Better left unsaid

I alluded to it in my last post, but our appointment Friday was a disaster...like, the kind I wish we could erase from our memories. It was bad enough that I went through my old posts and stripped out the clinic name. If I was an Italian nona I'd spit on the ground, as if to say, "Never again."

We were early, having left home at 12:30 p.m. to beat any potential Memorial Day weekend traffic heading south, so we arrived with an hour to spare. We hadn't eaten, so we found the cafeteria at the adjacent hospital and had a quick lunch.

The second we stepped onto the floor where the clinic was located, we were instantly confused. There were no windows in the corridor, just plaques on the wall to indicate which business was behind each solid metal door. Not terribly friendly.

Inside, it was very dimly lit and sort off-putting. The walls were painted in heavy browns and blues with sterile artwork on the walls and Newsweek and Time magazines on the coffee tables...no images of women and children, no pregnancy books, nothing to suggest we were anywhere other than perhaps a proctologist's office.

We didn't wait long before we were ushered back by a nurse to, "Stand right here, oh, you can sit in this chair so I can take your blood pressure, no, wait, I need your weight first, ok, now you can sit, oops, I need a photo of the two of you for your chart, stand together right here." WTH?? Get it straight, lady! It turns out, after all that, the doctor wasn't ready for us so we were sent back into the unfriendly waiting area to wait a little more.

Finally, the doctor came to get us. It went downhill fast from there. Between his apparent need to debate why he thinks we lost the twins; to his overt attempts to discredit most everything Dr. M. has done and said the past two years ("I see your doctor has your medication dosages here in this little handwritten calendar [waves hands around dismissively], but why don't you tell me what your dosages are...this really doesn't make sense to me..."); to his snide remarks about how they have patients fly in from Dublin, Ireland and China so several drives per week to and from Portland really shouldn't be too much trouble for Paul and me, to his overall arrogance...let's just say I was seriously pissed off within 10 minutes of being in his office. (I'm still not very good about standing up for myself in the moment...if I'd had my wits about me, I would have said, during his goings on about the twins, "You know what, today is the one-year anniversary of our positive blood pregnancy test...it's a little tender, so if you wouldn't mind, please move onto another topic. And, no, we DON'T need a third (actually, fourth) opinion by a Portland MFM. Give me a break.")

Personalities aside, we did learn some things:

• I need to have a Clomid challenge test done to check my follicle stimulating hormone (FSH) levels. This involves an FSH blood test at day 3 of my cycle, five days of Clomid pills to "test drive" my ovaries on days 5-9, followed by a repeat FSH test. If the results come back high, I cannot do IVF with my own eggs. Period, end of story. They charge $500 for this test, and I have to do it in Portland (i.e. two back-and-forth trips).
• I need a repeat hysteroscopy done, and if there are still polyps, I must have them surgically removed or they will not do IVF at all, with my eggs or anyone else's.
• I am too old to qualify for a multi-cycle discount, so we would need to pay the $15,000-16,000 per cycle as we go. However, I will qualify for the discount if we use donor eggs (less risky for the clinic because the success rates are so much better). The quoted amount (apparently, although we have nothing in writing) includes intercytoplasmic sperm injection (ICSI) - which is a must between my assumed poor response and Paul's sperm issues - and the freezing of any leftover embryos.
• DHEA is "a thing of the past" and he doesn't like to see his patients on it. The CoQ10 I started taking two weeks ago is fine, but I should discontinue the DHEA that Dr. M. prescribed.
• It's "doubtful" the Metformin has had anything to do with my poor response, but since I don't have PCOS, it's not necessary for me to take it.
• Dr. M. didn't stim me correctly for IVF, in his opinion. With patients like me, you have to start with the maximum dose right out of the gate, not step up. (That's good information to pass along to Dr. M. if we decide to go back...maybe he can do something different.)

In all, the whole visit left a very, very bad taste in our mouths. We had to stop and pay the $350 consultation fee on our way out and I could not get that over with fast enough. The more I think about the whole thing, the more upset I am. Paul left completely overwhelmed, mostly because he needs time to process information and didn't come into the appointment with as much background on IVF as I already have. He awoke the next morning and said, "You know, the more I think about it, the more I think he was really just trying to say they don't need our money." Exactly. Seventh in the nation for my age group absolutely does not trump asshole-ishness.

So, where does this leave us, besides wanting to run, crying, back to Dr. M.? I know, that sounds insane, but really, wow. Anyway, I will be calling Dr. M.'s office this week to find out whether they do the Clomid challenge and how much it costs (it's bound to be less expensive there). I purchased the book, Making Babies: A Proven 3-Month Program for Maximum Fertility a couple of months ago after it was recommended by my hypnotherapist, and we've decided to take the next three months to try and get my body into tiptop shape using the techniques in the book, which include both Western and Chinese medicine along with dietary changes. If the Clomid challenge isn't too expensive, I'll have it done soon, otherwise, we'll wait until the three months are up. That way, if my FSH does come back high, we'll know we did all we can to improve it, and hopefully the decision to adopt or use donor eggs will come more easily. I'll also have Dr. M. repeat the hysteroscopy, and if he can't remove the polyps in his office, then I'll schedule surgery closer to home.

