BrooklynGirl

With Friends Like These

Thanks to Karen for pointing out the absolutely appalling interview with Joseph Isaacs, the president and CEO of Resolve in this week's Newsweek.  The draft of the letter I'm hoping to send tomorrow appears below.  Please consider writing a letter of your own if you haven't already.

Joseph C. Isaacs, President and CEO
Resolve
7910 Woodmont Avenue, Suite 1350
Bethesda, MD 20814

Dear Mr. Isaacs:

I'm writing to let you know how disappointed I am with your responses in the March 13^th "Ask the Pro" column in Newsweek.

As the president of an organization whose mission is to "provide timely, compassionate support and information to people who are experiencing infertility and to increase awareness of infertility issues through public education and advocacy," you had an opportunity to clarify the struggles and medical issues of infertile people.  Instead, you left the faulty impression that women can avoid infertility if they "practice safe sex, maintain normal weight, avoid environmental toxins, don’t smoke and limit alcohol."  This dramatically overstates the control that women have over their fertility and suggests that infertility is not a disease, but rather a punishment for unhealthy lifestyle choices.

Like millions of women, I suffer from unexplained infertility.  After spending 3.5 years trying to have a child, I was fortunate enough to conceive by IVF and give birth in August of 2005.  What's more, I was lucky enough to be able to afford this treatment that was not covered by my insurance company, which, like others described on the Resolve website, has "been slow to recognize infertility as a disease."  Is it any wonder that insurance companies continue to deny that infertility is a disease when the President of the "only established, nationwide network of chapters mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders," is himself so quick to point the finger of blame at women for causing their own infertility?

What's more, your advice that the first tests infertiles should have with an infertility specialist are "a temperature analysis so they can see if you're ovulating. A laparoscopy for women will check for obstruction" is alarmingly out of date.  Although basal body temperatures are useful in documenting a pattern of ovulation, women can begin tracking these patterns well before consulting a reproductive endocrinologist who can do more precise blood tests and ultrasounds to pinpoint ovulation issues.  Further, laparoscopy is an expensive and invasive surgical procedure that, while may be required as part of a complete infertility workup, is something that is generally undertaken after less expensive, less invasive tests such as a hysterosalpingogram have been performed.

 

I strongly suggest you step aside as the president and CEO so that a more compassionate, better informed individual can take the helm of Resolve to advocate for the medical needs of infertile people everywhere.

Sincerely,

All Clear

I'm infertile, too tired to have sex, and still haven't gotten my period, but other than those limiting factors, I have the all clear to get pregnant. 

I saw my OB yesterday for a six month postpartum visit, and she said that if I'm content to have another c-section, I can get pregnant now.  If I'm determined to give vaginal birth a try, we should hold off another 3-6 months.

To which I say: ha.  Ha ha.  My OB has always had an exaggerated sense of my fertility so when she asked me how many children I wanted to have, I somehow managed to stammer out that wanting and having were two different things, especially when you are 36 and it took you 3.5 years and $20,000 to have your first child.

But the fact is that I would like to have another child (for many of the reasons that Julie and friends have eloquently enumerated here).  I don't know that I'm ready to cycle again or that I will ever be able to justify gambling The Boy's college fund (such as it is) on ART, but again, like Julie, I have not been able to part with the accoutrements of IVF, which are packed up and hiding in the back of my closet in case they should become...relevant.

In the meantime, I'm just going to focus on enjoying The Boy, who is practically perfect except for a slight reluctance regarding carrots.

What a Difference a Year Makes

I don't remember last year's Halloween.  We had just made the momentous decision to go ahead with IVF so we were consumed with that, but I don't remember whether we carved pumpkins, bought candy for trick or treaters, or just stayed home and drank ourselves into oblivion on this child-centered holiday. I just don't know.

So, today I was overwhelmed when I strapped The Boy into his Bjorn, and we went out to do some afternoon errands.  My neighborhood takes Halloween pretty seriously: there's a parade up 7th Avenue, the main drag in these parts, and almost all the businesses are open to trick or treaters beginning more or less as soon as school lets out.  We were swarmed by princesses, mermaids, and grim reapers as we bought our food and sundries.  I was unprepared for the masses of strollers, the beaming of the parents, the cuteness of the kids.

