Looking Backward; or, Last Year's Wishes

I gave up on the idea of New Year's resolutions a year ago. The fact that nothing I wanted out of 2010 could be gained through resolving to gain it just showed up the emptiness of the concept. I want a baby. Obviously. More than anything. And I will do whatever it takes to get one. And that might not be enough. And I don't have much control over when it will happen, if it ever does.

Sucks. But that's life.

Instead of resolutions, I made a series of posts about my wishes and my plans for the new year. And I figured I'd look back now--just a few weeks away from flipping to another new calendar--to see how things panned out.

Let me be blunt. My wishes didn't come true. I did okay with some of the less specific ones (like wishing that I'd appreciate my body for the things it can do rather than what it can't), but I just threw those in so I wouldn't seem totally grabby and But-I-want-it-NOW-y anyway. The big stuff, the real wishes, those didn't come true.

(Well, I guess technically I did get pregnant this year, too, which was Wish #1, but considering I never even got to feel excited while looking at the pee stick, I'm calling that one a draw).

I'm not even going to bother with writing out a new list of wishes this year. Just look up the old ones and plug in "2011" for "2010" because they're all the same. Oh, but you can change the first wish to "Get pregnant with a healthy baby that doesn't die or have serious genetic abnormalities."

When I look back over my plans for the year, though, the story is different. I did pretty well! I broke the plans into two different categories: Intended Achievements and Intended Explorations. I purposefully set pretty modest goals for each category (not "Lose 20 pounds and Run a Marathon," for example). And I managed to accomplish almost everything I set out to do.

I completed all of the scholastic tasks I set for myself, with the exception of taking my oral exam. But I have a date set for that in May, so I'm feeling pretty good about my progress.

And I accomplished all of my Intended Explorations! I started a regular yoga practice--I may not be an expert yet, but I've grown stronger and more flexible and I've stuck to a work-out program for almost a year. I did go to Scandinavia with Lawyer Guy, and we made an effort to check out the Brooklyn culinary scene. Not bad!

Re-reading my hopes for the year and seeing that I was able to fulfill so much of what I set for myself is a nice little boost in a depressing season. My wishes didn't come true, but that doesn't mean I was unsuccessful in everything in my life. I'm going to make a similar list for 2011 in an upcoming post with similarly modest goals. I may not feel the incredible surge of pride that I would if I resolved to swim the English Channel or finish my dissertation by next year and then succeeded. But when what I want most feels so out of reach, it's nice to have a few goals I know I can accomplish.

Money, Money, Money; or, What Would You Do?

Lawyer Guy and I are facing one of the no doubt many practical conundrums we'll encounter as we move forward with ART. I could use some advice from those of you with more experience in these sorts of things.

So, to set the stage first for where we are right now, LG and I are doing a natural (i.e. break) cycle for the month of December. I'm on CD5 and unmedicated will ovulate anywhere between days 18 and 27, though it's usually more in the range of CD 21-24. I will most likely, then ovulate the week before Christmas (though earlier or later are always possible) and won't get my period until the first week of the new year.

In January, we begin our last Clomid+IUI. If that fails, we'll be meeting with Dr. W. in early February to discuss next steps.

Our options, as she laid them out to me briefly, are either to move to injections+IUI (which has an increased risk of triplets that worries her) or straight to IVF.

All of this is very hypothetical at the moment, and there's no reason to spend tons of time stressing or evaluating or deciding what we'll decide to do in Feb/March, when there are cycles to get through right now and conversations waiting to be had (and test results--from the RPL panel--that still haven't come in).

But there is a complicating factor at play. While our current course of treatment is covered by our insurance, we have zero coverage for IVF or injectible meds (the IUI procedure and all monitoring/testing/doctors' visits would still be covered). We have enough saved to handle the both routes for at least a few months and parents who we could turn to for help in a pinch (though that's a last resort scenario) but would obviously like to do whatever we can to keep costs down (and I don't believe our clinic offers any shared risk or other incentive programs).

LG does have a flex spending account for medical expenses. And his benefits coordinator just let everyone know that they need to specify the amount they want to put in it by December 20th. And, of course, whatever is unused in the flex account at the end of the year is lost.

So, how do you think we should handle this? As of now, there's still a chance that Clomid+IUI could work and we wouldn't need to go out of pocket for fertility expenses at all. But it's highly likely that we will be paying for medications at the very least in 2011. We don't know anything about the pricing of IVF at Cor.nell, since we haven't officially had a chat with Dr. W about that yet, but I'm thinking $12,000-$15,000 is pretty standard. And maybe $2,000-$4,000 for the meds, a little less if we're just doing an IUI? (Hard data on these figures would be appreciated.) If we knew for a fact we would be going the IVF route, I'd want to put in enough to cover one whole cycle, but since we don't know anything yet, it may be too big a risk to lose that money at the end of 2011.

