades (which stop being fun and start seeming weird around the age of 13). Fireworks. Family picnics. Cookouts which, since most of our friends now have kids, are now more keep-the-kids-occupied than pour-me-another-drink.

And yet, this weekend my husband and I celebrated our own independence before he took off for his trip. We had a long, leisurely lunch while watching the Red Sox game. Went out to a late dinner. Had multiple glasses of perfectly crispy Chardonnay on a whim. Slept late, got up and played tennis then made a late breakfast. It felt like old, pre-fertility treatment times. We couldn't go to the family-oriented Fourth of July events. On the other hand, we didn't have to go to the family-oriented Fourth of July events. We were free to go wherever we wanted, whenever. No one being overtired, cranky or whiny forced us to change our plans.

Someday -- and I pray it's someday soon -- I hope that all changes. I hope to have a little person dictating what we do all weekend. I'll gladly give up every ounce of independence for that. But until then, instead of pining for the family we don't have, we can -- and will -- keep celebrating the one we do.

Tuesday, July 01, 2008

Comfortably Numb (for now)

When you're 100% sure you're not pregnant and you're offered your pregnancy test -- the end of the dreaded two week wait -- a day early, you jump on it. So that's what I did this morning. And I made it easy for the nurse. "I know I'm not pregnant," I told her. "So don't worry about disappointing me when you call." Sure enough, later this morning she called and told me I was right. She still sounded sad for me, and I felt like I needed to do the cheering up. "It's okay," I said. "I really knew." I really did.

I don't know if I got it all out on Sunday after the home test. Don't know if I've just grown accustomed to the disappointment and sadness. Or if I've grown a thicker skin. But for now all I feel is numb. And so, if the numbness is just the calm before the storm, if my breakdown is imminent, before it comes I thought I'd make a list of ten reasons I can feel good today:

1. No more progesterone suppositories. I'm sure the PIO shots are no Fourth of July picnic either, but may I just say that it's more than a little awkward to stand up at work and try to keep carrying on a civilized conversation with colleagues as you sense the tidal wave of progesterone crashing between your legs.
2. On the other hand, the progesterone worked. No period, which means that if there had been something to implant, it had a full two weeks to dig in this time (versus a too-short nine days last time). Hurrah for synthetic hormones!
3. I can now consume (and plan to, in large quantities, in the coming weeks) any of the following: Double lattes, champagne cocktails, Diet Coke, a delicious array of soft, dangerously unpasteurized cheeses, spicy tuna rolls, mojitos, deli sandwiches, Sweet & Low, shellfish (Legal's chowder - yum), steak tartare, to my heart's content.
4. I have two consults with fabulous new doctors scheduled for the week my husband comes home from business trip. Clean slate. New ideas.
5. I am taking a month off to recharge, which will put me back in that fightin' mood when the time comes to get started again (with one of two said new doctors).
6. No shots, "wands," poking or prodding during this month off. No one will utter the word "follicle." (Please.)
7. Next time, I might have a shot at twins (this time I only had one egg...not to push my luck, but yes, I do want twins. Strangely enough, despite all the knee-slapping fun I'm having with this process, I really think I'll pass on another round if and when I finally get pregnant.)
8. I can spend quality time thinking of creative, passive-aggressive responses to the 200 "When are you having kids?" questions I'll get at my husband's family reunion.
9. I'm one step closer to a baby. Since this can't go on forever, somehow that will prove to be true.
10. I'm functioning. I'm getting up in the morning, going to work. Maybe not running at 100%, but doing my thing. And that's something I wouldn't have thought possible in the face of another disappointment a few months back.

Fair warning: the numbness may thaw any minute. I can't predict how ugly it will be.

Monday, June 30, 2008

Preparation, Schmeparation

It's Sunday morning, three days before your two week wait is officially up. You decide, against the recommendation of your infertility clinic nurse, your husband and a nagging, vaguely Pollyanna-ish voice in your head that yearns for three more days of sweet hope, to break out the First Response and have a go at peeing on a stick. You tell yourself you're trying to prepare yourself, to take out some of the sting of shock that would otherwise rush through you when the nurse told you the bad news on Wednesday. And yet, there it is: the same sting as you stare at the dark pink single line.

