Will not attend

I think it’s surprisingly difficult for people to understand how hard it is for those of us struggling with infertility to attend events and gatherings. The crushing feeling of a birth announcement. The dread of declining an invitation to a baby shower. The feeling of sadness I already have in relation to Easter brunch… happy families, little girls with their hair braided and in bows, herds of strollers parked by full tables, baby boys holding small colored eggs. All the grief just gurgles to the surface.

I suffer just walking down the street or going to the grocery store. And it’s been almost 3 years of this. Get-togethers that I used to cherish have become fundamentally and crucially painful but it’s always juxtaposed against declining and having everyone wonder why/take it personally/stop inviting us to things altogether.

Every year, for the past 16 years, my girlfriends and I gather to make holiday cookies. It’s one of the most longstanding traditions in my life. Living abroad for the past 5+ years, it is a tradition that I have always looked forward to, a chance to see friends, reconnect, and laugh at the familiar antics of a bunch of grown women doing what they have done since they were 15. But this past year stabbed me like dagger. It’s no one’s fault. In fact, it’s to be expected. The tradition of cocktails and sugar cookies, gossip and catchups, has turned into a family affair. Toddlers waddling around the kitchen. My friends’ daughters playing with Christmas presents or sitting in their mom’s laps while they help roll out floury dough. Talk of high school hookups has transformed to cry-it-out sleep techniques and complaints of being tired with two kids in the house. What I would do to be sleep deprived because of two kids in the house…  I sat at an all too familiar table, both metaphorically and physically, a table that reminded me I’m the only one barren amongst friends, the only one without a child to climb up on my lap and help me roll dough, the only one without something or more appropriately someone to talk on and on about. Instead, I’m left with a broken heart and that same feeling of emptiness creeping up from my stomach. So I went upstairs and cried.

The difficulty is in the balance. This event was different in that I was unprepared. It was the first year our cookie-making seemed to revolve around our, or wait, their, children. So the question becomes, when we do know that there will be babies and children aplenty, when do know that conversation will be dominated by diapers and child rearing complaints, when we do know that there is a good chance the situation will push us to that very specific place of acute sadness – do we go? Do we submit ourselves to it anyway? After all, the reminders are everywhere – diaper commercials, pregnancy test ads, playgrounds I drive by, satan’s gift of social media… what’s one more painful situation? Just add it to the list. Because the fear is we will begin to be shunned. We don’t have kids to begin with so that eliminates us from certain events anyway. If we turn down every invitation or become a bumbling, crying mess at everything we do attend, surely friends will stop inviting us anyway. Not out of meanness. They think they are doing us a favor, saving us from… ourselves.

However, I remain adamant that it has a lot to do with other people’s behavior in these social situations. Have a heart. Be a little more understanding. You NEVER KNOW what other people are going through.

Of course pulling up a pack of strollers and jovial chit chat over preschool can’t always be helped. But there’s a difference between that and droning on about how annoyed you are with your nanny, how tough it’s been going back to work part-time while your parents watch the baby, how much of a mess the house is… It’s hard to listen to. The mindless complaining. Because we’d give anything to be in your shoes. I’d cut my veins open (more than I already have) just to suffer some sleep deprivation and drop my baby off at my parents’ house before heading off to work. I would literally draw blood. Be thankful for all those petty things that seem complain-worthy. You don’t know who’s sitting next to you listening.

But culture doesn’t change in a day. It takes time for people to learn certain sensitivities. It takes time to stop and think before speaking. It takes time to learn thoughtful compassion. So here’s the question: In the meantime, while society is still getting to grips with our pain and how painful these situations can be, do we venture out? Do we submit ourselves to it? Do we risk the heartache because it’s better than isolation? Or, is isolation more comforting in actuality?

I give major props to ladies in this community who make it to baby showers. You are my golden idols. Maybe it’s because it’s been so long. Maybe it’s because I now know I will NEVER be carrying my own child and celebrated at a shower in the same way, cooing after me, admiring my glorious bump. I’ll never have that. So maybe that’s what causes me to draw a line in the sand, a long, long line. We’re all different. We all have different capabilities and strengths. But my feeling is that I have suffered enough. I don’t want to spend more hours crying in a locked bathroom. I don’t want to needlessly expose myself to more gut-wrenching envy that often, because of who I am, turns into anger. “Why the (fill in the blank) are you complaining about your pregnancy bloat and having to drop you kids off at daycare twice a week?? Do you know how lucky you are???