Advice needed!

Time Keeps on Ticking: or, 4 dpiui

This going to be a bit of a random hodgepodge post, since nothing much is going on other than my slow, steady descent into irreparable madness. Every three seconds, I think to myself, "I have to be pregnant. I can't be pregnant. I must be pregnant. It's impossible that I'm pregnant."

And on and on and on.

In the meantime, Lawyer Guy accompanied me to the opera last night (more like, was dragged by me, but who's counting). It was the Met's recent production of Carmen, and I loved it. I spent most of the rest of my non-teaching time googling every bit of news that came out about William and Kate's engagement. A fun distraction from testing out my ute goggles.

* * *

Based on the two data points I now have to go on, I know that I won't have much of an idea if AF is coming or if something else is until 13 dpiui. Both positive test cycles I was positive I was going to get my period right up until that day. I keep trying to remind myself that there's just no way to know yet and that I should try to enjoy myself right now, because the tension only increases the closer to D-Day I get.

Oh, right, and I should start spotting the day after Thanksgiving, which I'm spending with LG's family this year. Awesome.

* * *

What else is there to say as I try to kill time? I'm leaning toward skipping treatments in December, but not because of my sister's wedding. After last month's chemical pregnancy I was determined to plow forward no matter what, and felt really good about that decision. But then LG received that most dreaded (to wives) of husbandly invitations: A Vegas Bachelor Party. And it's scheduled for the exactly the weekend we'd have to be on call for an IUI.

If I begged and pleaded and insisted, Lawyer Guy would refuse the invite. But I know how much he wants to go. Many of his friends have moved from the NY metro area and now have kids, so he doesn't see much of them. He confessed recently that he's been feeling kind of lonely--he's one of the only non-dads left in his circle and everyone's too busy to do the kind of socializing they used to. I know it will mean so much to him to be able to have some relaxed time with them all. And I think he would appreciate a break from having to jizz in a cup, too.

There's still the option to freeze the sperm and do the insemination while he's gone, but that doesn't appeal to me for a lot of reasons. So it's likely that December will consist of fruitless (but fun?) au natural attempts and we'll be back on the treatment horse in January.

* * *

Tick, tock, tick, tock. For now we just keep waiting. Though not as long as Kate Middleton waited for her proposal. I'll take her as my inspiration and dub myself Waity Slopie, invest in a series of figure-hugging colorful frocks, and head to a polo match. That should help pass the time.

Black and White; or, Planning Ahead

These days, I've been bouncing back and forth between some very different reactions to my upcoming RE visit. It goes something like this:

*zoom*
Shit! Only two cycles left before we visit the RE!
*zing*
Yes! We can finally get figure out what the hell has been going on the last 18 months!
*ping*
Dammit, they're going to find out there's something horribly wrong with me and Lawyer Guy and tell us it was a miracle we ever got pregnant in the first place and we should have no hope.
*pong*
No! You're going to get pregnant before you go. Duh, making the appointment is the magic bullet!
*boing*
No! You're not even going to be able to get an appointment because the insurance issues won't be worked out yet, and you'll have to visit a third-rate fertility clinic, like, out on Long Island or something. And they wont get you pregnant and they'll probably mess up your uterus even more!
*bang*
Still, it's great to start this process!
*bing*
But why did you have to get pregnant at all if all it accomplished was delaying your RE visit by 9 months?
*bazingbang*
AAAAAAHHHHHH!!!!! Be quiet crazy lady inside my head!

See? Totally exhausting.

I've been kind of relentlessly talking Lawyer Guy's ear off about this process, which is majorly stressing him out. We deal with upsetting possibilities in very different ways: I try to predict and plan for the worst case scenario, so I feel prepared; he tries to ignore it and just live his life until he has to consider unpleasantness. So for me, having a two-hour phone conversation with our insurance providers to get all the details on our infertility coverage is ultimately calming (if also anxiety-producing), but for him it's like a giant anvil of doom dropping on his head.

So to spare him any more of my obsessiveness, I thought I would lay out the potential steps to come here on the blog, so I can refer back to them, keep track of our progress, and adjust my mind to what's ahead (and, of course, so you all know what the plan is).

• Aug 4: Visit my OB for annual check up. Will discuss testing/REs with her (though I have made up my mind to see one no matter what she advises).Will most likely have just ovulated (or will be about to ovulate), so preliminary testing will be impossible at this visit.
• Aug 13: Leave for Scandinavia. Will get my period on this trip. Will not be able to get CD 2/3 blood work until following cycle.
• After returning home, will start acupuncture/ Circle + Bloom relaxation techniques and continue with my herbs, yoga, and tea. Basically go balls out to get an unassisted BFP.
  
