73=1 and other things screwing with my mind

CD73=CD1, that is. Yup, that's right-- the beotch showed up this morning, but she had to wait until I was at a friend's house for a kid birthday party. Wanted to embarrass me on top of everything else, I am sure. But crisis was averted, so there. What I don't understand, though, is why almost 10 hrs later I am still not trippled over in pain. I mean, I spend the first day of any old period curled up, popping Aleve, drinking red wine, and putting hot pillow to my midsection. And given that a fun little ride on Dildocam Jr. at Dr.YoungGun's on Friday showed 15 mm of uterine lining, this one was supposed to be the mother of them all. But like I said, so far-- very easy going.

Also, I had no pre-symptoms. Nothing, nada, zip. So I am pretty sure this is unovulatory, possibly brought on by the changes in caloric intake with the end of my craptacular diet this week. Whatever it actually is, the timing couldn't be better. I donated a nice round number of vials of blood to the lab on Friday, and now that I am officially their patient, I am expecting to be hauled in on Tuesday for Day 3 labs as well. Those two sets of bloods will tell us with a reasonable degree of certainty both where this visit came from and whether I can hope to ovulate on this new cycle. And by "round number" I meant 13. I like that number, I do. Admittedly, I like it much more when it represents the number of Jonah Gold apples that are all mine and nobody else's (insert evil laugh here), or, say, when it is the number of days of uninterrupted vacation ahead of me (oh, to dream...), but if one is to have a largish number of vials of blood drawn, 13 seems like an appropriate number, no?

So as alluded to above, Dr.YoungGun has a cute little ultrasound machine with a nice, slender, and probably ergonomically designed am... attachment right in one of his exam rooms. It's not a massive one, but I do think its resolution is better than what you normally find on an L&D floor. Because of what he saw on it, though, I am supposed to go drop my drawers for the big boys in radiology and their big, high-resolution machine sometime soon. Thus, the office machine will henceforth be known as Dildocam Jr, and the radiology one will, predictably, be the Sr. And yes, I know the big one didn't actually spawn the little one, but go with me on this. Interestingly, Dr.YoungGun didn't actually find anything on my left side, the one that was bothering me, and he is thinking that maybe I am working on a small hernia in there. But what is prompting this increased scrutiny of my insides is that he did find a largish (over 3cm) cyst on my right ovary. And it's complex, meaning it has some additional matter in it other than ovarian tissue. Apparently, if it doesn't make like a good cyst and scram, it will have to be surgically evicted. I guess I have to name it now. I am thinking Immanuel, like Kant, since it's so complex and all, but I am open to suggestions.

I am also supposed to get an HSG on CD8-10, so that will probably be next Monday. And JD is supposed to provide a sample at a date to be determined tomorrow. No home deliveries accepted at this clinic, so he will have to go there for the entire err... exercise.

I have to say that even though Dr.YoungGun and I didn't get off to a warm and fuzzy start-- I got a bit peeved when while explaining that my insurance is going to resist covering treatment since I recently had ovulatory periods it seemed to me that he himself was also taking that point of view, and I got even more peeved when he then said that it upsets him as much as it upsets me, to which I couldn't resist replying that I highly doubted THAT-- I do like him. He is thorough and knowledgeable, and seems to practice evidence-based medicine. I think I can trust him, and I can definitely see why Dr.B thought I should see this particular guy.

Speaking of Dr.B. I have to see him again. I told Dr.YoungGun that one thing I need to not happen is a higher-order multiple pregnancy, and that I would prefer not to get pregnant with twins either. I wanted to go straight to IVF, actually, with a single-embryo transfer. As it happens, Dr.YoungGun has a paper in press about singe-embryo transfers, and thinks it's a pretty good deal if the embryo transfered is a good-looking day fiver, but not so much if it's only a day three-er. However, none of this is material yet, because insurance won't cover IVF until we've wasted time on suffered through done three cycles of non-IVF first. This is apparently the downside of living in a mandated coverage state-- there are rules imposed on the doctors by the insurance companies. The upside, of course, is only paying co-pays for the whole thing. So, three cycles of chlomid or injectables. Probably injectables in my case, as we talked about greater control that would give, plus I do not like chlomid and its lining-thinning crazy-inducing ways. Dr.YoungGun is willing to mark my file "do not trigger if more than one follicle" and he says he can make any canceled cycles count as far as insurance is concerned. So this is what I have to go talk to Dr.B about-- whether I should be a strictly one follicle/embryo kind of a girl. My gut says yes. We also ran into Dr.B as we were exiting the hospital after the appointment and told him what I will be coming to speak to him about. He did not look thrilled, and he said something like "twins are not insurmountable" which, if we are honest with ourselves, does not sound like a ringing endorsement. So I am even more inclined to stick with one now.

