Don't forget to dance

As many of you know, infertility can takes it's toll on our self esteem and drastically change how we view ourselves and the world around us.

Tonight was a strong reminder of that. I went to a wedding that was filled to the brim with pregnant ladies, infants, toddlers and young children. Even though I didn't have the overwhelming desire to flee as quickly as possible like I would have a year ago, it was still a tough crowd to hang out in. I felt that oh-so-familiar funk settle in on me. Over the last six years I have mostly adjusted to a new normal of sadness and feelings of inadequacy and bitterness. I don't mean the times when these feelings are particularly strong and you would rather stay home and stare at the ceiling for hours than participate in the world; I mean the times when it is hovering around the edges and you know you ought to be enjoying things more, but you just don't feel up to it. That's how it felt tonight. That is how it so often feels.

Then the 10-piece Salsa band started up and Brad and I got up to dance. We probably only remembered about 5 moves from our ballroom dancing days, but it was more than enough. We felt the music move through us as we smiled at each other and flirted with our eyes. We sat out more songs than we danced - I'm afraid I am a bit out of shape, but we still danced quite a bit. We even participated in a conga line for a long song and it was so much fun to let the music tell my body what to do. I wish I could explain it better. I just danced and expressed myself and it felt great.

All the way home, I had a content grin on my face. I felt reconnected with myself - my old self. The one that isn't quite as broken and bitter. The one who defined herself in broader terms than just someone who couldn't have a baby.

It makes me wonder - is it worth it? Is it worth what we put ourselves through to be parents? Why couldn't we just have decided all those years ago that we would simply take a different path? Imagine . . . "Hmm, looks like it would take a lot to have a kid, why don't we just travel more instead?" Done. Just that easy. But, for better or worse, there seems to be something about the desire to parent that is beyond logic and it leads so many of us to tax ourselves to the near breaking point to achieve that goal.

Right now, Brad and I seem to be almost there. I'm sure we will say it was worth it. I hope we will also create a new new normal that feels closer to the old normal. Maybe we just need to go dancing more often.

Midwife appt # 7: 35 weeks and 6 days

This week's midwife appointment was last night and it went pretty well. I can't believe we are getting so close. Brad and I are both anxious - so close, but no guarantees. Even if it was a sure thing, I don't think either one of us could really believe it might work out. It is a dream we have had for so many years, how could it possibly come true now?

Nothing terribly exciting about the appointment itself. I got a little freaked out when Cathy wanted to time the heartbeat - she usually just goes by feel and I knew if she counted she thought it was a little low. Usually it is around 140, but it was only 120. She had me lay on my left side and patted the baby to wake him up and eventually got 144. Phew! She reassured both Brad and I that this was normal and no big deal. The baby could have been sleeping or it could have been the position I was in.

Cathy would hate to hear this, but I called Dr. Wonderful this morning to verify. The good thing about Cathy is she trusts the process. I think it is hard to give birth if you are terrified something might go wrong and I think that can be common in a medical environment. The good thing about Dr. Wonderful is that he lives in the "So many things go wrong!" mindset so if he thinks it is no big deal, we are doubly reassured.

I am starting to swell a bit from water retention and there are times when the baby's movements cause a bit of discomfort - either pushing on my ribs or kicking my pelvis. I don't mind. If I had my way, Little Butterfly would move non-stop and never sleep until after she is born (when she will promptly decide to sleep through the night!) I still love it every time he moves. It is extra special when Brad and I sit together and he can feel LB move too.

I am still a mess of emotions. I can go from happy to sad to anxious to happy to angry to peaceful and a many more in just a few minutes. I will suddenly feel like I am going to burst into tears only to have the feeling change before the tears come. It is very strange and I hope things will level out after the baby is born. I had one friend describe feeling like a veil had lifted after she gave birth. I hope that will be the case. I don't know if the mood swings are predictive of an increased of post-partum depression, but I am really hoping that we can avoid it.

Thank you, everyone, for your wonderful comments on my last post. I don't know what I would do without your support. I hope I struck a balance between expressing my fears and regrets without losing the part that I am also grateful and hopeful.

