Monday, April 28, 2008

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.

Friday, April 25, 2008

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.

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.

Wednesday, April 23, 2008

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.

Saturday, April 19, 2008

Positives and Negatives

The best news today is that Brad will be home in just a few hours! Yeah!!! It wasn't looking very good for a bit as his flight was delayed to the point where he would miss his connecting flight and the next one out wasn't until tomorrow afternoon. Fortunately United booked him on a NWA flight only to have a miscommunication between airlines so that he had to trek back and forth between check-in counters six times (about 5 minute brisk walk apart) before things gotten straitened out. He got through security as fast as he could and got to the gate just in time to board. Phew!

I am so happy about him making it home tonight, it doesn't seem right to go into the negative experience of my second prenatal yoga class. I'm going to anyway - maybe I will enjoy venting a bit. The short story is that it is extremely unlikely I will go back. I don't blame the instructor or the people in the class. They are just in a different point than I am and as Pamela Jeanne so beautifully pointed out in a recent post - it is easier to be happy with how things are when you aren't reminded about how you wished them to be.

I would like to tell this story by a dialog between me and the instructor. Actually it is the instructor talking about birth and me responding, but only in my mind.

Inst: During active labor, every (emphasis mine) woman will create a ritual that she does during each contraction.

Me: Actually, some of us will be talking to a neonatologist trying to figure out what to do when our baby is born.

Inst: Nursing is a learning curve for both you and your baby. Don't be surprised if it takes some practice and don't be worried if it takes a little bit for your milk to come in.

Me: What do you suggest if your milk comes in, but there is no baby to drink it?

Inst: Studies show that episiotomies aren't necessary. If you don't want one, you should talk to your OB now about her practices.

Me: Are these women really so ignorant about birth and accepted practices? When it comes to labor and delivery, is this really one of the bigger issues on their minds? Ah, if only I was so innocent again.

Inst: This is a good move for when you become overwhelmed during labor.

Me: Overwhelmed? With labor? It might last a day, a week? Let met tell you about being overwhelmed! Try being overwhelmed with the prospect of never having a baby. Let me tell you about be overwhelmed financially! How about years of infertility?! That is overwhelming. As long as I get a live baby out of it, I can survive anything labor and delivery can throw at me.

I will admit that I was not in the best place emotionally during this class. My last thought may have been a bit of an exaggeration because I know I will be very disappointed if I don't have a home birth, but in that moment I just felt like I was the only one in the room who truly understood that babies die and there may not be the opportunity for another. I felt very, very alone. The good news is that I have learned some moves that I can do on my own and I don't need to ever go back.

Back to a positive story, please read this post by StaceyB who recently gave birth to her daughter who was conceived with donated eggs. From someone who probably worries too much about how I will feel when this baby is born, it was a beautiful and reassuring post to read. I just love the last line. I think I have read it half a dozen times and it still brings (happy) tears to my eyes.

Monday, April 14, 2008

Another milestone

I went to my first prenatal yoga class last Friday. I realized after my last midwifery appointment that I felt comfortable enough with this pregnancy to be in a class full of pregnant fertiles. By "comfortable" I mean that I was feeling comfortable in my own skin. I was feeling . . . 'confident' might be the right word. So much of this pregnancy I have felt like a fraud or a failure as if I cheated to get here. I kind of did cheat, I guess, but I think most of you will know what I mean.

I'm glad I went - physically it felt great, but it was not without its challenges. On the way there I was very nervous. I felt like I was driving to the RE's to get an antral follicle count or a beta. So many things are made harder by infertility. I bet I was the only one going to class that day who was so afraid of the feelings that might be triggered that she was crying. Can I interject an "It's not fair!" here? Trying to parent with infertility is hard enough on it's own, why does it need to bleed into so many other aspects of our lives?

The last time I went to this yoga class (the only prenatal yoga of any quality I have found in Spokane) I was in labor with Ernest although I didn't know it yet. Going back definitely stirred up feelings of that loss. When I realized that was over three years ago, I started to feel inferior again to those people who get pregnant easily. Comically, even though I was walking into a prenatal yoga class with a snug t-shirt on, I tried to hold my tummy in like I wasn't pregnant. "Not me, nope . . . I'm just here to check the schedule. Yeah, that's it."