All of this was a lot, and it took me a few days to process. In fact, I am not sure I am really done processing it yet. AF showing up today is a lucky break, because it speeds up a bunch of tests which otherwise would've had to wait until after a period could be induced with progesterone. Hopefully, though, it won't be used by the money-grabbing assholes insurance to insist on denying coverage.

I was doing a convincing Goldilocks impersonation this weekend. We went to an adults-only party last night, and a few times I had to escape the bustle because everything seemed too trivial. Granted, there were people there whom I don't really know, and I did much better while talking to our friends, but still. Then this morning there was that aforementioned children's birthday party. It was a slightly cooler morning than was hoped for, so we were all mostly stuck inside the house, instead of outside, as was originally planned by the hosts. And while I usually do pretty well with children and babies, even if I still do my best to ignore most pregnant women or their state, whatever seems more appropriate, being stuck in the house with something like five babies and at least three pregnant women, even if not all at the same time, was a bit much. Things got a little easier when the festivities moved to a local farm, what with a much decreased concentration of stressors per unit area, but even so I bailed earlier than I absolutely had to. I was wiped.

At the adult party last night I spoke to the older sister of the birthday boy for a while, and she was telling me how she now has everything she dreamed of and worked so hard to achieve-- family (they have two school-aged boys), a graduate degree, a great job, and that now that she has achieved all that, she is lost for something else. A challenge, it seems. She can't find anything that will hold her mind and heart as much as all the challenges of the previous decade did. I told her (and she didn't take offense-- this is why I like her, and why I like talking to her when I see her, even though it's not often) that while if I concentrate, I can understand her concern, it is so far from my own that I just can't feel it, that it feels very foreign to me.

Today Niobe named the feeling that has been chasing me all weekend-- being a stranger, a flunky, an expelled student in the world of the normal, being stripped of its citizenship. From where I am standing, it seems permanent, the expulsion. It's been eight months since my citizenship has been pulled. Eight months exactly, today. That might explain the flashbacks. Or maybe it's just the normal overload that brought them on. Either way, I need a drink. And an Aleve-- it's finally starting to feel like the bad part is about to hit.

Pain is good

Well, it can be. Or, at least, it can be useful. I've had this annoying funny thing going in my left lower abdomen. It started way back when I thought it was ovulation twinges. Then I figured out how truly fucked I am, and wondered occasionally why that thing was still there. By Rosh Hashana it became noticeable, and I decided it might be a fibroid. By Yom Kippur services it was already somewhat painful and really annoying. Enough that I resolved to call the clinic on Monday and see if they could give me an ultrasound before my appointment with Dr.YoungGun, which, if you were bored and keeping track, was scheduled for October 11th. The nice nurse agreed that it sounds like a fibroid and that letting it grow for weeks longer is going to make it that much harder to shrink later, but explained that they can't give me tests before I see the doc because insurance doesn't like them doing it. She would, however, try to ask the receptionist to squeeze me in earlier for my appointment. Today the pain is beyond simply annoying, and into "driving is seriously not fun" category. So I called again. And, glory be, they are squeezing me in Friday afternoon. Two days from now. Wow. Better start filling out those forms.

Silent scream

I had a busy day today, and I didn't check my blogs until late afternoon. On my phone, because it seemed easier than trying to speak to all these other moms I didn't know at the synagogue event for the families with children in K. I didn't expect to read that Meg and her husband suffered another unimaginable loss-- their much loved and longed for daughter was born too fast and too soon, and left them only three hours later.