So my decision is this, to be selfish. Because it’s about self preservation in the end. It’s about surviving. I’ve been through enough so I don’t need to put myself through any more than is necessary. I already know I won’t be attending cookie making next year. I just can’t hack it. And the handful of other events that I know I could put a brave face on for… well, I’m going to stay home and drink a glass (bottle) of sulfite-free wine instead. Survival means making tough choices. And in these situations, I choose myself.

 

Turmeric – Miracle Spice

I know that my diet played a huge part in curing the adenomyosis flare up I was suffering from two weeks ago. Making such drastic changes to what I put into my body is, logically, what is going to have the biggest effect on combating any ailment (I don’t care what western doctors say.) Food and drink are the most important medicines we buy. But along with cutting out the gluten, sugar, dairy, chemically enhanced, genetically modified ANYTHING, there are other remedies I’ve implemented that must be playing their part as well. My doctor was so shocked at how much my adeno had shrunk at my last ultrasound that she asked me what I did… I must say, I was fairly flattered at the thought of a doctor asking me my advice. Of course, I was also still reeling with the shock that I hadn’t formed any cysts after almost two weeks on estrogen and that I had nearly healthy looking follicles growing. Usually I’m luck to have a handful all together. So this was flabbergasting. Let’s think positive that this bodes well for our 3rd retrieval.

I told her that I went back on my strict anti-inflammatory diet which I’ve outlined previously in other posts. The gist of it is that you aren’t putting anything into your body which isn’t nourishing you. Absolutely nothing that can cause inflammation like dairy, gluten and sulfites. Death by…. well, wine cheese and chocolate evidently. I’d probably die happy though. Just sayin’.

Besides the diet and gulping down gallons of water per day, I went back to two trusty and natural inflammation fighting supplements –  turmeric and ginger. Ginger I find easy to incorporate into my diet. I use it in stir fries. I actually love ginger tea. Ginger ale I find delicious. I even put raw ginger in my bath with epsom salts to detoxify and anti inflame. Turmeric was a little more questionable to me. I had never really cooked with it before and it’s far less common to come by. It actually looks a lot like ginger in its natural root form. If you can get the root, this is ideal. You can shave it up and put it into smoothies, curries and pour hot water over it for a feisty inflammation fighting tea. You can do the same with the powder form found in the spice aisle but it’s not nearly as potent. I found a great tea at Whole Foods that I’ve posted on my Instagram account that’s composed of ginger, turmeric and cinnamon. It is utterly delicious. To me, it’s the closest to a cookie I’m going to get until after retrieval. Sad, I know.

I was drinking that tea twice a day, every day, between my first “uh oh” ultrasound where my adeno flare up was detected and my last “wow” ultrasound where it could hardly be seen. I feel adamant it played a part. Turmeric, like so many other natural remedies is highly underestimated in its medicinal properties. But you can’t really argue with facts. Well, you can. I actually often do. But in this case it seems illogical to. Turmeric comes from the root of the Curcuma Longa plant. It is incredibly vibrant in color… and pigment… I’ve stained multiple towels and shirts. No wonder it’s used as a clothing and paper dye in India. Part of the ginger family, turmeric has been used for hundreds of years in Eastern Medicine. Historically, it was most commonly prescribed for stomach ulcers and indigestion. The active compound in turmeric, curcumin, is a powerful antioxidant that fights free radicals in the body, prevents blood clots and lowers the levels of enzymes that cause inflammation. What’s not to like, ay?

More recently, studies have proven turmeric to alleviate a range of horrible diseases including Alzheimers, arthritis, heart disease, viral infection and even cancer. I’d also like to add infertility, and more specifically, adenomyosis and endometriosis to the list.

My acupuncturist gave me a strong turmeric supplement before my last transfer and although it was another BFN, it had a serious effect on reducing my inflammation and getting my uterus in the best condition it’s ever been in. I was taking the liquid supplement once a day and it’s 95% curcuminoids – that’s some potent stuff. But it did the trick and doesn’t taste at all horrible. Oh yeah, I should have mentioned that. Turmeric on its own isn’t exactly pleasant, to me at least. It’s peppery and smokey and smells like you poured Indian food over a camp fire and let it smolder. But that’s why the trick is to mix it into things or get a high quality supplement like mine. Then you don’t even taste it.