I walked in, faking as much confidence as I could. Imagine my surprise when I discovered the class that was finishing was a post-natal yoga class - each mother with her newborn. I wasn't quite prepared for that. It was a class I often imagined taking with Ernest and wondered afterward why they didn't have a post-natal class with mothers of dead babies. If anyone needs to get in shape in a hurry and quiet the mind, it is those of us who give birth but don't take home a baby. I quickly exited for a bit to recollect myself and decided I would wait until most of that classes participants made their way out the door.

After that, there were only two moments that were particularly difficult. One was right at the beginning as we breathed. As I relaxed my body, the tears started flowing. Since everyone was supposed to have their eyes closed, I let them go. I think I have gotten so used to crying, I no longer care so much if someone happens to notice. If it seems like it might be helpful in that moment, why not cry? I dried my tears quickly when we were instructed to open our eyes again.

The rest went pretty well. I tried to focus on my breath and kept my eyes closed quite a bit - no need to look around and see all of those pregnant ladies. We did a lot of stretching type exercises and it all felt very good. At the end she had us place one hand on our heart and one on our baby and breathe - connecting our life force to that of the baby. This is the second time I cried in class.

If any of you used the Yoga 4 Fertility dvd, you know that this is how she ends the yoga session. By connecting these "two energy centers" you are hopefully improving your fertility. I followed this religiously at least three times a week for over a year. I tried got grow healthier embryos. After a transfer I imagined sending lots of energy to the embryos I hoped would implant and be healthy. During my last failed pregnancy with my eggs, I sent that baby lots of energy. Suddenly, mimicking those same movements, I felt the loss of every single one of those 37 embryos Brad and I produced. I tried so hard, but I wasn't able to save even one of them. After that, I couldn't wait to get out of class. I got into the car and sobbed for a few minutes. It was over quickly and I think I needed the release after sucking it up for 90 minutes.

In the end, I think the physical part felt great and I have hopes that the mental part will get easier so I plan on going back this week. If it doesn't get easier, I will stop going and doing it on my own. I am not going to torture myself emotionally for something I won't need to deal with long term.

Nothing else eventful going on. I still feel regular movement from Little Butterfly which I continue to enjoy. Our next OB appointment isn't until a week from Friday. Brad is out of town this week (in Turks and Caicos without me!) and I have been missing him terribly. Fair or not, I have come to depend on him to keep reminding me that everything is going to be ok.

Saturday, April 12, 2008

Is it healthy?

Today was the first really nice day this year. To celebrate, I went for my first bike ride on my new Novara Rondenee bike. Instead of getting the kid trailer I got a new bike. Hey, I need a new bike to pull the trailer! It was actually Brad's idea and I have been riding a 16 year old mountain bike as a commuter bike for the last 7 years. I wouldn't call myself an avid biker, but I ride to work around 3 times a week so I think it will get a lot of use. Plus I hope to take LB for rides soon (look at me . . . planning for the future!)

The ride was wonderful. It made me feel more like my old self. It was a bit awkward, both because of the different feel of this bike, but also because of the way my body feels differently. I can tell I have less energy and not just because of the pregnancy - I am just not that active in the winter. But it was still just so much fun!

As I was riding and realizing how much fun I was having I thought, "Hmmm . . . maybe I will blog about this." I started composing the blog in my mind. Then I realized, instead of enjoying the moment I was telling a story about the moment. "Craziness!", I told myself and brought my attention back to the feel of the wind, the view going by, the people I would pass and say "hi" to. I wondered if one or more of those people was trying to conceive and here I am with a pregnant belly - not only disturbing their quiet walk, but also shouting a friendly, "Hello!" "Hmmm . . . maybe I should blog about this" and off my mind went.

Back to the bike ride, Kami! "I know, I will start a personal journal again, then I will not feel like everything I do is a story to be told." And I started mentally composing a blog about how I will stop thinking about blogging.

Does anyone else do that?

For now, I haven't started a personal journal and I was able to mostly get my mind back to the moment. It was a very nice ride.


Before I delay even further, check out the icon below for a very cool idea. Or just go to these ebay sites: US and UK and buy something. All proceeds will go to help pay for fertility treatments for a well deserving person or couple. This time around the money is going to Calliope for a frozen embryo transfer.


Take Back the U.T.E.R.U.S.

Want to donate an item? You can go here.