Trying to comprehend that news in a room full of laughing children and at least one pregnant mom wasn't really working, and eventually I just put my head into my hands. I thought that I was picking apples, joking with friends, sleeping, shopping, cooking, and cooking some more all while Meg's daughter was coming and leaving, leaving Meg's and D's hearts and lives shattered. Again. The split screen going in my head was incongruous and breathtaking, stuff of horror movies.

If only.

I love science

Yom Kippur is supposed to be a complete fast, meaning no food or water. Health concerns always override, though, so a person who needs to take daily medication should do so, and if those need to be taken with food, should also eat something. Also, if you feel sick, you should take care of that rather than continuing the fast. Our synagogue, as I am sure most others, has a stash of orange juice for people who neglect that rule and then collapse during services. You are also pretty much standing throughout the last hour or more of the concluding service, but at least at our synagogue the rabbis always say up front that you should only stand if you are able.

When I am not taking a break from working, one of the things I do is teach biology. So all of the stuff above was a prelude to the story of how I came to empirically confirm the reaction mechanisms I teach my students. Our bodies run on glucose. Which is why doctors check your blood glucose level-- that's the delivery system to most cells in the body. But glucose, or any carbohydrate, is not essential for life. This is because we can make it. Not from sunlight and water, like the plants, but from other things we consume, like fat and protein. Water. Water is the stuff of carbon-based life. And not just because it's an excellent place for all sorts of molecules to hang out, mix, get to know their neighbors, and see if there isn't some chemistry between them. Ahem. Right. Anyway, our cells are about 90% water, and water molecules do many important things, such as hold on to protons or electrones for a little while, so a molecule can change shape, or a reaction can occur. But water molecules are also reactants. In order to break down larger molecules (such as fat and protein) we need water-- a molecule of water is added for every link between units that is broken (just like one is released for every unit connection when these molecules are synthesized).

Before I started the shock diet, my friend Aite loaned me her blood glucose meter. I played with it for a little while, but it only had about a dozen strips left, so I let it be eventually. When I started feeling funny the evening Yom Kippur started, I thought it would be good to take a measurement. Now that was entirely my fault. I took a nap Friday afternoon, and when I woke up there was really no time to eat before services. Which was just fine by me, but I kept thinking that I should have some water before we go. And then I forgot. So in reality I didn't have any food or drink from about 2pm on rather than the required 5:30 or so. So I was feeling funny in the evening. The blood glucose reading was 94, though, which meant I was going to make it till the morning. In the morning, though, it was 78. Leaving for services like that was not a good idea, seeing as 70 is considered critical. So I drank a glass of water. When I got back from the morning services, it was 72. JD got freaked out and wanted me to eat something. But basic biochemistry to the rescue I told him that was not necessary and drank three or four glasses of water instead. I only had one meter strip left by then, so I saved it until right before leaving for the concluding services. At which point, five hours later, the reading was 77. Ta-da! My body apparently sucks at many important functions, but at least it can still hydrolyze large molecules and use individual subparts to make glucose with the best of them. I drank another glass of water and went to services. I love science.

*******
We went apple picking yesterday, and I now have the apple I will eat tomorrow evening (and three each that I am allowed for three days after that) to start the exit phase of the diet OF DOOM (oh, no, not that again!). But despite my carefully planned schedule with Yom Kippur taking out a day of eating this crap, and then only three days remaining, yesterday was absolutely the hardest of it. If you watched me eat breakfast yesterday, you would've had to conclude that I was consuming sustenance OF APOCALYPSE, cooked as it was by the minions OF THE UNDERWORLD. Today should be better, since the apple, that round, blessed goodness of Honey Crispness that it is, is tomorrow. Hear that? Tomorrow. Less than 36 hours from now. Yes! I was a little disappointed that Jonah Golds were not ripe for picking yet, but Honey Crisps will have to do.

