Wednesday, 26 April 2017

One child family thoughts

To follow up my entry on "Sinkholes," and maybe blog oftener, I'm going to try to write a bunch of short(er) posts about various things on my mind, many of which will be fertility related (but not necessarily all). It's hard sometimes to break my thoughts into smaller topics, because one thought leads to another to another in my mind. But I'll try!


Today....Thinking more about a one child family.


What would it be like to stop the trying to conceive business? In my entry called "Release," I talked about an experience where I felt happy to be a one child family. That was a lovely afternoon. I was profoundly content that day! It also wasn't the whole picture.


It is still upsetting to have a seemingly normal 27 day cycle where we do everything right and don't get pregnant. It sucks to gamble and lose. It hurts to see pregnant bellies and new infant siblings at AJ's daycare and dance class and know that we are (seemingly!) one lucky cycle away from that being our reality, but still, oh, so far. The other day at Easter dinner my mom and stepmother in law started talking about why they decided to have more than one child. Tender confidences about not wanting the eldest to "grow up alone." Or acting on a partially understood maternal instinct. Or seeing the child's father grow in confidence and reaching an understanding that it would be OK to have more. All so sweet in hindsight. So sweet to have a bloody choice about it, at all. (I didn't say anything.)


I almost always refuse to let myself visualize AJ as an older sibling, or to picture how we might arrange our lives around two, because it feels too painful to dwell on a possibility that stays on the outside of reality. People cope with infertility in different ways; avoidance is one of mine. I squirm when other people "go there," no matter how innocently. That's protected emotional space. Back away!


On the other hand, I have become aware of a few things that could help me be at peace as a one child family. I'm not sentimental about babies. Maybe infertility has given me a cold dead heart, but I have no particular attraction to other people's babies. I'm jealous that they have the choice to have a baby, not of the actual baby so much.  I loved AJ as a baby, but I don't miss her as a baby. I love the person she is and is becoming. It is awesome to be a mother to a toddler and to contemplate all the possibilities that await. We have a family vacation to the ocean planned for the summer! Squee! And the thousands of dollars we could spend on treatments: How about taking a bigger AJ to Europe and Greece next year instead? That won't happen if I'm pregnant or parenting a young baby, but it likely can happen if I'm not.


The bottom line is, it is still painful to contemplate not trying any longer, or trying with such a reduced level of hope and intention that it amounts to not trying. (I'm not sure where that boundary is, for me.) Along with the pain I also have some awareness of the benefits of one child, even if that is not truly our choice.  Day to day, I find I can't only focus on the painful part or the peaceful part. I have to try to accept them both at once. It's weird. But this is our current reality, and my family means enough to me that I must have the courage to embrace all the feelings at once.

Monday, 17 April 2017

#Microblog Monday: Emotional sinkholes

Have you watched the documentaries on sinkholes? Terrifying, aren't they?


I feel like I've had emotional sinkholes lately.

I'm going about my day, doing things I ordinarily do, and it suddenly feels like....a piece of my identity, my self, isn't there. I feel vaguely like a liar, when I try to talk about myself to someone, because I don't know if what I'm saying is true. And my words feel dangerous, like they might tear open unexpectedly savage wounds in myself or others. Although I'm not trying to fool anyone. I'm not trying to hurt anyone.

I'm hoping this is some combination of ending a cycle (yes it still bothers me, especially the ones that are more "normal," but don't result in pregnancy), waking up at 3:30am, and maybe not blogging often enough.

I've felt this way before, at times of transition and flux. Somehow though, I thought I was done feeling that way. You know, married, established career, mother, financially stable. I thought those feelings belonged to my 20s or earlier when I didn't have any of those things and life was much less predictable.

I guess it's less predictable than I thought, and I'm less stable. It's not a pleasant feeling. But at least I know myself a little better, and I know that I've been here before.


Wednesday, 5 April 2017

Release

Last week I had a few days "staycation." (It's taken me a while to finish this entry). It was spring break for the public school board, but we were not able to go on a holiday anywhere because Mr. Turtle was completing his final practicum hours (Master's degree in counselling psychology). It's a first world problem for sure, but I was disappointed to not be able to go on vacation anywhere. Last year we went on a family trip and it was wonderful (despite Mr. Turtle writing papers). It made me sad to think we could not do something similar this year. Actually, I was almost dreading the coming week off work, worrying that I would be bored and would sit around by myself thinking gloomy thoughts. Usually I might look forward to reading books, but lately I have struggled to find books I am interested in and to keep my attention on them once I start them (an unusual problem for me, but a different topic.)