• Late August/Early September: have first RE consult. Praying hard that insurance issues are corrected by this point and I can go to N.YU. Will have good back-up, in-network REs.
• Mid September: Cycle # 8/15 begins. Get bloodwork. Will have hopefully had some other testing (HSG? SA?) by this point
• Mid-late October: Possibly do one treated cycle
  
• November/December/January: Break from treatments due to my sister's August 2011 wedding in California (try very hard not to hate her for this).
• February 2011: Dive into the madness of treatments for the foreseeable future

Wow, laying everything out like that really shows how much time all of this takes! February sounds so far away, but so much will happen in between now and then. The fact that the start of treatments will exactly coincide with due dates that would prevent me from attending my sister's wedding really sucks and was one of my fears back in November when I miscarried. I'm sure it will be hard to back off just when we've finally got the ball rolling, but I will just have to suck it up.

The other difficult aspect of heading into treatments is that LG and I are going to have to completely backtrack on how involved we've made our families in this process. Right now we don't call them every time we have sex or I ovulate or anything (I save that for my lovely internet friends), but they do know how long we've been trying, what some of my fears are, how long it's been since the miscarriage, and when we're thinking of enlisting outside help. That's fine and I don't mind them knowing (especially not my mom, who never ever brings up baby stuff unless I do first).

But I don't want our families to know about what treatments we're doing and when. If they're waiting hopefully for the results of an IUI or IVF, that will just make the disappointment much keener when something fails. I also really, really don't want my brother- and sister-in-law to know anything about our possible fertility treatments. I have enough jealousy and bitterness toward them in general. If I suspect they're pitying us for our sucky reproductive organs, I'll drive myself crazy (even though I'm sure their pity will be entirely in my head and they will never say anything to us).

I'm a pretty open person, so it will be hard to shut people we care about out of this process. But I just can't handle the extra pressure, so I know it's the right thing to do.

Moving Forward; or, What Comes Next

I did it! After reading through all your comments and e-mails and listening to my gut, I called to set up my RE consultation. I called kind of late and didn't get through to the nurse, but I left my information and I'm hoping to hear back (or call again) tomorrow. I'm shooting for an appointment date in late August or early September, right around the time I estimate cycle #7 post-miscarriage will begin.

After I made the decision to set the appointment up, I began to second guess myself. What if I'm moving too fast? What if I'm not giving us enough time to get this done on our own? Four months isn't that long to try-- we got our BFP in cycle 7 last time. Maybe we just take a little longer than most people. But then again, Taking Charge of Your Fertility recommends seeking help after four cycles of timed sex that don't succeed.

I still have this fear that I'm making problems up where none exist, and that by worrying over when we'll get pregnant I'm preventing us from conceiving. I think when I schedule the appointment I'll feel a little more secure. And of course I hope that we get pregnant before the appointment and have to cancel. That would be the best outcome! But with only two cycles left to try, I need to be prepared for what comes next.

With all I'm doing this summer-- learning German, renovating our closets, traveling to Scandinavia, writing an article to submit to a journal and a paper for my conference, studying for my orals and working on several seminar papers--it will be August before I know it. And then this show will really start.

Circling the Airport; or, Doctor's Visit Update

It's that time in my cycle again: early days. Nothing to pee on. Nothing to check yet. No phantom symptoms or pressures to have sex. It's nice, but not so conducive for blogging. There's really just not much to say!

I did have my check-up on Thursday with my Gynecologist, which was pretty uneventful. Lawyer Guy left work early to come up and be with me while I had my blood drawn for my thyroid test. But the doctor was backed up, and after she did her routine exam she said, "I'm going to take your blood sample myself right now." And she did right then and there! She was MUCH faster than the nurse/assistants had been the previous times. I barely had time to react between her strapping on the tourniquet and tapping the vein. I didn't pass out or get sick or completely panic. I shook a little afterward with chills, but was able to get them under control by the time I left the exam room to find my husband. He was proud of me and so was I!

My doctor said the results will come back in 7 days, so sometime next week. If the levels are elevated then I'll go get a full thyroid panel at another lab. We'll see what turns up.

My doctor was unconcerned about us not being pregnant yet. She said two unsuccessful cycles of trying to conceive post m/c were too short a time to get worried about. I'll be returning for another visit in August, which is when I'm due for my pap, and which will also be right when we finish out 6 months of trying for pregnancy #2. At that point, if I'm not pregnant again, we'll talk about what comes next.

