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Wednesday, March 24, 2010

Serenaded by Michael

Long before Michael Buble became a well known house-hold name, I was a fan. In the early years, I was lucky enough to catch his home town concert at Deer Lake Park in Burnaby. Now the crooner is playing multiple sold out concerts at GM Place.

Michael's recent single, "Just Haven't Met You Yet" is catchy but not one of my faves. I've met my Mr.Right, so it just didn't apply. Until today when I heard the words differently...

I'm not surprised.
Not everything lasts.
I've broken my heart so many times I stopped keeping track.
Talk myself in.
I talk myself out.
I get all worked up, then I let myself down.

I tried so very hard not to lose it.
I came up with a million excuses.
I thought I thought of every possibility.

And I know someday that it'll all turn out.
You'll make me work so we can work to work it out.
And promise you, kid, that I'll give so much more than I get.
I just haven't met you yet.

I might have to wait.
I'll never give up.
I guess it's half timing,
And the other half's luck.
Wherever you are.
Whenever it's right.
You'll come out of nowhere and into my life.

And I know that we can be so amazing.
And baby your love is gonna change me.
And now I can see every possibility.

But somehow I know that it'll all turn out.
And you'll make me work so we can work to work it out.
And I promise you, kid, I'll give so much more than I get.
I just haven't met you yet.

They say all's fair.
In love and war.
But I won't need to fight it.
We'll get it right and,
We'll be united.

Monday, March 22, 2010

Robitussin, Acupuncture and Pomegranates, Oh My!


Firstly, Cyballs and I want to say thank you for all the emails and FB messages we received after having shared our blog. As scared as I was to put this intimate news out there for the world, I can't begin to tell you how much strength I took from the compassionate and supportive messages you sent us. Just to know you're thinking of us and sending us strength, brings me to tears. So from the bottom of our hearts, thank you for being our cheerleaders.

When faced with the possibility of never having children, one will resort to strange and drastic measures.

It began innocently enough. A website here, a magazine article there. But it progressed and I began to obsess - blogs, forums, Yahoo Answers, you names it, I was reading it and taking it to heart.

Ahem. My list of tried anecdotes:

*L'Arginine
*Fertile Aid (yes I ordered a product from the internet that isn't FDA approved)
*Robitussin
*Lipton Brand green tea
*Molasses
*Radishes
*Hens
*Anything pomegranate
*Isla Mujeres (pure coincidence)
*Acupuncture

In my heart of hearts, I'm pretty sure I know most of that list isn't going to change a damn thing. But if it gives me hope, what's the harm? Truth is, there are some items on that list I've embraced.

Pomegranates: The fruit of fertility.
I've taken to wearing a pomegranate-coloured bracelet on my right wrist (click here to find out why). Since my obsession began, I've received a care package from Amanda with all things pomegranate. Also, Barb left me a plastic pomegranate in my drawer at work which now sits on a makeshift shrine in my living room. There's always pomegranate juice in the fridge, pomegranate hand soap in the bathroom and pomegranate lip balm in my desk at work.

Isla Mujeres

Back in October (when infertility wasn't on the radar), Cyballs bought us a trip to Isla Mujeres, Mexico for my 30th birthday. As it turns out, Isla happens to be the Island of Fertility (and not because of the abundance of tequila). The Mayans built a temple on the south point of the island in honour of Ixchel, goddess of fertility and childbirth. Imagine our surprise and delight.

When the time came to pack for our trip, you better believe Amanda's care package and Barb's pomegranate made it into my bag.

On the day we made the trek to the temple, I had the pomegranate and some pomegranate flavoured lip balm securely tucked away in my beach bag (and of course had a pomegranate fruit bar for breakfast). We had a nice chat with Ixchel when we got there, complimented her on the beautiful view her temple has and snapped some pics for future worship. Oh come on, you never know.

Acupuncture

I began acupuncture in November for my chronic jaw pain, but when I received my infertility diagnosis in January, Tammy, my Doctor of Traditional Chinese Medicine (DTCM) and acupuncturist starting focusing on fertility.

Tammy and I visit weekly and each week she focuses on different points depending on where I am in my cycle. For example, in my follicular phase (before ovulation), she does a point called "the conception vessel", points over my ovaries to help stimulate them and a point over my uterus to help with blood flow to my reproductive organs. Tammy also does balancing treatments during this phase, as well as a few kidney and spleen points.