Well, my fears did not come to pass and the week was quite enjoyable. I went to the zoo with AJ and my mom; I had a wonderful visit with a friend who has an irregular schedule; and I had a couple of days to myself with AJ in daycare to get a haircut, go shopping and even work in the yard. (So productive!) A old friend from overseas sent me a long letter and I spent many hours thinking about it and what to write back. By the time Friday came around I was ready for a low key day and I did not find my own company oppressive at all. And to wrap it up, on the weekend Mr. Turtle took a few hours off schoolwork and we went on a date night.

Apart from the fun stuff something I appreciated about this week was practicing release. I have thought about what word to use and I like "release" better  than "taking a break" or "not trying" or "just relaxing" (ugh!). We are in between tests and treatments (if there even will be more treatments) so I have been taking my supplements and charting BBT/CM/Ovacue and timing our dates with fate based on that. It's been going "well" in the sense that my cycles have been fairly predictable, but at the beginning of this cycle I wanted to do less. I decided to stop the supplements other than the prenatal and one CO Q10 pill. Mainly I was tired of trying to remember to take pills 3X a day and feeling guilty if I forgot. This way I take them once a day whenever I remember and then I forget about it. I took my BBT once at the beginning of the cycle, but then I got sick, and started waking up at a different time, and it was just easier to not bother. Same with the Ovacue readings: once I missed the first ones, it was easy to stop caring.

I paid attention to CM because I can't help noticing it, so it's not extra work. And I took OPKs, but only 4, not the whole box. We did our thing when it seemed right, but because I'm not temping I did not confirm ovulation.  It feels good to care less (certainly I do still care!) and it's good to know that I am able to let go of the incessant monitoring, and life goes on.

I also had some thoughts about family size and what it means. We went to a world-famous paleontology museum on the weekend as a family. After seeing a few exhibits, AJ started to get fussy and over-stimulated and asked to do the "puzzles." So we backtracked to a lobby in between galleries with soft chairs and coffee tables (brilliant). The coffee tables were inlaid with puzzles and other hands on activities (also brilliant). Mr. Turtle and I sat on the couch while AJ amused herself with the puzzles. I had a chance to observe other families going through. Usually, it makes me sad to think that AJ might not ever have a sibling, but as I watched families trundle past with two or more kids in tow, I had rather different thoughts. I saw clunky strollers (some doubles and/or with several "levels" weirdly balanced on top of each other) being maneuvered perilously through doorways, sometimes with one hand. Mothers (and some fathers too, in fairness) chasing one child, trying to pacify the other, feeding the next one, juggling crap, putting out fires. And there were Mr. Turtle and I, canoodling peacefully on the couch while our toddler played happily and quietly by herself.


Wow, I thought to myself, we have it so much easier. And I felt especially grateful for no stroller. Strollers were never my favourite part of infancy and I'm so glad we can easily leave it behind for a trip like this. There's even a chance that I can go to a museum and enjoy an exhibit, maybe learn something about the Mesazoic and Cretaceous periods. It's not guaranteed by any means, but it's within the realm of possibility. It didn't look like any of the mothers with two or more children, especially close to AJ's age, were likely to remember a single thing about the musuem when they were done.


I would still rather things were different. I would still choose to be one of those families wrangling two children through the musuem and wondering when this is supposed to start being fun.  Many times, I still want that mythical second child so badly I can feel it like a physical ache. But, I also made a small mental note that there are advantages to our current situation. I have considered this side of the matter berfore: I have forced myself to contemplate life with one child because that was always a likely possibility. But what was different this time is that the thought of one child gave me a distinct tickle of happiness.


We carry on. But somehow, I feel freer. Released. There is another colour in my emotional spectrum, even if it isn't one I see every day.

Wednesday, 22 March 2017

Ten ways I'm rocking motherhood

A week (or two?) ago Mine to Command wrote a post called "10 Ways I'm Rocking Motherhood." She challenged anyone reading to post their own ten. I was intrigued, partly because 10 seems like a lot, and I thought I would have to get creative. It took me several days to write this post, partly because it is a bit of a challenge and partly due to time constraints. But here goes!

I will pass on the challenge by inviting any other parents reading to write about 10 ways you are rocking motherhood. If you don't have children, 10 ways you are rocking at life, or work, or relationships, or.....whatever.

