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From Behind The Paper Gown

Posted Jan 07 2013 12:00am

The last post was a huge relief.  An outpouring of everything I had been thinking and feeling.  And, hiding for some reason.  Maybe it was through secrecy or shame.  But what I want to say and what many of you have been saying to me is – that’s not right.  It shouldn’t be that way.  We need to talk about this.

I’m writing this for all the women who have gone through it.  And, as one of them reminded me, you don’t have to get over any of this, you just have to get through it.  I’ve also found that it helps to have a sense of humor.  As strange as that seems, humor has been my medication for many obstacles in life.  Laugh at me and with me.  Because if we just sit around being sad and pitying each other, where does that get us?

Probably at an AA meeting or on SSRI medication.

Fear not, I won’t make this blog a diary for all things fertility.  But for at least this post, I’ve got some things I want to get off my chest.  Actually, out of my uterus.  Remember, ladies, it’s one uterus, two ovaries.  There will be a quiz at the end.  I’ll soon return to more exciting stories about triathloning – in other words, the runs where I’m poking along trying to keep my heart rate under 150, fearing that right around the next corner that nasty headwind will send me straight up to 153.  And then what. 

THEN WHAT! 

Sharing my last post was like opening up my legs and letting yet one more person look inside.  And if you’re keeping track, you are the 1,693rd person to see between my legs in the past year.  That’s right, my vagina has gotten more face time than apparently a certain professional runner out there who led a secret life as an escort.  Except my vagina has been leading a secret life as in infertile.  And it’s seen more action from an ultrasound wand than my husband.

Did I go too far?


So let’s start at the beginning.

I finally found something more expensive than triathlon: IVF.  We hesitated to talk about IVF because it’s a loaded topic; emotionally, politically, financially, spiritually.  We went through this process for a few reasons.  But the biggest one is: I am old.  I know in the land of real life that 37 is the new 17 but in the world of fertility, 37 is old.  Once you hit age 34, or your 35th year, you are considered of advanced maternal age.

You’ll have a geriatric pregnancy.  It's like full on Golden Girls every time you go to the OB/GYN. 

Unfortunately, after age 35, your fertility takes a huge nose dive off a cliff of egg quality.  Girls, let’s be honest.  Many of us have been getting our periods since we were 12.  Nearly 25 years later, you can’t expect that you have a fully operational death star machine in there anymore.  Things are rusty.  Squeaky.  Old. 


Are you laughing yet?  No?  Read on.

Being too “old” to do something I’ve been waiting my whole life to do was hard to hear.  We’ve lived for years pursuing our careers, taking the time to meet Mr. Right, finding ourselves - thinking that fertility was something we could just turn on or off.  A matter of stopping a pill and deciding it’s time to make the baby!  Not as easy as that.  And those girls who get pregnant by just looking at a penis?  The only reason that happens is because they are young.  Mostly under 30.  For the rest of us geriatrics, it’s not as easy.

And I know that sounds depressing.  But it’s the truth.  And one thing I've realized we've been lacking all along – through years of sex “education” or health “education” - is the TRUTH.  Many women have a poor understanding of what’s going on in their bodies.  Myself included.  And I feel like if only the gynecologist had handed me a manual of uterus maintenance and fertility at my yearly PAP exam: I would have been in a position to make more educated decisions.  I’m not blaming anyone, I’m just saying there’s something missing out there.    

The good news is that now countless late night hours reading fertility forums and googling scholarly articles has given me an honorary degree in reproductive endocrinology. 

The bad news is that I’m way beyond the age where any of this information is actually useful.

My journey began in October.  To prepare, I gave up coffee, exercise and wine. Like a friend said to me, so pretty much I should send someone for you to kill every morning. 

YES.

If I had to give title to the month, I would call it Track Marks On My Thighs.  I took a variety of injectibles to first suppress my ovaries and then wake them from the hormonally dead.  Reading through the risks and side effects sheets, I got as far as medication #1 (of many). I told Chris that I might just glow in the dark after going through all of this.   I learned that some fertility meds are actually abused by body builders.  Apparently shutting down certain hormone receptors puts production of other hormones into high drive.  I didn’t race when I went through this but I can assure you these injections did nothing to enhance the performance of my ass sitting on the couch. 

All they did to me was make me fat and give me headaches. 