In the luteal phase (after ovulation), Tammy focuses on points that boost my kidneys, liver and lately, spleen.

Basically, TCM believes that if there is an imbalance of energy in the body, then the body and its systems can't function properly.

As it turns out, I've had a luteal phase that is only 10 days long; most women don't vary too far from 14 days. Some OBGYNs and REs believe that anything less than 12 days is considered a a part of a luteal phase defect, while others believe anything less than 10 days is a deficiency. Either way, mine was not as long as it should be.

What does that mean and how does it affect fertility? The corpus luteum produces progesterone. Progesterone makes the lining of the uterus thick for implantation and is necessary to sustain a healthy pregnancy. The corpus luteum produces progesterone until the placenta begins to take over progesterone production around ten weeks gestation.

After a woman ovulates, the corpus luteum only lasts for about 12-14 days unless it begins receiving HCG (human chorionic gonadotropin) from a developing embryo. If the egg is not fertilized, the corpus luteum dies and progesterone production stops. When progesterone levels drop, the uterus lining stops thickening and is consequently shed during menstruation.

To sum up, if I conceive with a luteal phase defect, I will have an early miscarriage.

Thankful, since seeing Tammy, my luteal phase has gone from 10 days to 13 days! I have no idea if this development will make a difference, but I'll take it.

So if you have an anecdote, send it my way. As you can see, I'll try anything.

Saturday, March 20, 2010

In All Seriousness

I find the most overwhelming characteristic of infertility is how stressful it is. It's stressful because I don't know how long it will last. Because it's unexpected. Because it makes me feel different. It's stressful because it's physically demanding and emotionally taxing.

My prior posts make light of a situation that is anything but. After reading entries 1-3, Cyballs was reminded of how painful those weeks were. There really are no words that capture the despair that had suddenly become our reality.

In those early days, I spent a lot of time crying and very little time sleeping. On the days I managed to roll myself out of bed for work (and nothing more), I sulked around in a makeup-free-hair-in-a-pony-daze.

With indecision and uncertainty running rampant in my mind, Cyballs was there for me every single time, without judgement or expectation, holding the towel whenever I gave myself permission to lie in the shower until the water ran cold. He held my hand during testing and hugged me while I stared at the wall. Despite dealing with his own range of emotions, he was my rock and wanted nothing more than to make my pain disappear.

As it turns out, with acceptance, support and passage of time, it's become easier to cope. For example, I can (for the most part) talk about our infertility without crying. And for the first time since the diagnosis, I was able to be in the company of a beautiful baby (although when I got home, I cried myself to sleep in the middle of the afternoon). This is not to say it isn't just as painful, and some days are easier than others. But we're trying to remain optimistic and that's what's getting us through until we get answers - if we ever do.

The truth is we may never have the answers we seek. Unexplained Infertility accounts for 25-35% of major causes, and to date, all of our testing has come back normal (one more test - Laparoscopic surgery - before we are diagnosed with said cause and start Clomid.

All in all, it's not easy and the following guide best describes how I (we) feel, and how you, our family and friends can support us.

Guide for Family and Friends

You probably have difficulty understanding why getting pregnant has coloured virtually every aspect of her daily life. Brea hopes that by reading this booklet, written by psychologists with both personal and professional experience with infertility, you will better understand that pain she is feeling. This booklet also will tell you how you can help her.

SOME FACTS ABOUT INFERTILITY

It may surprise you to know that one out of six women who wants to have a baby cannot conceive. There are many possible reasons for this dismal statistic: blocked fallopian tubes, ovarian failure, hormonal imbalances, toxic exposure, to name a few.

All these barriers to pregnancy are physical and physiological, not psychological. Tubes don’t become blocked because a woman is “trying too hard” to get pregnant. Antibodies that kill sperm will not disappear if a woman simply relaxes.

WELL MEANING ADVICE

When someone we care about has a problem, it is natural to try to help. If there’s nothing specific we can do, we try to give helpful advice. Often we draw on our personal experiences or on anecdotes involving other people we know. Perhaps you recall a friend who had trouble getting pregnant until she and her husband went to a tropical island. So you suggest that Brea and her husband take a vacation too.