1. My daughter thinks everything I do is AWESOME. (And everything her father does too.)
I know this phase won't last forever, but for the moment, it is quite flattering. AJ imitates our daily activities and expressions. Cleaning the house is much more entertaining because she is so excited to do chores: she wiped down every surface in the living room the other day while I was vacuuming. She role plays going shopping and taking care of her kitties and babies. She thinks the silly songs and games I make up in the moment are the best thing ever. I made shadows on the wall once with my feet and called them "fishes", and she wants to "see the fishes" every night. She thinks I can make a shadow puppet for literally anything. When she was a bit younger I made her giggle hysterically just by opening and closing my eyes. Clearly, I'm fantastic.

2. I am surviving "death by a thousand details"
I do not brag about how busy I am because frankly I avoid being busy as much as possible. I like to have time to think, read, write, and spin my observations and experiences into meaning and myth. There are actually very few things that are important enough to me that I'd willingly give up my down time. But, inevitably, I do get busy. Life is about details these days, whether it's work or family life. There are dozens of tiny tasks required just to survive each day, hell, just to start each day. They must be done in a certain order at a certain time by certain people, who are, obviously, people and not always up to the task. So there are times when I don't love the daily grind.  On the other hand, I am managing, even if not always gracefully. I practice mindfulness. If I'm rushing out the door, feeling nauseous because that is how my body tells me I'm stressed, but the birds are singing beautifully, I stop and comment on it. (Usually I talk to AJ, whether she's there or not.) I talk about the sunset as I rush through the grocery store parking lot. I thank the drivers who let me into traffic after work. I praise the radio DJs for playing a song I like. I'm not perfect at this but these moments are part of what make up my day, and they matter.

3. Lots of time with grandparents
My dad only had one year with AJ, but I am grateful that he saw a lot of her in that time and was an important part of her life (she recognizes him in photos now, although I do not know if she will have any long term memories). We continue to do a lot of things with AJ's living grandparents. She sees my mom at least 3 times a week, sometimes more. She sees my FIL and his wife at least every two weeks, sometimes every week. My MIL lives on the other end of the continent, unfortunately, but we do the best we can, talking on FaceTime every week, for example. We are also planning to vacation together in the summer. It helps that I won the social/genetic/whatever lottery with my parents and in-laws. They are lovely people to experience life with.

4. I'm calm. And I'm enjoying life.
I've been a fairly anxious person all my life. I've learned to cope with it: I recognized quite young that unless I wanted to live a very limited existence, I would have to spend a lot of time outside my comfort zone. So I've gotten used to that. Nevertheless, I spent a good many years with a generalized fear that I wasn't good enough, was perpetually about to fail, owed everyone a pound of flesh, etc. Pregnancy was one of my most difficult experiences in that respect. Because I got pregnant against the odds, I assumed that every possible bad outcome was also likely to happen to me, even if it was statistically unlikely. However, through some kind of grace, and likely because I am surrounded by supportive people, I have not brought this anxiety into parenthood. Sure, I worry about things and I have painful lurid fantasies of disaster at times. But I don't worry perpetually if I'm being a good or a perfect mother. I trust my instincts and observations. If I make a mistake, I note it and do things differently the next time without a lot of guilt. I'm living a miracle, truthfully.

5. I'm a working parent and I'm doing a decent job in all my of roles.
Last year was a challenging year. I can admit that in hindsight, now that things are calmer. I went back to work as the mom of a (barely) toddler. I started a new job. My dad became very ill and died, and my mom became a widow. It was my tenth year teaching, but with all the role changes, I felt more like a beginning teacher than a veteran. Sure, I had experience and skills, but it was surprisingly difficult both to remember and apply my knowledge and to learn my new job. I felt like I had to adapt to a mild disability. This year I feel like I have regained most of my ability to to observe, learn, adapt, relate and innovate. I come up with ideas and I get excited by them.  I follow through. There are challenges, but I'm doing less swimming just to stay afloat. It helps that AJ appears to be enjoying her childcare centre and thriving there. In a way, I think my independence allows me to better appreciate her growing independence.

6. Mostly I'm kind and supportive to my husband, and he thinks I'm funny.
Mr. Turtle is also negotiating multiple responsibilities and roles. More than me, actually. He works, and is a part time student, and of course a dad too. It's a lot. He has gotten much more skilled at managing his time and life over the past four years. I don't always like that his attention is so divided but I'm also happy to see him pursuing his goals and doing a fantastic job. We still have a lot to talk about (not only AJ) and we make each other laugh. There are things we sometimes neglect (like chores) but not each other. I like to think we are a good example for AJ.