Today I am going to spend the day doing a bit of shopping, a bit of cleaning, and a lot of cooking. My family needs to eat, and I am hoping that the smells will be enough to hold me over until I can rejoin the world of culinary appreciation. I get to try my new slow cooker today. I am hoping to become good friends with it. Also, and this one goes out to Lori, who loves a good organization project, and to Niobe, who is threatening to make me alphabetize my spices, I mostly cleaned out the den of inequity that was my office last week, and just the other day I cleaned and reorganized my two problem cabinets in the kitchen, in the process collecting a whole bag of food for Monkey's school food drive (which was the motivation for tacking the cabinets in the first place). I am afraid I am rapidly running out of excuses for not dealing with my lazy Susans. See what you people are making me do?

Half way

Today is day 5 of my ten day attempt to shock my way back to ovulation. Only one more day to where I get to eat nothing for a day (never thought I would be looking forward to the actual fasting aspect of Yom Kippur). Then it's only three more days to an apple. Which I plan to pick on a farm on Sunday. I've lost a little weight, and am now just below the weight I was when I delivered Monkey. Which is a sad, sad state of affairs, but my mantra is that every pound I can shed now will make it easier for me to carry the next pregnancy even if it won't help me get there.

On the crappy news side of the day, my dad appears to have some sort of a liver inflammation. The lab is also reporting a positive test for Hepatitis C which strains credulity because given that the virus is only transmitted through contact with infected blood he is so much not in a high risk population it's not even funny. My sister also found that the test has an average false positive rate of ~35% in low-risk populations. So I am not buying the Hepatitis thing, but we are all worried about the inflammation. My dad's way of dealing with that though is to pretend that it isn't happening. He threw a nice little tantrum with the whole "doctors are useless and I am not going to see them again" line of argument in the starring role. We are not impressed. And he IS going even if it means that one or both of us have to fly back to escort him. Fair warning, I think.

Dr.BigShot

It went fine. He was professional, but not warm. Even though A came up several times, he never indicated in any way that his stillbirth was any more remarkable or regrettable than any other event in the history of my thyroid dysfunction. Like I said, not warm. But professional, so I did not get the urge to demand equal pay for equal work. He mentioned the study Dr.B first told me about that indicates that there may be benefit to treating me with thyroid hormone for the duration of trying and next pregnancy. To determine whether I would likely benefit, he ordered a bunch of tests, and will call or write with the results. Best news, though, is that there is new research that indicates that taking selenium could prevent post-partum thyroiditis outbreaks. So assuming the tests show what both he and I assume they will show, I am going to be adding more pills to my daily regiment.

In the "that was weird" category, while the appointment started pretty much on time (corrected for filling out fairly minimal paperwork), and ended a reasonable amount of time later, it took me very nearly a full hour to get my blood taken. Seems the lab was short vampires... er, phlebotomists today. I was afraid I would be late to pick up Monkey from school, but I ended up just barely making it.

Day 3

No, not CD3-- that would be too much to hope for, apparently. For the record, it's CD 62. Fun times.

No, it's day 3 of my last ditch effort diet. My mantra is "it's only ten days," but my secret psychological weapon is Yom Kippur that starts on the evening of the sixth day. So I am half way to that, and kind of looking forward to it since not eating anything will be a nice break from eating this stuff. And by this time a week from now I will have eaten my first apple in ten whole days. And believe you me, that will be the best apple ever. It will then take a couple more days to get back to all the normal food, so this thing is much more like two weeks than ten days, but again-- psychological games is how I get through it. That and it helps pass the time while I wait for the doctors.

Speaking of which, tomorrow is Dr.BigShot. We had a little dust-up with our insurance company over the referral, but it's resolved now. Why do I feel like it will still be a gigantic waste of time tomorrow?

Also, when this diet experiment is over, and I am back to my normal diet (I much prefer this latter meaning of the word "diet"-- the way one eats, to the former one, temporary change to one's eating habits with the goal of loosing weight) it will be less than two weeks to the RE appointment. By the way, in my last post I didn't mean to imply that I would love nothing better than to get me some needles and to finally get to try what all the cool kids have been doing for years, by which I of course mean IVF, not vodka-injected watermelon (the comment that is likely responsible for a few nightmares as unsuspecting seekers of a new way to get boozy find instead a discussion of BFN rituals). In fact, not so long ago I was bitching about having to find an RE. And that still stands-- I spent the last 8 years doing things to avoid having to have one, and I don't like to loose. But I am also not going to stick fingers in my ears and sing "la-la-la-la" to avoid acknowledging that I have been beat. And if I have, it's time for a new plan. And if that new plan includes needles, so be it. All I'm sayin'.

