Wednesday, October 31, 2012

Should we tell?

As my treatment draws closer, I’m increasingly preoccupied with whether or not to tell people about our infertility.  My mom and my best friend know details, and Henry told his boss why he’s had so many doctors’ appointments lately, but that’s it so far.  Henry is in favor of giving more people an idea of what’s going on, but I’m feeling more secretive.  Here are our arguments:

For telling:

It’ll make work easier.  This is why Henry already told his boss (which I was ok with).  My work is more flexible – I can disappear for an hour here or there without anyone noticing – but once I’m into treatment and my appointments are dictated by my body rather than the calendar it’s going to get harder.  I can only refer to sketchy “medical issues” for so long; my boss is pretty understanding, but “I’ll need off work next Wednesday… or maybe Friday…. for a, um, medical thing” is pushing it.

It’ll make our relationships easier.  A few days after my HSG, Henry and I went to a housewarming party.  It was only when we were walking up to the door and saw others with gifts that I realized that we didn’t bring anything.  Our friends didn’t care, but I felt awful. I see this kind of thing becoming common as we get caught up in treatments; Henry and I are both introverts, so we tend to retreat into our own little world.  It would be nice if our friends knew why.

It’ll give people the opportunity to support us, or at least to not say anything stupid.  If a friend was going through this, I’d want to know.  And although we are lucky to have extraordinarily polite friends and family who don’t really pry about our reproductive plans, the wrong question at the wrong time could be really depressing for me and embarrassing for the asker.

We can control the message.  Henry imagines saying something like, “We need a little help to get pregnant, but we have a great doctor and great insurance so it’ll all work out fine. Now, how about those Ravens?”  That doesn’t sound too scary.

There shouldn’t be a stigma.  One in eight couples will struggle with this, but given our age we’re probably the first in our peer group (or are we?).  We have the opportunity to put a face on the issue, answer any questions people have, and be a resource for others who might face something similar down the road.  It could be a really powerful thing.


Against Telling:

Woman in the workplace issues.  I don’t want my boss to think that my infertility is preventing me from doing my job, and I don’t want her to have my possible pregnancy on her mind when it could be years before we have a kid.  I said something about us trying for a baby a while ago, and now I regret it; I don’t want to regret telling her this.

I don’t want to keep anyone updated.  Right now, visits with friends and family are wonderful little vacations from thinking about fertility issues; once we tell, vacation’s over.  Plus, what if I get bad news?  Do I really want to feel obligated to tell people?  How many sympathetic head tilts can I take?

It’s private. The only three people I want thinking about my fallopian tubes are me, my husband, and my doctor.  Making things worse, the specific type of infertility I have is most often cause by pelvic inflammatory disease, which is most often caused by an STD.  Based on my sexual history it’s very unlikely that this is the cause in my case, but anyone who decides to look up my condition is going to read the word chlamydia.  Great.

It’s awkward.  Since most people aren’t constantly asking when we’re going to get knocked up, we’d have to be the ones to broach the subject. How would we do it? “Sorry I forgot your housewarming present, but I’m infertile”? Talk about your non sequitur.

I want to feel normal.  I want to get pregnant, not pregnant* (*through IVF).  One of the weird perks of my specific condition is that things are moving really fast, and there’s a decent chance I’ll be pregnant within a few months.  If no one ever suspects we had a problem, that’s fine by me.

Did I miss anything?

Monday, October 29, 2012

My HSG: Part 1

My first RE appointment was a whirlwind.  I happened to come in on cycle day three, so rather than a casual discussion of my medical history we jumped right into blood work and ultrasounds. By the end of the morning, my brain was so full that I could hardly remember the time and date of my HSG appointment; all other details were lost. There was something about a pregnancy test beforehand, and getting blood drawn for my genetic test that same day? It was a haze. 

A week later I am starting to worry about my memory lapses when the hospital calls to confirm my appointment. “Do you know where to go?” the voice on the other end asks. “Um, you might want to remind me,” I answer. He gives me directions that don’t sound familiar, but I take notes anyway.

The next day I’m standing in the hospital parking lot trying to decide where to go: to the hospital front desk, like the guy on the phone said, or to the fertility center, as I vaguely remember being told.  As I usually do in these situations, I think about my potential to look like an idiot: if I go to the fertility center and am wrong, I risk looking dumb in front of people who I am counting on to be invested in me reproducing.  Do I want them thinking I have stupid, can’t-follow-directions genes? If I go to the hospital front desk and am wrong, I’ll be wrong in front of people I’ll probably never see again.

“Am I in the right place?” I ask the woman at the front desk. “Yup!” she answers. Score!

I am handed off to a young male nurse who is more concerned with being cool than being clear as he leads me to the radiology dressing room. I am flattered - he seems to be trying to impress me with his nonchalance about what I am supposed to do with my street clothes once I've changed into the hospital gown (the answer, in case you’re wondering, is to put them in a yellow “patient belongings” bag and carry them to the exam room like a bag lady).  I do, however, appreciate his tip about wearing two hospital gowns, one forward, one backward.

Going over the consent forms, I think Mr. Cool suppresses a giggle when he asks me the first day of my last period. That reminds me – what about that pregnancy test? I’m not about to ask frat boy here, so I assume the questions about periods are sufficient and open the book I've brought along; inside I may be nervous, but I’m going to look calm and mature goddammit.