Someday I might have a post about our preparations and pictures of a nursery, but at this point we still aren't quite ready to start that process. I joke that we better not transfer to the hospital because we don't have a car seat to bring Little Butterfly home. We do have a room we painted in kid colors before our second IVF, almost 2 years ago now, but at the moment it is mostly a storage / sewing room. My midwife might be bringing the pool next week (we are planning a water birth) so perhaps we should get that room cleaned out - other than that it will be in the living room. Did I mention we have a cozy house?

Just to illustrate (again) my mood swings, here is a high and a low for today.


First the low:

I was reminded of when we learned that our third IVF was a complete bust - the only time we had a completely negative beta. I was so sure it would work, I didn't even take an HPT before the beta and even napped between the blood draw and the results. Because I had been upset about low, but positive betas in the past, the agreement was that Brad would get the results and not tell me what the beta was. If it was negative, he would come home from work (I had the day off) and give me the news in person. I didn't think this was a possibility so I didn't think about how cruel that was - to make him get the news and then drive all the way home thinking about how he would tell me. This is what I wrote in my journal:

We were so sure it would work that I wasn't even nervous. When Brad showed up at home, I was in shock. It was obvious Brad still was too. I will never forget the look on his face when he walked in the door. I was desperately hoping to see a look that said there was another reason he would be home so early. There wasn't. We held each other while I chanted "Oh God. Oh God. Oh God." In denial, we went to the store and bought an HPT. It was, of course, negative too.

That was a very difficult blow. I don't regret the great hope we had that entire cycle. It felt good to be that hopeful. I think it made the bad news much more difficult, at least at first.

A good moment:

Brad and I were sitting on the couch and I was feeling LB move around. It hit me that I was pregnant! I turned to Brad and said:

"Brad, I am pregnant . . . "
"Yes, you are" he replied with a smile that makes his eyes twinkle.
" . . . with our baby!"

That is the first time I have called LB "our" baby. And not just said it, but felt it. Nice.

Some posts I have been meaning to write

Are cousins better than hot wheels cars?

My nephew has a big heart. He was one month shy of his 4th birthday when we lost Ernest. Unknown to me, his mom hadn't told him he wouldn't be getting a cousin when he caught me crying. He asked me why I was crying and I told him it was because the baby died. "Oh. Well, I'm not sad," was his reply. I told him that I was glad he wasn't sad, but I could tell he didn't like the news. He didn't know what a "cousin" was, but he understood it was supposed to be a pretty big deal.

The next day, when I was in a room by myself, he came in and said, "Kami, I'm sorry the baby died." He then probed me for when he might be able to have a cousin. "I hope I have a cousin by my next birthday." I hoped so too. His "next birthday" came and went two and a half years ago. Since then he has been at least somewhat aware of what we have gone through. He knew we had a baby growing two summers ago and knew that that one had died as well.

Yesterday, now at a mature 7 years old, he called to ask how the baby was doing. I told him everything seemed fine and we were hopeful. I asked if he wanted to get a cousin. "Uh huh," was his reply. Poor kid, I think we have made this cousin thing out to something it can't possibly live up to. I thought I would get some idea of what he might expect out of this elusive cousin thing by asking about how he enjoyed having a little brother who is currently two and a half. "Yeah, I like it," was his somewhat neutral reply. I suspect he thinks a cousin must be more special. Still very sweet of him - even if a good part of it is for his own perceived benefit.

Then his mom came on the line and I told her what a sweetheart her son was. He practically had me in tears. She shared a conversation they had a few nights prior to this phone call as she tucked him into bed:

Nephew: Mom, is Kami still pregnant?
Mom: Yes, she is.
Nephew: I hope she has a baby this time.

Oh, me too!

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Midwife update:

I failed to provide an update after our latest midwifery appointment. It was pretty uneventful. The baby continues to be head down with good heart tones. We talked about the beta strep test and she said she could give me an IV during labor if I chose to get the test done and found out I was positive. That was good news. I also shared some of my anxiety about giving birth - mostly because I concerned that this anxiety my stall labor. No, I am not afraid of the pain or the safety of a home birth. I am afraid I won't bond with the baby because he / she won't be of my genes. I know that probably sounds crazy to some people and it is very possible I would have similar fears even if this baby was our mutually genetic baby. Sometimes I think the emotions come first (hormonally induced?) and then our rational mind puts a reason to it.

