Waiting

I love this time of year.

Many people find it hard to love, with its mud and mess, with their impatience to be done with winter already, and what's taking so long?? But other than June, with its maximum daylight and near-maximum heat, I like late winter / very early spring the best.

A friend and I just talked about spring. How, as lovely as it is, it can be a bit overwhelming. We're both introverts who like to take transitions slowly when we can. In the springtime, there's this sudden explosion of flowers and people outside swarming the parks. "Sometimes I want to tell springtime to just calm down a little," she laughed, and I laughed back, surprised and delighted that someone else feels this same way.

For me, a big part of the issue is that the fertility of spring sometimes makes me feel more barren in contrast. There are babies in strollers. Lambs with their mothers out in the fields. Ducklings on ponds. There's no escape from it all.

But February and March ... that's where I fit right now, in that resting space between seasons.

Even though we've had two more snowstorms during this cycle, they didn't interfere with my drives to the clinic, luckily. I can feel the sun gaining strength, this long and grinding winter releasing its hold so that something new can take its place.

Resting and waiting. Holding my breath. That's where I am now, and all of nature seems to be waiting with me.

What's ahead?

In TTC news, the egg did fertilize. A nurse from the clinic called the morning after retrieval, and from this point through Day 5, no news is good news. Each day the phone doesn't ring by 5 PM, I sigh with relief. Today, Day 3, I'm hoping that the embryo is 6 or 8 cells and growing, healthy and strong.

The Zen of My Clinic Commute

With each cycle I spend commuting there, the far-away clinic seems less far away.

I've learned how early to leave home (by 5AM), which route to take (the one that's longer but less congested), which lanes to avoid (the ones that end abruptly, and the ones where the buses hang out), etc. I've found emergency bathrooms and alternate routes. Of course, I know most of the clinic staff and their routines, too. It's a relief, because the more automatic these things become, the less space they need to take up in my brain.

Today I thought back to how very close I came to ruling out this clinic after my first consultation there. That first day, the round-trip drive took five hours. It was also the day that I saw the boldest move I've ever seen in traffic, anywhere. Picture a big downtown intersection. Two lanes are waiting at a red light to turn left. Then a woman turns left from the far-right lane (illegal), through the red light (illegal), to make a U-turn (illegal), all while blabbing on her hand-held cell phone (yep, that's now illegal, too). I shook my head and said, "Forget it. No way am I doing this every day!"

Now here I am starting a fourth cycle there. As I drive down busy but now-familiar streets, I think of the women whose clinic commutes involve plane flights or even passports. Mostly I think about the goal: being a mother ... someday ... if I'm lucky. The small stuff has a way of sorting itself out.

Yes, every drive has the usual irritations opportunities for practicing mindfulness. Really. I've been trying to say some standard loving-kindness phrases (May you be happy, May you be healthy, May you be safe, and so on) to any drivers who annoy me. It works surprisingly well. It short-circuits that instinctive—and totally pointless—Oh no you don't; I'll show YOU response.

If I can't get through the phrases without extra commentary ("May you be safe ... you asshole, because clearly you need help with that!"), I start over again. I haven't had to do it more than two or three times yet.

If all else fails, there's bubble wrap!
(source)

The Compost Pile

It's occurred to me that, except for comments on other blogs and a few "just the facts" TTC posts here, I haven't been writing much lately.

The main reason is a family crisis. Someone dear to me has been in the hospital twice in this past month, and spending time with her almost every day has been my focus. It will be for a while to come.

Also, my life tends to be organized around cycles anyway: cycles of TTC, cycles of moving inward and then outward again. Right now seems to be a time of hibernating, percolating, and, I guess, conserving energy for what lies ahead.

In the weeks that I've been away, I've written the beginnings of many posts in my mind. Then the time comes to get them out, and nope. Ideas go into the compost pile, churn around ... then stay down there to churn around some more. They're not done yet. I'm not worried about it, since there's plenty of fodder there, and compost makes great fertilizer when the time is right.

I'm not worried about my thoughts needing more time to ripen. What I'm worried about are my emotions, which feel awfully stuck and flat lately.

You know that line in my profile about loss and acceptance? Here's the thing: I'm not really sure how to DO the "acceptance" part. This blog is meant to be part of the process, not the result. And lately it feels like the process has gotten stalled.

So this week I met privately with the teacher who leads a drop-in meditation class I've been attending for the last year and a half. I didn't want to go into any details with him, because words sometimes get in my way. I can use them to skip over the actual experience and jump right into "fixing" it, which seems to be counter-productive with grief. He agreed.

Instead, he basically led me through a Focusing session, which involves attention to sensations in the body (the "felt sense") that underlie emotions and thoughts. Staying with the felt sense can lead to unexpected insights (less mystical than I'm making it sound) or a sense of shifting or release. Which is exactly what I need.

