Today they say ovulation disorders, and in particular ovulation induction, is linked to lower breast cancer risk.
And they say there are promising techniques under development for women who have had OHSS and have subsequently failed to fall pregnant.
I'm a young infertile. That is, youngish. I'm not as young as I used to be, and I'm not as young as some. I have crows' feet, it's true. But unless I'm terribly unlucky, I still have a good decade left in my reproductive organs. So - young.
Want to know what I'd do if you walked up and told me to be thankful for that?
Well, I'd grit my teeth, and I'd smile a brittle little smile. And then I'd put you on my grudge list. Because it's really irritating to be told that. It's irritating because it seems to ignore the fact that, old or young, there's no guarantee. It's irritating because age isn't the only, or even the primary reason most of us move on. We move on because we can't keep going - emotionally, financially or rationally... and on the odd occasion, physically. If anything the older couple has greater emotional and financial stamina than the younger couple. And rationally - well, we'll both reach our "99% of couples your age should have conceived by now so you should move on" point sooner or later, and getting to that 99% mark sooner because I'm young won't make it easier if I'm left in that unfortunate 1%. It's irritating because when it comes to infertility being young doesn't count for everything. Not nearly as much as people like to dismissively suggest.
So I'll smile my brittle smile and if I'm feeling sarcastic I'll remark in a scathing tone that we should thank God for eensy, teensy, tiny, miniscule, "quick Bob bring the really really powerful and expensive electron microscope", more infinitessimal than any particle as yet discovered by science, very small mercies.
And then I'll go home and I will. Sincerely. With all my heart. Because, you see, it counts for something.
It means the luxury of taking a break, if we want. It means moving to plan B at our own pace, without the distracting sound of that loudly ticking clock. It means hope for new discoveries, new treatments, new technology, new solutions. It means choice, options, opportunities. I remember this sometimes, and I'm thankful for our youth.
I'm exactly as thankful as I should be.
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Summing Up
After reading through all the comments, I felt like making a concise summary of my now clarified viewpoint:
Saying, "Oh well, you're still young," is like saying a) don't worry - the problem can be solved given enough time (can it?) and b) it could be worse (thanks for that). One of a long list of things you can say to dismiss or diminish the experience of being infertile.
(In addition, in some cases it also implies that infertility is a wholly female issue, with no relevance given to the age of the father.)
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Since this has come up again, I'll add this. I'm supposed to start screening for breast cancer in 2007. This is because of a family history. Now, I may not get it at all, or I may not get it for years, but I'm nearly at the age where I have to start screening and it's giving me a bit of a ticking clock sensation. I think it's making me slightly more sensitive to being told "well at least you're still young" or, in other words, "never mind it could be worse". That said, I think I'm in basic agreement with Thalya.
Today was Mr Bea's birthday. Upon getting out of bed, I changed into my candy-pink, frilly G-str.ing and matching, half-cup, push-up bra, hidden coyly beneath an off-white, see-through, bum-length top, with the ties down the front left half-tied in what I judged to be a carelessly inviting manner. After breakfasting and unwrapping the gifts, I lounged back on the couch and gave a stretch filled with innocent suggestion. "So, birthday boy," I purred. "What do you want to do now?"
"Well, it's raining - not really the weather for going outside," replied Mr Bea. "I thought maybe the National History Museum."
(Later he claimed that because I am already at the limit of human desirability just pottering around doing the housework in my tracky-dacks, putting on lingerie and acting all sexy makes little change in his eyes.)
But that wasn't my only source of disappointment. You see this past week, as my good deed, I have been keeping an eye out for those boxes they have on counters at shops, supermarkets and cafes - the ones that collect what little change customers might casually drop into them for donation to some charity. I only found one. I think it was for the elderly. I know there are just as many in Singapore as anywhere else, and I can only assume I've spent the week shopping at places with low expectations of their customers. I think I'm going to have to continue looking out for them to make it worthwhile. Less of a good deed than I was hoping for the last of the year, but perhaps it's best just to let 2006 fizzle out quietly, so we can get on with the next thing. Which, as it turns out and as the title today suggests, is pretty similar to the thing we were doing before.
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I'm having internet troubles again, this time because of the earthquake in Taiwan. I can't comment at the moment, in fact I'm not sure if this will post. Email is still getting through, but it's all very slow. Anyway. It's not that I'm not thinking of you.
I've got this notion in my head where the 2006 section of this blog won't be complete unless I go back and fill in the blank that was the stim cycle we kicked off in January. I got OHSS. I thought I might tell you about it.
Then I wrote this long piece of self-indulgent drivel describing everything I can remember from the first moment I felt my ovaries twitch until the day of EPU, and it was kind of huge already before I even started on the bulk of the story, plus it was, like, months ago so who would be interested now?
Then it occurred to me that I was interested and it is, after all, my bloody blog, and besides what if someone drops by one day wanting to know something about OHSS and there's nothing here?
In the end I wrote this.
Risk, Reponse, Pain, Morphine,
Eating and Sleeping,
Raving, Relief, Forgetting
Risk
FS decided that, on balance, it would be best to go ahead with EPU and cancel ET, but that's not the only way we could have handled it. Some clinicians would have cancelled altogether, prior to trigger. Others would have been gung-ho enough to go full steam ahead. I remember the sense of relief I felt when I realised I didn't have to agree with his approach. I could set a lower level of risk. Ultimately it was in my hands. After due consideration I concurred, however, based on the high likelihood that whatever happened, I would recover.
Response
When I decided to take the risk, I promised myself I would not hesitate to get attention if needed. On the evening of the second day post EPU - the day I would have had my transfer - I unilaterally decided to go to the emergency ward at the local hospital. This was because I'd started vomiting. I handed FS's after-hours number to the young doctor who came to see me and asked her to call him to discuss my treatment, which she did. I was admitted.
Pain
After EPU I woke up feeling less painful than I had for the past week of stims. Two days later the pain was worse than ever. A week post EPU I was lying in hospital during my morning examination, when the doctor asked me where it hurt. I said, "Everywhere," and he laughed and told me this was not possible. Over the next hour or two I played a little game with myself called, "Does My X Hurt?" I started with obvious things: does my pelvic cavity hurt? Yes, of course. Does my chest hurt? Absolutely. (By this time I was on intranasal oxygen as I was having trouble breathing.) Then I moved outwards: does my right forearm hurt? Pinky finger? Scalp? I made a list of parts that didn't hurt. It was surprisingly short, and excluded many bits which had no logical claim to pain. I wondered if my sensors were simply so overloaded I had lost the ability to distinguish where my pain was coming from. It seemed plausible.
Morphine
At first I took morphine, and at first it worked. But as time wore on it became less effective. At the height of my illness, it took only the merest edge off my pain. But I started refusing doses before then, for this reason: it messed with my sense of time. After a dose I might close my eyes and try to rest. What seemed like an hour would go by and I would open them again to find only a couple of minutes had passed. I found I had to make a choice between enduring only 95% of the pain I would otherwise feel, but for a length of time which was subjectively four to ten times longer, or gritting my teeth and enduring 100% of the pain, but in real time. I kept changing my mind.
Eating and Sleeping
I couldn't. In truth, this started within the first week of stims, but it worsened until about a week post EPU. On my third day in hospital a nurse counselled me to force down a cup of milo - the most substantial thing I'd ingested since my arrival - because I was having a hypoglycaemic meltdown. It was good advice. I learnt that forcing myself to eat when I believed I couldn't was not only possible, but would make me feel better. It also helped me catch forty-five minutes of long-overdue sleep. I slept only about two hours a day, in two or three snatches, for the best part of a week. Mostly this was down to restlessness, pain and discomfort, although a week post EPU a night nurse spent some time pleading with me to get some rest, and I confided that my breathing difficulties were making me afraid to sleep. I was literally afraid I wouldn't wake up again. From this I gained the hope I needed to make it through - it struck me that things weren't so bad I wanted to die.
Raving
I told everyone everything without inhibition or regard. My sister (who visited me faithfully every night) gleefully rung me for several weeks after my discharge asking me if I remembered this part of our conversation, and sniggering and gloating when I admitted I did not. At one point I even showed her - up close and personal - my indwelling urinary catheter. She has reliable witnesses to back her story. This was a fascinating experience. It made me understand, for the first time, that the unforgivable things our mother said to us during her cancer treatment weren't merely the angry outbursts of a woman pushed to her limit. They were actual ravings, mad ramblings of which she genuinely has no recollection, and for which she can't be held responsible. I didn't understand this before.
