Sunday 27 January 2013

IF and relationships podcast

One of the first blogs I started reading was CGD's Adventures in Infertility (and Divorce) Land.  She tells an absolutely gripping story about struggling with IF and how it changed her life journey.  Her story is a great study of people and what they are like. And it's the story of one woman's resiliency, and that is a story worth sharing.

CGD participated into a podcast about infertility and divorce and  posted the link to her site: Episode 18 (Infertility and Divorce)  Actually, it should be called "Infertility and Relationships" because the focus is on how IF affects relationships and what couples can do about the challenge, not only about divorce.

Thanks in part of CGD and the ladies, here's a list of things to discuss with Mr. Turtle before beginning any treatments:

1) If treatments are Plan A, then what's Plan B and C and....
2) Couples counselling before treatments
3) Keeping up with "dating" and activities together
4) listen to the podcast?

...later (or sooner)... the Turtle

On normalizing. And being irrational.

Since I don't have any IF treatments scheduled, and won't for likely many more months, this blog and the thinking and research we doing around IF has a couple of  purposes.

1) Learn about the diagnosis and possible paths to take, so that we have a plan and are as informed as possible when we do start medical testing and interventions

2) Normalize the diagnosis and what it means.

#2 is pretty significant for me. I am very grateful for the Internet and the wealth of stories  on it, which has already done a lot to normalize things for me and help me to realize that many others have walked a similar path, or will be setting out on one. I began the normalizing process from the time I started charting on Ovagraph.  Since discovering Stirrup Queens and committing to learning about and thinking through IF, I've been searching out and reading blogs on a fairly regular basis.

What I like best about the blogs are  the human voices. When I heard that IVF was most likely in our future, the first thing I did was read everything about the process on the clinic website. The clinic website is very thorough and informative, and reading the information gave me some confidence that the doctors will probably know what they are doing. Reading about IVF also made me feel like my body was going to become somebody's science experiment. I have nothing whatever against (ethical) scientific research and experimentation, but I  prefer it to happen in a lab somewhere, not inside my uterus and endocrine system. That's a little close for comfort. I also have had next to no medical intervention in my life. I have never had a serious illness. The only prescription drugs I have ever taken are antibiotics or pain-killers to assist with recovery from temporary illness or injury.  I have never been on the Pill. My approach to my physical self is this: If it's working fine, be grateful and don't mess with it. (And don't let anyone else mess with it.) When I switched doctors, it took 5 minutes to go over my medical history. Dr. Gnomish was impressed. "Most people show up with a bag of prescriptions and a medical history as long as their arm."

Mr. Turtle has a different history. Diagnosed with a chronic condition in his teens, he has a history of medical interventions (some helpful, some dangerous, thanks to medical incompetence) and he has been taking prescription medication for several years as part of his management plan.  (He is also very responsible about taking care of his health.) I don't know if having a history of treatments makes a person more accepting of the necessity of future treatments. It seems to me like it would, but I could be totally wrong. But for me, the prospect of extensive medical intervention does feel like a challenge to my identity. I've always assumed I would be able to live without it, barring a life- or sanity- threatening illness. It's not a moral qualm (not yet, anyway): I don't think IVF is unethical or immoral. (Why is maybe another post.) It's a matter of trying to adjust my sense of reality.

Reading people's stories on their blogs reassures me, I think, that undergoing fertility treatments doesn't make someone less human. IF is definitely a challenge to one's identity and assumptions, but people can deal with that challenge and continue on with their lives. I am deeply reassured  to hear this, and even as I try to learn more of the medical information and the "nitty gritty," I continue to feel a need to remind myself of this truth.

Then there's my irrational side.

One of the best (in hindsight) aspects of the  year I spend living abroad  was that I confronted my irrationality. My irrational side was  present long before I ever started living abroad, of course, and I dealt with plenty of irrational impulses (like everybody).  But I didn't really confront or understand the power of  Turtle The Completely Irrational till I was in Europe. And dealing with homesickness.


I started feeling homesickness about 4 months after leaving home. I felt like my mind had turned into a high-tech movie theatre that provided me with (highly idealized) images of Canada and my past life 24 hours a day. It didn't matter what I was doing. It didn't matter what I was thinking. I lived in a twilight zone of deja vu where memory leaned out of the past and ripped out the fabric of the present. At the worst moments, ever fibre of my body and mind told me to get a plane ticket and go back home. Immediately.