It still baffles me that when we ask our endocrinologists, “what else can I do?”, they respond with more synthesized drugs, higher dosages, or of course my favorite — nothing. But there is SO much more we can do. We can control everything we put into our bodies and everything we put near our bodies. I stink right now. Seriously. As I’m writing this. I just got back from a run and I’ve stopped using anything but natural aluminum-free deodorant. Yup, no antiperspirant for me. It’s fairly tragic for the people around me. I realize this. But it’s something I can do. And I sure as hell don’t want aluminum in my precious eggs.

My adeno is tiny. My endo is quiet. My uterus has gone back to its normal shape. I have 20 healthy looking follicles. Thank you turmeric. Thank you.

 

 

Day to Day

Life is tough enough. Life is tough enough before you add infertility to the mix. By nature, I’m not an optimistic person anyway. I like to refer to myself as a realist. Imagine my dismay when we started this journey and everyone told me to just, “think positive and it would all work out.” At least at some very juvenile level, when it all didn’t work out, and we find ourselves still battling my diseases with no pregnancy to speak of, 2.5 years later, I can whisper under my breath, told ya so. But it’s not the kind of thing you want to be right about.

The day to day for someone battling infertility is different. For instance, I started my morning with 8 pills. No big deal. But a hassle all the same. I’m lucky in the fact that I don’t mind swallowing tablets. I know some women who just can’t and are forced to eat mouthfulls of gummy vitamins to get all the supplementation they need. Tonight I’ll be taking 6 more pills before bed. Goodnight and swallow this.

Next week, once I start my 3rd IVF cycle, I’ll transition to pills plus the added joy of stimulation injections. Been down that road before. I think anyone can see how stabbing yourself in the stomach 3-5 times a night turns into a hell of a lot more than a hassle. As if the physical aspect wasn’t bad enough, the pinching, the bruising, the bleeding, the NEEDLES, there’s the mental side of things. Am I measuring out my medication right? Is this the proper way to mix it? Did I contaminate my syringe when I wiped with that pre opened alcohol swab? Did they send me the right amount of meds? Is this bill right??? Probably. Your bill is probably right. Did you almost fall out of your chair? Then it’s probably right.

So, you’ve taken your vitamins and you’ve got your medication ready. The rest of the day is smooth sailing then, right? Wrong. If there is one ailment that conjures an obsession unparalleled, it’s infertility. But this isn’t us being irrational, though I know at times I can be. It’s more due to the fact that this process is all consuming. Meds are in order. Check. Now it’s time for breakfast. Well, I can’t have starch, gluten, caffeine, nightshade vegetables, dairy, processed meats, or sugar… i.e. I can’t eat cereal, milk, yogurt, toast, butter, jam, an omelet with anything normal in it, delicious sugary cured bacon, or a bagel. Yup, I’ll be having a protein shake. Again. The funny thing is that when my acupuncturist put me on this diet for my endometriosis and adenomyosis, she stapled the foods I can eat on top of the foods I can’t eat because she said that would be “psychologically easier.” Not really. I just look at all food I want to eat and flip to the second page to see I can’t actually eat it.

Once I finish my breakfast it’s time for fertility admin. This means confirming and reconfirming doctors’ appointments. For me, booking travel back and forth to California for treatment as there are no IVF services where we currently live. Then I check bank accounts. There is payment on its way to our surrogacy agency and the only way I could get it to them from here is by ordering a “bill pay” service which meant my bank taking 2-3 days to write a check and 5 days to send the darn thing to them. Nope, still not there. Can’t forget the IRS. Never forget the IRS. There are some receipts in my wallet that I need to add to my IVF folder for tax filing. I’ve booked my acupuncture for the start of this cycle so now I just need to get together the $500 that it’s going to cost. Too bad money doesn’t grown on trees. It’s really too bad. I wanted to go for a run later but know the fumes from running alongside the road are bad for my eggs and I don’t need anything else not working in our favor. Cutting out toxins doesn’t just mean not sucking in the fumes of bleach when you clean the bathroom…. It means no plastic due to BPA. Don’t even think about microwaving that tupperware’d lunch! Natural cleaning products. Coconut oil instead of lotion. Can’t paint the spot in our ceiling where they had to punch a hole through because of a leak. Oh, and what glass of water am I on today… drink drink drink.