Relief
A week post EPU they punched a paracentesis tube through my abdominal wall under local anaesthetic and drained off a small proportion of the fluid. The first breath I took afterwards felt so much easier I disintegrated into loud, racking, uncontrollable sobs of relief which brought enquiring hospital staff from nearby rooms and went on for a good ten minutes whilst the radiography nurse hugged me and passed me tissues. Twenty-four hours later I started having the curious sensation that I was deflating, like a balloon, and sure enough next morning's weigh-in confirmed that my weight had finally plateaued. During my hospital stay it had shot up by 25%. Fuck. That's a lot. When Mr Bea came to visit me the day after that, I noticed how much less tired he looked, and so did everyone else.
Forgetting
A few days after discharge I was lying in bed at home, enjoying, for the first time in almost exactly a month, the sensation of being able to lie on my side. Already I could feel myself losing touch with the physical reality of the illness I'd had. This speed of forgetting took my breath away. I told Mr Bea then I would do it again, if necessary. He looked startled, and hugged me tight, muttering platitudes about bridges, and crossing them. The final lesson was this: temporary physical pain is nothing to be afraid of. Only the permanent repercussions of our actions or inactions are important. The other day I looked, but I couldn't find my paracentesis scar.
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P.S. I have a big backlog of blogs to read today. Sheesh - it was only a weekend off! Take care - I'll get through them slowly.
Christmas. I guess it had to happen. And don't get me wrong, I'm glad it did, I'm just sorry not everything we wanted to happen "by Christmas" has, and yet it's here anyway, ready or not.
And... now I'm over it. Because I made some good decisions about Christmas this time around. I stopped treatment back in, what - end September? I let my "if it hasn't happened by Christmas" deadline go, laughing all the while at my naivety. I moved country - a measure which may be a little extreme for those who just want to make a quick getaway after the pudding. And there's one more thing.
In my family, we always had The Main Christmas Tree at my grandparents' place. It was where everyone gathered on Christmas morning to perform a little ceremony we called, imaginatively enough, "Christmas Tree" - basically a morning tea and the official exchange of gifts. The Christmas tree at my parents' house was a size down, and various other relatives who lived on their own or in pairs had little trees, just big enough for one or two.
This is our eighth Christmas together since we got married. And true to tradition we have always had a little desktop tree, just big enough for one or two. We were planning to upgrade, you know, as soon as we "started our family". Now I could bang on and on here about the definition of family, arbitrarily self-enforced hierarchies and the necessary re-examination of traditions over time, or I could just show you this:
And if you don't feel you can have a Merry Christmas, then at least let me wish you a happier new year.
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Other bloggers who are trying to enjoy Christmas despite infertility (and in some cases succeeding, to a greater or at least more drunken extent): Josie, Kir, Miss E, Katie, and Beagle.
This is going to be a downer post, considering the time of year. But heck, you hang out in the infertility blogosphere, one more won't hurt your Christmas spirit.
It's about this. Libya and the sentence it passed down this week on those health workers from Bulgaria. Now, I'm no expert or analyst, just someone who reads the popular press from time to time, but it reeks. Did someone say confessions extracted under torture? Are we sure this is a fair trial? And they're giving a which penalty?
You can insert a whole lot of back-porch, coffee-wine-and-cigarettes style political discussion here, because I'm just going to say this: yesterday, after a long lapse, I rejoined Amnesty International.
Human rights are important. If they were protected more often, we wouldn't need so many good deeds.
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This kind of fits under good deeds. I'm sure you've all heard by now about Meri-Ann, Thalia, and The Smarshys, and have probably even been around to offer your condolences. But Manuela wants to know who gives those messages of support to non-bloggers in times of similar trial? Too often, it's not real-life friends and family, which leaves... no-one very much. So Manuela's asked for a few words of solace that she can pass on to a real-life friend. If you're minded to, head around there. If you want.
It's not the last time I'll mention the International Infertility Film Festival on this blog, but I am going to return you to your regularly scheduled program.
I know it's report card day, but I'll get to that later.
Meanwhile, remember this series of posts about infertility coping strategies? Add this from Nica. Affirmations in the form of questions. What can I do to improve my chances? What has gone right so far? Etc etc - it just might work.
In cycle news, I've just worked out where this veritable blogging frenzy is coming from. I'm ovulating. Shortly you will notice a sharp decline into a more relaxing slothfulness, punctuated I'm sure by the usual end-of-cycle breakdown between January 4th and 7th. Just so you can't say you weren't warned.
But I just created a website for the film festival. It's here. I thought it might be more practical that way.
I've adjusted the cut-and-paste html so it links back to the "official" site, but for all the (wonderful!) people who've already put their poster up, don't stress - the FAQ I posted yesterday is staying where it is, and will contain a link to the site anyway, so no biggie.
For everyone else, check the FAQ for instructions on how to spread the word, and make sure to subscribe to the festival news!
This FAQ is no longer being maintained. Please visit the real FAQ on the official site.
It's on! It's on! The first International Infertility Film Festival (IIFF) on March 31st! How do I know this? Well, because Vee and Max have put together a few logos for the choosing. Go around there and vote on your favourite!
Mel from Stirrup Queens has suggested a challenge be laid down "a la Stephen Colbert's green screen challenge".
So! Who wants to join in? The challenge is to create a short film about infertility and/or pregnancy loss, upload it onto the internet somehow (I used Youtube) and let me know where it is. I will link all entries here (although, of course, everyone will be quite free to link as much as they like as well). I'm going to set the festival date as... let me see... March 31st 2007. We'll watch, we'll enjoy, we'll laugh and cry, it'll be a day to remember.
So that's March 31st, 2007 - mark it in your diaries.
Now, you can make a short film in any way you want, from video, to hand-drawn stills with soundtrack (or even without), to archival footage (naturally used in such a way as to not break any copyright laws, even if you do choose to record it directly from your TV screen using a hand-held camera). But in case you want to do as I've done and use a computer game, here's a quick how-to.
I first heard about this technique through Modern Millie who told us about Decorgal's Standing Alone short on pregnancy loss (2006 release) *Warning* - short depicts near-term pregnancy/baby loss. Standing Alone was made using Sims2, but by following links to Machinima.com I discovered a whole range of computer games could be used this way, and I was struck with a sudden desire to piss about and see what I could do. After some research I decided The Movies would give me the most flexibility and control, and when I saw the game on special just before moving over, it seemed like it was meant to be.
The rest is history. Actually, the rest, as of this point in time, is a tiny short called "A Seasonal Reminder" but let's not split hairs.
Decorgal has a great FAQ all about making shorts using Sims2, and if you want to use The Movies, there's a pretty good in-game tutorial. There's also a forum somewhere, though I can't seem to find it at the moment, but mostly you can work it out by fiddling around and using the help menu. If you want to use other games, well, I can't give you any specific help but someone out there can. My biggest tip is don't try to script the movie first. It won't work. Play the game, build your sets, create your stars, gather your costumes, familiarise yourself with the available action sequences. Then get a basic storyline together, and write the script as you're doing the voiceover at the end. A few sound effects and you're done. It's pretty straightforward really.
Jules just alerted me to this free online taster, in which you can create a sort of online cartoon strip. (If it moves, it counts as a film, far as I'm concerned.)
I've been asked if you need to buy the computer game in order to use it like this, and you do (except if you're using the free online taster that Jules found, see paragraph above).
So March 31st guys - how about it? I reckon a few films is all we need! So who wants to do one?
Did someone say infertility film festival?
(Special thanks to Mr Bea for voicing "Ken".)
**Director's Notes**
For those who asked, this was made using a computer game called "The Movies". It basically involved playing the game at max cheats in order to manipulate the sets, costumes and action sequences I wanted to use into being (which was a major pain in the arse). The actual script was done last, and the "come to mamma" line is courtesy of Mr Bea.
This is the least altruistic report card so far. But, as previously discussed, I maintain that a good deed is a good deed, whatever the motive. This week's motive was Christmas shopping.
Every year we ask each other what we'd like for Christmas, and seldom can anyone come up with a reply. So every year we make a luke-warm guess or, in my somewhat more practical family, chalk up a gift IOU to be filled when the giver or receiver actually can think of something, and it's never quite satisfying. Because I love giving. But not for the sake of exchanging unecessary tat so we can all appreciate "the thought". So this year, we decided to go whole hog with the charity gifts.
We chose this site, because they offered a range of gift packages to suit every taste and budget, promised to send all our money to the nominated charity, and checked out nicely on a google search of independant sources. We decided to personalise our gifts by matching the receiver carefully with a particular cause, and agreed that if we knew of the perfect non-charity gift for someone, we'd get that too. My mother, for example, is getting to help a women's cancer screening program in Guatemala, because she's a cancer-surviving woman, and also a studio portrait of myself and sisters in a handsome frame, which I hope to replace with a more likeable photo before too long.
