Monday, February 23, 2009

Hysterical over Hysteroscopy

I wasn't worried about going in for the hysteroscopy this morning (although my nightmare about rats last night doesn't exactly reveal an uncluttered subconscious), but now I know that I should have been. Clearly my uterus chose not to heed my letter (I should have known), because it did not go well at all.

The procedure itself was fine -- at this point I am used to all manner of instruments, dyes and other accoutrements having their way with my reproductive tract. Although I will say that when she couldn't get into my uterus initially and tried dilating my cervix and going in again, I had to concentrate very hard on not screaming bad words. What made the whole thing really suck, though, was what the pictures of my cervix and uterus showed: scarring from the D&E. The kind that requires more surgery to remove. For someone who really doesn't like surgery very much I'm seeing a lot of that operating room, dontcha think?

As if that didn't satisfy my shit news quota of the day, I also learned that the pathology report from the D&E was back, and showed that our embryo had the genetic defect tetraploidy (i.e. it had four sets of chromosomes instead of two). On the spectrum of genetic defects that cause miscarriage this apparently is nothing standoutish, but it is sad and disturbing to hear all the same (the only upshot of this news is that I can finally stop irrationally blaming anxiety, the pedicure I had, what I ate and getting angry at my mother as possible causes of my miscarriage). Although the defect is relatively standard, they're running genetic typing tests on both me and my husband just to be sure it was a fluke. Which I guess should make me feel better -- we'll rule out more things -- but instead just makes me feel like there's yet another thing to worry about.

Also, I learned -- accidentally, by reading my doctor's computer screen -- that it was a girl. My doctor confirmed what I saw and said she was sorry I saw it as she knows that information can be upsetting. It was jarring and sort of emotional for a moment, but I don't know if knowing is any sadder than not knowing. I had this embryo. It was unhealthy. It would have been a girl if it had been healthy. But, again, it wasn't healthy. What more can I do or say about it?

I opted to work from home today (good choice), and I drove back home after the appointment feeling overwhelmed. So I did what any girl in my situation would do: I stopped at a pizza joint -- the really good place in town, not the pseudohealthy place that makes wheat crust -- got two slices of cheese and promptly inhaled them, with a diet Coke and without abandon or remorse, when I got home. This reckless behavior will likely continue tonight with the consumption of good-sized quantities of alcohol and chocolate. I'm just telling you -- I don't expect or want you to stop me.

PS: I just got a baby stuff catalog in the mail: the last straw for today, thank you. Called and told some poor call center lady that I am infertile and cannot be getting their catalog delivered to my home. Found this oddly satisfying.

Sunday, February 22, 2009

An Open Letter to My Uterus

Dear Ute:

You're on again tomorrow -- it's all about you, just the way you like it. It's been a while since we've had a good look at you, and I can only hope that you haven't been dreaming up any new tricks while unsupervised. Recall that only seven weeks ago your shenanigans put us in the hospital and led to the D&E that I'm sure was no summer picnic for you either. I appreciate your noble attempt to hold onto that poor tenant, but I'm sure you'll agree in retrospect that you were a wee bit slow on the uptake with that one.

At any rate, we've both had some time to heal since then, and I hope the break has been good for you. Tomorrow, a hysteroscope -- a medical term for paparazzi, I believe -- will pay you a visit and snap some photos, so please have your best Paris Hilton pose all ready to go. But it would be nice, particularly in the context of what you pulled back in December, if you could just be sort of boring. Look pretty, but please don't try to be particularly interesting. You'll have plenty of time to shine in a few weeks when we send two new prospective tenants your way. Hopefully, they'll be the kind that stick around.

Also, try to relax. I know these situations can be tense, but cramping up won't do either of us any good. So do what you have to do -- yoga, meditation, vodka martini, whatever.

Thank you in advance.

Happy thoughts,
Good Egg

PS: Say hi to those ovaries and tell them to rest up -- they're on next.

Tuesday, February 10, 2009

A Way Forward

All right, something in me is trying to say. Time to perk up a bit. Loosen that death grip you have on your grief. As my family likes to say, Stop the wimp. The voice is tiny and tentative, but there it is. So I'll listen and make this post all about the path forward, even though doing so feels a bit like trying on an ill-fitting hat. Even though more of me would rather wallow here a bit longer.

Here's what I got from my (still fabulous in every way) doctor when we met for the infamous WTF appointment (this one being my most difficult yet -- the most fitting to ask, seriously, WTF?) post-miscarriage. The IVF cycle went well, but could be improved. Of 18 eggs retrieved 17 were mature, and 9 fertilized. Of those nine resulting embryos, however, only the two we transferred looked truly viable and only one looked really good. Of course, we'll never know which one implanted and it doesn't really matter since it turned out to be a total slacker anyway. She blames the miscarriage entirely on a run-of-the-mill (my word, not hers) genetic issue, which is one of those pieces of news that should somehow make you feel better but absolutely doesn't.

To improve embryo quality for the next cycle, she is adding the medication Repronex and scaling back the Gonal-f, which apparently will help by adding LH to the FSH mix. I believe that Repronex is made of urine from post-menopausal women (I read once that it was post-menopausal nuns from Italy, which seems too strange for someone to have made up), which probably should make me wince a little but at this point sounds positively dreamy if it will give me a live, healthy baby. Since no post-miscarriage period came on its own (as if), I took Provera and am now waiting patiently. Once it arrives, I will go on the Pill and will go in for an office hysteroscopy to make sure nothing strange is going on in there (girl parts convention? sorority party?) before getting started with IVF #2 and that new protocol.

I feel just as I would've guessed I'd feel at a moment like this: terrified, hopeful, pissed off. Wanting desperately to believe what everyone keeps telling me about all I have going for me. Oh, wait. I'm trying on this hat. Okay: I feel determined. And a little bit brave.

Wednesday, February 04, 2009

Pity the Fool

Somehow after the humiliation of dropping off that first "sample," (See? I still can't even say it.) I dusted myself off and found the willpower to drop off the second. By the grace of God, my long lost high school friend was not at the lab the next day, the test results turned out to be normal a week later and my symptoms have largely subsided (save some heartburn which for me seems to turn up every now and again as a delightful companion to stressful life events). Still, with the luck I've had over the past several weeks I'm beginning to worry whether any other irksome medical issues want to demand some investigation. Perhaps a UTI is lurking, just waiting for the right opportunity to rear its frequent pee-making head.

Outside of my digestive tract, I've been trying to figure out what to say about how I'm feeling, which has been a challenge since I'm not sure how I'm feeling. Mostly my emotional existence has devolved into a state of pretty constant self-pity, and my friends, pity ain't pretty. Sometimes I start thinking of myself in the third person, as if I'm watching me on a movie or following my story in a novel. That's when I really lose the belief that I am capable of ever moving on and charging ahead. I feel so sorry for this poor girl who just can't seem to capture her commonplace dream, who instead sees her raw hope dashed time and time and time again. I cry for her and her poor beginnings of a baby that was never meant to be. It's so hard to accept the idea that her amazing marriage can't seem to evolve into a family, that they might never know what it's like to hear their own children run through the house.

There's no reason for me to think all of this. No one has told me it is not going to happen for me -- in fact, the people with actual qualifications to make such projections have told me there's every reason in the world to think it will. But these days, what I feel most acutely is the absence of my brief brush with motherhood, the gaping hole that it left behind and the fear that I am a fool for ever having hoped. And that I might never get there again.