One thing stopped me, and that was because I was able to recognize these thoughts as irrational. My strongest impulse was to go back home so I could go to British Columbia in the summer time, like I used to do as a child on vacation. But it was the middle of winter. Even if I hopped on a plane that moment and was back in Canada, there was no way I could make the images in my mind reality.

Once I'd figured that out, I could give my rational mind some space to reach the other following conclusions:

1) I hadn't yet accomplished what I wanted to do by going abroad, so if I went home immediately I would not be happy with the decision in  the long run
2) I could have many great experiences by staying in Europe for the time being. I needed to live in the present.
3) Major decisions should be made (mostly) rationally
4) I couldn't ignore or shut down the irrational side my mind. But I could accept it while not letting it control me.

I ended up staying in Europe several more months and having some great experiences and growing as a person.  When things got crazy I hopped on a bus, got out of the city, and spent hours walking in the hills by the sea, surrounding myself with beauty and calm.  The homesickness faded after a couple of months, leaving me instead with a heightened appreciation and love of what I had left behind. A few months later, I did happily return to Canada to stay, but not because of Irrational Turtle's prompting.  And having met Irrational Turtle, I learned to recognize her style. In other words, I learned to separate myself from my irrational thoughts, kind of, which is why I'm talking about myself partly in the 3rd person, which may sound pretty daft, I realize. Call it another coping mechanism.

Irrational Turtle has been back, with some new tricks, since we started trying to conceive.

On one hand, I think I'm being pretty rational. When we started TTC, I read up on pregnancy, childbirth and infancy, etc. Mr. Turtle and I talked about what we want our family to be like.  When IF entered the picture, we started learning about that. On the other hand...

There is. No Way. I can reach  the end of a menstrual cycle without picturing an embryo growing in there, imagining giving people news, counting forward to the months to a birthdate, mentally rearranging my life around a pregnancy. I do it every month. I don't tell anyone. Sometimes I deny to myself that I do it. But I do.  I don't know how much mental and emotional energy goes into this exercise. A lot. I can't admit to people what I'm doing. They just see me tired and preoccupied and sometimes apathetic.

For the first few months I would google early pregnancy symptoms, and stare at The First Week on the Endowment for Human Development's website. (What an incredible website that is.) Eventually I stopped doing that. I haven't even charted this cycle, which was when we learned about the male factor IF. I used the Ovacue up until ovulation, or possibly a day or two before, then stopped using it.

Now, at the end of the cycle, I still wonder if, if. Maybe Mr. Turtle had a good day the day we BD'd.  Maybe he just happened to give a bad sample the day of that sperm analysis. Maybe everybody is just wrong about everything and I'll get pregnant anyway. As long as AF isn't here, it could mean it happened, right?

A few months ago I started trying to cope with this by saying (to myself alone) that I have an Imaginary Baby at the end of every cycle. Basically I let the thoughts happen, but I put the adjective "imaginary" in front of nouns like "pregnancy", "embryo", "baby" etc. This helps a bit in that I can let the thoughts happen (Irrational Turtle cannot be shut up or argued with) but I don't let them become too real.  And then when the cycle ends, I can say goodbye to the imaginary baby. Not "feeding" the impulse with websites or googling also helps.

I think now that we know about the male factor IF, I also use Imaginary Baby fantasies as wish fulfillment for being "normal." Proving that I haven't fully accepted IF as the new normal. I also find myself feeling really rather kind and generous toward expecting parents/grandparents and others in the Fertile Club toward the end of a cycle. Because maybe this time I'm going to be part of that club. So I can like them and identify with them for a while. (Come AF, I'll want nothing to with the Fertile Club for several days, after which I'll slowly come to peace with their existence again.)

Something else that I do plan to do as another normalizing/coping exercise, is begin a knitted garment that is especially dedicated to TTC and IVF and  hopefully pregnancy. I absolutely won't touch or begin any baby stuff until there's a freaking ultrasound picture of a fetus.  But, I can make something for myself.

Till next time, sincerely, The Turtle

(with input from Irrational Turtle)

Wednesday 16 January 2013

Referral to clinic

Today I had a brief appointment with Dr. Gnomish where we discussed a referral to the fertility clinic. Actually, he already knew what had to be done and had all the information for the referral, but he needed my permission obviously, as the referral is always made in the woman's name. The discussion was mostly general (he's not allowed to discuss Mr. Turtle's diagnosis with me, although obviously I know what it is.) He mentioned that there are three basic causes of infertility: female factor, male factor, and incompatibility (both partners are OK but for some reason can't reproduce with each other.) We did go over the results of some basic tests I had last summer. He confirmed that everything (thyroid, blood, hormones) were normal for a fertile woman.  So hopefully we are only dealing with male-factor IF. We shall see, I  guess.