And now for an unrelated brag. Because I have to. JD is off on a business trip, which means that I had to bring Monkey to school with me tonight for the Curriculum Night, which was supposed to be a no-munchkin affair. Since we were going there straight after her gymnastics class where we had gone straight from school, and since she is a little sniffly, I was pretty much prepared to have to leave right away, or at some point before the thing was over. But she did so much better than I had any right to expect-- she sat quietly and drew for the portion of the evening where various admin types and specialized teachers (art, music, gym) told us about their approaches and broad curriculum outlines for the year, and then she just amused herself for the hour and a half we spent in the K room while her teachers told us in much more detail about what is in store for us this year. I am really proud. Unfortunately, that ended up meaning she was late going to bed, so I hope she will be ok getting up in the morning. She can be a little (read: a lot) grumpy sometimes, and after tonight I almost feel like I am due for it.

How has blogging been good for me.

Let me count the ways.

First, as I stare down the barrel of assisted reproduction, I feel no ambivalence. Granted, this is not strictly from blogging, more from reading infertility blogs for these many years now. ART in all its many forms has become the most natural thing to me, the point brought home again by HBO's new show Tell Me You Love Me where one of the couples is dealing with inability to conceive for over a year. They talk about getting tested and getting treatment as of pathologizing the process, and I feel as if I am watching them through the wrong end of the telescope. While having insurance coverage for ART, of course, also helps, I almost feel like I cheated on this particular exam-- I got to acceptance and even welcoming by sneaking a peak at everyone else's final papers and all of their rough drafts-- but I don't care. There's been so much I've had to wrap my mind around in the last seven and a half months that I am glad I don't have to work on this, at least on this. I don't want to present myself here as a fearless leader of a roving band of IVF avengers, seeking out treatment wherever it may hide-- it's not that my hands didn't suddenly tremble when I started reading the packet that arrived from my future clinic this weekend, but it was, I am fairly certain of it, from the reality of this new hope right there in my hot little hands. And I do mean little-- you should see how small my hands are.

Second, well... second. It's taken me over a week to process this sufficiently to write of it at all, and I am still not sure I have fully processed it. I changed someone's mind. And her ways. And I did that because all of you gave me the courage to believe that my reactions to the dumb things people say are not unusual, that it's not my problem, and that nobody gets to tell me how I should feel. See, there is this woman, let's call her T, who lives in my city. She is a former student and a friend of a musician friend of my parents, who lives in the same city as them. When T and her family first moved to my City from the Old Country, the friend of my parents asked us to help them a bit. Which we did-- had them over for dinner, went to their place, told them about some resources, etc. No problem. That was seven or eight years ago. A few months back, this friend of the family asks my sister who was visiting my parents at the time to take with her some books for T. My sister does, promptly dumps them in my house and we both forget about it. Well, I saw them once or twice since then, but had no desire to do anything about it. Why? Because I had a feeling this very nice woman was going to say a lot of stupid stuff to me. With the best of intentions, of course.

Long story short, the friend talks to T a few weeks back, finds out she doesn't have the books yet, and the whole thing ensues where our mom is after my sister and me for not delivering the books, and then T starts calling and leaving messages too. Finally, I decide to take a deep breath and take the books to her. Which I do Friday before last. My mom likes to tell me that not everyone is after me, and that I shouldn't be afraid to see people because they may say stupid things. But at least in this case my feeling was right on the money-- T said just about every well-meaning stupid thing there is, and because I was sure I was not insane (or at least insane in the exact same way a lot of you are), I replied calmly, but honestly to every one of them. From implying that seeing A was "done to me" (excuse me? that was my choice, I made it, and I do not regret it in the least), to asking whether we are thinking of having another baby (and how does that change the reality of my son being dead?), to saying that it's no way to live (and how do you know how I live? and what gives you the right to judge how I live?), and I few more that I can't ever reconstruct anymore.