Past that...I think we'll be looking for a third clinic option. Dr. M. doesn't do ICSI ("Oh, I didn't know there were still clinics around the U.S. who didn't do ICSI," said Dr. Asshole, as if to say how disturbing/charming that was). Now that the Portland clinic is out, that leaves clinics in Seattle and surrounds (and possibly OHSU in Portland). We can cross that bridge when we come to it.

It would have almost less disappointing to hear, "Sorry, it's too late to help you" as my dream predicted than experience the sheer arrogance and dismissal we got at our appointment.

Right where I am 2012: 9 months, 3 weeks, 0 days

Angie over at Still Life With Circles started an annual blog project called Right Where I Am last year, and I thought I'd participate. The point is to write about how you are as a babyloss mama in grief today, not yesterday, not tomorrow, but right now.

*******

Right now, I'm physically sore and exhausted after Paul and I finally rallied and got started on a big project we've had planned since before we conceived the twins: the creation of a new raised garden bed area. The project has turned out to be much more involved and difficult, physically (for me, at least) than expected...although the fact that I busted my ass this morning with my 8-year old push mower, trying to tame our front lawn (if you can call it that) and flower beds (no kidding, I mowed my flower bed, that's how country I am) hasn't helped anything. I have a blister, sore feet and sore muscles to show for it...and a sense of starting something, accomplishing a part of something, a feat neither of us has been able to pull off since we lost Aliya and Bennett last summer. We've been stuck in this grief- and depression-induced inertia, with the best of intentions, of course, but no energy or motivation to actually get started. On anything.

So, this is something we started, and can finish, hopefully this weekend. That's huge. And when we're done? Ah...yes, more time to grieve. More time to question and ponder. We're probably staying busy today to try and blot out the bad feelings we earned yesterday at our big IVF clinic consultation. Suffice it to say, it did not go well, more because of the vibes we got than anything. I'll write more about that in a later post.

As far as grieving today, though, I'm in a very ok place, and I hope that Paul is, too. We've had some laughs, got really, really dirty (aside: don't make fun of your hubby's dirt half-mustache when you aren't aware you have a giant dirt smudge on your cheek yourself, smarty pants!). He's still outside, trying to tame our massively overgrown backyard, so tall in spots that the dog seriously doesn't have to hardly squat to pee! It's really that bad. (I think he might have mowed the patio, too. It would figure.)

That's where we are...living, or trying to, grieving in spurts, trying to get a fire lit under our feet so we can get something done. We're not supposed to write about how we were feeling before, but you know if you read this post. I'm much, much better now. My counselor pointed out, as I noted how deep my low trough was compared to where I emerged late last week and still remain, that while anti-depressants are certainly a tool we can look into if I need it, "Really, it's just grief, sweetie...it's all just grief."

Amen.

*******

(I just looked outside to find my husband mowing the patio, as expected. As I watched, he ran over the dog's Nylabone and shot the thing in three pieces three different directions. One piece actually landed in our new garden, many, many feet away (like 40+). Progress, not perfection!)

Feeling peaceful

One year ago today, my doctor confirmed what Paul and I had discovered the night before: we were finally pregnant.

This afternoon, one hour shy of the time I got that long-awaited call last year, we will meet with a new fertility specialist in Portland to see whether we may ever get to experience that amazingly gleeful feeling again.

Wish us luck, please...

Past

I am currently sitting in my car, waiting while Paul gets a quick haircut at the shop of the little Asian barber he used when we lived in this city. I sit across the street from our old house, the 1910 Craftsman I bought as a single woman, one tiny room, tucked under the second story gable, where I planned to set up the nursery for the baby I'd planned to conceive -as a single woman - using IUI with donor sperm because I'd given up on finding love. The room had already been a nursery, painted in a beach theme with seagulls and beach balls and a puppy on its sand-colored walls.

Then I met Paul, we fell in love, married, remodeled the house and sold it, those nursery walls painted over with a sensible taupe.

Sitting here, waiting, always waiting, I am struck by how much everything has changed. Back then, life was pretty simple. Back then, we were eagerly trying to conceive our first child, unaware that 4.5 years later, where there was hope, there'd be heartbreak, no idea that infertility and babyloss were in our future.

So much has changed.

Waving the white flag

I have, in the last hour, come to the realization that my depression is getting to the point where talk therapy and acupuncture may not be helpful enough anymore. The daily burden I carry in my heart and thoughts has me underwater more often than not lately. While I'm no stranger to antidepressants, having taken them for 7 solid years during my 20s, I never thought I'd have to consider them again.