7. We spend a lot of time having fun.
We have pretty simple family amusements: playing at home, spending time with family or sometimes friends, going to the playground, bikeriding, swimming, going to the zoo. But when we have time away from basic survival requirements, we spend a lot of it having fun. I also do fun things for myself: reading (though less than usual; I'm re-defining my priorities and interests in books), a weekly stepdance class, occasional blogging. When Mr. Turtle is finished his degree (soon!) we should have more time and energy to come up with family activities. I can't eliminate uncertainty or trouble from my life or anyone else's. But it's entirely possible to make fun a priority, and it's good for all of us.

8. We limit screen time.
The online world is important to our family. Hello, this blog! Also Mr. Turtle's online courses. And I use social media, maybe more than I should, to learn about what people are thinking and get a sense of the zeitgeist in the world. Lately I'm thinking that perhaps my attention has become too scattered: I would be better off deciding on an area about which I would like to learn more and seriously applying myself, rather than browsing through whatever media happens to be shared around my circles. There are things I personally could do better, but so far AJ at least is thriving without devices. She is intrigued by them, make no mistake. About the only thing we have let her watch so far are cartoon nursery rhymes on our phones. And we have to be Really Clear that there's a limit on it: one song or two, and then No Crying! otherwise she fusses when we say it's time to put the phone away. But it's a good reminder of how addictive screens can be and that we need limits. AJ has not watched a TV show or a movie in entirety. We have an iPad but only use it to talk to Grandma and sometimes to look up recipes when we are cooking. I would like AJ to get a sense of herself as storyteller/creator before introducing her to TV shows or movies. (I didn't have a TV till I was 11.)  I love to watch her involved in imaginary play and see no need to interfere with what she is doing naturally.


9. Mr. Turtle and I are a team.
Since we've become parents, I have more and more appreciated the team aspect of our relationship. The only parenting task that I did and Mr. Turtle never did was breastfeeding. Well, that and fixing AJ's hair. He is baffled by her hair. But that is funny precisely because there is no other parenting task Mr. Turtle does not do. We have a routine where we share jobs: Mr. Turtle does baths, I do bedtime. One of us might play with AJ while the other does a chore. I do laundry; Mr. Turtle shovels snow and cuts grass (depending on the season). I vacuum; he cleans the bathroom. We are about even when it comes to shopping and cooking. But we can each take over and/or help the other out when needed. Who does what evolves over time, but the main point is we share and it makes daily life much more enjoyable.

10. My daily routines, my thoughts, my times of work and rest and my transitory moments, are full of love and grace.
There is no way to control everything in our lives or every outcome, but when the big and small tasks and sacrifices are done with love, it feels like our home is a safe and beautiful place. And this sense of love and security is the one thing I most want to pass on to AJ, because it is about the only thing that a person can keep with them at all times and that is very difficult (I hope impossible) to take away. My parents gave me my sense of inner worth and safety and I know from experience how precious a gift this is.

Monday, 27 February 2017

#Microblog Mondays: Alternate milestones

Everybody knows about the traditional milestones: birth, starting school, graduation, birthdays, engagement, wedding, first job, having children, retirement, death...(did I miss any?)

But what about alternate milestones: moments when you know everything has changed, but there's no official recognition? I have many of these in my life.

I was pondering an alternate milestone the other day: the first time you break one of a set of dishes. Mr Turtle and I did not need many basics when we were first married, so we decided to register at a handicraft store for a line of pottery I'd admired for years, but couldn't justify buying as a single person. It found pride of place in our new credenza in our new house and we used some pieces everyday while keeping most for special occasions.

One piece we use everyday is the sugar bowl. One day about six years after our wedding Mr Turtle dropped the lid and a biggish chip broke off. A few months later, on Christmas Eve in fact, I knocked the pepper shaker off a crowded counter and it shattered.

The pepper shaker will need to be replaced. But we still use the sugar bowl, and the other day when I was looking at it, it occurred to me the chip looks like AJ's bite mark.



One of the the cute things about when she started solid food was seeing her little crescent shaped bite mark on food.

I've become rather fond of the little chip and I don't think I want to replace the sugar bowl anymore. I don't want to break or damage more dishes, but at the same time it makes me think about what has happened since we were married, how things have changed, and how grateful I am for many of the changes, even though things (lots of things, not just our dishes) are not new and perfect anymore and never will be again. It's ok to be marked by time and change, and to be reminded of it.



More Microblog Mondays

Tuesday, 21 February 2017

Small victories

6:30am on a weekday, after a long weekend, seems like a good time to celebrate the small things that give me the courage to Carry On (to greatness, or just till the evening, whatever it's going to be).