She was very reassuring and said, "When you hold your baby for the first time, you will bond." I know that seems to be most peoples experience with donor gametes or adoption. If not right away, then within a few weeks. I keep reminding myself that I am likely not that different than most people.

I then confessed through tears that I was afraid I would see too much of Belinda in our baby. My midwife said, "Well, maybe you shouldn't have used a known donor." That wasn't quite as helpful a response as her previous one. I wanted to say, "It is a little to late to change that, don't you think?" She then went on to say that I need to be happy for the baby because those chemicals do affect him. Of course, I know that, but what do you do? I am not always sad (although it may seem that way to readers of this blog) and when I am sad I tell Little Butterfly that it isn't about her. Not that he can hear or understand, but maybe the act sends a little bit less sad chemicals or a little bit more loving chemicals through the placenta. At any rate, I have decided that my therapist may have it right - that it is better to grieve than to pretend everything is ok or to put it off until . . . .when? When Little Butterfly is born? When he is a year? When she is 5?

In the end, I decided she is doing the best she can. I am quite certain she has never had a client who has gone through infertility or donor gametes. Instead of expecting her to understand, I have made an appointment with my hypnotherapist in hopes she will have some positive influence in calming this anxiety.

Oh, the really cool part about the midwife visit is that we will now be seeing her weekly. We must be getting close!

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Never:

I think my RE was right when he said that I am someone who holds on to my dreams very (too?) tightly. It is hard for me to let go of how I thought it would be. Even before I knew Brad was "the one", I wondered what kind of children we would make together. In those early days, I didn't think too much about how we would parent together (I didn't know him well enough yet), but I did wonder how our children would be as a genetic blend of the two of us.

Yesterday, as I read the wonderful news that Mrs. Spock has given birth and welcomed Jonah, I was reminded again over what I will never experience. Mrs. Spock's sister (Auntie Noonie) wrote the announcement post which contained this paragraph:

He looks just like Mr. Spock, except he has Mrs Spock's ears and nose. Oh and he has his Auntie Noonie's giant Peggy Hill feet! :-)

I am genuinely happy for Mrs. Spock and hold no ill will toward her sister. It is what we humans do. We welcome a newborn baby and we look for those physical characteristics that tie us together. We delight in those things the prove we are of the same blood. While I know that there is much more to family ties than this genetic connection, I still long to have that experience.

Yesterday, far too late in the evening, it hit me . . . I will never have that experience. Never. What a hard word. When I thought that I may never have that experience or may never be a mom, it was scary, but so much less certain. That tiny bit of hope made it easier to deal with. That word never grabbed a hold of me and held me so that I could barely breathe. I wanted to scream to the universe: "But I wanted to have that too! Please let me go back and try again! I promise this time I will do it better. This time I won't be so afraid and I will go to an RE sooner. PLEASE! "

But I can't go back. I need to be ok with never. Unfortunately, like the concert that seemed like a good idea until it was sold out and suddenly became the concert you can-not-miss, never makes losing my genetic connection much more important than it probably is. At least, that is my hope and, when I am less fatigued, I think I actually believe it.

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Ponderous man, really ponderous

While I was taking a break in writing this post, I popped over to Stacyb's blog who has a timely post about the genetic connection between mother and child. In it, she talks about a good friend who is mourning the loss of her mother - her adopted mother. Stacy makes some good points, but what struck me was the question, "What makes your mom your mom?"

Hmmm . . . that is an interesting thought.

What makes my mom my mom? We are nothing alike and haven't gotten along well since I was a teenager. I know she did the best she could, but sometimes it feels like I raised myself. When I think about her as "my mom", my first thoughts are of how much we look alike. I have her hands, her eyes, her smile and her body shape. We are both far sighted. Outside of that and a penchant for noticing what is missing in our lives more easily than noting what we have, we don't have a lot in common.