Yes, I want to write more about Focusing. In coming weeks, I'll probably be writing less about my own analysis of things and more about whatever practices are helping me to feel less stuck ... after I, you know, actually DO them. Until then, lots of good but unfinished ideas will be getting thrown back into the compost pile.

From Rainer Maria Rilke:

“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”

The View Through the Windshield

Years ago, I lived in a very small town that was trying to draw attention to its "international" airport. It was international in the sense that, several times a year, a small plane used its single runway for travel to or from Mexico. The town held an "air fair" at the airport one year to raise publicity.

Because there's not a lot to do in small towns, many people came to check out the fair, me included. And because people in small towns tend to help out their neighbors (defined in the broadest sense), I got offered a free flight at the end of the day from a friend of a friend of a friend.

He was the pilot of a small plane. And by "small," I mean that he was able to pull his plane around on the runway using one hand. That was a little alarming, but I had just watched these planes taking off and landing all day without problems, so I climbed into one of the four seats and buckled my seatbelt.

It was totally different from any of my previous trips in jets. For one thing, all the instruments were right there. I could watch for flashing red lights, listen nervously for alarms... but no signs of danger appeared. As I relaxed, my focus drifted beyond the cockpit and out through that fabulous, huge windshield. Whoa, I could see everything! I noticed details I would never see from 20,000 feet. I picked out all the local landmarks. I waved at mountain bikers winding their way along a dirt trail.

Then we banked to the left, and the mountains filled the windshield like a wall. They were 10,000 feet high, so they'd been impressive from the airport on the valley floor. But from this midair vantage point, they seemed so much bigger. They went down for thousands of feet, and they went up for thousands more. They seemed endless.

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I thought of that flight lately when I wrote about the depressive fog of TTC for so long. Somehow, looking back to see how far I've come makes the path ahead feel longer, the obstacles more daunting, not less. They block out everything else on the horizon.

In TTC news ... well, there is no news right now. Things are quiet, actually. My next cycle should start early next month.

Wouldn't it be nice to see the outcome as clearly as I saw the peaks from that airplane, or to feel the excitement and expansiveness I did that day? Instead, I'll have to stick with this grounding reminder from Anne Lamott's book Bird by Bird:

"E.L. Doctorow said once said that 'Writing a novel is like driving a car at night. You can see only as far as your headlights, but you can make the whole trip that way.' You don't have to see where you're going, you don't have to see your destination or everything you will pass along the way. You just have to see two or three feet ahead of you. This is right up there with the best advice on writing, or life, I have ever heard."

The Fog

After my recent burst of sunshine, I was shocked by how little time it took for the depressive fog to settle right back down. It's humbling. Whenever I dare to believe that I'm learning to live with or through it (if not "get over" it), there I am stumbling around, lost again.

Why now? No special reason, really. Winter is coming, with its darkness, cold, and relentless (family-focused) Christmas cheer. I just wrote another huge check to the RE. Right after that, the baseline ultrasound picked up a minor problem that meant I'd have to sit out this past cycle.

Of course, none of this stuff is tragic (well, maybe the check...) or new, so you might think that I'd be better at coping with it by now. After all, it's been five years since I started TTC. Then again ... it's been five years.

It just wears me down sometimes.

(source)

More Not-Awful News!

After the fertilization report, five more days dragged by. The nurse had told me that no news was good news, and each day I sighed with relief when 5 PM passed with no phone call.

I'd expected to feel excited and cautiously optimistic, as I did the one other time I've made it this far. That time, having a fertilized egg—the first ever—felt momentous. I felt responsible for it. Didn't like the thought of it being so far away. I imagined bringing tiny booties to the lab, fussing and brooding over it like a huge mother hen.

Seriously, though, I was desperately curious about this embryo, not just in terms of whether the cycle would succeed, but in terms of its identity. Who might it become? What wonderful tapestry was its genetic code weaving right now? The medical staff and I had set things in motion, but now came the most miraculous part, the part for which we hadn't and couldn't have written a script.

I remember that feeling of awe. During the last five-day wait, I had the excitement of a fresh transfer to come right afterwards, and the innocence of never having had a pregnancy loss. This time a longer road lies ahead, and I'm more aware of each step. This time what I mostly felt was tired and numb—preemptively depressed, as if feeling bad now could keep me from feeling totally wretched if the embryo did not survive.

I KNOW that this is pointless. There's a magnet on my fridge that says, "Worry is like a rocking chair. It will give you something to do, but it won't get you anywhere." I'm not even sure how much of what I felt this week was worry. It had even less clarity. It was more like defensive withdrawal.

