RESOLVE TO KNOW MORE

National Infertity Awareness Week ends in 12 minutes, so I'm going to try to whip out a post before it's too late and the moment passes forever. This year, the theme is, "Resolve to know more." I've been pondering on this theme all week ... What to say about it ... What I think about it.

As it turns out, I'm pretty good about knowing more. I started out this fertility journey by reading every word of Toni Weschler's Taking Charge of Your Fertility, so I knew all along that our timing was solid. I started using ovulation predictor kits pretty early on too. I read blogs and articles. I attended an open house and a free IVF seminar given by our clinic. I studied every haphazard paper and brochure they threw at us. I made giant lists of questions for the nurse. I tried acupuncture and read about eating for fertility. I bought books and signed up for newsletters. I spent hours on the phone with my insurance company and compared medication prices across four different specialty pharmacies. I scoured through reviews of Fertilaid and other fertility-enhancing supplements. I attended Resolve support-group meetings. I powwowed with other infertiles and picked the brains of those who had gone before.

So where has all of that gotten me? I sit on my sofa at the close of my third NIAW with a full head and an empty womb.

I was talking with Philip about the theme, and we wondered if ignorance is bliss. Some women go through this fertility-treatment process not knowing much of anything about the (scary) meds they're taking, about the (depressing) odds of the therapies they're trying, about the (infuriating) specifics of the failures of their own bodies. And I think often, they might have an easier time of it. They trust their doctors; they do what they're told without questioning; they believe it will work. And I think it might save them considerable time, confusion and anxiety.

Still, I was never going to be one of those women. I'm a researcher. I study how to do something, and then I do it. I don't leave things up to chance or luck or other people. And I don't wait around for God to magically step in and fix my problems either. I work. And I work fucking hard. I stay up late. I learn. I do. And experiencing infertility has only made me more this way.

I can tell you what (three) companies in Orlando offer insurance plans that cover IVF. I can tell you who the best fertility doctor is (mine) and what clinic has the highest success rate (mine). I can tell you about the benefits of acupuncture. On a miserable Christmas-break day spent on the phone with my insurance company, I found out it actually covered $2,000 worth of our IVF drugs. And Philip and I spent our entire Saturday today resolving to know more about the sign-up bonuses and travel rewards of various credit cards, so that when we unfairly have to pay out of pocket for IVF, we'll at least get something in return.

I can't tell anyone to resolve to know more, because maybe your defense mechanism in dealing with the pain of infertility works precisely because you know less. But I know that when I weigh it all out, I'm glad I know more. In the end, when we've reached our resolution, I won't have any regrets. Either we'll have a baby, or we'll know we did everything in our power to make one. I won't wonder if there was some clue I missed or some thread I didn't pull hard enough.

And that's all I hope for my fellow IF girls. I don't want anyone to give up because they just didn't know enough. If you hit a wall, consider if maybe you need to know more. Plus I'm here, and I know a lot. So don't be afraid to ask me questions!

STILL FIGHTING

These last couple of weeks were rough for Philip and me. It began with our final IVF consult, which did not go awesome. Here are some things that happened:

1. The cheerful woman who came in to take my ultrasound chirped at me: "Let's see if that cyst went away!" To which I replied, "Uhhhmm, I don't think I have a cyst?" She frowned and claimed that my nurse had just told her we were checking for a cyst. I've never had an ovarian cyst in my life, to my knowledge.

2. We found out our stimulation injections were going to start a week later than I thought, and I had to stay on birth control for another week.

3. My nurse tried to rush through all the injection instructions while Philip was in the bathroom. I interrupted her: "Can we please wait for my husband to get back? He's the one who will be administering these injections."

4. After being shuttled from an exam room to a nurse's office, we were shuttled to the checkout area, then shuttled BACK to the nurse's office so that, at our request, our doctor could give us a wham-bam overview of preimplantation genetic screening (PGS) of embryos, a test the doctor had never brought up to us as an option.

5. After all of this stellar customer service, we went back to the checkout area, where the clerk asked us how much we owed. "I don't know?" I replied. She made a phone call and then said, "That'll be $11,710." <commence choking on my own saliva>

Would you like to know what is stressful? ALL OF THAT. Being caused unnecessary alarm about an imaginary cyst. Getting my carefully plotted timeline thrown into the dumpster. Getting overwhelmed with information when my partner is taking a quick pee. Getting herded from room to room like cattle. Getting the world's most rushed explanation of a very complex, controversial testing procedure. And then being charged an astronomical amount of money for all of the above.