My first obstacle in the process was getting my ovaries to shut down.  They would not be suppressed!  Nurse called:  this is weird.  Well, if you knew me, it’s not.  I don’t back down easy to a challenge and it’s safe to say my ovaries are just as stubborn.  Finally, they quieted down and we could begin the process.  Up to 4 injections a day!  

Along with lots of medications, I made many, many trips to the doctor.  You actually never see the doctor – you see his technicians and nurses.  They take blood, do ultrasounds.  You sit in the waiting room with a lot of other women.  Many doctors cycle women at the same time so you see the same women, over and over again.  Yet you’re all sitting there in silence, scrolling through your smart phones. 

After a few visits, I just wanted to get up and say: YOU, over there, I know you’re looking at Just Mommies trying to find more information on IVF success rates.  And YOU, you’re symptom checking in the Fertile Thoughts forum.  And YOU, you’re looking up success rates of someone your age going through this while wondering if you’ll be the next success.  And YOU, the only male in the room who is hiding behind a Food and Wine magazine, we all know why you’re here so don’t try to brush it off, we know the man in the gray coat is coming to get you and we know you are here to touch yourself.  And ME, you see, I’m just like the rest of you, nervous, anxious, googling what my numbers mean, afraid to call the nurse YET AGAIN because I don’t understand what’s going on with me, alone, pumped full of hormones, desperate to talk to someone, anyone about my experience so much that I just want to stand on one of these stupid beige chairs with the Today show blaring in the background and shout to all of you:

CAN WE JUST TALK ABOUT IT ALREADY!?

And then your name is called.  Your appointment was 30 minutes ago but it’s not as if since starting this process you haven’t noticed the ticking of every freakin’ second.  To add insult to injury, the appointment takes 3 minutes.  Forget that you’ve spent about 90 minutes arranging your life to get here.  After the appointment, you plan to check the voicemail box where the nurse leaves the results from your bloodwork or ultrasound.  They tell you to call after 3 pm.  Which means you start calling around 2 pm. 

Nevermind the nurse never called until after 3 pm.

And at 3:01 pm, I was on google searching for the meaning of everything.  And I’ve found the meaning of everything

Except secondary infertility.  I’m still not sure why it happens.

Then, it’s time.  The magical union of the stars, moons, planets, your follicle size and estrogen level.  The doctor calls: it’s time for your trigger shot.

Next you wait.  Exactly 35½ hours until you go in for egg retrieval.  It’s a procedure done under full anesthesia, in my case, very early in the morning.  Chris went with me because, of course, he had to give a sample.

Now, let’s talk about the husbands of infertiles.  What you don’t know is that 30 percent of fertility problems are actually male factor.  Mine not being one of them.  He’s got perfect swimmers.  The first time he went in to give a sample to make sure his swimmers were swimming on AT LEAST a 1:30 base, he reported back to me.  You see, I envisioned some dark room with mood lighting, black velour curtains, a leather couch and some stacks of magazines.  Yes, I just described to you my husband’s bedroom while we were dating.  Imagine my shock (pity?) when he tells me that they put him in an examining room.  Bright fluorescent lights.  With nothing.

ARE YOU KIDDING ME?  HELP A BROTHER OUT!

Knowing this, I almost felt sympathy when I told Chris that we had to be at the doctor’s office at 6:30 am and he would have to come with me to give a sample.

Isn’t that a little early in the morning?

I suppose.  But excuse me: I have shown my vagina to at least 20 different people in the past week while wearing nothing but one of the paper gowns that might as well be the size of a cocktail napkin and all you have to do is sit in a room with a door closed, ALONE and have a party with yourself.  I want to know how to get that lucky.

6:30 am, got it.

We parted ways, he to the sample room, myself to the surgical room where the last thing I remember is the large clock ticking on the wall.  Time ticks so obviously when going through IVF.  Every second.  Every day.  And then, I woke up being wheeled into recovery.  Where I found Chris who told me that after weeks of injections they retrieved (drumroll please….wait for it...):

One egg.

Huh?

Let’s try that again……..

ONE FREAKIN’ EGG.

Fact: Women are born with 1 to 2 million eggs.  Yet I went through all of this to woo my eggs out of me and only ONE egg shows?  

ONE EGG!?