Thankfully, the shift changes and nurse dude is replaced by a competent-seeming middle-aged woman.  The doctor is running behind, so I take the opportunity to ask about my genetic screening.

“Do you know where I’m supposed to go to get blood for this drawn?” I ask, holding up my screening kit.
“Oh, they didn’t take it when you were signing your paperwork at the center?”
“Um, I didn’t go to the center.  The guy on the phone told me to come straight here.”
“I think you’re supposed to go to the center first. Let me check and see what you should do.”

Five minutes pass, during which I calm my nerves by contemplating whether my hospital gown is better complimented by bare feet or my multicolored TOMS.

“You’re going to have to go back to the center.  They have some paperwork for you to sign and you need to take a pregnancy test.”  Shit.  It’s now twenty minutes past my appointment time, and I can feel the Advil I took to prevent cramping wearing off.  I get dressed and practically run to the fertility center.

My stress disturbs the center’s tranquil atmosphere, and I get the side eye from the desk attendant when I admit my mistake.  I smile sheepishly; hopefully my contrite genes will make up for my can’t-follow-directions genes.  I quickly scribble my name on some paperwork and pee in a cup.

Once my hopes for a surprise positive have been dashed, I’m cleared to go back to radiology.  “And my genetic test?”  “Well, the FedEx guy is supposed to come at noon but he hasn’t come yet.  If he still hasn’t come when you’re done, we can take it today. Otherwise you’ll have to come back.” It’s now 3. Craaap. “Okay.”

I run back to the radiology dressing room and I’m changed in no time.  It’s only when I walk back into the empty hallway that I realize I have no idea where to go next.  I freeze.

I have on two hospital gowns, my TOMS look like something a mental patient would wear, there’s a sheen of sweat on my forehead, and I’m holding a crumpled bag lady bag with my clothes stuffed inside. I don’t look like someone who should be allowed around children, much less have my own.

I am halfway between laughing and crying when an impeccably coiffed woman in a lab coat clicks down the hallway.  “Hi, um, I’m Chelsea... I, um, went to the wrong place, but I’m back,” I explain meekly.

“Oh yes, I’m Wendee.  I’ll be doing your HSG.  Come on back.”

Here we go.

Read part two here.

Sunday, October 28, 2012

Impending Hurricane

Here in Baltimore, everyone is anticipating Hurricane Sandy’s arrival tomorrow.  We’ve gathered our bottles of water, extra batteries, and non-perishable food items.  We have candles and flashlights and books and booze.  The patio furniture is secure, the Halloween decorations are back inside. The only thing to do is wait.

I haven’t been officially diagnosed with anything yet; my only appointment with my doctor to date has been the preliminary one. He ordered a series of tests and we said we’d meet again once they were done. My disastrous HSG was performed by my clinic’s physician’s assistant and Google led me from her words to my self-diagnosis and probable treatment. My nurse confirmed my fears over the phone, told me to prepare for the worst. But the words haven’t passed my doctor’s lips yet.

I know this hurricane’s projected path; all the models agree. But we won’t know the extent of the damage until it hits.  The only thing to do is wait, and prepare for the worst.

Friday, October 26, 2012

Overachieving at Being Infertile

I’ve always been an overachiever. I was the valedictorian of my high school, I took extra college classes for fun, and I hand made an unhealthy amount of stuff for my wedding. 

So, when Henry* and I set the date for when we would “start trying” (a full year in advance), it was only natural that I turn my obsessiveness to conception.  I immediately checked Taking Charge of Your Fertility out of my public library.  Once I had a handle on my cervical mucus, I followed it with How to Choose the Sex of Your Baby (because, why the hell not?).  I started reading pregnancy and parenting blogs.  I developed opinions on breastfeeding, natural birth, free range kids. 

Six months before T-day, I threw out my birth control pills and replaced them with prenatal vitamins.  In addition to my vibrator, my bedside table now held a purple folder with my Xeroxed charts, a basal body thermometer, and my very own copy of Taking Charge. My plan was to learn about my body by charting to avoid pregnancy, and then flip the switch and get pregnant right away.  I Googled “preconception” and went to my doctor for a physical for the first time since high school sports. I memorized information from Babycenter and started bookmarking cute crib bedding.  My charts looked perfect.  I did a great job of not getting pregnant. 

We started trying in April 2012.  When it didn’t happen the first month, that was ok.  A January baby would have been a little too close to the holidays for comfort.  When it didn’t happen after three months, I started to worry.  I knew the stats; 60% of people conceive in the first three months by simply throwing their birth control away.  We had good timing, how was I behind 60% of people? Toni said to get yourself checked out if you had well-timed sex for “more than a few months” without luck.  I made an appointment for September. 

After month four I broke down crying in front of my mom.  After month five I broke down crying in front of a sweet OB/GYN who told me I was probably fine, but gave me the number of the reproductive endocrinologist she had used to get pregnant.  Three days after I learned that cycle six was officially a failure, I was in his office with an ultrasound wand in my lady parts while my skeeved out husband looked on. 

My ovaries were fine; my blood work was fine.  Then came my HSG. My HSG is a post for another day, but rest assured that I am an overachiever at being infertile.  Go straight to IVF; do not pass go, do not collect two hundred dollars. 

This blog will be about my whirlwind tour of reproductive medicine.  It’s been less than three weeks since that first RE appointment, and this ride shows no signs of slowing down. I hope our happy ending comes just as fast. 

*Not his real name.