The appointment threw me into a massive funk, and in the midst of that funk, we had to make progress on two giant homework assignments: Figure out what credit card to apply for that would yield the best rewards for spending upwards of $11K, and read/decipher a pile of jumbled papers about PGS so we could let our doctor know asap if we wanted to do it.

Oh, and by the way, in the middle of that, Philip was trying to get his mom signed up for health insurance via the Affordable Care Act before the deadline, AND he was working on filing our taxes.

So what happened was, we started bickering. A tense moment here, a moment of lashing out there.

Things came to a head on a Saturday night. We were out at a pub crawl in our neighborhood for a friend's birthday, and I didn't want to be there. I just wasn't in the mood to be celebratory and crazy with a bunch of people I didn't really know. Plus, we'd been trying to cut out alcohol consumption ... Philip wasn't in the mood to babysit me, and on the walk home, our patience ran out. There was yelling in the streets. There was sweater throwing. There was stomping on said sweater.

When we got home at 2 a.m., the quarrel escalated to even higher comical telenovela levels. We were both drunk and tired. At the height of the argument, I ran out to my car barefoot with no license like I was just going to drive away. (Where the eff was I going to go?) Philip followed in his underwear, angrily hurling my shoes up onto the carport and standing behind my car to block my path. The standoff lasted for awhile before I agreed to come back inside if he would get my shoes off the carport roof. He did.

The next day, we laughed about the dramatic fight, but we were war-weary. Usually weekends are our time to reconnect and recharge, but we went into the following workweek completely drained, and the bickering continued. My closest ally was distant and cold. The loneliness I felt was crushing.

On a Thursday night, Philip went to see a friend perform in concert while I ran a 5K race. I tried to meet up with him afterward, but I had the venue wrong. I stood inside Austin's looking in vain for a group of people who were at Stardust. Back in my car, I started crying maniacally. I was bawling so hard I had to pull over. I let the sobs just wrack me; I wailed as loud as I wanted. I cried until I was weak and shaky.

Is this when it happens? When the infertility becomes too much? When the couple doesn't recognize each other anymore? When they finally give up on each other?

Philip texted me, offering to leave and bring us dinner.

I replied: "No don't leave. I tried. I've cried what's left of my makeup off. I'm smelly. I'm going to take a shower and go to sleep. I feel really bad for dampening your evening. I'm lonely and unhappy and that doesn't make me an appealing wife."

He wrote back, "I'm coming home."

He decided to keep trying, to continue fighting for us, like he has since the very earliest days of our relationship. He had plans with some friends on Saturday, but he canceled so that the two of us could reconnect. We slept in, made love, made breakfast. We booked a kayaking tour near Cocoa Beach, and after, we sat overlooking the water enjoying nachos and mixed drinks. We prioritized each other; we prioritized relaxation. We traveled the distance back into each other's space. And in the following days, he lovingly studied all the medication instructions and bravely injected me with very high doses of artificial hormones.

SCOPING OUT MY INSIDES

Would you like to hear about my hysteroscopy? OK!

So I was very nervous. Everyone kept telling me, "Oh, it's no big deal," which made me mad.

"It IS a big deal!" I huffed to Philip.

"No one can win with you," he replied. "You'd be upset if they told you it was a major deal and scared you."

Which was true.

I took great care to pick out my surgery-day outfit: the baggiest, comfiest, frumpiest sweatpants and hoodie. I took extra care with my socks. The socks are the only personal item you leave on for a procedure like this, and it's like being initiated into a very select sorority to wear your first pair of infertility socks. I chose a fuzzy black pair with snowflakes. Yes, those were the perfect socks, good job.

At 10 p.m. the night before, I remembered that the nurse had instructed me to douche. Have you ever douched before?  It is the most abusive thing you can do to yourself, on a number of levels. I didn't happen to have any douches sitting around, so off to the CVS we drove. The CVS was closed. "Well," I said, "the rapey Walgreens it is." I literally witnessed a robbery at this Walgreens once. At this point, Philip and I got into a fight. Because that is what you do when your nerves are on edge about an impending surgery and you're off buying a douche late at night from the rapiest drug store in town.

Also I am trying to find as many excuses as possible to say the word "douche."

So we studied the douches for awhile until we found the right one. Then Philip acted squeamish about carrying the box. No, I was not having that.

"I'M the one who has to douche, AND I'm the one who has to undergo the surgery -- I think you can handle carrying the box!" I said indignantly.

"I'm not only going to carry it," he said. "I'm going to hold it out to the cashier dude face-up like this." And that is what he did.