The hope that each cycle carries is like a funnel. It starts a mile wide. You just finished an IUI. Millions of sperm were right in the ballpark of that ripe egg. There's no way it could not work! The week progresses. You're not as bloated as you were a few days ago. That breast tenderness is gone. Hope narrows. But maybe I'm in the x percentage of women who don't have any symptoms at all! You take the test -- it's negative. Hope narrows again. But it's only 93 percent accurate the day before your missed period. I could definitely be in the seven percent! Someone has to be, don't they? Don't they?

Soon, your rational mind, violently opposed to all things Pollyanna, sweeps in. You're not pregnant, it says. And thank goodness I'm here. All that optimism isn't good for you. It leaves you so unprepared for the bad news that seems to come, time after time after time.

Still, I will go through the motions, will go on Wednesday for the blood test. I suppose that, in the end, the home test eased me into the bad news, but it's done nothing to show me how to survive yet another disappointment.

Thursday, June 26, 2008

Some Lemon for Your Wound?

Just when I think the two week wait couldn't get any harder, my husband announces there is a business trip to Asia. He leaves the Sunday after my Wednesday pregnancy test and will be gone for my birthday and the two consult appointments I have with new REs (if my test is negative). So let me get this straight, I say. While I'm still melting down from a negative test (no one has ever accused me of being an optimist), wallowing in self-pity over having another childless birthday, and consulting with two new doctors on when the hell (if ever) I'm going to get pregnant, you'll be on the other side of the earth? Yep, that's about it.

After I recovered from the blinding, irrational-yet-inevitable rage, I felt instantly guilty for said rage. What if there was a fertilized egg trying to attach and had decided, you know what, this woman is too high strung for me? After all, I was 9 days past my IUI -- smack in the middle of the 6-12 days required for implantation. Or what if it had already attached and was now shaken loose by my fury?

As my obsession about this point continued this morning, a very wise friend of mine made a good point: If getting upset were a good way to prevent or end pregnancy, why would birth control exist or unwanted pregnancies ever progress at all? These women's doctors could simply say, "Yes, you're pregnant, but if you just get pissed off at someone and scream and yell a little, problem solved!" And if getting upset were so harmful, why would God make pregnancy hormones turn women into emotional time bombs?

The thing is, life doesn't stop handing you lemons just because you're in the two week wait, or pregnant. And we don't stop feeling upset, angry, sad, anxious, irritable or sensitive just because we're trying to become mothers. While we may not always feel capable of making lemonade, the least we can do for ourselves is keep the juice out of our wounds. I'm trying my best not to add worrying about worrying to the angst of the two-week wait.

As a completely random (in every way) aside, there was just a commercial on ABC for a special with "seemingly traditional" families who are adopting monkeys -- yes, monkeys -- as their children. Walk them around in strollers and everything. Maybe they're onto something. Maybe if this human baby thing doesn't work out....

Wednesday, June 25, 2008

New Day, New Blog

It feels like a new day, so the time seemed right for a new blog. I'm not pregnant (as if!)...at least not that I know of. But my friend and previous blog partner Lisa is pregnant with twins, and I just "graduated" from a mind/body infertility group where I learned how to be some semblance of my normal self again. So I'm looking for a fresh start as I continue my hunt for a few good eggs.

I did not think it was possible to do this, by the way -- get a fresh start without a positive pregnancy test. To my mind, it was so all-or-nothing before: infertility=stuck permanently in a rut of total depression; get pregnant=find instant happiness. I'm learning the truth is somewhere in the middle. Yes, infertility sucks. It's brutal. It taps a deep sadness that gets right to your bones. But this depression feeds on itself and it's possible to cut the cycle and avoid falling so deeply into it each time. It's possible to catch yourself as you tell yourself lies -- "I'll never be a mother." "I am being punished." "I wasn't meant to get pregnant." -- and create a new internal monologue: "I am going to be a mother, one way or another, and I'm doing everything I can to achieve it."

Sound impossible? Unattainably enlightened? At times, it certainly is. At times you need to curl up on your bed and scream and cry and curse everyone you know who had a baby without scientific intervention. But that doesn't have to be all the time. There are pockets of joy to be had. And I'm searching for them even as I continue my egg hunt.