Brea appreciates your advice, but she cannot use it because of the physical nature of her problem. Not only can’t she use your advice, it upsets her greatly. Indeed, she’s probably inundated with this sort of advice at every turn. Imagine how frustrating it must be for her to hear about other couples who “magically” become pregnant on vacation. Your well-meaning advice is an attempt to transform an extremely complicated predicament into a simplistic little problem. By simplifying her problem in this manner you’ve diminished the validity of her emotions, making her feel psychologically undervalued. Naturally, she will feel angry or upset by this.

The truth is: There’s practically nothing concrete you can do to help Brea. The best help you can provide is to be understanding and supportive. It’s easier to be supportive if you can appreciate how being unable to have a baby can be such a devastating blow.

WHY NOT HAVING A BABY IS SO UPSETTING

Women are reared with the expectation that they will have a baby someday. They’ve thought about themselves in a motherhood role ever since they played with dolls. A woman may not even consider herself part of the adult world unless she is a parent.

Worse, Brea is not even certain that she will ever have a baby. One of the cruelest things you can do to a person is give them hope and then not come through. Modern medicine has created this double-edged sword. It offers hope where there previously was none – but at the price of slim odds.

WHAT MODERN MEDICINE HAS TO OFFER THE INFERTILE WOMAN

In the past decade, reproductive medicine has made major breakthroughs that enable women who in the past were unable to have children now to conceive. The use of drugs such as Humegon can increase the number and size of eggs a woman produces, thereby increasing her chances of fertilization. In vitro fertilization (IVF) techniques extract a woman’s eggs and mix them with sperm in a “test tube” and allow them to fertilize in a laboratory. The embryo can then be transferred back to the woman’s uterus. There are many other options as well.

Despite the hope these technologies offer, they are a hard row to hoe. Some high-tech procedures are offered at only a few places, which may force Brea to travel great distances. Even if the treatment is available locally, the patient must endure repeated doctor’s appointments, take daily injections, shuffle work and social schedules to accommodate various procedures, and lay out considerable sums of money. All of this is preceded by a battery of diagnostic tests that can be both embarrassing and painful.

Infertility is a highly personal medical condition, one that Brea may feel uncomfortable discussing with her employer. So she is faced with coming up with excuses whenever her treatment interferes with her job.

After every medical attempt, Brea must play a waiting game that is peppered with spurts of optimism and pessimism. It is an emotional roller coaster. While trying to cope with this emotional turmoil, she gets invited to a baby shower or christening, learns a friend or colleague is pregnant, or she reads about a one-day-old infant found abandoned in a dumpster. Can you try to imagine her envy, her rage over the inequities in life? Given that infertility permeates practically every facet of her existence, is it any wonder why she obsessed with her quest?

Every month, Brea wonders whether this will be it. If it isn’t, she wonders if she can muster the energy to try again. Will she be able to afford another procedure? How much longer will her husband continue to be supportive? Will she be forced to give up?

So when you speak with Brea, try to empathize with the burdens on her mind and on her heart. She knows you care about her, and she may need to talk with you about her ordeal. But she knows that there is nothing you can say or do to make her able to conceive. And the fears that you will offer a suggestion triggers even more despair.

WHAT YOU CAN DO

You can give her support and not criticize her for any steps she may be taking – such as not attending a shower or child’s party – to protect herself from emotional trauma. You can say something like this: “I care about you. After reading this booklet, I have a better idea about how hard this must be for you. I wish I could help. I’m here to listen to you and cry with you, if you feel like crying. I’m here to cheer you on when you feel as though there’s no hope. You can talk to me. I care.”

The most important thing to remember is that Brea is distraught and very worried. Listen to what she has to say, but do not judge. Do not belittle her feelings. Don’t try to promise everything will be okay – such as telling her “of course you’ll have a baby one day”. Don’t sell her on fatalism with statements like “Everything happens for a reason” or “What will be will be.” If that were truly the case, what’s the point of using medical technology to try to accomplish what nature cannot?

Your willingness to listen can be of great help. Infertile women feel cut off from other people. Your ability to listen and support her will help her handle the stress she’s experiencing. Her infertility is one of the most difficult situations she will ever have to deal with.

PROBLEM SITUATIONS

Just as an ordinary room can be an obstacle to a person who’s visually impaired, so can the everyday world be full of hazards for an infertile woman - hazards that do not exist for women with children.