We debated over a present for SIL's family. In the end he won and we bought a gift from the same charity to send a child to school, because she's planning to finish her degree someday and become a teacher. In return he agreed not to purchase this book for our nephew.
Also, for the first time I wished our clinic gave embryo pictures. Because I was seized with a sudden (though not, I think, morbid) desire to include Christmas photos of the ten little embryos who tried so hard this year, especially the three who "almost" made it.
I can't remember how old I was when someone first asked me if I wanted to have children. I think five. Many girls my age answered with squeals, or giggles, or vehement and wide-eyed head-shaking, and continued to do so until well into their twenties, but not me. I always shrugged matter-of-factly and said, "Yeah, one day." Even then, I never considered childlessness an option.
I was in my late teens when the feeling first came. The feeling that "one day" should be "now". I mentioned it to Mr Bea, who looked alarmed, but he needn't have worried because the feeling lasted less than twenty-four hours and it was more than a year before it returned. And when it did it lasted only a day or two. Then a week. Gradually these little sputters of maternal instinct became a whirring engine, a driving force, just waiting for someone to let go of the brake. I was expecting to take off on a road that would last me the rest of my life. I guess you could say we got stuck in traffic.
Then last week it happened. I was eating a sultana scone with a generous slab of butter when I looked up to find a new feeling had arrived. The feeling we two were complete. That our family started and ended - here. And it was ok.
It's gone again now. Who knows when it's coming back? But I wondered if this is how things change - with a feeling that lasts a few hours, then a day or a week, until gradually the great maternal engine sputters out again and we leave it by the side of the road, in favour of some other journey.
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In cycle news: I've just spoken to FS about our next cycle, which is FET#5. He's away over Christmas until the 15th of January, which is right on the border, but probably just a little too late, to front up for a January transfer. So we've agreed February. The protocol will be an OI/FSH cycle with injections starting on day eight, but with a few adjustments to dosage to try and improve the quality of the luteal phase.
I was flicking through the online excerpt of The Infertility Cure last week after it was recommended to me by gracie (who didn't leave a contact/url - but thanks gracie!), when I read that the average couple goes through seven cycles of ART before they conceive or give up. Seven. That number keeps coming up.
- Mananabanana conceived on their seventh (and last) cycle.
- A woman at one of my transfers said she was on her sixth (and second last) transfer.
- A message board discussion (at Essential Baby) some months ago indicated a wide consensus that seven transfers was enough.
- Let's not even start on biblical sevens.
"How many cycles have we done?" Mr Bea asked.
"Well, that depends how you divide it up," I answered. "Because it's only been four transfers and you can't really count..."
"How many ART cycles?"
"Seven."
It's interesting. As a species, we seem to have an inbuilt quit-point. You can imagine how it went, back in the prehistoric days. Two cavemen have heard a rumour you can make fire by banging two rocks together. "Here," says one, handing the other two clods of earth. "Try it. Huh. Ok, try again. No? Try again - it must be true, I heard it from a friend of a friend of mine. And again. Again. Again. One more time. Tell you what - why don't we try flint?"
We've invented this myth of human progress as based on persistence, determination, perseverance in the face of great odds. But the real story of human progress is one of giving up. Without that, we're just apes in a cave, banging clods of earth together, getting nowhere as we watch them crumble apart.
More thoughts on quitting by our Stirrup Queen and Serenity.
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Disclaimer - average means, of course, that some people will do more and some people will do less. I'm sure no-one's taking me literally here, but I thought I'd mention it. We're all faced with different circumstances - diagnosis, response to treatment, external factors... I just saw the number seven come up a surprising number of times in all sorts of different situations and it got me wondering whether there was some sort of evolutionary principle involved. I was not, in any way, trying to say that doing more or less than seven cycles is wrong, not least because our individual decisions on where to draw the ART line are based on a complex array of factors and what I would still like to think of as a sophisticated knowledge of human biology. My main point is that quitting is an essential part of the success story of the human species. Ok, I think we're all clear.
Remember this post from less than a month ago? Well, I'm glad I wrote that down, because it's nice to be reminded I can get things done, now we're trying to move in at the other end.
I need to buy stuff, but I don't know where to shop. I need help with things, but I don't know who to call. I try to arrange things, but my messages disappear without response and my efforts feel empty and useless, without weight or consequence. Often, I can smooth my path with cash, but decide to endure petty frustrations so our money can be saved for IVF and calming treats, like icecream sandwiches which are made, ok, by hacking off a slab of icecream with a cleaver and putting it between two slices of bread. Yummy. In case this sounds whack, don't worry - icecream comes in such flavours as peanut butter, creamed corn and bean - all perfectly normal sandwich ingredients.
So there I was, eating a black-sesame-seed-flavoured icecream sandwich and thinking about tossing it all in and going back to the flat to nap on our single - sorry "twin" - airmattress* in order to free it up so Mr Bea can have a turn by himself for a few hours overnight (hardworking breadwinner that he is), when I was approached by one of the many, many tin-waving volunteers of Singapore, this time collecting for HOME.
HOME is the Humanitarian Organisation for Migration Economics. They provide training, financial and legal aid, and support for low-paid and unskilled migrants. For the people who can't smooth their paths with cash, or calm themselves with icecream treats, or even gain access to basic housing or medical care in a country whose systems are as mystifyingly foreign to them as they are to me. For those whose language problems extend beyond the misuse of the word "twin"**. For those who are facing the same problems I am, but magnified a hundred times over by poverty and lack of choice.
How could I not? I gave them some cash. I hope it helps someone sleep better tonight.
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*We bought a queen-sized bed second-hand last week. But we've had trouble getting it delivered. Two delivery drivers and a self-drive option have fallen through. Meanwhile, I went to buy an airmattress, and ended up with a "twin" which is actually a single and has become something of a running joke. Just as well it isn't, as I was assured, big enough for two people because the only pump I could find to blow it up with is an itty bitty bicycle pump. It took me nearly three hours to get it inflated. (I had to stop every now and then to recoup my strength and attention span.)
Fingers crossed for driver number three (delivery option number four) this Sunday. Looking forward to a proper night's sleep, and the end of our nine-day bed-buying epic. Next item: chairs. Stay tuned.
**And yes, it has been pointed out to me that "twin" is singular, and that twins, in real life, are ordinary-sized people. It's a SINGLE bloody air mattress. That's what it is. That's what it should be called.
My mother always maintained that if you weren't doing a good deed out of the kindness of your heart, you weren't really doing a good deed. I turned this thought over in my mind for some years and decided to disagree. A good deed is a good deed. Surely it doesn't matter if you're doing it selflessly, or in anticipation of praise, or through fear of reprisal. The end result is the same - the deed gets done. Say thankyou and go home.
And the pragmatic (ie greater) part of me still feels the same. But the romantic (ie atrophied) part of me has always been on her side. So the pedantic (ie overused) part of me has resolved the argument thus: you have good deeds, and then you have good people. Good deeds are done for any number of reasons, but only doing them selflessly makes you a good person.
I have pledged to do fifty good deeds. I'm doing them because I need to feel like my life is worthwhile. Because I need something to feel proud of; through which to gain back some self-esteem. Because I need to fill in my time, and build a social network. Because I need, I need, I need. Me.
So the deeds get done, and you know, I think that's the main thing - let's not forget it - but I don't think it makes me a good person, and frankly I get a little uncomfortable when you say so (sweet as that is). Then again, I need to keep writing the report cards in order to stay motivated and committed to the task. So.
The next Thursday Report Card is coming up. Please tell me stories about similar charities in your area, and how you/your cousin/neighbour/whoever worked for them. Please tell me stories about that guy you knew/knew of who once benefitted from a similar deed. Tell me about related good deeds, or unrelated good deeds, or even better deeds. Or tell me if you think it's not so much a good deed as a complicated, double-edged deed with both benefits and drawbacks and did I ever think of that? But don't tell me I'm a good person. Because the kindness of my heart is not what's at the heart of my kindness. Thanks.
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We're technically moved in, insofar as we're sleeping in our new flat (albeit badly on a single - sorry "twin" - airmattress, yes, both together, I know, I'll explain later) but can't yet eat there (cook there, to speak more stricly - later, I promise). I'm about halfway caught up with your blogs. It'll all happen.
My luteal phase was thirteen days. Which is... ok I guess. Actually, thirteen days is fine. Good, even. Also, my cycle was a normal length - 35 days. Which is fine. Except.
Except.