On fertility: I had an ovulatory cycle, with no medication. I am as sure of this as I can be without lab testing: I had a sustained BBT rise, and positive OPKs around the time of the rise (but only for 2 days). After two anovulatory cycles, that feels like a victory (albeit one I had no control over). So, does the small victory mean there is hope of a bigger victory? This time, probably not. It looks like the BBT is dropping. But in the long game, just maybe. Also I'm happy that I avoided obsessive googling of symptoms and possibilities. I started reading message boards at one point, and then I thought: "I just don't relate to this stuff." And I actually stopped and didn't start again. Thinking about what it would take to stay in the long game, I think the best approach is to carry on TTC with emotional detachment and indifference. Is that possible? Probably not, but I can at least not feed the crazy. Much.

On family: Yesterday we took AJ to a local playground that she enjoys a lot. In the summer I used to take her almost every day. But it's been several months since we went (winter, cold, snow). It so happened that one of AJ's daycare buddies, "K", was also at the playground. They smiled big smiles at each other and waved. Interaction is still rather tentative, but you could tell they were happy to see each other. K's mom, I'll call her "Ana", and I engaged in some small talk, which felt increasingly comfortable. We started talking about communication. Ana shared that she had noticed how verbal AJ is. She then told a story of something she witnessed at the daycare.

There is a little boy in AJ's room, "J", who hits people. He has even hit me a couple of times when I was there to pick up AJ. From what I've observed, he doesn't do so with any emotion, but it's like he's picked up a habit of doing this to people, for whatever reason. I've seen him approach several of the children and swat or kick them. I saw him kick a child in the face who was lying on the floor crying, once. It always seems to be other boys although that might be because there happens to be more boys than girls. The daycare staff, from what I've seen, are prompt at intervening and giving the message that this is not how we treat our friends, we are not happy with our friends, we are sad, etc.

Ana shared her impression that J particularly picks on her son, who also happens to be smaller in physique. She told me that she had also seen AJ "stand up for" K. Apparently after one incident AJ had walked up to J and told him that "This is not how we treat our friends" (basically using the words the staff use). I was quite touched by that. I try not to read too much into situations, because we are talking about toddlers here, who are only starting to develop their social skills. But still, you hope as a parent that whatever age children are, they are getting the right messages. There are always going to be some negative and some positive influences. It meant a lot to hear that AJ is learning the positive. I know she has empathy, because I have seen her approach a crying child and try to comfort him, and she will pretend play sometimes with her toys where she is consoling them. She is also a cautious child, not one to take a lot of risks. But, even cautious people hope that when it is called for, they can face a challenge. So it meant a lot to me to hear that she stood up for K, both in terms of her development and how the situation is being handled at her daycare, as children learn by imitating.

We left the park with smiles for everybody and an invitation to K's birthday party next week. Wins all around.


Monday, 6 February 2017

#Microblog Mondays: The Ants Go Marching (and so does time)

Last night I was snuggling with AJ before putting her in her crib. She wanted to sit next to me in the recliner (not in my lap) and was asking for songs. She asked to hear "The Ants Go Marching".  This was a first: it's always been "The Wheels on the Bus" or "Old Macdonald Had a Farm," before.


I started singing, stumbled a bit remembering the tune, and then remembered that "The Ants Go Marching" was a song I sang to her all the time as a newborn.


I enjoy a good flashback. But those days already seem so unreal. Bittersweet.








Microblog Mondays

Wednesday, 25 January 2017

Reality is a bitch

But who can retrieve hope out of a 10 foot deep pit toilet? Who, you ask?

Me, that's who.

January is almost over. I'm fairly sure I'll survive the rest of it. I have almost finished the things I absolutely have to finish. I am still standing; I have most of my wits; and I feel strong: albeit a little smeared by the shit of circumstance.


Ah, let me back up a bit.

We had our follow up appointment with Dr. Cotter. I always have a sinking feeling anticipating these appointments, and it didn't help that I had to drive across the city in winter weather. I felt crazier trying to figure out the parking machine at the clinic than I ever felt while taking any fertility drugs. I narrowly restrained myself from cursing a blue streak at it and the bystanders behind me for the insult of existing and making demands on my stressed mind.


That was my mood going in, but I was quite prepared thanks to the detailed charts and notes I kept during my Clomid cycles, and the fact that I blogged about the matter and received some helpful comments.


Dr. Cotter chose, uncharacteristically, to open with a positive: "You ovulated several times!" (with reference to the first three Clomid cycles). She followed this with "We received some new information from the latest semen analysis." I allowed myself to briefly fantasize that this new information was good, even though I knew it wasn't.


Mr. Turtle's last SA (September 2016) showed a drop in numbers from 17 million (2013) to 1 million. That moves him from the "moderate" male factor infertility category to "severe."