Friday, April 11, 2008

Dirt Cookies and Mental Meandering

It's not that I need a reason to get a poor night's sleep these, but last night it was dirt cookies that kept me awake. The link goes to an article about Haiti's poor surviving on "food" of yellow clay, salt and shortening. "Surviving" might be too strong of a word here. It kills hunger pangs and little more. Their small island can't sustain their population so they import much of their food and with rising costs due to fuel prices and items like corn now being used for biofuels, the basic staples are now out of reach for many.

All night long, I wondered what it would be like to eat dirt cookies. What if I was pregnant there? Here I worry about getting enough protein, fruits and vegetables. "I really need to eat more leafy greens", I tell myself. Even when I complain that I am "STARVING!" I am only a few hours passed my last meal. I laid in bed and thought how incredibly fortunate I am to have our tiny little house, with a yard to grow my own veggies if I like and enough money and resources that I am likely never to go hungry.

I wondered what we could do to help alleviate the situation in Haiti. We have spent, last I noticed, 517 billion on Iraq. How much less it would cost to feed a small nation. But that isn't a very good long term solution. Perhaps they could learn to be more independent. What if they could grow enough of their own food? The simple answer is that their population is too big for their environment. Maybe we should do nothing and let nature "self correct". It is in many ways an awful thought and it got me thinking about the world as a whole. In The Gambia, there are more people than the country can sustain. Wealthier countries and private organizations have flooded this tiny country with NGO's (non-government organizations). They are given food and immunizations. As a result, more children survive into adulthood. There are more mouths to feed and not more land to produce it. Should we be sending birth control instead of vaccinations? Perhaps we could send industry so people could get descent jobs and improve their own financial situation. Perhaps they would discover that having less children could be a good thing.

With more money (and less children), they could improve their own standard of living. They could eat more meat, buy computers and cell phones, maybe even their own cars. They could start living the good life like we do in developed countries. They could follow in China's foot steps. How quickly would that send the whole world into crisis? Surely, our planet cannot support everyone living the way we do in the US. Imagine the pollution and depleted oceans and rising cost of resources if everyone consumed like we do.

What do we do? There are 6 billion people on this planet. For a random comparison, there are around 150,000 chimpanzees - down from a population of over 1 million. We can't make space for a few hundred thousand extra of just one other species, but humanity can fill every nook and cranny. If anything covered the Earth like we do, we would be in a panic to exterminate it as fast as we could. Covering the planet is not enough. We alter and shape it's ecosystems all over the world too. One person with a bull dozer can change the earth more in a day than entire armies could do centuries ago. What are the lasting effects of one woman taking birth control pills and flushing the part her body doesn't use into our water supply? What about one person keeping his yard perfectly green with just one species by using copious amounts of herbicides, pesticides and fertilizer?

Take those things and multiply it by six billion. That is a thousand millions. How do we get our minds around the impact we have? How do we come together and declare that enough is enough? What if we decided to have a zero or negative population growth? I understand that economies don't do well if there isn't constant growth - heck, we measure the strength of our economy on new home starts. How much more growth can we take?

I recently heard the last two hundred years described as the "Fraternity Years" of our society. We developed all these new technologies - eagerly opening new box after new box and throwing it's contents over our shoulder. The concern wasn't "What is the impact?", but rather, "Oooo! What can we do with this?". It is a hopeful term, in my opinion, because it implies that we will eventually grow up. Personally, I don't see anything changing soon. The powerful get there by doing whatever it takes - and they will use up the world if we let them. We let them because we just aren't that uncomfortable. My fear is that by the time we are willing to trade in our SUV's, 2000 square foot homes and watermelon anytime of the year, the Earth and the humans living on it will be in very sad shape.

Wednesday, April 9, 2008

Midwife appt # 5: 30 weeks and 5 days

I believe I am starting to get into the routine of things and feeling more comfortable with my identity as a pregnant lady. Last night as I chatted with Cathy (my midwife) I realized I often would sit with my hands on my belly so I could feel the movement in my hands as well as in my body. It was nice to feel a little bit normal in my pregnancy instead of feeling like I don't belong in this sub group.

I still take care not to do the public belly rub thing or behave in ways that might look like I am bragging or showing off my belly. Often I will ask Brad, "Does this shirt look too tight? Does it look like I am showing off?" I also try to wear short or 3/4 length sleeves or otherwise try to expose my Infertility Awareness Bracelet. I doubt there are many people in the area the know what it means, but at least I feel I am doing all I can.