Fast forward through call backs from doctors’ offices, lunch composed of spinach leaves, the development that if I have formed a cyst on either of my ovaries due to the estrogen that THEY put me on then this cycle will be cancelled (must confirm that appointment), and it’s dinner time. Tonight my husband and I are meeting friends at a Japanese restaurant. No sushi for me. No rice for me. No soy for me. This leaves me with something called a “Yoshi’s Salad.” Basically, lettuce leaves, shredded carrot and avocado. Hey, I’m thankful for the avocado. Tremendously.

6 more pills before bed. And when I say bed, I don’t mean sleep. I will lie awake in bed googling vigorously for at least an hour and a half. What supplements can I take while stimming? How many days did you stim? What was your dose of follistim? How much overfill is there? Which stool softener did you use after egg retrieval? How did you avoid hyper-stimulation? What else can I do to better my egg quality? What should I be feeding my husband to better his sperm quality? After I’ve dizzied myself into the oblivion that is answers which only lead to more questions, I eventually fall asleep.

Here’s the kicker. All of the above doesn’t even include the norm. The stuff we have to do every day as part of our routine, as part of life. It doesn’t include work. It doesn’t include family. It doesn’t include regular medical checkups like the dentist and the dermatologist appointment I need to schedule. It doesn’t include grocery shopping, water bill paying, and rent. Let’s be honest, it doesn’t include what actually constitutes day to day life.

So when we feel that our disease is taking over, it’s because it probably is. So fight back. Look for the joy in the small things and remember what makes you YOU. Before needles and bills and surgeries, she’s still there. Get that sh*t done and dig her out.

 

Coping with Endometriosis & Adenomyosis

What does it feel like? Well, this morning it felt like a dull ache shooting down from the middle of my back to my left ovary and back up again, on repetition, until the painkillers numbed me just enough for it to transition to a constant stinging sensation on my west side.

I didn’t want to take any painkillers for the sake of my precious eggs that will be retrieved in a few weeks but the flare up over the last couple days has turned out to be more than I can bear without a little help.

The upside is that the reason for the flare up is that I got my period. This will mark my first non-IVF induced period in over a year and a half. I don’t ovulate and I don’t get my period. So the pain is a marker of something positive. That’s my version of looking on the bright side.

The first time I experienced a flare up, I was in high school. Chem class. The worst. (The class and the flare up.) I was sweating profusely and in such excruciating pain that I nearly fainted. That was the beginning of horse tranquilizers and birth control, which tamed the beast until we started this journey of TTC. Once the birth control was removed from the equation (no chem pun intended), the pain was back with a fury. When I went through my initial screening to begin IVF, the endo/adeno flared up, in revolt I believe, so badly that my husband had to come find me curled in a ball on the floor of a local grocery store, rocking myself back and forth on the cool tiles, crying. Now look, I may not have the highest threshold for pain but I’m no wimp. I tore the ligament in my right knee nearly in half playing soccer. I fell out of multiple trees as a kid (tomboy.) I got hit by a truck while cycling to work. And hey, that wasn’t even the bad bit because the adrenalin sets in. The bad bit was changing the bandages on my gravel stuffed wounds weeks later. See, I’m actually pretty tough.

What that means is that even someone tough is at the total mercy of these diseases. The pain is so horrific that it cripples you. This is not an exaggeration. I’ve heard people say, “I get bad cramps too.” I mean, I literally just laughed. I would kill for cramps. This is not cramps. This is some little monster who has dug himself into the innermost crevices of my body and is grating against those crevices with a cheese grater. And how do our bodies cope with this? Sweating. Nausea. Gagging. Dizziness. Headaches. Change in heart rate. Bloating. Sore muscles. The list goes on. These are just a few of the side effects. I suppose the most predominant, that needs to be mentioned, is infertility.

So what are these diseases, actually? Endometriosis is a condition where the tissue that forms the lining of the uterus grows outside of the uterus, onto and into other body parts. Adenomyosis occurs when the endometrial tissue that should be forming that same uterine lining, grows into the muscle of the uterus. During my last ultrasound, my adeno was so inflamed that it had completely mutated the shape of my uterine wall. Nice.