So I'm still in the holding pattern of the last year, and there are certainly *worse* places to be. I know that I can get pregnant without intervention, but I also know that a past pregnancy is no guarantee of a future one. I guess I'll just put August in my mind as the date: if we get pregnant before then, that will be great, but I'll mentally try to prepare myself to not. In August we'll also take our Scandinavia trip (we're planning 10 days to Copenhagen, Stockholm, Oslo and Norwegian fjords--MUCH on this in future as the plans progress), which will ideally lessen the blow of any bad reproductive situations. Or at least provide a distraction.

In the meantime, it's CBEFM pee sticks, temping every morning, sex on demand, legs over the head, and all the other delightful perks of long-term baby making. Oh, and my new "wonder drug," a cup of red raspberry leaf tea every morning. It gave me my first cycle with no breakthrough bleeding in two years! Give me time and I'll be acupuncturing and alternative-remedying with the best of you.

Of Mice and Men; or, My Best Laid Plans

Okay, I lied (just a little) in my previous post. I do have some--let's call them "intentions" for 2010 beyond the babymaking that lies in the realm of the wished and longed for. I still refuse to call these "resolutions," because that term implies to me a desire to radically unmake or alter or shift or switch the current course of one's life, and that's not what I'm planning to do. I don't need to lose 50 pounds or change my career or move to a new state. I just need to advance a little farther along the path I've already set for myself.

So that being said, here are two categories: Intended Achievements and Intended Explorations.

Intended Achievements in 2010

1. Finish my course work for my PhD, including all incomplete papers.
2. Put together my Oral Exam committee.
3. Draw up my Exam lists and begin reading.
4. Take my Exam (possibly deferred depending on certain life changes that may necessitate taking a semester off next year. No more needs be said).
5. Help my husband more with housework.

Intended Explorations in 2010
1. Develop a yoga practice.
2. Travel to Scandanavia
3. Visit at least one new restaurant in Brooklyn each month.

So there we have it. What I wish and what I intend, what I'll accomplish and what I'll explore. Modest but important goals that I anticipate successfully completing.

Not a bad way to start the Awesome Year of Hope and Achievement, no?

Getting There; or Relaxing Can't Make Things Worse

There's a new plan, and it's no plan at all.

Meaning, we're taking a break from "planning." I'm not temping, not checking cervical fluids, not worrying about the timing of our sex life.

Things have been much better since then. Husband has felt less pressure and I've felt more relaxed.

I've spent the last few weeks thinking about all the things I can do in the next year if I don't have a baby: Finish all my coursework for my PhD program; teach my entire first year of my fellowship; attend my friend's wedding in Florida in June; present a paper at the Wordsworth conference in Grasmere, England next July.

And... my husband and I are planning a big trip to Scandinavia for Midsommer's Eve!

Basically, there's a new timeframe. I'll wait until I'm 30 before I worry about getting pregnant. When I turn 30 in May, we'll have been "trying" for 15 months, so that will be long enough to move forward with any testing or treatments we may need.

In the meantime, not planning lets me enjoy my life. It's not about "relaxing makes babies." It's more that relaxing makes babymaking more...relaxing! I'm young, I'm fine, I'm happy and I have a wonderful marriage, a fulfilling career path, good friends and family, and a city in which I adore living.

When the baby comes, it will be great! But I should make the getting there good, too.

Trying to Let Go; or The Wisdom of Mothers

I just got off the phone with my mom, after finally telling her about our hopes of getting pregnant and the stress I'm having over it. I share a lot with my mom usually--I've always gone to her when I'm distressed about something. These last few months of wanting to be pregnant and feeling so upset when I'm not have been so difficult to keep from her. I found myself snapping at her constantly and passing it off as general stress because I felt so burdened by my concealment of what was really troubling me.

So I'm really glad I talked to her about what's going on. She reassured me that there was nothing wrong and told me that it took over a year for her to get pregnant with me and with one of my sisters (though much less time with the other two). That after three months, it's absurd to think there could be a problem, and that I need to just (here's the dreaded word) relax.

Except she's right. I do need to relax, and I know that more than ever after last night. I'm putting so much pressure on my poor husband--unintentionally, but he feels the weight of my hopes and expectations nonetheless--that it's affecting his ability to "perform." Last night he couldn't finish. Nor could he this morning--the first time we've had a back-to-back like that.

I feel just terrible that he's psyching himself out like this, that he's absorbing the intensity of my desire to get pregnant and turning it into pressure on and recriminations against himself. He and I both need to learn how to deal with our anxiety and frustration around this issue.

We don't know when we'll get pregnant. We don't know if we'll get pregnant. All we know is that we will one day be parents-whether without help, through intervention, or through adoption. I have to keep reminding myself of that fact: this is not in my control. This is not something I can plan. This is something that comes as a gift, not a reward for effort, planning, and precision.