In the comfort of my own home, I will indulge. I may have said this before, but I once had someone say to me, "Oh, I am sooo tired. The baby was moving all night and I couldn't sleep." I can tell you that I still relish every single movement. When the baby is moving at night, I pause to enjoy it. I would gladly lay awake in bed for hours just feeling LB doing whatever it is she does in there. I don't ever want to get used to this feeling. I want it to always be special. Last night, talking to Cathy, I was just sitting there happy to be where I was at.

Soon we got to the meat of the visit. Brad and I got to feel the baby's head, but this time we could feel the back and the rump as well. I really had to push hard to feel the back, so I don't feel comfortable doing it without the midwife. Maybe that will change as time goes on.

Cathy checked for the heartbeat and it sounded good. I asked her if she actually counted the beats and she said that she has a feel for the rhythm. If it doesn't seem quite right then she will actually count/time the beats. So everything is still looking good.

Cathy asked if I have been having any swelling and I haven't had anything to complain about. She asked how I was sleeping and that answer continues to be not very well. I still have nightmares or at least less-than-pleasant vivid dreams every night. I have learned to cope by napping on my lunch break and sleeping all I want on the weekend. I am surviving and I don't really expect it to improve anytime in the near future.

All is well. We will see Dr. Wonderful in just over two weeks and we continue to feel hopeful. We are still not so hopeful that we are willing to bring anything baby related into the house and we rarely discuss names. As far as I am concerned "Little Butterfly" will work just fine between birth and when we come up with a name. I have thought we might have a Naming Ceremony like they do in The Gambia where I was a Peace Corps Volunteer. (typically when the child is one week old - Don't worry, LB, we won't shave your head). We have also asked friends not to plan any baby showers until after LB is born. We may change our minds on these things, I suppose. In the meantime, we are taking it one day at a time and are content to enjoy today.

Tuesday, April 1, 2008

29 weeks 5 days: Still pregnant and still emotional

At least I seem to be at a new stage of emotional. Now, instead of just crying over the past, I cry about the future too.

I still have those moments when I am just sad for what we have been through. I still feel the pain of the years, multiple failed cycles, the pregnancies that almost made us parents, and the loss of my genetic connection. It seems that I am less often sad about using donor eggs than I have been, but that might be because I feel the need to suck it up with that very DE baby moving around all the time (can I say I continue to relish each and every movement?!).

As for the past, the letting go letter to my genetic baby I mentioned some months ago . . . still not done. I composed parts of it in my head which probably helped, but then I decided to take Niobe's advice (I think it was her) about some dreams not really going away. While I was doing all those IVF cycles, I imagined our Someday Baby(ies) off to the west (toward our clinic) existing in a parallel universe. While we had embryos growing, the connection would be stronger and when those embryos died they would be more completely in the parallel universe and less here in our universe, but we were still connected. I decided I like them hanging out there. I don't want to let them go. I don't think they will ever be fully in my universe, but this way we are still connected at some level. I can still acknowledge those 36 embryos and one baby who just didn't live long enough. I know it sounds crazy. It is really just head games because I don't believe in a spiritual realm or in life after death. But it makes me feel better and that is good enough for me.

I now also cry about the future. Why? Because I can almost believe in that baby being in our arms soon. More and more often little details pop into my mind and it is so overwhelmingly beautiful the tears just burst out. While Brad and I were looking at bike trailers last weekend, Brad was digging around in one, pointed out a little mesh pocket and matter-of-factly said, "LB's toys can go in here . . . " Suddenly I am in a busy REI trying not to completely lose it. Imagine! Us. With a baby! A baby with toys!!! Even now I am tearing up. Such hope! Such promise! Please, LB, stay alive and be healthy.

It continues to be an emotional roller coaster, but at least right now I can blame pregnancy hormones. I am looking forward to the day when I start to feel more like myself again. I imagine being happy in a way I haven't been in many years. Do you think it could be that good (assuming this pregnancy works out) or do you think I am fooling myself? I have told myself over the last couple of years that I can't expect a child to make me happy - that is my responsibility not a brand new baby's. Yet, isn't it easier to be happy when life is working out closer to the way you want it to? I think it is.