Dr. Cotter was quick to add that "men's sperm counts go up and down like the temperature in [Western prairie-steppe city that has huge temperature fluctuations due to the Chinook phenomenon]. "Men can go from zero to millions in a few days," she elaborated, and said that this was true for men of all ages, including men in their 20s.

"With those sort of numbers," she continued, we would usually go to IVF, but we know you didn't produce any eggs on [very high dose of follicle stimulating hormone]. And you were three years younger then, so....[pause]."

"It does seem unlikely that we'd get a better result now," I mutter at Dr. Cotter and the indifferent universe.

"So the question is...." [pause to lean forward and make intense eye contact] "How aggressive do you want to go?"

There is another pause while some part of me registers that the last time I heard about aggressive treatment, it had to do with my dad's esophageal cancer. Also that at the moment I feel not very aggressive at all, but maybe this is one of those times that you fake it till you make it.

"Would you consider donor egg? Would you consider donor sperm?"

I stare at Mr. Turtle. "It's not off the table. But we haven't talked about it lately." Mr. Turtle adds, "Yes, we'd definitely have to have more conversations about that." He then steered the conversation back to his SA and recurrent lymphedema as a possible reason for it.  Mr. Turtle has Crohn's disease and is immuno-compromised because of the drugs he takes to manage it. Anytime he is fighting an infection, he gets a lot of swelling in the genital area which increases body heat, probably killing sperm or causing them to not develop properly.  We talked about how at the time we conceived AJ, Mr. Turtle had been doing lymphatic massage for drainage. He didn't think that at the time it made any difference, but maybe it had? Also his perception was that he was in worse health overall at that time than at present - but still managed to conceive a child, which is interesting. Dr. Cotter looked up his medical records on her computer, corroborating what he was saying with what his other doctors had observed.

Her recommendation after this discussion was to repeat the sperm analysis twice more, to see if there are any changes or if the low numbers seen in September continue. In between the analyses, Mr. Turtle can try what he can to reduce the lymphedema. He also has follow up with other doctors to get more opinions. So that's all good.

After we talked about that, I felt like I should bring the conversation back to my issues, although for a change, I was (sort of) the receiver of good news. I asked:

Assuming Mr. Turtle's sperm counts improve, would Dr. Cotter suggest trying Clomid again or look at something different?
Dr. Cotter reiterated that she feels Clomid is the logical treatment, because I did ovulate on it, it has been used for a many decades, and because "we know that Clomid at low doses works for women at the end of their reproductive lives." She seems quite positive on this point. She also implied that considering the one anovulatory cycle, she might increase the dose. She also talked about Femara/Letrazole as a possibility, but noted that it works in "a very different way" and she could not judge if it would be better than Clomid or not.

I asked if there was an advantage to going off Clomid for a while before trying it again, and she said yes, you need to take a break every four cycles. If we do try Clomid again, I will want to ask more questions, such as the short luteal phase on the ovulatory cycles and in what circumstances she would consider additional things such as a trigger shot/progesterone supplementation. But that conversation can wait till we know more about what's going on with the sperm and if improvement is possible.

I asked if there were any risks to taking DHEA over an extended period of time, and she said not that we know of, and agreed to give me a prescription for it for another few months. It shouldn't do any harm and it might do some good.

And then because I felt I should, I asked what were the options for donor egg should we choose to go that route.

Most of the donor egg information I already knewfrom asking the same questions three years ago. Two options:  fresh cycle with an (unpaid) egg donor, 38 or younger. Since we don't want to recruit a donor this isn't likely an option for us. Option 2, we can buy frozen eggs in batches of 6 from a US egg bank. The cost is $10 000 plus $1000 shipping cost, plus the cost of the IVF cycle. The donor eggs would need ICSI and assisted hatching as the freezing process makes the eggshells tough. (She actually said eggshells).  As Dr. Cotter was talking, I couldn't help thinking of all the things that could go wrong during this process.  Another wrinkle: Dr. Cotter said the egg banks might refuse to sell eggs to a couple with a low sperm count, because they would worry about it affecting their pregnancy rates and that's how they market themselves.

And what about donor sperm? Dr. Cotter had floated the idea of donor sperm with Clomid and/or an IUI as an option.