The key part of the conversation, although it weaved through and around the above gems, was the one that started with T asking whether I have heard of X, and getting up to go get the book by X because she "would like me to read it." I replied "Please don't," and had to say it several times before she understood that I meant it. From there, she got to tell me that I don't understand that she just wants to help me, and I got to tell her that I understand perfectly that she is trying to make herself feel better by making herself feel that she helped me. Is it so bad that people feel bad about what happened to you and want to help you, she asked.

The answer, although I am sure you all know it by heart, took me a good long while to get through to her. Of course it's not bad that people want to help. It is bad when people confuse genuine altruistic help with egotistical need to feel like they helped, to make themselves feel better about the unjust world by feeling like they helped to fix it. Even when in reality they haven't. Even when in reality they made it worse. T tried to defend by attacking, by implying that it's uncool of me to make people feel bad for wanting to help. No, it isn't. People who really want to help don't care what form it takes. They do what we, the people who are hurting, need them to do for us. Sometimes it's listening, sometimes it's food, sometimes it's booze, and sometimes it's kindness of delivering sensitive news in a sensitive way, or of understanding that we can't share in their joy right now. This is altruistic help, it's help for our sake. Egotistical help is where the person offering it knows exactly what we need, even when we disagree, and is going to push it on us come hell or high water, or will be righteously pissed when we refuse. This is wanting to be seen helping, to rescue us, to be single-handedly responsible for us "making it." And it only compounds our grief and pain to also make us responsible for not hurting the feelings of the egotistical helpers, because you know, they wanted to help. Therefore, I refuse this burden. I refuse to assume the mantle of having to be the model of grace and comfort for those seeking to make their world feel right again even if it means messing mine up some more. I refuse it not just because it is unfair, although it is grossly unfair, to ask us to also take care of everyone else's tender feelings, but because it helps nobody, not a single person except for the egotistical helper. But even that isn't the kicker. The kicker is that having received the confirmation of their bestest most kind and generous helper in the world status, the egotistical helper in question is only going to go on to do this again. Maybe to one of you, and maybe to someone who will come after us. Because as sure as the world goes on turning, rhythmically, evenly, without fail, even as our individual worlds stop, and then start on again, uneven, screaching, through the haze and the pain of our stories, there will be those who come after us. And so it stops with me, if I can help it. I hand out no medals, and I speak the truth.

This is why, I said, bereaved parents don't tend to tell others what to do. We say "I am here if you want to talk," or "this is what helped me," or, simply, "I hear you." We understand that there is nothing to do. This pain will not be put in a box, it won't be caged, it won't be willed away. This is the pain each of us has to learn to live with, and there is no cheat sheet for this exam. And so we abide with each other-- we offer the kindness of understanding, of encouragement, but never judgement, never solutions. Because we know that there are no solutions.

The miracle is, I got through. She understood, or, as she said, started to understand, and apologized. It took an hour and a half and left me wrung out and unable to think it all through for a while. But worth it, I think.

As long as the second part turned out, I still owe you a third. And the third has been most directly beneficial to my household. See, a little while ago, Niobe wrote of grocery shopping and writing. While I didn't comment on that post, I have been mulling it over, and I realized not only that I do feel very similarly about writing, but that I do not, to any degree of approximation, keep a fridge remotely as organized as Niobe's. So what did I do about it? Although the thought of recruiting Niobe to do my shopping did occur to me, fleetingly, I decided instead to stand up to my own deadly sin (sloth) and cleaned my fridge. Took everything out, threw away things that were going bad, or haven't been used, washed the shelves and the drawers, and arranged everything that remained with a certain degree of organization. I am still very proud of that accomplishment, and even hope to tackle some long-brewing writing projects (read: serious posts that need a great deal of thought to come out right) in the near future. Although this one took much longer and required much more concentration than I originally expected, so maybe I already started.

Worth the price of admission

From the Rosh Hashana liturgy:

May we never abandon our memories. May our memories inspire deeds which lead us to life and love, to blessings and peace.

I never noticed that passage before yesterday morning, and I went back today-- not at all typical as I am not usually big on attending more services than strictly necessary-- just to get another look at it.

This is exactly what I needed to hear this New Year, and I hope it brings a measure of comfort to some of you as well.