Dr. Gnomish did not discuss IVF or specific treatments with me, just saying that it was up to the doctors at the fertility clinic to look at those options with us. It's also up to them if I will have any further testing.

Since the clinic takes up to 6 months to follow up on a referral, it doesn't look like anything noteworthy is going to happen anytime soon. In my ideal world I would have an IVF cycle during summer break, so I don't have to worry about work while going through it.  Seems highly unlikely that that will be the case, however. I guess we'll just keep learning about fertility, mentally and emotionally processing things, and of course saving up. I should find plenty to blog about in those areas, even if I don't have treatments updates yet.

Catch up later, The Turtle.

Tuesday 15 January 2013

Introducing The Turtles: Only the interesting facts.

Alright, now that the blog is up and running, and we've named this piece of cyberspace, I can tell a bit more of The Turtle's story.

Although it is nice to think somebody might read this one day and find it helpful, as I have found others' stories helpful, right now telling this story is really about me getting used to it. 

I am 33 years old. I like my number.  3's are magical. 3X3=9. 

The past 7 years of my life have been pretty fabulous, I think.

Starting at age 26 or so, I decided that I was capable of having a good relationship and that it was time to move my life forward. A variety of factors led to this remarkable conclusion, but that is a whole other story. Let's just say that before that point there was some uncertainty as to what I wanted to do with my life, and who I wanted to spend it with.

(I did have an interest in fertility starting in the late teenage years. In high school I discovered and loved  this image:

Can't look away, can you?  However, during my university years (long, but fun; took up all my early 20s)  fertility was all in my head.  Not much interest in babies.  Art, dance, poetry, and  later music were the ways that I strove to create. Despite a few fits of angst, some lasting months or years, I had a very good time discovering myself.  Inevitably life threw a few Unanswerable Questions at me, but I survived healthy and whole.)

Jump forward to age 28. I met my husband on an online dating site.  It sounds cheesy to say that I knew he was The One from the minute I looked at his profile, and yet that's almost totally kind of absolutely true. I have a very excited journal entry from that week to prove it. "This time it feels different." It was. (He was my first real relationship.)

Fast forward 2 years: We were married at age 30. Nothing could have felt more right.

We both knew we wanted children from the time we were dating. So, after a year of marriage, we figured might as well go for it. Funny, I had a notion that babies were either going to happen immediately, or that it was going to be difficult. 

August 2011, I started taking folic acid. I went to my doctor for a physical. He said I was in excellent health and that we should try for a year, and then consult with him again if there was no pregnancy.

We started "trying" in September of 2011, meaning aiming for roughly the middle of the menstrual cycle.  No dice. I started reading up on fertility and reproduction online (apart from the basics you learn in sex ed, I didn't know that much.) By December, I had had enough of shooting in the dark and decided to see what was out there that could help. I tried OPKs, found them confusing, and finally bought and started using the Ovacue in December of 2011. The first real disappointment I had was during Christmas vacation with the inlaws that December. I really, really, really wanted to be pregnant that Christmas. Instead I got  the nastiest period e-ver.  I was bummed. It was my first hint of what a bitch this journey could be.

January 2012, I started charting seriously with the Ovacue on Ovagraph. Through the forums, I learned some of what other people go through, and the physical and emotional territory of Trying to Conceive (TTC).  I had some wonky menstrual cycles that winter and wondered if something might be off inside me, but then things seemed to stabilize by the spring of 2012. In May we had our second memorable disappointment. It was the first cycle where Mr. Turtle had been openly hopeful for whatever reason.  When it ended in nothing, I felt his disappointment keenly, as well as mine.  After that I think we both started reigning in our hopes. We continued to try with enthusiasm but didn't get carried away thinking what might happen (and of course, nothing did.)

September 2012 marked the end of the fateful year. I changed doctors from mine of many years to Mr. Turtle's doctor (more convenient to get to and highly recommended by Mr. Turtle).  I'll call him Dr. Gnomish.  Dr. Gnomish cheerfully informed me that I had "primary infertility." Primary infertility means that you have not been able to get pregnant with your first child after one year.

So, now it had a name.  I rolled the words around in my head but didn't say them out loud to anybody, except Mr. Turtle. I had primary infertility. I couldn't decide if I wanted the label or not. On one hand, it sounded scary. On the other hand, at least now our issue was named. It was on a map somewhere. It was territory I could own.