Of course, I still love her and would miss her if she were gone, but it makes me wonder - Perhaps this is why I struggle so much with the genetic connection. Perhaps the strongest connection I have with my mom is my genetic connection and some subconscious part my mind can't conceive of a mother / child relationship not based on genetics.

Let's hope that I can prove myself wrong, if that is the case. Either way, that is enough navel gazing for one day. I am off to take the dog for a walk.

I don't look back, darling. It distracts from the now.

Ha ha ha - that is me not at all. You may recognize that quote from Edna in The Incredibles. They are words of wisdom that I just don't seem to be able to practice.

And so . . .

One year ago today, I had my first ultrasound for our last chance cycle with my eggs. Things were a bit different that time around because I didn't get suppressed - I was just one month out from our last failed (negative beta) IVF cycle and we were starting on my natural day 3. I had 14 antral follicles - more than I had ever had. I knew that it could be because of left over drugs in my system from the previous cycle and these eggs could end up not being the healthiest, but it was still so hopeful!

We had planned on transferring all our living embryos back on day 3 like we did in the previous cycle. My RE was sure we wouldn't have more than about 6 and since 6 hadn't even produced a pregnancy, he wasn't concerned about having higher order multiples.

We eventually retrieved 20 eggs, 17 were mature and 14 fertilized. On day 3 most (12?) looked really good with 7-9 cells (most were 8) and low fragmentation. The embryologist called to suggest we grow them out to blast because we couldn't transfer all 12 on day 3 and he couldn't make a call about which ones would grow the best. I remember him saying that "it is like I am working with an entirely different person." We were over the moon. We might get an heir and a spare out of this - or at least some on ice for the first time.

On day 5 things had already started to go downhill. None had made it to blast, but a few were promising. I remember how my heart sank the next when my RE walked into the prep room (for the transfer) with a picture of a single embryo. We had 5 more still living, but they didn't look good. He was very hopeful though because we had one "beauty queen" - the best of all our 37 embryos over 4 cycles and it was hatching.

I was still discouraged and cried every day for the next seven days until the beta at 13 dpo. I was tired of taking PIO shots for failed cycles and asked if I could come in a day early for the beta. My RE agreed and it was a whopping 2.8 - positive by some standards, negative by others. They offered to let me come in again, but since I had positive betas of 26 and 37 (they like to see at least 50 although 100 is better) that ended in early miscarriages, I declined. Lovely AF showed a couple of days later and all our chances were behind us.

I don't know why I am sharing this other than that the past has been on my mind a lot lately. I don't even think it is doing me any good. I may be trying to make sense of it - to fully come to grips with what we have gone through and perhaps let it go or have it not hurt so much. It hasn't worked so far that I can tell and I really should try a different tactic. I keep telling myself that I want to be more like Brad - he is so good about letting go of the things he can't change and being happy with whatever there is to be happy about.

Wait. What's this? I think it is . . . yes! A smile has come to my face! Can I just say that I am a thousand times blessed to have Brad in my life? He lifts me up. We have fun together. He kept me going almost single handedly over the last 6 years (not true - there was Stacey and Kari and Kathy Jo among others, but he was there every single day). He loved me even when I was too sad to show that I loved him back. He makes me smile. We are a team.

No, I'm not bipolar, just a little more emotional than usual. And as long as we are on the emotional roller coaster let me sprinkle in a little anger / frustration.

There have been some friends IRL who have suggested or flat out told Brad that he needs to get me a gift for after the baby comes. Some people even call it a "pushing gift". It really irritates me because Brad has put as much into this over the last six years as I have. Sure, our roles have been different. I did more research and got all the shots and I get to be pregnant. He remained hopeful and steadfast when I faltered. He has picked me up and held me when I cried more times than I can count. Did I mention we are a team? I can't believe that anyone would imply that I deserve a gift and not Brad. I realize it may be pertinent when the guy's primary role was to have an orgasm during sex, but you can't fight infertility for long without both members of a couple baring the battle scars.

Damn, it just occurred to me that he probably will get me something. He is such a hopeless romantic (reason # 342 why I love him so much). Anyone have some ideas for a "You survived six years of hell for this" gift for Brad?