Basically, when these diseases flare up, the endometrial lesions formed by the diseases, which are a lot like sticky blisters, are rubbing, bleeding, releasing fluid and just generally getting angry within our bodies. This can lead to tons of scar tissue and body parts even fusing together. So with every movement, any slight jostle, or swallowing of water, or breath taken, these exacerbated blisters are growing, spreading and becoming more inflamed. Can’t put a bandaid on those suckers either. A lot of them are attached to bowels and bladders, places you just can’t get to in order to relieve the pain. For me, it hurts every time I use the bathroom. I trained myself for many years to think this was normal. It’s not.

Here’s the cherry on top – there is no known cure for either endometriosis or adenomyosis.

If you know me however, I’m not the type of person who takes no for an answer. During my last FET cycle, my adeno was also inflamed and growing right through the center of my uterus, almost definitely effecting my uterine lining and thus, embryo implantation. I couldn’t sit back and let this happen. So I did everything. I changed my diet to an anti-inflammatory one (which I have talked about in other posts) but the main regiment consisted of no dairy, no sugar, no carbs, no nightshade vegetables, no alcohol that contains sulfites, no caffeine. I placed hot castor oil packs on my abdomen every other night. I took a turmeric supplement. I drank gallons of ginger tea. I practiced hot yoga. When I could, I jogged. I submitted myself to acupuncture. And I cured myself. Well, for that time-being. I shrunk my adeno and I didn’t feel horrific (physical) pain when my period came following my BFN.

I guess the lesson is that although there is no cure for these horrible diseases, they can be managed through natural remedies, and probably most prolifically, through what we eat and drink. To me, these treatments, though frustrating (have I mentioned again recently how much I miss bread) are a lot better than invasive surgeries, which, can only temporarily remedy the problem anyway.

I did admit that I had to pop a few painkillers over the last week to survive. I didn’t want to but I didn’t want to be bed ridden either. I’m back on my natural remedies and the pain was still so bad yesterday that I had to sit in a lukewarm bath for an hour just to keep myself from screaming.

Ultimately, I believe that we need to do what we need to do to survive. And if that’s 2 Motrin, so be it. If it’s a hot water bottle and enough ginger to start a natural soda company, good for you. You are the one suffering. You are the one who knows best.

 

Paleo Chocolate Cake in a Mug

The fortunate (or maybe unfortunate) thing about this recipe is how gosh darn simple it is.

Ingredients: microwavable mug, 2 tbsp cacao powder, walnuts, 3 tbsp honey, 1/8 tsp baking soda, 1 egg, 3 tbsp vanilla almond milk, 1 tbsp coconut oil, 3 tbsp almond milk, 1/4 cup coconut flour, cinnamon, pinch of salt to taste

1. Mix all ingredients except walnuts in the mug
2. Optional: Top with handful of walnuts, dollop of honey and sprinkling of cinnamon
3. Microwave 2 minutes (careful when removing as the mug will be very hot)

Cleansing Broccoli Soup

 

Again, an Instagram request, here’s my no nonsense recipe for inflammation fighting, detoxifying, Paleo, Whole 30 friendly, soup. No, it’s not a cup of water.

Ingredients: 2 heads of broccoli chopped, box of organic chicken stock, cup of baby carrots, half a cup of spring onion (green part only), cup of roughly chopped celery, tsp white pepper, tsp dried basil, tbsp turmeric, tsp ginger, salt and black pepper to taste

1. Throw all ingredients in slow cooker
2. Cook on high for 3-4 hours
3. Blend with an immersion blender
4. Serve with cracked black pepper, mixed seeds for crunch and a swirl of coconut cream

That’s it! Enjoy!

We Didn’t Choose Surrogacy

Surrogacy chose us.

When every RE you speak to whispers the word as if it’s he who must not be named, you know it’s your only choice. And trust me, it was a death within itself. To be told in the utterance of a single word that you will never grow a beautiful bump, you will never feel your own child kick inside your belly, her heartbeat resonating against your own flesh and blood, never wear maternity clothes, never get smiles from strangers because you’re expecting, never have your husband rest his cheek against your stomach in anticipation – talking to your belly, never waddle around the house eating pickles (organic) and ice-cream (coconut dream), to know I will never carry that child next to my own heart as she listens to the sound of her mother’s voice, that she will never hear that maternal hum and we will never have that bond, well it breaks me. It broke me.