Dr. Gnomish also pointed out that until Mr. Turtle did a semen analysis, we could not proceed further with any investigations or treatments. Mr. Turtle agreed, and then proceeded to forget about/procrastinate the test for the next 3 months. We kept on  trying with each cycle. By now I felt like quite the expert when it came to using Ovacue to identify my most fertile time. Indeed, I could predict within an day or two when my period would start. Which it always did, month after month.

Finally, Mr. T did the test in December. Christmas happened. Luckily my cycle didn't deliver up another disappointment right on Christmas surrounded with family. But, there was AF right on New Year's day, on time as usual.

First week of January, Mr. Turtle finally had meeting with the doctor to discuss all his test results.  He had several to go over, since he has a chronic autoimmune condition.

All the tests looked great!

Except for one.


Mr. Turtle blurted out the news to me when I had barely gotten in the door of the house (coat and boots still on).  He has lots of swimmers (above average), but the viability, or motility (heard both words used) of the swimmers is very poor. Dr. Gnomish said that we would need IVF to conceive.

I continued taking off my coat and boots. 

Neither of us was exactly surprised. Mr Turtle had suspected the his chronic condition, and/or the medications he takes for it, might have damaged something, although we can't identify one particular cause. I imagined that something was very likely wrong with one of us because we had had some very good timed cycles, and not even one positive.  But I had thought, logically or not, that the doctor would suggest something else before IVF. Isn't IVF supposed to be the last resort? Now we had been told, go nuclear or go home.

I spent a weird couple of days trying to process it. Mr. Turtle did too. We have been supportive of each other, reassuring ourselves that we still have options.  Talking and touching and sharing unconditional love, despite this news.

"This isn't a crisis," I said to Mr. Turtle on one occasion. "If your child was in a terrible accident and was fighting for life in the hospital, that would be a crisis. I don't think this is crisis."

I'm not totally sure I'm right about that, actually.

I found myself looking at people's family pictures, on facebook or whatever, thinking "That isn't going to happen for us. That can't happen for us." It is weird. Infertility is completely, totally different from deciding to not have children, or not being interested in children. Even if you don't want children, you still see yourself as part of a genetic tree, with seeds that you could plant somewhere.  Whether they consider it important or not everybody assumes they can have children. That assumption is part of how you define yourself. Infertility throws that assumption out the window, and lets in a blast of cold air at the same time.

In terms of action to take, Dr. Gnomish requested an appointment with me so that we can get a referral to the fertility clinic.  I promptly made one. In fact, it's tomorrow. I think the real reason I wanted to write all this out today, was so that whatever happens tomorrow, I don't have to worry about saying it. I can just focus on what comes next.

There is one thing that I have found helpful in the past few days, apart from lots of cuddles with Mr. Turtle. And that is reading blogs on Stirrup Reading about other's experiences has made this whole challenge feel a lot more human already.  And so I am glad to get torthúil up and running too.

We tell ourselves, this is only the beginning.

sincerely, The Turtle

still bobbing at the wharf.

This blog is one step in an unexpected journey. 

It isn't the first step, but it feels like a freighted one.

This is my fertility blog.

I can't bring myself to write "infertility blog," though obviously, infertility is the issue. Otherwise I would be having babies right now, not blogging about how it's hard to have a baby. However, I'm goal-oriented, and "infertile" sounds like a dead end. At least at this point in our journey, I'm holding on to the idea that we are not at a dead-end, but at a bend in the road, a change in the itinerary, a foray into the fuzzy part of the map. We're bobbing at the wharf, one toe in the water, anxious, but....looking ahead with something like optimism.

What's torthúil?

I'm not much for learning foreign languages, but I have an affection for dead or rare ones.  According to the online Irish dictionary, "torthúil"means "fertile" or "fruitful."  So the title: "Fertile Journey" or "Fruitful Journey."  There, that's the optimism again. Honestly I don't know how to pronounce it, but the look of the word also reminds me of "Turtle," or "Tortoise" and turtles are just awesome. So I guess that could make me and my husband Mr. and Mrs. Turtle.

The word also looks vaguely like "torture." Which brings to mind the existential and sometimes physical anguish of infertility. Which I have yet to really experience, and here's hoping for the best. But we are venturing into risky territory.

So,  there's part of the introduction. It doesn't make a whole lot of sense, I know, but it's the beginning of this new online alter ego. It will take me a while to get used to it.

Sincerely, The Turtle.