She goes to her family’s house for Thanksgiving. Her cousin has a new baby. The men are watching sports while the women talk about their children. She feels left out to say the least.

Thanksgiving is an example of the many holidays that are particularly difficult for her. They mark the passage of time. She remembers what came to her mind last Thanksgiving – that next year, she would have a new son or daughter to show off to her family.

Each holiday presents its own unique burden to the infertile woman. Valentine’s Day reminds her of her romance, love, marriage – and the family she may never be able to create. Mother’s Day and Father’s Day? Their difficulties are obvious.

Mundane activities like a walk down the street or going to the shopping mall are packed with land mines. Seeing women pushing strollers strikes a raw nerve. While watching TV, Brea is bombarded by commercials for diapers, baby food, and early pregnancy tests.

At a party, someone asks how long she’s been married and whether she has any kids. She feels like running out of the room, but she can’t. If she talks about being infertility, she’s likely to get well-intentioned advice – just the thing she doesn’t need: “Just relax. Don’t worry. It will happen soon,” or “You’re lucky. I’ve had it with my kids. I wish I had your freedom.” These are the kinds of comments that make her want to crawl under the nearest sofa and die.

Escape into work can be impossible. Watching her dream shatter on a monthly basis, she can have difficulty investing energy into her career. All around, her co-workers are getting pregnant or talking about their children. Going to a baby shower is painful – but so is distancing herself.

THE BOTTOM LINE

Because she is infertile, life is extremely stressful for Brea. She is doing her best to cope. Please be understanding. Sometimes she will be depressed. Sometimes she will be angry or irritated. Sometimes she will be physically and emotionally exhausted. And sometimes she’ll put on a brave face, but her infertility will never be far from her mind. She’s may not be “the same old Brea” she used to be. She may not want to do many of the things she used to like to do.

She has no idea when, or if, her problem will be solved. She’s engaged in an emotionally and financially taxing venture with a low probability of success. Overall, only about one-third of people using special fertility treatments succeed in having a baby. The longer she perseveres, however, the greater her chances of pregnancy become.

Maybe someday she will be successful. Maybe someday she will give up and turn to adoption, or come to terms with living a childless life. At present, though, she has no idea what will happen. It’s all she can do to keep going from one day to the next. She does not know why this is her lot. Nobody does. All she knows is the horrible anguish that she lives with every day.

Please care about her. Please be sensitive to her situation. Give her your support - she needs it and wants it.

Friday, March 19, 2010

The First Test

My trip to NRGH for the Hysterosalpingogram (HSG) was the first test after having arrived on Infertility Island. And what a welcome I received!

Now if you're unfamiliar with the HSG procedure, firstly I'm envious and secondly, you're about to get the low-down.

WebMD defines said procedure as an "x-ray test that looks inside the uterus and fallopian tubes and the area around them."

Sounds routine, right? Oh so very wrong. What "they" fail to mention is how the procedure is performed.

And with this post goes what is left of my dignity...

The gist:
1) Lie on table with my feet in stirrups
2) Curved speculum placed into "lady parts"
3) The nurse (gently) holds knees apart
4) Dr. H. attaches a clamp to cervix and cleans it with a special soap
5) Evil doctor inserts a catheter through cervix and into uterus
6) Cervix dilates, cramping begins
7) Cramping worsens
8) Dye is injected into uterus
9) Worst. Cramping. Ever.
10) Nurse tells me to watch the overhead monitor
11) I think, there's a fucking tube coming out of my uterus, not so interested in watching the monitor
12)Dye fills my hoohaahooterus* and spills out into my abdominal cavity
13)Forget what #9 said, this is WORST CRAMPING IN THE HISTORY OF CRAMPS.
14) Diagnosing doctor calls out from behind the partition, "right's (fallopian tube) clear
15) Silence
16) Breath holding
17) "Left's clear"
18) Breathe out, it's finished and there weren't any blockages, abnormalities, polyps, fibroids or adhesions.

PART 2

1) Remember those cramps? Yup, still there and still as intense
2) Recover on exam table
3) Decide to try to get dressed
4) Pass out
5) Wake up on guerny surrounded by nurses
6) Get wheeled into a recovery room
7) Cramps
8) Throw up in hair and all over hospital gown
9) Cramps
10) Spinning room
11) Throw up in a tray
12) Cramps
13) Try to drink some juice and eat some crackers
14) After a couple hours, begin to feel better
15) Decide to try to get dressed again
16) Have nurse locate my missing underwear??
17) Success! I'm dressed and still standing!
18) Leave hospital
19) Slip on a muddy area of the lawn and slide down the little hill
20) Cy helps me up and into the car
21) Cry

And I thought I'd go out for breakfast after everything was all said and done.