Not to mention this is a handy passage for those extra special people in our lives who think that "it" means nothing and that we should be over "it" by now.

Four weeks

My OB gave me a name of an RE. I spent last night worrying about whether I should worry about the RE, Dr.YoungGun, having only graduated med school in '98. But he seems to be a blatant overachiever-- he has papers up the wazoo (last one, accepted but not yet published is about reducing multiple pregnancies in IVF-- me lieky), so much so that there shouldn't be any room up there for his equally numerous awards; he is on faculty of the Fancy Med School, etc. etc. So I am leaning towards not worrying about his youth and inexperience (yes, I know some cultural references from before my time in this country).

Since it's the same hospital, giving the RE's office my hospital record number meant the dead baby story came up on their screen, and I didn't have to give details. While she was pulling up the record, she asked me how long we have been trying. I started with "I have PCOS." She said "Ok, PCOS," indicating there wasn't going to be "it's too early for you to see a specialist" in any case. Then she looked at the record while I recounted my ovulation going AWOL, and didn't question me on the veracity of my conclusion that I am stuck rather than just experiencing a long cycle. His first available was October 11th, though, so that is my current appointment date. But she was nice enough to immediately say that she will put me on the cancellation list. So theoretically it could be earlier, but practically, I seem to be looking at a 4ww. I am not as frustrated as I was afraid I would be. The receptionist who booked my appointment was as nice as she could've been. The wait is "only" four weeks-- I was secretly afraid it would be much more. And it's nice to start the New Year (Jewish one, for those of you who think I just lost the last of my marbles) with a plan.

My wishes to all of you, all of us, for a good and sweet year. As my sister says, this one will not be hard to beat, but here's to hoping next one will bring happiness and joy to those of us in desperate need of both.

From the couch

It occurred to me today that there may have been a reason other than my general tendency to procrastinate for why I kept putting off sorting Monkey's clothes. I mean it's plain as day that the child has grown quite a bit lately. And her closet is overfull (thanks, Mom! You know, in the shout out to the Universe sense-- my Mom does not read here, to the best of my knowledge.). And yet, despite "sort through Monkey's closet" being item number one on my to-do list since last week, it wasn't until today that I actually braved it. It was a daunting task, to be sure (see above re:overfull), and I knew she is attached to some of the items that would have to go, but with this level of dedicated avoidance I find that it's usually not a bad idea to look for another reason.

With the setup like this I don't suppose anyone would be surprised if I revealed that the last time Monkey's clothes got sorted was within a month before A died. Within the last couple of weeks, really. That she has grown since then is obvious to anyone who sees her on semi-regular basis. She is visibly taller, visibly more a school kid than a pre-schooler. But apparently my inner logic here was that if I don't go through her closet, if I do not confront the magnitude of what needs to be packed away, I don't have to face yet another measure of time passed. Who knew time could be measured in piles of clothes on the floor? One child's piles. Only one child's.

Last Thanksgiving, I think it was, JD was saying something about how there isn't as much stuff for boys, and consequently my Mom's retail therapy sessions aren't likely to result in A having more clothes than he can possibly wear (as has been the case with Monkey on occasion). "Watch me," my mother said. We groaned, and we laughed. But don't we all now wish we could.

In the end, though, it was OK. It was even kind of fun. I went through the closet while Monkey was in school and put everything that was in my estimation questionable into a laundry basket. Then, after JD got home, Monkey tried it all on. JD had to be there, of course, because I needed an ally for contentious votes. For things we weren't sure about, we asked her to dance or to do a cartwheel, both of which, accompanied as they were by running commentary or funny faces, made us laugh. In between laughing, JD shook his head at how much she's grown, and I kept trying to get her to take that off, so we can try this other thing on now. I think we did pretty well for a school night.

Slim has left the building

When I was first diagnosed with PCOS, I was told I would need lots of help to ovulate and get pregnant. The probability that I would be able to do that without chemicals was slim to none. That idea didn't sit well with me, mostly, I think, because I found a lot of information on the disease that indicated that it was at base an insulin metabolism disorder, and I found information that said those are amenable to treatment with proper diet, in this case low-carb. Interestingly, Karen H, NP who diagnosed me, did not bring up low carb diets herself, but she told me to go and research the disease, and when I came back saying I wanted to try this, she was enthusiastically for it. I think there was a policy at the department that she couldn't promote a "fad" diet, but she could talk to me about things I found. So I set off to low carb in earnest, and a year later had my first ovulatory period. I was also some pounds lighter, felt tons better, and was exercising pretty consistently. Four more months later, I was finally pregnant.