I put myself back together for the future. And I know, without doubt, that our bond will be stronger because of this pain we’ve endured. Once I did tape my fragmented heart back to some semblance of a shape, it was time to learn about what surrogacy really meant. Not the Lifetime movie version. For real.

Let’s be frank. Surrogacy is expensive. I don’t care what the agencies say, how is $100,000 medical treatment NOT expensive?? Surrogacy is take-a-loan-out-against-your-house, sell everything unnecessary and check each tiny receipt, expensive. Here’s the real rub, we don’t even own anything to take a loan out against. So the only actual way to have a baby through surrogacy without busting the $100k mark, (yet again,) is to have the surrogate do it for free.

“I’m sure you have a friend or family member who can do it for you.” – Our Fertility Doc

Well it’s really not that simple. Having friends and family, and having friends and family who will selflessly give up their own body for you are two entirely different things. From my introspect, it’s difficult to understand at times because I would do it for any of them. And I really would. I would give them my uterus (if it wasn’t broken), bone marrow if they needed it, or a kidney. Blood donation is a no brainer at this point. But, as my husband so rightly put it, “they aren’t coming from the same place as you.”

And what place is that? Well, that is a place of suffering. Because when you have suffered like those of us in this community have, you would do anything ANYTHING in your power to not have anyone you know go through a similar threshold of pain.

The amazing truth is that I have two friends who would be willing to do it for us. When the doctors advised us that surrogacy was the only real option, their hands shot up like school-children playing Heads Up 7up, but for something so much more painstaking and remarkable than a rainy day game. To consider someone else before yourself in the breath of a mere moment, without hesitation – Those aren’t friends. Those are my sisters. Sadly, the timing just isn’t right. One friend has yet to complete her own family and the other is battling infertility herself. It doesn’t matter. I cherish the offers. I cherish them.

Okay, I take back that last bit about it not mattering. Obviously it matters very much. If a friend or family member is willing to be your surrogate, or you are able to find a surrogate in a jurisdiction where it is illegal to pay her (Canada, UK), then you are cutting the price in half. That’s a big half.

The next option we looked at was Canada. Because it is illegal to pay surrogates in Canada and the price of healthcare is significantly less expensive than back home in California, we could save a bundle. We currently live in the Caribbean so could fly directly to Toronto quite easily. But wait. Time to read the fine print. It is very popular to hire a surrogate in places like Canada and India, the main reason being that it is so much cheaper. So what’s the catch? The catch is that if that surrogate turned around and said, “I want to keep your baby,” there are no actual written laws protecting you against this happening. Yes, technically, she could hold that baby in her arms and even though every single fiber of that babies being was made up of you and your spouse, she could still keep your child. The chances of this happening are slim. But the chances in a change of heart on her part… leading to months of legal battles, time in courtrooms, flights back and forth to her home country… well are you willing to bet your baby’s life against it?

The answer for us was no. It’s just not worth the risk. We’ve fought too long and hard, gone through too much already, to lose our own child to someone on a whim. Even if the chances are slim to none.

California law on the other hand protects the intended parents. There is actual case law protecting us. But this means, of course, that it is probably the most expensive place in the world to attain a surrogate.

Last night I wrote about owning decisions. Not wanting to risk losing our own child on the more financially manageable and reasonable route, means owning the decision to take the path less traveled (or more traveled if you’re rich.) Debt. Change in Lifestyle. Being more frugal. It’s time to own it. Because in this case, in particular, no one else will.

Crack Bread

Ironically, not ttc friendly. White starch. Dairy. Sodium. Basically no nutritional value. But it tastes delicious. Okay, it tastes divine. And sometimes we need psychologically friendly instead. Plus, I had requests on Instagram for the recipe….