My temperature dipped dramatically at 10dpo. That night I started spotting lightly. Days 11, 12 and 13po saw bright red spotting for the first half of the day. And cramps! It was one step shy of "light menses". I checked back through my notes from this year. My spotting has started at 9-10dpo every cycle I know the ovulation date for. Not as dramatically when I've had the help of progesterone, but nonetheless. At 9-10dpo. And I know a lot of people experience spotting and I know it's not impossible to get pregnant on one of these cycles, except.
Except.
The chemical pregnancies. Three of. And I know there are other reasons for a chemical, and it could still be the quality of eggs gained from an OHSS cycle, or one of "those things" and I know prior to IVF I had two completely normal luteal phases, with maybe the teensiest bit of brown spotting at 13 and 14dpo so maybe this is all just a drug-induced fuck-up that will sort itself out much like the luteal phases of breast feeding women who've said they were fine once baby was weaned, except.
Except.
Those AIH cycles were atypical for me - shorter, by several days, and with much more obvious signs of ovulation than usual. What if this is my normal cycle? What if I only get two or three good ones in a normal year? I also know that even a ten day luteal phase is considered fine by many, and that implantation will mostly have happened by then, and that even if it is on the short side it's treatable except.
Except.
We have been treating it - with OI (FSH) and LP support and it hasn't solved the problem, and don't they say frozen embryos are sometimes a little slower? And what's the deal with my progesterone levels being normal - in fact, great - during my luteal phase even whilst the spotting is going on? Normal progesterone levels and an abnormal response of the lining? How do you fix that? And I know we're still young and if we keep throwing shit at the wall someday something will stick and maybe it'll be cycle six, or sixteen, or even twenty-three but fuck it we can't even conceive without IVF and I don't know if I want to keep going that long and I'm not sure it's worth it and I'm starting to feel like I could do something else with my life and still feel it was all worthwhile and maybe we'd even be happy and maybe people would come to respect that and maybe I'd come to see this whole exercise as nothing more than blind worshipping at the false idol of parenthood and not something I ever had a good reason to pursue because some days I forget why we're here and I wonder what's keeping us going except.
Except.
I think I should try one more time.
It's my post-lap cycle. Bound to be screwy, right? And the others - they were post-progesterone-support cycles. Bound to be screwy, right? Right? I mean, it's all still under control. Isn't it? And we haven't exhausted FS's list of FET protocols. One of those will probably work fine. Right? And if we don't try everything we'll regret it one day, right? Won't we?
I asked Mr Bea how many cycles he thought was "reasonable". He said he thought any number of cycles was reasonable. So I asked him, with some irritation, how many he thought we would do, before giving up. He blinked. He said we've only been doing IVF for a year. Only a year.
He said at four to six transfers a year he doesn't think it's logical to give up and move on until we've got three or four years under our belt. But he understands I might want to stop sooner. And he's happy for now to say let's use up our frosties and do a second fresh cycle then see where we're at.
I'm tired. Because apparently when I said I'd take a few months off to see if my body would reset without the drugs, what I secretly meant was I wanted to take the rest of the year off and go back in January, confident that half our problems were solved, and we were simply looking for the "right" embryo. But it's going to take longer than that, if it happens at all, and if the next FET doesn't work, we - what? Take another several cycles off so my body can reset so we can do another FET that doesn't work and then take another break of several cycles...? How many years would we go on for at two to three transfers a year? "Logically" speaking?
I'm losing faith. I feel like pursuing something else - something I can have faith in - except.
Except.
Not quite yet.
-Sydney Smith, 1771 - 1845.
I got into a taxi last Thursday and asked the driver to take me to the Rid.ing For The Dis.abled A.ssociation of Singapore. And he asked me a bit about it, and I could only answer in part because it was only my second day as a volunteer there, but I explained that riding helps disabled children with balance, motor control, communication and confidence. And that I help by wandering along beside them for safety and encouragement. He nodded, but with a firmly unconvinced expression on his face. "I just... how shall I put this?" he said. "Horse riding costs so much money - surely they could learn those things through other, cheaper sports. Then the money would be better spent."
Well, fuck, the money would be better spent feeding the starving children of Ethiopia than helping the disabled children of Singapore play sport of any kind. I mean, wouldn't it?
After the lesson several volunteers had a disgruntled discussion about a group of university students who'd come to write an assignment on the association recently. Apparently they'd found themselves described as "a bunch of middle-aged expatriate ladies who lavish praise and then sit around drinking tea" which "totally missed the point". And I have to agree, it did totally miss the point. But at the same time it was not (I reflected as a forty-something-year-old woman with an upper-crust English accent offered me a chocolate slice which she described as wonderfully moist, deliciously rich, and baked by the wife of the Dutch Ambassador to Singapore for an absolutely marvelous charity stall she'd attended recently) wholly without truth.
So I was already forming a post in my mind where I discussed the fact that these women could have been lolling about in the salon complaining about their maids instead of lifting a wheelchair-bound child in and out of the saddle and watching him finally pluck up the courage to trot halfway down the arena - not to mention what would happen to a twenty-seven-year-old ex-polo pony without the RDA to find a use for him - and the fact that the facilities form part of a polo club that would exist with or without a charitable sideline, when I saw the book.
Doing A Little Good - the coffee table book of the Riding For The Disabled Association of Singapore. And the quote, inside, from Sydney Smith. It summed it up well, really, because when all's said and done, perhaps the RDA is one of life's more frivolous charities - but, you know, half a dozen physically and intellectually disabled children smiled today. And I think that's worth something.
First, my laptop stopped connecting to the internet. This makes it very hard to keep up because Mr Bea's laptop doesn't know who you all are. Especially difficult if I have started reading you recently, or if you have requested not to be listed on my blogroll. I am assured my laptop will be made to connect to the internet once we have our own broadband account which we are in charge of (instead of using various wireless points). Should hopefully happen next week sometime.
Secondly! I am having trouble commenting even if I can read your blog. Typepad is giving me the most trouble, although this is not 100% consistent and everything from blogger to wordpress has bitten me in the arse. If I don't have your email address, just pretend I said something far wiser than you could ever have imagined and that all your problems are now solved. Because that's how I wish it went in real life.
If it makes you feel any better, my mobile's giving me trouble too. The world is trying to silence me. It must think I talk to much.
Litany ends.
Sooner or later it's going to come up. Someone will say, "Let's go out to eat!" and this will bring about the question of where. "Somewhere different," you'll agree. Then all at once it will come to you.
Why not the first and only, Chinese, revolving restaurant, located on top of a flour silo - in Singapore?
I have decided, on the Fifty Good Deeds front, that Thursday will be "report card day". I hope that's Bridget-Jones-esque enough for the genre. This, then, is report card number one, on the subject of tissue selling.
Now, if you're hoping to find, within this post, sordid tales of international black-market organ trading, I might as well disappoint you up front. We're not going to be talking about that kind of tissue. No, we're going to be talking about the kind of thing you blow your nose on, you know, the papery stuff. Oh, alright then - there'll be a short but highly shocking story about international black-market organ trading at the end.
Back to the paper. Tissue sellers are found in many corners of the globe. It is, let's be frank, one step up from begging, but it's not begging, because as we all know, that would be illegal in Singapore along with many other things (such as failing to flush the toilet, chewing gum, and being naked in the privacy of your own home if the neighbours can see you but not, since 2004, oral sex between consenting, heterosexual adults and thank goodness for that).
Besides, those little packets of tissues are a useful, nay essential, part of Singapore life. Sooner or later you're going to learn about hawker centres and food courts. Think shopping mall food court. Ok, now pretend the food is actually really good and prepared on a short-order basis. Right, now lower the price. Lower - that's more like it. You can get a full and delicious meal for around S$3.00. That's about $1.90 in the US, or $2.50 in Australian, or $2.20 in Canadian, or 1.5 euros, or a quid, or for gosh sakes where are you from then well why don't you just go ahead and perform your own currency conversion. The fact is you can't cook a meal in your own home for that little.
However - and here's the catch, plus the place where I get back to tissues - when you rock up to one of these places, it will be crowded, and busy, and you're going to have to find a place to sit down. And little packets of tissues are the locally-acknowledged placeholders. Pop one down on the table in front of where you intend to sit, then wander off at your leisure to survey your food options.
You might think, from this, that not-technically-begging sellers of tissues do a roaring trade in Singapore. Really, I haven't a clue. And there's a debate to be had about whether one should encourage this type of behaviour at all or outrightly refuse to participate, instead favouring the middle-class beggars with official badges and little receipt books which line the most popular shopping streets of this city, shaking their tins and ringing their little bells. But that's a complex debate and we can have it later, or indeed not at all.