This is not something I take lightly. A dear friend, who has known me since junior high school, expressed surprise when I admitted several months ago how much I struggled with being on antidepressants back then, how inept I felt. She said I handled that time in my life with grace, which couldn't be less how I saw myself then.

Now is no different. In fact, it's probably worse. But I have to face the fact that I mostly feel like *I* am getting worse. I know we've been warned to expect 18-24 months of hard grieving for the loss of our twins, but I can't fathom plodding along for another 9-15 months the way I am now.

A search of Dr. Google indicated at least two meds are safe to use during ART and pregnancy. My counselor had surgery and has been out, so I'll have to wait until next week to talk this through with her.

It doesn't make me happy to consider meds again, but a) not much does make me happy right now, and b) I know that, as a tool, meds can help. I need to do what I can to help myself.

Today

Our little loves

Nine

Nine months ago I became a mother. At this moment, back on that day, August 5, 2011, I was in a daze, conscious but not really there, in shock and riding the waves of oxytocin charging through my system. Aliya and Bennett had slipped silently from my body less than 30 minutes before. If I recall, this particular moment of time was the decision point - are those placentas coming out or not? Will I stop bleeding or not?

The answer was no to both, and I was whisked through the quiet hallways into the operating suite to be put under and cleaned out, breathing through a tube, the mint green walls the last things I saw, the narrow table I was asked to slide over onto making me nervous because it was so skinny ("So are you!" they said...which was weird, because I wasn't.)

Nine months...36 weeks...the bare minimum amount of time I had hoped to grow and nourish my babies inside my body, and now the length of time we've lived without them. Nine months and our lives have been forever changed.

Breathe

For as much as I thought I'd steeled myself over the last several days for the inevitable negative pregnancy test - especially in light of several days of spotting, half of which occurred while I was still on progesterone in oil shots - today it hit me like a ton of bricks. I spent most of the day fighting back tears, feeling like someone's sitting on my chest, making it hard to breathe.

This failure feels like one notch closer on the giant universe clock toward "too late, Amy, no biological children for you." Remember, Dr. M. told me, maybe off the cuff, but still said the words, "If you're not pregnant in three to six months, then it's time to consider donor eggs." That was in January, when I learned my real Anti-Mullerian Hormone (AMH) level (0.28...really, really low).

Granted, while we've tried to get pregnant the past three months, only one of those attempts - this last one - really counts in my mind. I mean, two infertiles who really can't get pregnant on their own to save their lives (and have been told they can't) aren't likely to succeed the old fashioned way. So, yes, we tried, everything was perfectly timed, we know I ovulated, but we didn't get pregnant. Not a big surprise.

This last one, though, it counted. He said three to six months - which to me, means three to six ART attempts - and now we're down by one.

Also, since a baby conceived last month would have been due in January, and my birthday is in March, I now have very little hope of having a baby before I turn 39, unless I conceive on my own, which, yeah. (Or, I suppose, unless we conceive multiples on the first attempt with the new clinic (if they can even help us) and they're born early but healthy...I'm not going to wish that on us.)

Put these two things together, and mix in the dream I awoke from this morning where the other clinic, the one we're consulting with at the end of the month, told me it's too late, there's nothing they can do to help, and Dr. M. was right (noooooooooooooooo!!!!!!!!), and I feel a little neurotic and backed into a corner.

While I do look forward to getting a second opinion, I'd be lying if I said I'm not completely terrified.

If I was just a "normal" infertile still, one who hadn't already conceived my own biological children and lost them to a rare second trimester miscarriage for what feels like a stupid reason caused by my own body, then considering donor eggs wouldn't be quite as painful as it is to me. Just like with adoption (and I swear to God, the next person who suggests adoption to either Paul or me as the "obvious" next step in our journey may be killed), moving on means not only grieving the babies we have lost, who we wanted and tried for so desperately, but also grieving me ever, ever having my own biological children.

Paul and I can't even talk about it right now, the two of us. I can't because I want to scream and pull my hair out, and he can't because he wants us to have our babies, not just his babies. We've been together, committed, for nearly 7 years, and married for 5.5. We expected to have a lifetime of US, our future, being able to conceive and birth and raise our genetic offspring, together. Any other option right now is unfathomable.

On top of all this...there's plain old grief. Next week, the 11th, will mark the one year anniversary of our first of two back-to-back IUIs that got us pregnant with the twins. From then until August 5th, nearly every week will harbor an anniversary date from our pregnancy, from the date of the first home test, to the blood test, to the first ultrasound, to Aliya's first abruption, to bedrest, to my first HMO appointment, to our big NT scan in Seattle...all the way to the days before our lives fell to shambles, when things were going wrong that I just couldn't see clearly. And then the end.

Part of me had secretly hoped to conceive during this past cycle so at least Paul and I could have a little joy to distract us from what looms large in the months ahead. No such luck.

It's already started...and it hurts.

Not...

Not pregnant.

Not surprised.

Wish this seventh consecutive day of spotting would turn into something productive.