60 seconds of pure magic

I had the most amazing experience. I don't know if the events leading up to the experience had anything to do with it or not, but I will outline them if for no other reason than to give some context.

Last Friday Brad and I went to the local gym to work out. I decided that I would go for a swim if I owned a suit that would fit. Fortunately, I had a one piece that was years old and had stretched out so I was good to go.

The pool only had a few people swimming and they were mostly older - probably 60's or greater. I shared a lane with a nice gentleman for a few laps until one was vacated and I moved to that one. It felt just wonderful to swim. Doing the breaststroke felt kind of funny, as if my back was bending too much, but swimming on my back or underwater felt great. For more than 6 years I imagined I would swim later on in my pregnancy and here I was doing it.

At one point I even openly acknowledged my pregnancy when a young lady (early 20's at the oldest) joked that when I swim on my back all she could see were two boobs. She laughed and said she wished she had a bigger chest. I replied, "Well, these are pregnancy induced." It was odd to be so guiltlessly open about being pregnant, but I figured this was a fairly safe crowd - being men in their 60's and 70's and this one lady who probably wouldn't be thinking about kids for years to come.

"Yeah, I had that happen when I had my son, but they went away again," was her next statement. Normally, this would likely give me a twinge of jealously, but I guess I was enjoying the swim too much.

Shortly after, I called it good and headed off to wash some of the chlorine from my skin and suit. As I clumsily stepped out of my suit - trying to take if off while bending over my growing tummy without letting the suit touch the floor - it hit me. "I'm pregnant!" I giggled out loud. For about a minute I just sat there in the shower, occasionally giggling with no other thought in my head than, "I'm really pregnant!" No, that's not true . . .I remember thinking, "Thank god for modern technology that I could get pregnant." But mostly it was just joy, pure and simple.

I couldn't wait to share it with Brad, but by the time we met up about five minutes later, the moment had passed. The best way I could describe it to him was that for those 60 seconds or so I was pregnant without baggage. I didn't feel the weight of years of failed treatments and failed pregnancies. It didn't matter about the donor eggs. I had no fears (or even thought) of the pregnancy not producing a baby.

I imagine that is how people feel when they get pregnant easily - not for a magical moment, but most of the time. I'm not going to lament the loss of innocence, however. I have mostly come to terms with that aspect of infertility. Besides, I don't want to sully that experience by wishing I could have more of those times. If I never have a moment like that again, that will be ok. It is enough that I can hold on to the memory of it.

Tee hee hee . . . I'm still smiling.

OB appointment #7: 33 weeks 1 day

I have been looking forward to this appointment for days. Dr. Wonderful is very nurturing and I think having Brad gone for a week left me with a bit of deficit in the nurturing / warm fuzzy department. Brad does what he can, but he is only one person and I am needy these days. To be honest, I think Brad enjoys the reassurance too.

Perhaps my expectations were a bit too high because now I am feeling a little disappointed. I got a hug at the beginning and some verbal warm fuzzies, but then he went right to, "What are you going to do about the beta strep test?"

For those that don't know, it is routine in this country (at least in the last 10 years or so) to test pregnant women for beta strep AKA Group B streptococcus or GBS. It rarely causes any symptoms in adults, but can make a baby sick if infected during delivery. In rare cases it can cause serious, long term consequences and even death. If the mother is positive or "colonized" she will be given a intravenous antibiotics during labor. According to the CDC this has decreased the number of cases from 0.7 cases per 1000 live births in the U.S. in 1997 (before routine screening) to 0.37 cases per 1000 live births in the U.S. in 2006 (See note 1) (Interestingly, this is up from 0.32 / 1000 in 2004 - a little antibiotic resistance?)

It seems simple enough . . . just take the test and treat it if I am "colonized". One problem is that the treatment may not be compatible with a home birth. Since my midwife is also a nurse, it may be possible to have an IV. There may also be other options for treatment that aren't as well studied since most people give birth in a hospital and get an IV anyway, why not just add some penicillin to it?