Because the woman who came towards me through the crowd as we stood under the shelter of a shopfront, waiting for the usual afternoon deluge to pass; the woman who offered those little packets to one person, then another, gracefully accepting each refusal and moving on - well shit, she was selling tissues you know? And I realised my first Good Deed didn't have to be a big one. So I gave her some money, and she offered me a fist full of packets, but I only needed two. And then she moved on, and it was done.
Meanwhile, in another part of town, a nineteen-year-old girl was waking up in a bathtub full of ice. She vaguely remembered the previous night's clubbing, and the mysterious but charming man who had bought her a drink. As her eyes started to focus, they fell on a telephone sitting on a chair by the tub, and a piece of card containing a set of printed instructions. She shook her head slightly, to dispel the fog, and squinted at the words. "Important!" the card began. "You need to dial emergency and ask for an ambulance..."
---
I feel a bit funny about the report card thing, like I'm crowing to the world about how great I am, especially when I've started with something so small. But I had this intention of, sort of, making it part travelogue, part report card, part validation of the little things that lots of people - probably you! - do from day to day that go towards making this world a better place.
Grand gestures are grand, but they take organisation and there's a lot of good intentions that fall shy of that initial hurdle. Sometimes I think you should just do something, however small, or reach into your pocket rather than tie yourself up analysing where the money could or should end up.
Besides, it's my first week - you expected world peace? If I can achieve that I will be crowing.
Lastly, a timely reminder to be careful with your drinks if you're out partying this holiday season. Those organ traffickers are everywhere. So I've been told by a friend of a friend of mine.
It's almost exactly a year since we were told ICSI was our only option for having a genetically-related child. I've spent the year whining, and moaning, and crying, and getting depressed, and feeding my highly-developed ability to stress over things which are a) unlikely to happen and b) not under my control anyway. And I don't regret a minute of it. I was completely justified, and I make absolutely no apologies. Nevertheless, I feel it's time to move on.
I just can't do 2006 all over again. It was, like, way hard, man. We will never, ever get our baby if I continue in that vein, because, put simply, I won't be able to continue at all.
So allow me for a moment to experiment with being a "good person". I don't want my fertility journey to be punctuated solely by inevitable failures, disappointments and setbacks. I want there to be moments of light, pockets of pride, days of sunshine. Crap like that. I am determined to go from weepy pussy-job to bitter old crone via vomitously perky gal. I am therefore setting myself this challenge: during our next year of fertility treatments - or whatever else may come - I'm going to perform Fifty Good Deeds In Celebration Of Life. And, to keep me honest, I will report them back to you.
This is also, apparently, a way of integrating into the local community - a staggering 15% of Singaporeans over fifteen years old are active volunteers . Come on - fifteen percent. That's pretty damned good for modern society.
Now, about the ads (if they're not here now, they're coming in a minute). I've put them there with the idea of donating any money to worthy causes. So go! Click! You know you want to.
Finally, if you have any requests or suggestions for Good Deeds you especially want done, you just go right ahead and leave them here. Then you can be a do-gooder by proxy. Now doesn't that sound fun?
Alrighty then.
I am woken from my fitfull snooze by an overwhelming sense of dread. "What have we done?" I ask myself. "We've made a hard thing harder. We've increased our chances of failure." And my eyes flutter open in alarm.
They meet the black of the sky, and a smattering of lights twinkling far below. I am hanging somewhere over the islands of Indonesia, between the choice I have committed to and the consequences I will have to bear. And I sigh, relieved, because I realise this feeling is normal, or in other words meaningless.
---
The eagle has landed, dawdled around the streets and idled at the hotel. Now she's vaguely wondering what to do next. Willing to take requests.
In cycle news: it's 1-2dpo and we're waiting to see what sort of luteal phase we get this time. I'm currently choosing to believe all our luteal phase troubles are behind us, but tune in for progesterone-fueled angst as the week progresses.
It's Fly Day. Two months and two days since Mr Bea flew away. Last week, he wrote me one of his lovesick poems, of which this title is my favourite line. Being of a less romantic bent, I replied with a shopping list. Flour, bicarb, sugar, eggs, oil or butter, milk, syrup, thickened cream, bacon.
Since he's been gone I've waited out a two week window, had morning sickness, received a more-than-negative-but-less-than-positive beta result, made the decision to take a break, quit my job and move to a country I've never visited before, turned in my notice, taken our beloved dog backwards and forwards to the vet clinic for a mysterious waxing and waning illness, applied for and obtained a Singaporean residency visa, witnessed (indirectly) the births of three children - two of which were the second born since we started trying, the other of which was born to my first IVF cycle buddy, and one of which I wasn't told about at all until after the birth, filed tax returns for myself and Mr Bea, completed the pre-removal insurance and customs paperwork for our shipment, sat for a long-deferred family photo, had a general anaesthetic, laparoscopy, hysteroscopy and dye study, attended a weekend conference related to my job, taken our beloved dog backwards and forwards to the university teaching hospital for specialist care having reached the limits of experience of half a dozen general veterinary practitioners, worked full time during the busiest two months of the year, congratulated several more people on their pregnancies, whilst wistfully thinking about how close in due dates we'd be if only that beta had been a teensy bit more positive, sorted and packed an entire household of belongings and transported most of it into storage, made some decisions about my career path, cooked real food, finished dozens of DIY jobs in order to make the house ready for tenancy, contacted insurance companies, mortgage brokers, and banks in order to completely rearrange our finances, finalised our utilities bills and arranged for bills to be paid in our absence, voted in a by-election and changed both our addresses on the electoral role, worked through a big backlog of thoughts and feelings related to our cycles so far, arranged to have our property marketed and rented out, had the car serviced and detailed and put up for sale, revealed and discussed our infertility amongst selected family and friends, booked myself on a plane, supervised shipment of the core of our belongings, kept the house in presentation condition for viewing by prospective tenants at a moment's notice, blogged, applied for a new job in an entirely different industry, mentally prepared myself as well as can be expected for our treatments to come, arranged for our beloved dog to be cared for by family until she's well enough to fly, held someone else's newborn and smiled, researched the rental property market in Singapore, and ovulated, on time, by myself.
Can you hear me roar?
I want you to know two things. First, I didn't do it by myself. I had a lot of help from family and friends, and I do include you guys under "friends". Thankyou so much. Second, a lot of people have implied that I might be finding the move to Singapore stressful. All I can say to that is, "Not compared to infertility." Compared to infertility, it doesn't even raise a flutter. So if you've read this far and thought, "Wow - I couldn't do that!" like I thought two months ago, then sister - you are wrong.
So, where am I at the end of all this? Well, I'm looking forward to tomorrow. Mr Bea and I will be cooking pancakes together for breakfast.
And I'll see you on the other side.
I want to talk about my mother's breast cancer. That's not true. I want to talk about me. But bear with me whilst I come at it via the topic of my mother's breast cancer. It started when I was fourteen.
At the time, it was everything - our whole world. We ate it, slept it, watched TV around it, came and went from the house according to its will. My mother wasn't one to bore people with the gory details - even though she arguably should have because, just a heads up, gory details are a lot easier for your children to deal with than unexpected violent and seemingly irrational mood swings - but nevertheless it was there. Always there.
And now? Well, it doesn't come up that much anymore. Don't get me wrong - if the Cancer Council come around, our family donates. If my mother hears of someone who's been diagnosed she might say a word or two, and we all know it's not just ordinary sympathy. It happened, there's no denying, but it's not happening. It's one of life's traumas, like high school or that time you broke your arm, but it's finished, it's over. There's little else to say.
I was thinking about this because of all the infertility blogs out there by all the people who've tried and failed and tried again. And don't get me wrong - inspiring stuff, but frightening at the same time. I'm reading all these stories about people who've done huge numbers of cycles, had multiple miscarriages, spent years pursuing treatment, and still can't see a light at the end of the tunnel. But what I tend to forget are all the blogs that went bust along the way. All the people whose stories I started reading, who got knocked up and subsequently stopped telling the tale. And what about those who never had a blog, because their journey didn't get that far? How many of us blogged from the very beginning?
Logical Bea wants me to write this down. Because she's said it before but it's not getting through, and she's tired of seeing me worry out of proportion to my actual situation. So here it is: the blogosphere contains a selected subset of infertiles. And those with the longest, most heart-rending stories are over-represented. Because the rest? Most of them are like my mother. At some point they find themselves with little else to say.
I wonder if that'll make me feel better.
---
Two more sleeps til Fly Day.
I see you standing bravely and I see you standing true
And I wonder how you stand at all with all that you've been through
And I want to soothe your hurting and I want to hold your hand
But I never want to be someone who truly understands
And if I can I'll...