And, as so often happens when I remember where I was a year ago, I was overcome.  Last year, I wouldn't have dared to hope that I would be obliviously out and about on Halloween.  I couldn't imagine that I would be lucky enough to have this.

The Good Enough Parent

It's an amazingly simple con most baby stores have going, and it runs something like this: "Well, sure, the $50 version of the Thingamajig You Must Have is fine, but all the good parents seem to be buying the $200 version."  And like that, even though you were settled on the $50 version, you find yourself considering the $200 version, or compromising on the $150 version because you want to be a good parent.  After all, who's a better judge of your potential parenting skills than a random employee at a baby store?

I'm aware of the con--you're aware of the con--but it's hard not to fall for it.  Especially if you're a nervous first time parent to be who's afraid of spending too much time on this for fear of inviting the cruel winds of fate into her home.

Now, the con is one thing when you're talking about bouncy seats and boppies, but something altogether different when it comes down to medical decisions, like cord blood banking, for instance.

My OB's office is blanketed with pamphlets about various private cord blood banking programs, and without having thought too much about it, I assumed we'd bank (I assumed this without having heard of cord blood donation to public banks, which now seems the most attractive option to me).  I mean, who knows?  It seems like your own personal stash of stem cells is something you'd want to keep on hand if you could, right?  Plus, if those stem cells could actually help your child, wouldn't you be a bad parent not to have banked them just because it was a couple of thousand dollars you could have spent on something a little more frivolous, like say food or shelter?

Well, if you haven't seen it, there's a really great article about private cord blood banking in Monday's San Franciscio Chronicle that dispells some of the myths floating around out there. 

What do you think?  Private cord blood banking: yea or nay?

Transitions

My best friend is coming to visit this weekend.  I'm excited to see her, but also nervous, because (as I've mentioned before), our friendship hasn't been what it was before my husband and I started trying to breed.

It's not that she was one of my flagrantly fertile friends, getting pregnant just by thinking about having sex, but rather the opposite end of the spectrum: she's single, anxious about her singleness for biological clock reasons as well as other reasons, and largely uninformed about potential fertility issues (as, naturally, I was before I had cause not to be).  Anyway, over these many years, the worse things got for my husband and I in the child having department, the less I talked to her.

Though I've talked through virtually every other major life issue with her since I was 5 years old, I did not happen to mention that we'd decided to do IVF because I didn't want to get into it.  Then I dodged her calls for weeks during the extended am-I/or aren't-I stage of this pregnancy because I couldn't bear having to explain it all.  When I finally spoke to her, I said something along the lines of "I'm pregnant, but I don't want to talk about it," and because the could-be pregnancy was all that was consuming me from January on, again, we didn't talk much.

Until she told me that she was quitting her job and moving.  She doesn't live close as it is, but now she'll be further away-- a plane ride instead of a road trip.  As I had not discussed any of the IVF stuff with her, she had not discussed any of her moving plans with me.  That seemed fair, but still sad.

She's excited about the place she's moving and the house she's buying, and I responded the way I would normally respond: that I can't wait to come visit and see it all in person.  And that's true, but by the time the school year ends, I will have all but arrived at my doctor's no travel date (because of the thrombophilia and the pre-term labor threat, she's being fairly conservative).  After that, well, who knows.

When I was little my bedroom used to face her house, and we would shine flashlights into one another's windows at night--our own version of Morse code that always said the same thing, "I'm here. I can't sleep.  Wish you were here too."

I've missed that. 

Holiday from Hell

Mother's Day is on Sunday.  Bah humbug.

Once upon a very long time ago, I used to buy cute little cards--I was partial to Mary Engelbreit--for my mother and my mommy friends and send them off in the mail, graciously sealed with a kiss.  I had no angst about this because I wasn't ready to be a mother yet, and besides those cards were just so darn cute.

But then came the spring when we decided to get pregnant.  We started in March, and though I was a little surprised when I wasn't pregnant by that special Sunday in May, I wasn't too concerned.  Next Mother's Day I'll be a mother, I thought to myself, still thinking it was just that easy.