Dr. Cotter told us that "donor sperm is expensive" although the numbers she gave were in the hundreds of dollars, not thousands which is less expensive than eggs, at least. She then went off on a tangent about how sperm costs more or less depending on the race of the donor: Caucasian sperm is the cheapest, and Black/Hispanic sperm goes up in price with Asian sperm being the most expensive. Asians have low sperm counts and sperm donation is not a cultural norm. "There is literally one Asian donor in Canada and he is in high demand."  I don't know why she thought all these details were necessary since we are obviously white and not likely to seek out a different race donor but what do I know. She told us how sperm and eggs are flown all over the world and that is normal. At the end of this informative disclosure all I could manage was "It's an interesting world you work in."  "Oh yes, very interesting,"Dr. Cotter said breezily, as though she had quite enjoyed discussing professional business with us. Maybe this is her way of testing if people are really serious about "aggressive" treatment.

It's an interesting word, aggressive. A google search of "aggressive treatment" brings up this definition : "Aggressive care describes a particular approach to a life-threatening illness or condition. A patient receiving aggressive care will receive the benefit of every medication, technology, tool and trick that doctors can devise to treat his or her illness."  "Aggressive" usually (to me) has a negative meaning, such as a person who wants to pick a fight and threatens with words or actions.

But in the context of illness, aggression sounds kind of positive: Imagine soldiers of medicine fearlessly fighting the enemy disease! If you are aggressive, you must really be doing something. No more talk, all action! It seems cowardly to say, well shucks, maybe I don't feel like being aggressive. It rather reminds me of times in my life (mostly as a child) when well-meaning people kept telling me to be more assertive, maybe even more aggressive, with the stated or unstated implication being, if I didn't, the aggressive people were going to win or get all the good stuff. By the time I was in my 20s, I felt I had proven that I could have a good life without being aggressive, i.e. something I wasn't.  But the notion they planted still lingers in my thoughts: if I'm not aggressive, I'm not really serious about what I want, and I won't get it.


The thing is, at least with regards to infertility, I see aggression as illogical. Aggression implies an opponent. But who or what is my opponent here? My own body. So aggression means two things: I'm fighting my own body, or, I'm asking doctors to fight my body (while I passively watch? how is that a thing?). Neither possibility makes a whole lot of sense to me. Maybe the key piece here is self-image: I see myself/body as fundamentally good and beautiful. My body is not so much my property (I didn't ask for it and I don't get to keep it) as a sacred trust. To harm it or hate it feels deeply wrong and always has. In so far as "aggression" means harm or hatred, I can't go there. At all.


But you might say, it's just a word. Why not focus on the treatment options, not the words.  Well, because I think words actually do mean something. Words tell us truths about how we and others think, if we listen attentively. The words we use are not coincidental or accidental. They have histories. The histories tell the story of real things and real people. Real bodies. When Dr. Cotter calls DE/sperm IVF "aggressive treatment," she's telling a real story with real world consequences.


And whether I have another child or not, all my life I'll be telling my story. More than that, I'll be telling my child(ren) their story. What kind of a story do I want to tell?


That's where my thoughts are at. Not whether I can conceive naturally or whether DE IVF or some other treatment will "work." Those are valid questions, but I won't be able to answer them until I try, and when I get the answer, it may well be too late to do something differently, and thus the answer itself will be useless. So truthfully, none of those questions or their hypothetical answers will actually determine our course. The one that will is, What kind of a story do I...do we....want to tell?


So back to retrieving hope.


I'm actually feeling quite good. January is almost done. The days are getting longer. My daughter is beautiful and my husband walks with me on this path. We don't have to go back to The Fertility Clinic for another four months (after the second SA) and I'm quite happy about that. We can cycle unassisted. Or not. But we probably will.  We can talk about DE IVF and the other options Dr. Cotter floated. Talk is good.


Basically, I'm not being aggressive. And I feel just fine about that.

Tuesday, 17 January 2017

I need some suggestions

January is more than half done, hallejulah. I don't want to wish away a day of my life but January isn't my favourite month. It feels like everybody is making New Year's resolutions in December and my only thought is: please can I just get through January.


Anyway. We are at a turning point/checkmate/stalemate (I can't metaphor right now) with regards to trying to conceive #2. I'm not feeling very optimistic at this point, not going to lie. But optimistic or not, we still have to decide to do something, or nothing, which is still a decision.


We have completed our 4 cycles of Clomid, 100mcg. No pregnancy achieved. According to progesterone levels, I ovulated the first three cycles (levels were 11.3, 18.9 and 22.1 respectively). All 3 ovulatory cycles had a relatively short luteal phase, according to the charts I kept (about 9 or 10 days). Other than that though I was encouraged to see my charts looking mostly the way they are supposed to for a fertile person. My temperature was low prior to ovulation, then rose, with the highest point about 7 days after ovulation. From there it would plummet. I had one or at most two positive OPK's in each cycle (I stopped testing after BBT rise).