...let someone else walk with you.
And if I can I'll...
...move on ahead and leave you.
And I see you huddled by yourself, black against the sky
And I want there to be somebody who holds you when you cry
And I wish you hadn't lost so much for what you hope to gain
But I plan to be just one more girl who doesn't know your pain
And if I can I'll...
...let someone else walk with you.
And if I can I'll...
...move on ahead and leave you.
And what I really want to do...
...is tell you sorry then just pass you by.
---
I thought of dedicating this song to a few people in particular, but I kept thinking of more and more candidates, and I didn't know how to choose. Let's just say if you think this is for you, it is.
I've given away the stuff we don't want, and stored the stuff we rarely use, and watched them pack the stuff we'd prefer not to do without. Now I sit, looking at the stuff I need.
A bowl. A spoon. A cup. A pair of chopsticks.
Sandwich ingredients.
Somewhere to lay my head.
My purse.
A towel and a dishcloth.
Soap, toothbrush, toothpaste, moisturiser.
Half a suitcase of clothes -
Food, shelter and health.
And human-ness:
Devices for communication.
My dog.
The memories I'm trying to drink in, desperately and in vain.
Love.
Hope.
Dreams.
It's not much, you know. Not much at all. Just the things worth clinging to, when everything else is gone.
---
*A removalist term I have learned. Removal and uplift - means they came today and packed and took away all the stuff for shipping. I also like the name - sounds like it means something good.
Four more sleeps til Fly Day.
*Update* - I think the itinerary is about set, now. I'm actually quite excited about it. I've just spent the weekend ghost-writing cover letters, and emails of introduction and enquiry. I'm taking a small slice of credit for her success as a royalty payment.
I think what excites me most is the attitude. That she'd have the gall to apply for even quite prestigious universities in some far-away country she's never visited, and then gamble a couple of thousand dollars worth of money she doesn't really have on the off-chance it helps her dream come true. And all on her own two feet - no mister or anyone else to carry her through. Damn. She puts me to shame.
---
So we've had the conversation about fulfillment in life, and expecting to find it through motherhood, and failing (at least so far) and turning instead to contemplate finding it through work. And I've decided this makes good sense. I'd like infertility to become background to a life in which I create and pursue other dreams. I'd like to think, for the moment at least, that motherhood, if/when it happens, will create a part, not the whole, of that tapestry. I just need something else in my life that actually means something to me. And a beer with old friends last night has brought me closer to deciding a path, closer to realising what excites my passion and has, for as long as they've known who I am.
But enough about me. Let me live vicariously through someone else for a moment.
My sister - who struggled to enter the career I may soon leave behind - is also creating and pursuing her dreams. Yesterday she obtained permission from her boss for 2.5 weeks leave. This morning she booked return flights to New York, and in exactly two weeks she departs our sunny shores to do a whirlwind grad school recon of the USA. Time is tight, and she's just sitting down to work out how much is possible. And I realised I know some USians, and some of them even live in the towns she's thinking of visiting. And I thought you might be neighbourly enough to give her some practical advice - especially with transport options.
So this post is a call to all US citizens and travellers. She needs an itinerary and she needs one fast.
Here's the long list of programs she's applied to:
Texas A&M Uni, UC Davis, Cornell, North Carolina, Uni Pennsylvania, Purdue, Tufts, Uni Wisconsin-Madison, Washington State, Colorado, Virginia-Maryland.
Here's the short list of programs she's really interested in:
UC Davis, U Penn, Purdue, Tufts, UW-Madison, Washington, Virginia-Maryland.
Here's the really short and gravely unambitious list of universities she thinks she has time to visit:
UPenn, UW-Madison, Washington, Purdue.
These aren't necessarily her top four from the short list, just the four she thinks make a nice-looking intinerary, based on a few hours' internet research. Well. That won't do.
She has fifteen full days in the US, and two half-days on either side. By bus, train, plane or car, I think she can make it to more than four universities. I've been on the road with her before - I know she can cover more ground than this, if she thinks it's possible. Help me show her it is.
Restrictions:
She wants to have a full day at all the universities she visits.
U Penn has requested she visit on the 1st of December, and Virginia-Maryland wants her there on the 4th.
She arrives at JFK on Saturday the 25th of November, and leaves again on Monday the 11th of December.
So if you have any tips, send them on. And even if you don't, think of her in a couple of weeks time, and remember to wave her hi.
---
What's with the lack of non-car directions on uni websites? Where are the public transport options, people? Good grief!
Well, I think you all deserve a prize for bothering to comment on that one. I've decided your prize will be my taking that post off the top of the front page before I make us all sick.
I'll let you know what my conclusions are with respect to this train of thought, but I'll try and spare you the angsty hand-wringing and constant expressions of self-doubt along the way.
Having said that, I did find the comments helpful. For a start, I remembered everyone goes through these little moments, especially when coming up against obstacles to the accomplishment of their plans (and as Carol points out, IF can come between a gal and even her dreamiest job). Then there were a couple of practical pieces of advice - Serenity mentioned life coaching, and Steph had some specific suggestions about social work which bear thinking about. I've also been musing over Lut's choice to have the family first, and the rest later - in direct contrast to the way people usually think about it. I think it's a smart idea and I hope it catches on. Also, it makes me less afraid to explore other paths now, rather than feeling the need to commit for life. Which may or may not have been what she was driving at.
In any case, I don't think I can bear looking at such a pitiful post any longer, so let's just push it down the page a bit and agree not to mention it any more.
I don't like talking about what I do for a living. I go to these social gatherings now and then where people ask me and then when I tell them they look all enthusiastic for about twenty seconds because it sounds like something that should be interesting to talk about, even though in practice it's not. Then they come up with these stories about so-and-so who really wanted to be what I am but never quite got there, and inevitably they ask me why I chose my job. I dread these conversations. Perhaps I should explain.
You know those women who decided on a whim one day not to use contraception and are now complaining about getting knocked up and raising a kid? Don't you just hate them? Well, metaphorically speaking, I am such a woman. People kept asking me in high school what I wanted to be when I grew up and I got bored with telling them I didn't know, so racked my brains and gave them the best idea I had at the time and, well, since then I just haven't managed to think of anything better. That's the whole story. And now I'm here, I don't exactly like it, but I still can't think of anything better. Well I can, but, see profile re: infertility.
And to make matters worse (warning: middle-class whining about complete non-problems continues for another whole paragraph) my sisters are, metaphorically speaking, the infertiles who struggled for years to gain what I take for granted. Woe, and again I say woe is me. I like to say I inspired them. Whatever - point is they both chose the same career path I did, and they both strove hard for years to claw their way into my position whereas I skipped and hopped straight from highschool to uni to graduation to my first job in the minimum possible time, all the while trying (but failing) to think of a more appealing alternative. Yes, it really sucks being me.
I think I'm ready to get over it.
If the longest I can work full time without throwing some sort of "stuff all this I'm going to Morocco to find myself" fit is under a year, it's time to move on. Mr Bea, bless him, has been very tolerant up til now. He says, as if he's not directly contradicting himself, "Sure! Alternative Career Path A sounds perfect for you - go for it!" and also, "You know, the career path you're on suits you so well, I really think returning to it** is the right choice!" plus, from time to time, "Well, just don't forget to send me a postcard! With camels on it!"
The fact is, what little satisfaction I do derive from my job is completely offset by the enormous level of stress it causes me. Causes me, mind you - other people don't seem to respond this way. And there are many who find my job intensely satisfying, but for some reason not me. The bottom line is I've been trying to follow a career path I find to be highly stressful and mostly unsatisfying. I mean, it's just stupid, isn't it? Plus I'm not very good at it.
Also - and this is key - in the shit fight between Mr Bea taking the job he really actually does want in Singapore, continuing to do IVF, and devloping my career, developing my career got so totally done over by the other two it woke up in hospital in a completely foreign state where the authorities are still waiting for it to recover its memory so they can ascertain its identity and contact its next of kin. And no-one, it seems, has so far reported it missing.
To sum up.
Please help Bea discover her purpose in life. A small prize* goes to the winner.
---
*Prize may be, like, really really small.
**Read "falling back on it".
Well, I've had my last day at work*. I am now officially "between jobs". I worked the last shift alongside a colleague who has been wonderful to me all year. She's taken up slack for me, covered and swapped shifts for me, she even came in on her Sunday off to help me out for two hours during the pre-beta crisis of our most recent FET.
But here's the thing. She did all this without knowing. She may have suspected that something was up, but she never asked questions or demanded explanations. If she saw I needed help, she gave it. And she never once acted like I owed her one. I am, and will forever remain, thoroughly grateful for her.