This particular douche was medicated, which means you mix in some iodine, which turns the liquid in the bottle a lovely shade of dark purplish-brown. Then you grit your teeth and slowly squirt it up into your hoo-ha via a very phallic-looking plastic wand, which feels cold and icky, and then the brown liquid trickles back down into the toilet. I have no idea why anyone would voluntarily choose to do this.

My douching mission complete, we went to bed and arose promptly at 6:30 the following morning so we could be to our clinic by 7:30. A very kind surgery nurse led me to a little room with lockers to undress and don a handsome hairnet and some paper booties over my awesome socks. I also had to take a pregnancy test, which always makes me roll my eyes.

Then I laid in a hospital bed in a small curtained area for awhile and stared up at the ceiling, where a light tile showed a colorful ocean scene full of fish and other cheerful marine creatures. A nurse came by to explain the procedure to me, and another nurse came to insert my IV while Chicago's "After All that We've Been Through" played tenderly over the muted sound system.

I was also handed some post-op instructions. I was not, under any circumstances, to:

1. "Drive a car, if a child, no bike riding, skate boards or gym sets."
2. "Drink alcoholic beverages (not even beer)."
3. "Make any important decisions such as signing legal documents."

Not even beer?! And there goes the big house closing I had planned for the same day as my hysteroscopy. :/

Philip got to join me after awhile, and he told me about an episode of Inside the Actors Studio playing on the TV in the waiting room, in which James Lipton was very self-congratulatorily sharing about a book that Matthew McConaughey had personally sent him.

"And James Lipton was challenging us," said Philip, "to go back and watch all of Matthew McConaughey's romantic comedies and realize what an amazing actor he's been ALL ALONG."

The anesthesiologist came in and gave me a quick rundown of what to expect from the anesthetic. And then it was go time. I walked myself into the OR, clutching my hospital gown closed behind me, and climbed up to lay down on the table.

The staff immediately got to work. A tube started blowing air into my nose, and my legs went up into the most serious stirrups I'd ever seen. "I like your socks," said one nurse, and I remember a brief feeling of victorious pleasure at the compliment. Then they started to strap me in, which felt claustrophobic for about one second before I started to slip off into dreamland and suddenly felt cozier, calmer and more tucked in than I ever have in my life.

Moments later I came to sudden consciousness and cried, "I'm still awake!"

"We're all done, dear," said the nurse.

Next thing I knew, I was laying back in the hospital bed in my curtained corner, feeling drowsy and crampy but overall pretty damn chill.

"Your heart rate is a lot slower now than before the procedure," Philip said. The nurse came and asked if I wanted soda crackers, water and Tylenol, and I nodded. She brought me this tiny bottle of water with a straw in it, and I sipped it quietly like a 5-year-old.

Time passed slowly or quickly -- I wasn't terribly with it. Then it was time to get up and change back into my clothes. I walked back into the little locker room in a bit of a daze and looked at myself in the mirror. I had electrodes stuck to the bare skin on my chest. I allowed myself a brief moment of self-pity, because really, I did look pitiful in my hairnet and electrodes, and who would have ever thought I'd have to go through all this nonsense just to MAYBE have a baby someday?

Then I snapped out of it and peeled the electrodes off. I got changed without further incident, until I somehow jostled a plastic basket of menstrual pads on a shelf and it tumbled to the floor, spilling maxis all over the place like some sort of slapstick act. I cleaned up the mess, shaking my head, and exited.

Outside the locker room, the nurse showed Philip and me some images of the inside of my uterus, which kind of looked like a fleshy pink balloon. Then we walked out into the waiting room, where I encountered my friend Alison, who is also seeking treatment at my clinic, and burst into hilarious laughter. "Fancy meeting you here!" I bellowed, while everyone else in the room looked on with puzzlement.

Then we drove home, and I proceeded to wolf down a blueberry muffin and some apple juice and then sleep for four hours on the couch. I felt some pretty bad period-like cramps and had a little light bleeding, but that was the extent of the aftermath. I was back to work the next day.

Later when we met with our RE, she said she had removed a "skin tag," as well as some "redundant tissue" inside my uterus, but that it was nothing out of the ordinary, and the tissue shouldn't have affected my fertility. They sent the tissue off to a lab to be biopsied, and results came back normal.

I wasn't supposed to have sex for a week, but eff that noise: I wasn't going to let my last chance to try to conceive naturally get thrown into the trash, especially since I had heard of other people who got pregnant naturally after having had a hysteroscopy. So we tried, and my hopes were soaring, because I had also started acupuncture again, as well as Chinese herbs and supplements with hopeful names like "Fertilaid" and "Pregnitude."