No, actually it was 3 eggs.  Two were immature.  One was ready. 

The doctor comes in. 

I’m disappointed.

That makes two of us.  Do I get a refund?  A sympathy card?  At least a freakin’ lollipop?  He tells us they were expecting 6 to 7 eggs (most women get 7 – 15 eggs).  They got one.  All we could do was wait.

The next 3 days are the longest wait of your life.  Until you’re in the two week wait.  That is absolutely the longest wait.  The embryologist calls with an update on our one little egg that could.  It fertilized!   And then, that’s it.  You wait until transfer day.

Transfer day is 3 days later. Again, you show up at the office early in the morning.  The nurse hands you the usual paper and cloth gown.  And this time also hands one to your husband.


Husband gets that on the first try.  You’d think the medical field would have picked up on this by now?

Embryo transfer takes place in another surgical room.  The nurse seats you in a chair which she then quickly inverts until you are nearly hanging upside.  Like a bat.  While wearing nothing but a paper gown on your lower half which she quickly removes.  It goes without saying that my you-know-what was out for all the world to see.

Meanwhile, my husband, in scrubs, is spinning around on the doctor’s stool like it’s his first time at the playground. 

The doctor walks in.  He extends his hand.  My husband stands up to shake it.  The doctor then proceeds to have a conversation with my husband about the origin of his last name.  All of this is taking place over my vagina.  Which, again, is completely uncovered.  But apparently very much part of this conversation.  And if it could talk, at that moment it would have screamed: DOES HE LOOK DUTCH!?

The doctor gets to work, telling us we have one nearly perfect embryo to transfer.  A pipette is inserted and the embryo moves to the top of the uterus like a little shining light of hope on the ultrasound screen.  You hang upside for another 15 minutes.  As if women haven’t contended with gravity for thousands of years, god forbid you go vertical too soon and the embryo falls out.  The hardest part of this day?  Going home to do nothing but lay on the couch. 

People live like this?

Next up?  The two week wait.  In my case, the 18 day wait.  During which I took a series of HCG booster shots to trick my body into thinking it was pregnant.  But after about 9 days, I knew I was.  You can easily tell.  The first thing you notice when pregnant is bizarre, vivid dreams.  You start waking up to use the bathroom in the middle of the night, several times.  Your chest tingles.  Your mouth gets a strange metallic taste.  You just know

Then, I had the dream: the dream that I took a home pregnancy test and it was positive.

The next day, while giving myself a progesterone shot, Max pointed at me. 

Mommy, baby.

What the …?  How soon until all of us in the house start seeing dead people? 

At 18 days, I went in for my beta and it was positive.  Very positive.  1200.  The nurse tells me these numbers are great.  Two days later, my beta has tripled to 3600.  My progesterone is over 100.  Everything is much higher than expected.    

A few days later, in between restless sleep and trips to the bathroom, I had another dream: a dream of two bright shining perfect pennies, heads up, sitting next to each other.  I woke up the next morning and told Chris:


Call me clairvoyant (and send me 20 bucks to predict your race season), but a few days later twins was what the ultrasound confirmed.  Funny how a woman just knows.  They tell me in the entire history of the office, only one other person has had one embryo that split.  Identical twins are nature’s mystery.  A fluke.  I felt like the lucky one.   

In between then and what sadly was the end, I had more odd dreams.  And then, all of a sudden, the odd dreams stopped.  As did the nightly trips to the bathroom.  And I knew something was wrong.  I started having night sweats.  Soon after, sitting at my desk, I confirmed it was all over – my head spins, what always happens when my hormones start dropping.  

But wait – our infertile journey does not end here.  It actually ends in the hospital.  I’ve always chosen a D and C per the recommendation of the doctor so they could gather evidence for testing to determine what went wrong.  In each case, after 6 weeks of waiting, they’ve reported back to me that nothing was wrong.  That’s not reassuring.  But maybe this time it would be different.

The worst part about surgery?  Not the gown that doesn’t close in the back.  Not the pity that every nurse gives you.  Not when they weigh you so you can say to yourself so THAT’S how much weight I actually gained.  It’s no eating or drinking after midnight.  And when your surgery isn’t scheduled until 3 pm, this is borderline disastrous.  Mostly for your husband who has to listen to you all day saying I AM SO HUNGRY.