I guess I felt she had earned a right to know. So before we said those last goodbyes, I told her. Just a brief outline - nothing detailed, nothing heavy. She said she was amazed at how well I'd held it together, and I laughed drily and said it was comforting to know she hadn't been spying on me closely. And she wished me luck, and she said she hoped I found happiness in the end.
And then she paused, looking worried. "I just never realised it was so common to have trouble," she said. One of our colleagues has just given birth to an IVF baby, and another has been advised to start treatment, and is weighing her decision. Three other workmates have lost unborn children in the last twelve months. We are only a small business.
"And you know how I feel about kids," she continued. She feels ambivalent, and more inclined towards her career at this stage. "My mother and sister conceived fairly easily, though," she added, looking sideways at me.
I shook my head firmly. "My mother has three children," I replied, "and never spent longer than two months trying to conceive any of us. You're not your sister, neither are you married to her husband."
And there was a pause, whilst I considered what to say next. But in the end I felt I had to.
"It's more common than you think," I told her, "and you have less time than you're expecting. You're already in your thirties - your fertility, and that of your husband, will start to decline significantly in a few years' time, and dramatically once you reach forty. Don't assume. Don't wait til you're ready, or finished with your career. Above all, don't wake up on your forty-first birthday with a sudden and burning desire to procreate and not enough time for Plan B."
In the silence that followed, she played absently with her ear lobe and stared at her lap with a troubled expression on her face. I waited. When at last she looked up, she promised to give it some serious thought, and I felt I had done my duty, so returning part of the enormous favour she'd done me.
She'll probably be fucking pregnant by March.
---
*Actually, they've asked me to do a couple of casual shifts next week, and like a fool who thinks time will just expand to allow me to get everything I need to done and then some, and is having many moments of anxiety over how we're going to pay for this lifestyle we've agreed to follow, I accepted.
You guys rock. You really do. Things are much clearer to me now than they were this time last week, although I'm sure it won't last. Luckily, we've written it all down. And now, for what it's worth, I want to tell you what I've learned.
I've learned that, in this uncertain world of infertility, it's impossible to set the rules ahead of time. Saying you'll quit after cycle X, or you'll do as much as it takes, no matter what, is a recipe for anxiety - as is any other rule about how you'll react on a given day, or to a given situation. There's enough worry without the fret over whether you'll be able to follow through on your self-made promises. And that's not to say you should throw out all your standards - but you need to give yourself permission to take it as it comes.
As for the short game, the flash points where everything is an overwhelming crisis - they're going to come and go. You may be able to identify a pattern, or a situation that sets you off, or you may be struck down without warning. Whatever the case, you need to ride them out, nothing more. Analysing and problem solving mean nothing here. The only thing that counts is your ability to distract and de-stress. Meditation or exercise, whatever music puts you in a better frame of mind, breathing exercises, or busying yourself with some sort of achievable task - whether work or recreation - can tide you over until the panic subsides. Until it's time to make the next choice; to roll the next set of dice.
And if you're ever wondering why, and there's no logical answer, try picking up a coin. Weight it on one side, according to your prognosis and the number of embyos you're transferring. Then flip. Because the universe plays just such a mystical game of chance.
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If anyone still has any bullet-proof coping strategies they just have to share, you just have to share them. I can't speak for anyone else, but I'll be reading.
So much of the stress of ART is not based around specific events where things have gone wrong. Rather, it's a background stress - the not knowing how things are going to turn out in the end, and the wondering what bizarre and unexpected twist is going to derail it all next. Good, I can see you nodding along.
What I've noticed, and what I don't know how to deal with, are the flash points. The predictable meltdowns that punctuate a cycle. It's taken me four FETs to identify the pattern, and though I imagine it's not the same for everyone, I also suspect I'm far from unique.
Two days before the next test or procedure. That's when it happens.
Two days before the next blood test, ultrasound, or transfer, you can find me crying, hyperventilating, snapping irritably, unable to sleep properly, having difficulty getting through my day to day life, and feeling generally overwhelmed. On these days it reaches a point where having children becomes a secondary priority, eclipsed by the desire to just make it all stop. Of course, after a few hours, I am back on track. But while it lasts, it's horrible, just horrible.
I suppose identifying the pattern is the first step. Well I've done that. Good for me. But now what? Tell me - I'm not the only one, am I? So having been there, dealt with that, what advice can you pass on?
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I'm going to throw out the first suggestion. Try to arrange things so I'm not facing additional stress on that day. Turn down the invitation to that social event. Arrange my work so I'm not doing the shift that causes me the most anxiety.
There's a balance to be struck between giving myself permission to opt out on that day, and keeping myself busy and distracted. But I think I'm working out how to strike that balance. Example: getting a haircut and having coffee with a good friend would be a good idea. Working a long and hectic shift followed by dinner with nosy relatives who can't stop talking about who's had which baby and when am I going to follow - bad idea. Sitting at home with nothing to do but twiddle my thumbs and consult Dr Google - another bad idea. You get the picture. Still working on how to arrange my life so this is possible, but that's another post. Let's work with theories for the moment, and forget the practicalities.
What else?
I guess we tend to use "should" and "shouldn't" a lot more than is good for us, when it comes to what we think or do under certain circumstances. Because it seems for every permission there is an equal and opposite permission.
Permission to hope, and permission to not hope. Permission to be sad, and permission to have fun. Permission to get out there, and permission to stay in and crawl under a rock. Permission to give up, or to keep going. Permission to make your own choices, and not follow everyone else's - and I'm talking about those who have been in your shoes (those who haven't we obviously ignore because how do they know what they'd choose?).
Permission to indulge and nurture yourself, whatever that means today. But also permission to scold yourself and tell yourself to buck the hell up.
Permission, in short, to do what you need to do, instead of what you imagine you should be doing.
And here's one to add to the list - permission to change and grow. To start reacting differently to certain situations.
It's easy to fall into patterns of behaviour and, having established them, to repeat them ad nauseum well beyond their period of relevance. To choose an example - I think we all know what it's like to carry on as if we still like talking about other people's pregnancies. When people expect you to be "Pregnancy Sympathiser Person", it's easiest to play along. But if you eventually break this pattern, it's just as easy to get stuck in the new rut. People expect you to be "Don't Talk To Me About Your Pregnancy Person" and it can be just as awkward to move on from there.
Why do you (ok - let's switch to "I" at this point) feel the need to automatically respond the way I did before? To save myself the energy of coming up with a new behaviour, and establishing new social patterns? To meet the expectations of others? Whatever the reason, I'm sure it's not a good one. This is, apart from a shitty, fucked-up situation, also a life-changing series of events. I need to give myself permission to grow, to change, to adapt, to accommodate - to become the person I'm going to be because of, or despite it all.
I hope she's nice.
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I also want to say thanks for all the thought-provoking comments. I feel I'm really learning something here. If anyone has any more, I'm all ears. Meanwhile, I'll be working on Strategising - Part Four.
Oh - also - I started temp charting today! I'm a little bit excited. Do you think "first thing on waking" means upon becoming "consciously aware" or "able to perform the brainstem reflex of hitting the snooze button and tying yourself up in the sheets for half an hour before realising it's morning"?
I started posting this in the comments, but it got too long. Here's what I'm hearing.
Most people don't like the idea of a deadline as a coping strategy. Or at least not when put in those terms.
Deadlines are set for other reasons, of course (though I really hate the idea that money is one of those reasons - it's just an extra level of unfair.) But no-one so far has said they told themselves, "We'll do X number of cycles, and if that doesn't work, we'll move on," purely because it helps them to think that way. Because it helps them to know that, whatever happens, they'll never go through this shit more than X number of times.
Yet I know there are people who do think that way. I met one at my first transfer. It was her second-last transfer, and I'll always wonder if she was successful, and if not whether she changed her deadline. Because when it comes to the "creeping deadline" strategy the "creeping" is as important as the "deadline". You calm yourself down by saying, "Only two more cycles, no matter what!" but you keep yourself from worrying about their failure by secretly giving yourself permission to carry on.
So, to sum up, I'm beginning to think coping involves giving yourself permission to keep going, and also permission to stop. Permission that doesn't hinge on the outcome of your treatment.
I'm also toying with the idea of "permissions". (Can you tell?) Permission to keep going. Permission to stop. Permission to hope.
What other permissions do we need to give ourselves in order to cope?
I'm going to attempt to make this post seem more important than it really is, by linking it to the National Infertility Awareness Week "Take Action" campaign happening over at Stirrup Queens and Sperm Palace Jesters. Don't let the linkage fool you - I'd love to think of this as a selfless act of "reaching out" to the infertile community, but in truth it's as much about y'all "reaching out" to me. So let's not go overboard and paint me saintly, or anything.