Ingredients: sourdough round loaf, stick of butter, olive oil, minced garlic, mozzarella block, cheddar block, green onions, Parmesan, salt, fresh parsley, red pepper flakes (optional)

1. Preheat oven to 360 F
2. Cut bread into hatches, so normal slices first without cutting all the way through, then cross over those slices (as pictured above)
3. Cut mozzarella and cheddar cheese into medium sized chunks (I’m very technical)
4. Separate half the butter into knobs and melt the other half with a quarter cup of olive oil and a couple tablespoons of minced garlic plus a pinch of salt
5. Finely chop green onions and parsley
6. Shove knobs of butter and chunks of cheese in between the hatchings of bread
7. Pour olive oil/butter/salt over the cheese stuffed bread
8. Sprinkle with a Parmesan, green onions and parsley
9. Bake for 15 minutes covered in foil and then uncover and bake for 3-5 more minutes
10. Drizzle with a touch more olive oil, and an optional dash of red pepper flakes
11. You’re welcome

Choosing a Clinic, an Agency, a Doctor

How do I choose? I suppose there’s the trifecta of initial, mandatory requirements. It’s within our budget (at least at first.) It’s inside the proximity of our geographical needs (or so it seems.) We like them and/or there are reviews and ratings that lead us to like them (for now.) I guess the point I’m trying to make is that we all set certain standards and have expectations, especially when we are making such critical decisions. The thing is, this process isn’t stagnant. We need to be more apt, or maybe just more ready, to accept various changes once we are committed.

Because I’m talking all kinds of surprises, from the most minuscule (my clinic is close to my parents’ house and therefore in a great location, but wait, upon multiple visits we realize parking is an absolute freaking nightmare and we’re paying more in carpark fees than we would if the clinic was further away) to the more profound (you, our doctor, told us we had a very high chance of success but then apologized for failing us after 2 unsuccessful IVF cycles and none of our genetically normal embryos implanting.)

Things, perhaps, are not as they seem. So where does that leave us? With more questions and more indecisiveness, increased anxiety and stress… well yes, but proactively, it leaves us with only one real choice and that is: Own your decisions. So many things are bound to change on this oh so rocky road, new stop signs, accidents, mortalities, shortcuts and increased premiums (for sure.)

How do we choose then? We collate all the most important information, use this to decide and then hold ourselves accountable to our decision. For us, in terms of IVF, the most important data was the clinic’s ratings (both online and via word of mouth recommendation,) our gut feelings towards the doctors, embryologists and support staff (how honest we felt they were, that they were making us a priority and we weren’t just another number in the herd, that what they ultimately wanted for us was a successful live birth as opposed to good scores, and that our doctor would make herself available to us for all of these reasons), and then finally, if/how we were able to get the money together to pay for treatment there.

So we started there and we chose a clinic. But somewhere along the way, I forgot to own it. I became infuriated with people. Albeit, certain incidents were true and utter incompetency and warranted upset. I once had an embryologist shout to me from the lab, whilst my legs were spread open ready for transfer and a ultrasound technician in training fumbled with the device sloshing allover my abdomen, “your embyro is stuck! It’s stuck to the side of the petri dish! Oh wait, I got it…”

Cue insanity.

Afterwards, our RE apologized profusely and told me that embryos can’t physically “get stuck” and our embryologist just chose the wrong language. Well, that’s the flipping understatement of the century. They made it up to us. But it wasn’t without repercussion.

But this is the exception. Most of the time, people were just doing their jobs. They made mistakes. But they were insignificant and they are human. Our coordinator repeatedly pronounced my name incorrectly. Appointments were mis-scheduled. Both of our doctors went on vacation immediately following the news of our final embryo’s inability to implant. It’s disappointing. But it’s life. What was really happening had very little to do with these people we decided to hire and everything to do with my grief. The acute sadness was being funneled into rage-driven verbal weapons that I was firing, with free will, at the people in closest proximity. I was not owning my own decision to work with this clinic and its staff. I was not allowing myself to grieve. I was just getting angry and blaming people for things that were not going to change, no matter the aggression I generated.

There is of course a flip-side to this. If you are truly unhappy with your doctor, clinic, agency, then you should not be working with them. No way. No how. We are going through way too much, paying way too much to get it wrong. But changing clinics carries its risks as well. Will they get my protocol right? Will they make too many changes? Will they not see the relevant realizations learned from my last clinic? You have to cake-baker measure these pros and cons against each other. Only then can you make what you feel will be the right decision. For us, it was sticking with our same clinic as we move on to IVF for surrogacy. For others though, change may be exactly what they need for success. I’m a pretty bossy person but would never tell someone which is actually right for them.