Apparently my doctor was overbooked which means I got to wait, starving, for 3 hours beyond my scheduled surgery.  Meanwhile, I listened to what should have been very private conversations in all of the other surgical waiting rooms (would it kill them to close a door?).  The woman across from me who apologized for having trouble coming out of anesthesia (I’m warning you, I’m a puker).  The foreign man across from me who was having his knee scoped (I want to bring my cell phone into the surgery).  Were you planning to tweet about it?  Better yet, the older woman who was having her leg amputated.  When the surgeon, for the third time said, can you confirm that it’s your left leg, she barked back – YOU BETTER NOT TAKE MY GOOD LEG.  At that point, I was so hungry, I texted my husband:

If they don’t get me out of here soon, I’m going to eat her good leg.

And then it’s my turn.  I never had surgery until I tried to make babies.  I never realized how risky all of this could be.  Surgery is an ephemeral experience.  You lose time in your life with absolutely no recollection.  And in my case, you wake up in mesh panties with no idea how they got on to you.  It’s like waking up from a night of crazy drinking without the fun memories.

As soon as I wake up, I’ve always wanted out of there immediately.  The golden ticket?  Producing urine.  Me (asking the nurse): how can I get out of here.  She:  you have to go to the bathroom.  I’ve never been one to back down from a challenge.  And after nearly 20 hours of not eating or drinking, going to the bathroom proved to be a big one.  Imagine my disappointment when I missed the measuring container. 

I’m going to need more water please.

And then?  You go home.  In all of my cases, the recovery was quite painless.  I’ve never taken any pain medications in the recovery process, not even after the c-section.  So many people spend so much time trying to avoid or escape pain.  As an athlete, I’ve never understood this.  Same reason I don’t use an iPod when I run.  If it’s going to hurt, I want to feel it, hear it.  That way I know to appreciate painless effortless when it happens.  

So here we are at today.  I’ve got my WTF appointment in early February.  That’s where I go into the doctor’s office and ask WHAT THE F*CK, I paid how much to get my period (which I still haven’t gotten – lost in the mail!).  I’m thinking about bringing Max with me since last time that went so well.  He threw a plastic uterus across the room.  Yeah, they’re a lot easier to deal with when their embryos, aren’t they, doctor.  I’ve compiled a list of about 1000 things to ask.  I’ve done my research.  And, like I said, I’m google certified which means I know a little about a lot but just enough to ask all of the right questions. 

So that’s where I’m at. 

I’ve really appreciated the emails and suggestions I’ve received.  I’m interested in hearing about anything – send me your success stories, your naturopathic experiences.  At this point, I’ve decided that if someone told me to eat my dog’s sh*t to have another baby, I would do that.  Seriously, I was on a run the other day and thought to myself – would you eat Boss’ sh*t?  Yes, yes, I would. 

But I would probably hold my nose while swallowing. 

I’ve tried to find the bright side of what we’ve gone through.  The side of “that which doesn’t kill me makes me stronger” or “it builds character.”  Maybe it’s like Dorrance said, this type of stuff doesn’t build character but reveals it.  If that’s the case, maybe my character still has room to grow.  Because while I’ve never given up on much in life, there are times I’ve felt like giving up on growing our family through my own body.  There’s only so many times you can walk into the same brick wall and think to yourself this feel good, I want to keep doing it. 

Yet at the same time, I realize we’ve chosen this path.  I know we don’t need to do any of this.  We chose this.  We knew the rewards and consequences.  We, and our doctor, felt after going through several other losses, this would be our best shot.  Now that it’s failed, in part I feel guilty about being upset – we have a child, he is perfect and both my husband and I are healthy.  What’s there to complain about?  Absolutely nothing.  And we know that.  Yet it’s going to take some time to come to terms with the idea that what we want for our family may not be something that we’re going to have.  And though we realize there are other options for growing our family, we’re not ready to explore those yet.  

In my next post, I’ll talk more about rebuilding my fitness after all of this.  Which is where the real fun begins.  Let’s just say that I’ve learned to slowly grab my Fuel Belt bottle while running because that movement alone brings my HR up.  Opening a gel?  Shoots that puppy straight up into the high 150s.  Embarrassing?  Or hilariously funny?  Ah, humility.

As always, thank you for reading. 
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