I've been thinking about coping strategies over the last twenty-four hours. I want to start a discussion. I'm going to try to stick to simple outlines today, and follow up later in the week once I have your responses and thoughts. Now, obviously, different things work for different people at different times. Which people? What times? Would you find these strategies helpful? Well, what have you found helpful, then?
Here are two strategies I'm thinking of trying out:
Coping Strategy One: A Firm Belief In My Own Mediocrity (aka "that stuff only happens to other people")
It's paranoid to believe I'll be one of those unfortunate patients who, without any sort of explanation, fails one transfer after another, or loses pregnancy after pregnancy. Isn't it? I mean, I know these are real concerns and real people (some of whom might be reading this post) have to face them. Is it naive to make myself believe that won't happen to me, or is it necessary? And if it's necessary, how do I do it?
Coping Strategy Two: The Creeping Finish Line (aka "just one more cycle")
The trouble with agreeing to do as much IVF as it takes, is realising it sometimes takes an awful lot. The thought of being prepared, if necessary, to go through years of IVF can be overwhelming. What about agreeing to a limit, subject to last-minute changes of heart? Or does the pressure of having a deadline do more harm than good?
Well? What do you think?
From my most recent conversation with FS:
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"...so just call me when you want to do another cycle. Although you'll probably go off to Singapore and call me saying you got pregnant all by yourself and don't need another cycle!"
"Really?"
"No. I'll see you next year." O...kay. "Til then, have a good Christmas and just forget about it."
Right.
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Today is cycle day one. Or "CD1" as we in the biz like to call it. And guess what I didn't have during this luteal phase? Anyone? (Clue - look at the labels down the bottom. Hint - I did have the lap/hyst/dye, and I'm still on break).
Also - I appeared to ovulate around CD13. I have done that exactly once before, that I know of. I'm a 16-19 day gal. This year, it's been anything in the twenties, and only then with help from our friends the injectables, except for that last cycle where I started injecting on day 8 (or was it 9?) and ended up ovulating on day 17. So - unaided, day 13. I wasn't expecting that.
Now I know what you're thinking. Did I really ovulate that early, or did I have a strange and stunted luteal phase? And I'd be thinking the same thing, except... on CD12 of the cycle in question I suddenly thought, "Fuck! I think I'm ovulating!" and I marked the day down on my little fertility friend chart, and predicted that today... that's right, today... would be CD1. Which it is. So.
Now, I did have a little spotting on the day after the lap/hyst/dye, so it hasn't been completely spot-free, but I'm ignoring that because hell, if you can't spot for 24 hours after a lap/hyst/dye when can you spot?
So.
So...
Several theories come to mind.
1. It's a coincidence. See what happens next cycle and this time, buy a bloody OPK to give yourself some credibility.
2. The physical handling of your uterus during transfer is causing the spotting. Well, it was pretty firmly handled during the lap, so why didn't I spot like crazy because of that? The dye cleaned things out? Maybe? And what about that first cycle - you only got a little spotting and that was at about the time your period was due? Lots of holes in this argument, I'm afraid. At any rate - no transfer, no pregnancy so even if this is the reason, there's no solution.
3. The luteal phase hormones he's given you are causing the spotting. But the spotting wasn't worse with higher doses of hormones. And those hormones are supposed to prevent spotting, so this would be a really perverse thing for your body to do. If this is the case, over the next few (rest) cycles you should get a normal luteal phase length with no spotting. Easily tested. And then I guess we can discuss completely natural cycles, and see what happens.
4. That durrned embryo is causing the spotting. The amount of spotting seems to have been more or less inversely proportional to your hCG reading on beta day. You spotted the most with the BFN, and the least with the first cycle, which produced the highest beta. Although, to be honest, there were less spotting days with the BFN than with the next cycle, even though the spotting was heavier, and... I just think you're being dodgy, that's all. At any rate, what are you going to do about it? Monitor, OPK, record, gather more data, try to achieve some statistical significance.
5. The mental stress of cycling was causing the spotting. Relax and it will happen! (Hahaha - gotcha.) Alternatively - it's the power of springtime! Lucky I'm moving somewhere equatorial then, isn't it?
In any case, what I have to do seems pretty clear. OPK, record, monitor. See what happens. Mull. Draw shaky conclusions.
And he told me to forget about it!
I told my Grandma. Grandma "IVF doesn't work, is painful, expensive, and therefore just shouldn't be allowed" J. I've wondered, since she unwittingly said this to my mother*, how she'd take the news.
"It doesn't always work," she says. I know - but there's still a good chance of it working in our case... probably... eventually. "It's expensive," she says. Well it's valuable. And within our means. "It's painful, and difficult," she says. We've been doing it since January. We've got through this much, we'll get through some more. "But why... what's wrong with you? Or can't they explain?" It's not important what's wrong, Grandma. The point is, we need IVF if we want to conceive a child.
And then... then she smiles. And then she laughs. "Well this is good news!" she tells me. And it's my turn to look at her askance. "Well, I thought you weren't trying at all," she explains. "This gives me much more hope for good things."
Later, taking the kettle off the stove, she tells me how she's going to put us on her prayer list. "And I've had a lot of success lately. Not," she cautions, turning from her teabag jiggling to look at me through the top of her glasses, "always in the way I'd imagined, but good news nonetheless." And she turns back to pour the milk.
For a second, her confidence infects me, and I believe that her prayers are our missing ingredient. Then it's my turn to caution. "Just don't hold your breath, Grandma," I say gently.
"I never do any more, darling," she replies, and sets the tea down. And her thousand-yard stare goes straight through the window, and into an emptyness beyond. Life goes so quickly for her now, and she's given up trying to forsee all the twists and the turns. Things happen in the twinkling of an eye. One day, all of a sudden, I was born. The next, out of the blue, we were married. And tomorrow, all this will be over, who knows how? But she remembers what it's like when you're young. And remembering, she smiles in sympathy - a smile to save up for an older me, for the day I understand.
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*Within days of a) my revealing the news to my parents and b) my EPU. Good timing, Grandma J.
The woman at the cafe looked sideways at the pram trundling past, and I saw the flash in her eyes. Envy? Grief? It was similar to looks I'd seen on her before, handing in her form at the counter, waiting for her blood test. I remembered her sullen mumble of thanks - belated, like a nicety almost forgot, when the receptionist whispered her good luck on what must have been another beta day. Other times she'd just sat, distant, not bothering to suppress a sigh.
I wanted to say, "I know," and thereby take from her a little of the melancholy she so clearly overflows with. So I met her eyes, but she dropped them quickly away.
And in a second I'd moved on, unrecognised.
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The embryologist was talking in a low voice to a couple in the hallway as I headed for the changing room. I heard him ask, "Have you had decent eggs in the past?"
"No, we've always had terrible eggs," the woman replied, and she seemed so composed.
"Ah," he responded, awkwardly, and, "Well."
And he glanced at me as I went by, and stalled a little til I passed out of earshot before continuing. "Well," he resumed, "the thing is..."
And I shut my change room door.
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I started noticing her in May. Tall and slender, she was always seen in tailored trousers, a stylish button-up shirt with collar, and a neat jacket or knit jumper. Low, black leather heels, and a loose clasp around her long, reddish-brown hair. Poised and graceful. Confident and controlled. The expression on her delicate features meandering between polite, pleasant and blank.
When she hands in her forms, she always smiles. If she walks through the door ahead of you, she holds it. If you let her into the lift first, she bows her head modestly and treats you to a polite expression of gratitude. She is always alone, independent.
That day, I saw her once again, lining up for another embryo transfer. Not yet, then, I thought. Not for you, either.
As I went past into the theatre, she smiled politely at me.
---
"The girl next to you in recovery was so young," my mother said, as we left the hospital.
I knew the one. She'd been there with her mother, too.
"They were freezing her eggs," I replied. "They got forty-nine, and forty-five were mature. They froze all the mature ones."
"So that's different from what you had?"
"They froze our embryos. The success rate is much higher."
"So why freeze eggs?"
"Because you have no sperm to make embryos out of, usually."
"But why would you be doing IVF at such a young age if you had no sperm? Oh. You don't think...?"
I shrugged. "I don't know her story." There was a pause.
"You don't think she'll get OHSS like you had, do you?"
"I don't know." Probably.
"She seemed in so much pain, Bea." I nodded.
I remember her telling the nurse, through tears. I remember her limping to seated recovery, heat pack held against her swollen abdomen. I remember her baby face - barely twenty. And her mum, stroking her brow, helping her home.
We held the lift for her.