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On Day 5 I knew that, whatever the outcome, someone from the clinic would call. It was hard to focus on anything else as hour after hour ticked by. I considered writing a post about the wait, then thought, If you write about it, you'll jinx it. I heard a song with sad lyrics and changed it, thinking, If you listen to sad songs, you'll end up sad. I thought of taking a break and calling the clinic myself. If you call them, it will be bad news.

Although I'm grown up, sane, and mostly logical, no, apparently I'm not above magical thinking now and then. I just try not to give into it, since it leads to nothing but more of the same fantasies of control in situations where, clearly, there is none. So I went ahead and called the clinic anyway. And eventually they called back.

Turns out there was more good news. The embryo made it to Day 5, and they were able to do the biopsy and freeze.

I'm in shock. I'm incredibly lucky.

It was Thursday evening when they called. I said a prayer of thanks but still felt mostly numb for hours. Then the tears came and, with them, the thaw. Slowly, the fog of preemptive depression has lifted. Now I'm able again to connect with the wonder that has been here underneath it all along.

Believe me, I know how far this stage is from a birth or even a pregnancy. A five-day blastocyst has, what, about 200 cells? I can't use the word "baby" to describe it, but all the same, these lines from the old nursery rhyme have been echoing in my mind and heart, putting words to the wonder that's there:

Where did you come from, baby dear?
Out of the everywhere into the here...

Into the here.

It's Not Awful News!

Overall, this cycle has been very low-stress, except for the clinic commute. I wasn't oversuppressed on BCPs, so things moved fairly fast. There were very few medications to order, and they cost under a hundred dollars. No need for five or six FedEx orders per cycle like last time, when I was so anxious about making sure that I had all the necessary meds on time, without wasting a single precious, insanely expensive drop.

Best of all, there was no breathless rollercoaster ride, no wondering if (despite all the meds) I would end up with two eggs, or four, or none at all. There was the daily grind of the commute, but it was a mindless, emotionally neutral sort of grind. One day at a time. Breathe in, breathe out.

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The most "interesting" moment came the night I did the trigger. (Although I used no ovary-stimulating drugs, a trigger shot was required for precise timing of ovulation and egg retrieval.) If you're squeamish, this would be a good time to skip down toward the bottom of this post!

I've done a few intramuscular shots before, and while the needles are, um, impressive, they're also very sharp, which is a good thing.Truly, most of the time, there's been no pain at all. There's just that instinctive resistance to doing something your body KNOWS is wrong (stabbing itself) even when your mind says, No problem, it's cool. I imagine that skydivers have to overcome the same instinct when they jump out of airplanes.

Anyway, everything went according to plan. I drew the target, hit the bullseye, pulled back on the plunger, saw no blood, and injected. Then I pulled out the needle and ... instantly, blood poured down my backside. What the...?? There was so much that it ruined my bathroom rug (which was ugly, so no big loss) and ruined my pajamas (which I'd made myself, so grrrrr). I clamped a paper towel over my behind and tried to clean up the mess with one free hand. Bear in mind that it was now after 11 PM, because that was the precise time I was told to do the deed.

The blood didn't stop. I saw more droplets pattering on the floor and realized that the paper towel was now saturated. Not good. Suddenly I felt a little light-headed and queasy. Maybe I'd had my blood drawn too many times in recent months. My blood pressure is always low, so it doesn't take much to make me feel light-headed. I decided that the cleanup could wait and lay down until the feeling passed.

My biggest fear was that this weird occurrence (which I still can't explain) might affect the outcome by letting some of the medication leak out, or whatever. So the next morning I took a home pregnancy test. They measure hCG, which is the same hormone in the trigger shot. A positive test result would mean that I didn't totally screw up the shot. And sure enough, my pregnancy test turned up a strong positive, which (fake though it was) was lots of fun.

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Then came the egg retrieval. That was interesting, too. Because this type of IVF retrieves just the one egg that the body normally produces on its own each month, they gave me just a form of "twilight" sedation. In other words, I felt that shit. Feeling someone muck around in your ovaries with a needle isn't great. On the other hand, full anesthesia adds more cost (and risk), which I could do without.

The room had a painting on the ceiling. I guess it was meant to give the person on the table a more distracting, calming focus than a sea of blank ceiling tiles. This painting showed a street with people strolling and French flags hanging from balconies. As the nurse slipped the medication into my IV, she joked, "Are those flags waving now?" I laughed, despite the fact that I was trussed up in knee stirrups (What do you call those things?) and splayed out on the table like a Thanksgiving turkey. "Are the people on the street speaking French now?"