* Hoohaahooterus is a term coined by Lollipop Goldenstein, author of the blog Stirrup Queens (see blog roll). She defines it as: a collective names for all one's sexual organs.

Wednesday, March 17, 2010

Ready or Not

My intial visit with Dr. H. was overwhelming to say the least, but the doc was calm, concise and optimistic. He laid out the plan of attack for the next 6 months:

1) Hysterosalpingogram (HSG)

2) Semen Analysis

3) Luteal Phase progestrone (P4) blood work

4) Day 3 Estradiol (E2) and FSH levels

5) Laparoscopic Surgery

Now then, after #5 is complete, and assuming they don't find or can't fix something they may encounter, I'll begin taking the fertility drug, CLOMID. If after 6 CLOMID cycles there is no resulting pregnancy, we'll be sent to a fertility clinic to begin discussing Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF)

Sound overwhelming? Tell me about it.

So many things were running though my mind. Do I want the docs to find something and hope they can fix it? What if they can't fix it? Am I strong enough to face what IUI and/or IVF treatments entail? Can we afford $8000+ per IVF cycle? Do we want to consider adoption? Egg donation? Sperm donors? Surrogacy? What if they don't find anything at all? Does that mean nothing's wrong? Or will I be diagnosed with Unexplained Infertility?

I'm not ready for this. I don't want to think about it. I don't want to make decisions. I don't want to go through the invasive, embarassing procedures. I don't want to explain what's going on to family and friends. I don't want to deal with people asking me if we have children or if we're trying. I don't want to see pregnant women. I don't want to be around children. I don't want to see happy families. What I want is a break from my mind. But if I want a chance to have children, I really don't have a choice.

Monday, March 1, 2010

Getting IT Out There

There comes a time for all of us when people start asking the big question: "So when are you going to start having kids?" I'm fairly certain each of us at some point in our adult lives has experienced this question from family, friends and people who just want to know your business. For me, I was inundated with this question when me and Cyballs made it legal. And at the time, we practically sang "no way, not right now".


Oh how carefree (and unassuming) we were.


We happily went about out married life, enjoying being newlywed and head-over-heals in love with each other, life and the hope for things to come.


Fast forward to November 2009...My doctor had some concerns with some of the "things" I was putting out there during our conversation. I ended up leaving that day with a referral to an OBGYN and not a worry in my mind. And why should I? I felt fine. Cyballs and I weren't trying to conceive (TTC). Things were a-okay as far as I was concerned, but I obliged Dr. O.'s concern.


Now in hopes of maintaining at least some of my dignity, I'll keep the details to a minimum. January 5, 2010 went a little something like this:


Me: Yay I get to sleep in a bit today!

get ready, have breakfast, talk to dad before his surgery, drive to meet Dr. H., read my fabulous book in the waiting room


Dr.H. - I have a referral from Dr. O., can you tell me more about why you're here?


Me: Well Dr. O. was concerned with some of the things I was telling him during my checkup. I proceed to provide the details.


Dr.H. - Hmm. Well. The definition of Infertility is...Launches into the world of infertility


Me: Oh


Dr.H. - Gives me more information on infertility


Me: Oh


Dr. H - Begins to outline the plan of attack


Me: Oh.


As it turns out, once I got all those "Ohs" out of my system, I did end up asking some questions. A lot of them in fact, since a 20 minute appointment turned into a solid 45.



At the end of the appointment, I left with a date for a visit at the hospital for a Hysterosalpingogram (which earns an entirely separate blog post), a requisite for blood work, a copy of surgery instructions for a to-be-determined date, a connection with a sympathetic-eyed (empathetic perhaps?) nurse and a concerned yet hopeful doctor.


Yes, I make light of it now, but the mood and my heart were anything but in that moment and the weeks that were to follow.


As I sank into the car to call Cyballs, my head began to throb and Dr. H.'s unwelcomed words made themselves at home in my spinning mind.


Primary Infertility. Two little words that have instantly changed our lives...