By the Mother's Day after that, my bravado was gone.  I'd had a miscarriage by then, and I switched to a fancy GYN in Manhattan who had started talking about Clomid.  At the time, Clomid sounded scary, but I was willing to try it.  Maybe I'll at least be pregnant by next Mother's Day, I thought, trying to be optimistic, but not really daring to believe it.

Last Mother's Day found me in stirrups at my clinic having intimate relations with a catheter and a fellow who was not my husband.  It was IUI #3, and subscribing to the three-strikes-and-you're out rule, it was my last shot before moving to IVF.  During that two week wait, I learned first that my brother and second that a close friend were expecting their second children.  I thought of it all as the Mother's Day curse, and who could really be surprised when it ended with a chemical pregnancy?

This year, amazingly I'm 24-weeks pregnant, and in the last week, various medical professionals have patted my belly and wished me a Happy Mother's Day. 

And I have wanted to slay them all.   

The depth of my animosity has surprised me.  I thought I might enjoy this a little bit, but I can't.  There's a chicken-counting component to it that makes me nervous, but it's also the basic unfairness of it all.  Because Mother's Day seems to me like a super-selective college that only accepts 9% of its applicants and tells some really amazing people "no."

Now, I'm not knocking the mothers I know and love.  There are some people out there who deserve to be celebrated and taken to brunch and dosed with all the champagne they can handle.  Pass the collection plate, and I'll chip in! 

But let's not do it on Mother's Day.  Let's choose something a little more ecumenical.  Call it Kick Ass Women's Day.  And we will all get together and eat some of Moxie's Rhubarb Coffee Cake and Julia's Oatmeal Buttermilk Pancakes (apparently, we're having brunch) , and we'll celebrate everyone.

I wonder if Mary Engelbreit makes a card for that?

The Family Approaches

My parents are supposed to arrive in 5 days.  I am simultaneously more nervous and less nervous about the whole thing.   More nervous because they are still demonstrating gargantuan proportions of not getting it.  Less nervous because I'm finding their not getting it funnier and funnier.

As evidence for not getting it, I present the following: for the past few months, whenever I would chat with my Dad on the phone, he would ask about how the job hunt was going, and I would pause awkwardly and say, "Well, you know I'm student teaching until late June, and I'm due in late August so job hunting really isn't at the top of my list."  Because it seemed all too self-evident, I didn't bother to point out that schools begin in early September (the man works in education so he knows how school schedules work), about a week after I'm due, so it's downright implausible that I would be able to start a new job this fall.

After multiple conversations with my husband and my therapist, I decided to excuse my father's ignorance.  Since he's a man, and men don't actually give birth, may he didn't understand how it all works, that here in the U.S. of A., we like to take a little more than a week to adjust to the whole "Holy Shit!  We have a baby!" thing.

This week, however, my mother called to chat. I finally had the opportunity to relay the whole ultrasound saga to her (we're still waiting on the official report, by the way, but all the bits that needed to be seen at the 3rd ultrasound were finally seen), and instead of following up with any medical-type questions, my mother instead decided to start with, "So, have you started looking for a job?"

Again, I was floored.  More floored this time because the woman has actually had two children and knows from her own personal experience that one might want just the teensiest bit of downtime after giving birth--a woman, who in fact took a whole lifetime of downtime after giving birth and never returned to teaching after she got pregnant with me.   But I digress.

"Well, mom," I tried to explain, "You know, the whole pregnancy has sort of sidetracked the job search a little bit since I am due in August and school starts in September."

"Oh," she said and changed the subject.

This is weird, right?  So legitimately, mind bogglingly weird that I just have to laugh.  The visit is going to be downright surreal.

Family Matters

I was a freak long before the whole infertility thing, but this experience has really emphasized my freakish side.  And not in a good way.

The deeper I sunk into the infertile muck, the more I withdrew from the fertile folks around me, including family members.  Perhaps especially family members.  It was hard, see, because in the time we were trying to reproduce, my brother managed to have two adorable daughters.  He was happy.  His wife was happy.  My parents were happy that they had grandchildren to spoil.  I, of course, was miserable.