All this choosing is fresh on the mind because, along with choosing to remain with our fertility clinic, we have also decided on our surrogacy agency. This is choosing on steroids. It’s ‘The Rock’ of choosing. Yup, I just went there. These people are filtering the women who are going to be responsible for rearing my child during it’s most vulnerable state. The woman who will be feeding, exercising and resting our baby in her womb, a womb, I am so exquisitely and painfully aware, is not my own. It is the most massive responsibility. (But more on this later.)

So we’ve educated ourselves. All we need to do now is stand by our decision firmly – be ready for bumps, boulders and the rest. Satan can set that road on fire. We’re ready.

A Silent Grief

Let’s talk grief. No one wants to. That’s the problem. I grieve every day. Every single day. I think about each and every baby that didn’t make it. The ones that didn’t survive being thawed. The ones that didn’t survive within my own uterus. The ones that arrested in a tiny petri dish with no one but a lab technician to say goodbye (and I’m sure she didn’t.) I grieve the solemn loss of what could be. And this is the worst part. Every time we lose. Every time we get a BFN on one of those flimsy little plastic sticks. Every time we hear those words, “I’m sorry, it’s negative” or “there’s no heartbeat” or “I’m afraid it’s a chemical pregnancy,” we aren’t only grieving that particular infant loss but the loss of opportunity. We’re thinking about strollers and cribs and preschool, about a growing baby bump, playing catch, first words, names, of course names – and we’re thinking about how all that, in a mere instant is swept away. And we’re thinking, although we are afraid to, whilst the world around us revolves on and everyone else is having their second child and complaining about lack of sleep from breastfeeding, that we might never get our happy ending. We might never hold our child in our arms.

I remember, so pristinely, the moment my doctor handed me the pamphlet on IVF.

“You just don’t ovulate. You don’t respond well to stimulation. You probably have early ovarian failure.”

And then our other doctor:

“You fall outside the norms of IVF research.”

As if it wasn’t crushing enough, to hear (and know), repeatedly, that my body had failed us, that I had to put my husband through the most acute sadness because my most innate function as a woman was broken, there was also everything I was going to put us through to try and make my body work.

They are those far lesser sadnesses that we endure because it’s just part of the process. We’re also grieving the loss of our own bodies. We’re grieving the initial loss in being told, as women, we are broken and then we are grieving each snap of the whip as we push through treatment protocols to try and fix ourselves. It’s not quite as simple as multiple injections day after day (though to me, that would be bad enough.) Yes, it’s a multitude of needles that we poke ourselves with each night in the ass and in the stomach, but it’s also the preemptive surgeries, the uterine scratches, the lovely and excruciating saline HSG, the MRI, the hundreds of dollars worth of supplements that make our stomachs turn, the excessive needling from acupuncture, the lack of exercise because we’re often told not to, the bloating from the multiple hormone injections and tablets, the adult acne and sun spots, the invasive ultrasounds that have become the norm, the many MANY blood draws, and I haven’t even gotten to the actual egg retrieval and embryo transfer. We put our bodies through hell. And we do it happily. Because if this is what it takes to get our baby, then so be it.

At the bottom of the totem pole is the grief over the loss of our lives. It’s sad in itself that this falls to the bottom. What I mean by this is that we are grieving the loss of life before infertility, when a Saturday night was a romantic dinner for two and not, which part of your butt shall I stab you in tonight honey? We’re grieving the loss of our time together, before we were sad, before I felt like this shell of myself. And we’re grieving the loss of our finances. We moved to the Caribbean, albeit beautiful, but away from our family and friends, away from home, to save money for a house. There was a time when we thought we could buy a house, put money into savings, think about getting a second car, splurging on dining out (our favorite thing,) going on vacation together… but now the expense of fertility treatment always comes first. It sunk these dreams in one fell swoop. (Pretty sure it wasn’t a stork doing the swooping either.) The bills themselves are enough to make you cry. We spent $100,000 on fertility treatment last year. $100,000.

But we keep paying. We keep charging forward, through the undeniable grief, and not because “it’s worth it,” although I truly hope it will be, but because you cannot put a price on bringing a life into this world. You cannot put a price on that kind of joy. You cannot tally up those future moments in which my baby will be holding my hand, tucked away in my husband’s arms, thinking, we did that. We did. And we will.