I did not ovulate on the fourth cycle. I didn't ask the number for this one. My BBT chart is basically flat and low, no temperature rise. I had positive OPKs starting day 9. They were positive for about eight days, went negative for three, went positive again. I have never had this happen before. I finally gave up because it was too frustrating. I had various kinds of cervical mucus throughout, some of which looked fertile but as previously noted there was no evidence of ovulation at any point. This cycle lasted for 34 days and finally ended with what looks like a pretty normal period. I was glad that I at least did not need to use the Prometrium to induce a period which wasn't something I wasn't anxious to do. I am now unmedicated for the first time since October. What I notice so far is that my BBT (follicular phase) is lower by 3-4 tenths of a degree than it was when I was taking the Clomid. (I didn't chart prior to taking Clomid so no idea what it was before).


We have the follow up appointment with Dr. Cotter this Thursday. I'm trying to think of what I should ask her / talk about. I don't know if we will be offered any treatment options after Clomid. Maybe she will interpret my 3 ovulatory cycles positively and be willing to try something else, maybe not. I'm also so busy this month I haven't had much time to research or think about things, and it's still hard to think past the disappointment.


From the little I've had the time to read, here are some possibilities I found for when Clomid doesn't work:
  • Keep trying Clomid at same or higher dose (we were given four cycles, but surveying the internet I see that some people have had it prescribed for up to a year ...!!!... )
  • Clomid with a trigger shot
  • Go off Clomid, go unmedicated or take birth control pills for a couple of cycles, try again with Clomid
  • Femara
  • "Injectibles" - not totally sure what those are....needles??
  • IUI (we were not previously considered candidates for this because of male fertility issues)
Does anyone have any ideas of what else we could ask about?


We will also get the results of Mr. Turtle's latest semen analysis. I mainly focus on the female side on the blog, because it's easiest to write about myself, but we are a double infertility diagnosis. So that could be very important information going forward.


I haven't officially been given the results of my salinohysterogram, either, but unofficially I was told everything looked good and I had follicles growing.


I plan to ask if there are any negative side effects to continuing to take DHEA/COQ10 and if not whether Dr. Cotter can refill my prescription for that. I don't feel terribly hopeful right now about "trying naturally." But neither do I feel ready to make the decision to stop.


There is also the donor egg option. Since I wrote this post and this post, donor egg IVF has not become any more appealing to me. I definitely don't have the desire to start that process right away; at the same time I can't yet shelve it permanently.


I took the day off of the appointment. I wish I could spend it relaxing, but I will be busy with individual program plans and report cards which are due this month. The nicest thing I can probably do for myself is get that work done so I don't have to do it on the weekend.


Any ideas to kick start my tired thought process are welcome!!


Monday, 9 January 2017

Microblog Mondays: This Child

I feel like I've been living a dual existence lately: caught up in the process of trying to make a second child (I'll update on how that's going another time: basically, Not Good), while being riveted by AJ and how she is growing.

She really isn't a baby anymore. Of course, I still call her Baby Girl, and probably will when she's 20 if she'll let me. There are moments where I fleetingly see the newborn in her (a certain sleepy, secretive smile, the shape of her head and way her ears stick out when looked at from the back, the way her face crumples up when she cries). Will I also still be seeing those flashes of the newborn when she's 20, I wonder? But most of the time, she's busy reminding us over and over again she's Not a Baby.

I have four photo collages up in the dining room, two big rectangles with 12 photos apiece and two smaller ones, 8 photos each. In theory these are supposed to be updated every year; in reality this job is procrastinated because sorting, printing and displaying photos is a terribly time consuming and therefore difficult and stressful. So the photos have not been changed since shortly before AJ's first birthday, and they are all of her in the first year of life. Lately, I'm thinking I really have to change them up, because she Does. Not. Look. Like. That. Baby. Anymore.

I don't know; those (not so) old photos have somehow brought it home in a way that everything else, even all the developmental milestones, haven't. The baby is a child.

In a way it's therapeutic: As AJ grows into an individual, she grows away from the whole process of conception and pregnancy and even birth and infancy. It's nice to be reminded that life is evolving and surprising and meant to flower beyond its (amazing) beginnings. Her growth and change is a reminder that the future is unwritten and could be very different from the past and from the future I imagined in the past. And that's.....sad and delightful and frightening and liberating all at once.

I savour the moments that I have with this child, this totally unique life.

Also here is the Susan Aglukark song with the same name as this post. Because.



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