I tried to be a good sport--I really did--but I failed.   I never knew how to tell my family what I needed from them: involvement, but not overinvolvement; support, but not prying; space, but not absence.  I sent them links to information from Resolve.  I sent a book on infertility with little sticky notes explaining what was going on with us, but they never really "got" it, and they continued to make offhanded comments from time to time that really pissed me off. 

With this IVF cycle, I never had the eureka moment of finding out I was pregnant--there was the low beta, the confusing everything else--so I never made the call to my parents in which I said, "Guess what?  I'm pregnant!"  Instead, I parceled out information on a need to know basis, always couched in self-protective detachment, never with any enthusiasm.

In my head, I had written the email I would send out to my family after the Big Ultrasound. I would tell them that we were finally starting to believe this might happen, that we were allowing ourselves to be excited, that there were maternity clothes and pregnancy books in the house.  But it didn't happen the way I had hoped, and so the email wasn't sent. 

I haven't even shared the ultrasound saga with them.  In fact, the weekend before the ultrasound, my mother asked if there was any medical news, and as I paused to weigh whether or not to tell her about the big day we had coming up, she said, "This is just the weirdest thing."  Another offhanded comment.  A space filler.  But it sent me scampering back to my hole.  I said nothing.

My mother is disappointed that she isn't "sharing" this experience with me (important bit of background information: my maternal grandmother died while my mother was pregnant with me), but I have been so reluctant to acknowledge this experience for myself that there really hasn't been anything to share.  Not that this is something my mother understands. 

But all this will change in a few weeks when my parents come to visit.  They keep talking about the restaurants they want to go to and the wine they want to drink (not an activity high on a pregnant woman's list of things to do).  My dad keeps asking if I'm going to get a job when student teaching is over in mid-June, when I should be 7-months pregnant.  It boggles the mind.  I can't imagine how this visit could go well.

I know that I've brought it on myself, but I don't know how to fix it.

Any ideas?

R.I.P. Georgeanna Jones

It's hard to imagine life without home pregnancy tests, supplemental progesterone, or IVF, but that's what it might have been like without Dr. Georgeanna Jones.

• In the 1930s, she named the pregnancy hormone human chorionic gonadotropin and argued that it was produced by the placenta, not the pituitary gland. (This kicked off the research that led to the development of the HPT.)
• In the 1940s, she identified luteal phase deficiency in women suffering from recurrent pregnancy loss and suggested that it could be treated with supplemental progesterone.
• In 1981, Elizabeth Carr, the first American IVF baby, was conceived under the medical guidance of Dr. Jones and her husband, despite vigorous protests.

She died over the weekend at the age of 92, and though I hadn't heard the name Georgeanna Jones until just a few hours ago when my husband mentioned reading her obituary, I feel a little like I lost a friend.

Thanks for everything Dr. Jones.

What to Say?

I'm not sure what to say these days.  I found the whine quotient in my last post a little high and generally unappealing. 

I want to be grateful and appreciative that I am, at 18 weeks, still pregnant and mostly okay.  Yes, there is the possibility of gestational diabetes and yes, I am getting weekly injections of 17-alpha hydroxyprogesterone caproate in case my low progesterone puts me at risk for pre-term labor, but in the scheme of things, these are manageable.

Although most of our friends know our news at this point, I'm still closeted to casual acquaintances.  I'm not a slender girl so I'm not really showing, though my clothes are starting to fit in odd ways.  I had planned to look at maternity clothes this weekend, but the closer I got to the store, the more nervous I started to feel so I turned around and came home. 

A close friend of mine is newly pregnant--natural conception after a couple of months of trying--and she was saying how exciting it will be for us to "share" this experience, and I thought maybe she was right.  Then she proceeded to voice her concerns about hot baths, a couple of sips of red wine, and the safety of eating fresh mozzarella and blue cheese.  I wanted to bond with her about these issues--I really did--but the urge to roll my eyes was a little stronger.

I guess I'm still looking for my niche.