But, alas, nope. My period came right on schedule, and with it the usual tears, alcohol drinking and angry prenatal-vitamin boycotting. But then as always, I got my shit back together, and now we move onward full steam ahead to IVF Land.

GUESS WHO'S BACK

<Walks hesitantly onto stage. Taps microphone. Clears throat. "Hello? Is this thing on?" Looks out at empty auditorium. Takes a deep breath ...>

Sooooo, I'm back. As un-pregnant as ever, but not quite so angry. I've spent the last, hmm, let's see, seven months feeling pretty guilty about virtually yelling "Fuck everything and everyone!" and then dropping the microphone and disappearing off the face of the Internet. It's how I was feeling at the time, and honesty is good, but I could have said it all a little more nicely. For example, "Hi, kind people who actually spend their precious free time reading my ramblings, I think I need a little break from this."

So, I'm sorry. I apologize. I don't blame you if I'm talking to no one now, as you probably gave up checking to see if I've updated long ago.

For some reason I've been feeling the urge to write again. They say time heals all wounds, which isn't exactly true, but it does allow space for some reflection and distance from the injury. My thoughts have started to well up inside my brain once again, and I'm beginning to crave an outlet.

I was just so mad when that last IUI didn't work. Like just furious. It hurt so much more than any other disappointment we had faced thus far. I don't know why. And I just had to be done for awhile. I wanted to focus on my new position at work. I wanted to have a normal, festive holiday season -- not a miserable one dwelling on my childlessness. For the next several months, I didn't want to be heartbroken, sad-sack, infertile Erika; I wanted to recapture some of my pre-infertility carefree spirit and be thriving, enviable Erika -- great husband, great job, great cats, great house, weekend warrior, jet setter.

And I did, for the most part. The sadness of infertility was still there, in the background, but dull. Philip and I ran and boot-camped. We spent a weekend in New York City. I spoke at a wedding symposium in Saint Lucia. We bought a new car. We got invited to visit friends in Cartagena, Colombia, and on a whim booked tickets the day before Thanksgiving to fly out the day after. We spent Christmas with my whole family in Illinois, and we spent MLK Day in a tent in the Florida Everglades. It was a whirlwind, it was intense, it was gloriously distracting. All the while my eggs got older, but I was (mostly) too busy to think about it.

I said we'd revisit fertility treatment again in 2014, and we are. We are laying the groundwork for IVF, slowly checking off our clinic's prerequisites. We attended the seminar; I got tested for rubella immunity. Philip scheduled his labs, and I scheduled a hysteroscopy. We also switched doctors, a decision I feel good about.

I never wanted to need IVF. I claimed as an ignorant 29-year-old that I would never do it, that I'd "just adopt" if I ever found myself unable to get pregnant. I still don't want to need IVF. I'm giving acupuncture another go and pounding a crazy cocktail of vitamins, supplements and Chinese herbs in the hopes that I'll be one of those magical people you hear about who was "just about to start IVF" when they conceived out of the blue. Unlikely, but it can't hurt, right?

But now that I've (mostly) got my head around the idea and gotten the ball rolling, it's exasperating how slowly the process is going so far. More diagnostic surgery, more RE appointments, three weeks of birth control ... it's starting to look like it'll be summer before we really get this show on the road, and I'm impatient as hell.

And what about my infertility demons? My silent suffering? My perpetual state of resolution-less limbo? It's back in full effect, proportional in large part to how hard we're trying. The more treatments we undergo, the more money and effort we throw at this, the more failure hurts.

My friend Vicky says everyone has their crosses to bear, and she's allowed to say that to me because she had her second son only with the help of IVF. And it's true: Everyone suffers, one way or the other. I like to think my suffering is the worst kind, but it's not. Why am I so precious about infertility? Sure, it's a unique kind of pain, but isn't all pain unique?

I heard the stories of two friends (who already each have a child) who went through miscarriages -- a loss I've never had to bear, a loss that takes a toll not only on the emotions but also on the body in a very brutal, physical way. And while I cried for them, I also felt like something had been taken from me. No longer could I wear my pain badge like I'm the only survivor, the only strong one, the most afflicted. It's a horrible, shameful thing to admit, but it's the honest truth.

So have I become any wiser during my absence from this blog? I think yes, a little, but only because the passing months just allow more time for life to happen -- more babies were conceived and born (much to my great envy), but also: Other babies were lost, new friends came out as infertile, and on a broader scale, jobs were lost, marriages ended, houses were broken into, grandparents passed away. Everybody muddles through this life thing, and I've realized we need to celebrate when we can.

Then again, you're catching me on a good day, when I haven't cried or screamed or moped about infertility. :)