But the issue is even more cloudy. Consider the following:

• Tests are typically done by swabbing the lower 1/3 of the vagina and the perineum (and sometimes the rectum). The idea is that if a person is colonized either in the vagina or in the rectum (more common) then the person should be treated. I asked my doctor how a rectal colonization could be a problem during labor / delivery and he said that it is swabbed with the theory that a colonization of the rectum could spread to the vagina during the weeks between the test and delivery. Why not test everyone a little later in the pregnancy then? Because some will delivery earlier. Why not make a guess with each individual? My opinion is that it protects the doctor and makes studies easier if there is a "standard of care"
• The studies I have seen look at the number of babies infected, but don't talk about who gets a little sick and who gets very sick or dies (or how many).
  
• Many studies found that preterm infants were the most at risk. What are the risks at full term?
• Studies have found that the following people are at greater risk: blacks, women under 20, health care workers and obese women. I am none of these. What are my risks?
• From the land of lies, damn lies and statistics: Prior to routine screening a woman would have about seven hundredths of a percent chance of having a baby get infected. After routine screening (assuming treatment if needed), a woman would have a bit less than four hundredths of a percent chance. Yes, it decreases my chances by about 1/2, but the chances are pretty darn small in the first place.
• Some studies found rates of infection lower in non-hospital birth. (One anecdotal story of a woman who tested negative for GBS before and after delivery, but the child got infected with GBS and had lasting complications)

Currently my thought is to either not test at all or try to time the test as close to expected delivery as possible (there is only a one to two day turn around time for test results) and only do a vaginal swab. If I test, I will have a plan on how to treat it. Some internet research found that it may be possible to use oral doses or watch the baby closely for infection and give an IM shot if needed (normally the baby will show signs of infection within a couple of hours.). There is also the risk of late onset GBS infection (after three weeks) but whether that infection is picked up from the mother or another sources is even more mysterious.

I don't make this decision lightly. It is hard to go against expected norms - even when the risk is low. I don't like going against my OB's recommendations. I consider myself more than up to the task, but as crazy as this sounds, I find I want to please him. This made the discussion very stressful and has led me to start thinking that it is time to move away from seeing my OB. I don't need to hear about worst case scenarios and how birth is fraught with risks. (See note 2)

I adore my OB, but he is a product of his medical enculturation. He has to believe in his understanding of birth and medical practices just as my midwife believes in her views. Although I believe "the truth" is somewhere in between, I have opted to follow a more natural approach to birth and I believe my mental space is an important factor in that. I need to trust that my body knows how to birth a baby and that a home birth is as safe (or safer) than a hospital birth. At the same time, I know things can go wrong and I hope to have my OB "in the wings", if you will just in case.

To that end, I will make an appointment with my OB for four weeks out when I will be (if all continues to go well) 37 weeks along. At that point, I will discuss it being my last planned prenatal visit with him and ask how he wants to handle the birth. That is, would he like to know when I go into labor, would he like updates or would he prefer contact only if it looks like a transfer to the hospital in imminent. I'm going to miss him being part of this pregnancy, but I think it will be for the best.

Notes:
1) From this CDC web page
2) This is one of the reasons I am not keen on a hospital birth - the staff are trained to watch for trouble and if you want to feel afraid, just be around people who are fearful - even Stephen King recommends watching scary movies with people to heighten that sense of fear. If a woman is afraid, her labor will stop until she finds a safer environment. Or in the case of a hospital birth, she will get pitocin to artificially keep labor going.

Males do influence baby's health

Here is an interesting article on the influence of a father's health in relation to the child. It's kind of a scary read for those of us with known male factor issues. Are we still at an increased risk of having a special needs child? Sometimes I get so wrapped up in having a live baby, I forget that living does not equal healthy.

It is kind of long, but I encourage you to read it. As a teaser: One of the amazing studies shows that a male mouse can be damaged in utero by an environmental contaminate in a way that doesn't damage the genes, but changes which ones are turned off or turned on. This has been shown to then affect that male's offspring to at least 3 generations.

The article is supposed to be protected for subscribers only, but I didn't sign in and I still got it. Please let me know if you can't access the article and I will post it here.