I felt light-headed and spacey, a little more relaxed than I had been, but fully awake. Then came the speculum and needle. It wasn't awful, but it was worse than my first no-stim IVF retrieval. That time, just when my toes were starting to curl and I was starting to think, "Well, this sucks," it was over. This time it went on longer (still probably <30 seconds), because the doctor saw two mature-looking follicles on the ultrasound and cleaned them both out. "Usually, the body picks a dominant follicle and the other egg withers, but you never know..." he explained. As it turned out, there was only one egg. I'm glad he tried both follicles, though. Wouldn't that have been a super-mega bonus prize to get TWO eggs naturally!

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The next day, I was out of cell range for a while. When I checked voicemail, there it was: my clinic calling with the fertilization report. I punched in my code, shaking, having flashbacks to that last awful time. But this time it wasn't awful. Oh my God, it WASN'T AWFUL! It was good news! I sat down on the ground in shock—GOOD shock!

Whatever happens now, I feel validated that my choice to return to this clinic was the right one. We've already gotten farther than with last month's "throw the book at it" medicated IVF.

Moving On

Lately I can't seem to make decisions. Like, about anything. Maybe it started with burnout over medical choices, but now this indecision is filtering down to the smallest details.

In a store tonight, I was trying to decide which type of mouse toy to buy for my cat. There were only two choices, but the first style was kind of ugly, and the second style might be too small. It might get lost under furniture and doors. And who knew if my cat would think the first style was ugly just because I did? Also, BOTH types had small parts; could they come off and be a hazard?? No, probably not. But I still could not decide. I mean, what if I wasted $1.99 ON THE WRONG MOUSE?

Well ... what if I did? With that thought came laughter and instant release. I really don't have to obsess over every single thing, after all. I really can just toss the closest toy into my cart and move on, secure in the knowledge that my cat will be happy tonight and I won't have to waste any more brain cells on this choice. How refreshing.

After agonizing over last month's huge decision for a while, I'm finally moving on medically, too. I'm trying no-stim IVF with my other clinic again. They're the place that got me pregnant last winter. It was a scary choice, because this type of IVF goes against most conventional wisdom, but I think it's the right choice for me.

I've never responded well to stimulation, and the increased expense of full IVF just isn't worth the increased number of eggs produced (if any). More importantly, I'm afraid that the meds may harm what's left of my egg quality. Far better to have one good-quality egg than two bad ones at three times the price. Also, unlike IUI, IVF ensures that the sperm and egg meet. It bypasses problems with the egg entering the fallopian tube or the sperm penetrating the egg. Finally, I'd like to do genetic screening on the embryos, to help make sure that they're healthy before transfer.

This is going to be a long process. I'll do several cycles, do the testing, then—I'm hoping with all my heart—do an FET. Strangely, the fact that it will be a long process is making it feel less stressful, not more so.

The most stressful part is the commute. This clinic is in another state, and the drive there is at least a three-hour round trip (more if there are accidents) through two metro areas. Normally, I like driving. I've driven cross-country (2,000+ miles) several times, but this ... this just sucks. So I leave home at 5 AM to avoid the worst of the traffic. Thank God for audiobooks. They pass the time and calm me down. When I made this trek last winter, I was listening to The Worst Hard Time, a great book about the Dust Bowl and Depression. That sure put my stress into historical perspective!

five lanes going nowhere
(Yes, officer, I came to a complete stop before taking photos.)

Dignity

"As you face loss, hurt, and conflict, invite a sense of your own dignity. Sit up, stand up tall. Have respect for yourself, and patience and compassion." (Jack Kornfield, A Lamp in the Darkness)

I like this quote, so I've been thinking about what it means to have dignity … and I'm honestly not sure. At what point does "invite a sense of your own dignity" become "pretend that you are fine when you are not"?

I'm pretty sure that dignity does not just equal decorum, which means conforming to all the rules of polite society. Dignity has more to do with honoring a person's worth, which is something inherent, I guess. But what does that mean in real life? After two pain pills and a sleepless night, these distinctions seem pretty obscure. They still seem important, though. I need some kind of guidelines to follow.

Staying in pajamas all day does not conform to the rules of decorum, but when is it actually undignified or unhealthy? Does it matter whether I've consciously chosen to be gentle with myself, or whether I've just given up? And wouldn't scolding myself for feeling defeated be undignified in its own right, if dignity requires patience and compassion like the quote above contends?

See? It's confusing. When I get caught up in these questions, my mind eventually drifts back to the days right after getting the bad news. I found myself responding to everything with an attitude of "So what, who cares?" I'd look at my unmade bed and think, "It doesn't matter." I’d look at work piling up and think, "I don’t care."

Then it felt very important to stop, even physically put a hand over my heart, and acknowledge, "I DO CARE."

No, these things can never mean as much as my baby's life. I may act on them (the work) or not (the bed). In any case, I cared enough to notice them.

The point is that the part of me that cares (to whatever small degree) about other things is still alive, and it wants (to whatever small degree) to stay that way. Maybe that is dignity.