Only to miscarry at six weeks. One of the scary things about it was not knowing whether my periods and my ovulation would come back. So while we waited, I went to see Dr.Fancy-Shmancy who my then-OB recommended as a PCOS and fertility specialist. She told me that there is no cure for PCOS, that I would have to do treatments to ever be pregnant again, and that the probability that I would do it without her services was slim to none. Remarkably, I felt signs of ovulation only three weeks after the miscarriage, had my period two weeks later, and got pregnant with Monkey on the very next cycle. Slim and I were getting to be good friends.

I was one of those lucky ones who loose weight while breastfeeding. By the time Monkey was 4 months old I was about 8 or 9 lbs below the weight I was when I got pregnant with her. I actually was kinda-sorta slim. I still had room to go, but I was better off than I could remember. I even bought new clothes, sizes 4 and small 6. One hypo-thyroid episode later, I was up at my pre-pregnancy weight. Where I remained up until Monkey was about a year old and was only nursing first thing in the morning and right before bed, when I gained, and I am not exaggerating, 20 lbs in one month. I quit breastfeeding and started on the strict low carbing again. I stopped gaining, but couldn't loose. Unbelievably, my period returned, as did ovulation. I started to believe that I had this thing all figured out. Another year later, frustrated by my inability to loose the weight, I went on Metformin, and later, Avandamet, both insulin-regulating drugs. I lost about half of it over the next two years. Then, on our first try, I got pregnant with A. Slim was positively moving in.

I didn't know what to expect after A died. It took fifteen months for my period to come back after Monkey, but only about 2.5 months after I stopped breastfeeding. I started Avandamet again less than two weeks postpartum. My first ovulation was a little less than six weeks postpartum. That was a big load off my shoulders. Slim, my old friend, was with me again. Throughout the thyroid escapades, the length of my period jumped around a lot. But I thought that was all about the thyroid, and while the length may jump, I wasn't worried about ovulation going AWOL, only about my ability to be vigilant enough to spot it.

Doubtlessly, you know where this is going by now. The test results are back. LH=19.7, FSH=7.5, and progesterone=0.6. That SOB Slim has left the building without so much as a goodbye. No "it was nice hanging with you," or "it's been fun," or even perfunctory "good luck." Asshole.

I was able to get a call into my OB's office before they switched to the answering service. Dr.B's nurse called me back a little later, took the info, and send the good doctor himself an email. If he doesn't get back to her before then, she will see him on Tuesday and will reiterate, in person, the urgency of the request. She is supposed to call me back that same day. In the meantime, I am gaining weight, despite the nontrivial dosage of Avandamet I am on. My game plan for the near term is to wait out Rosh Hashana next week and then to start a low-calorie diet that I used with success once before (before I was ever diagnosed) for a brief period, then switch back to my usual low carb in an effort to shock my body into ovulating again. I am not holding out much hope, though. I think this time Slim may be gone for good.

Hurry up and wait

I did a good job not freaking out about what the test results are going to show. Up until now. Last week I told myself it was too early to freak out. Over the weekend we had guests or went to someone's house every day. Tuesday morning I started to freak out, but then I had errands. Including going for those tests. Which is how I got over the morning freakout-- by telling myself it's silly to freak out over tests I haven't done yet. Then Tuesday night and yesterday I was preoccupied with the whole first day of school thing. So I even took it in stride when the results weren't back yesterday afternoon. I figured I can hold on for one more day. I was so proud of myself for not even calling until after 4 o'clock. Very patient of me, no? But guess what? The results are not back today. They (the lab) promised them (my doctor's office) to try to get them done by tomorrow. They (my doctor's office) promised to call them (the lab) early in the day to see whether they are done and whether they can fax the results. But now I am feeling myself tense up and go into the full-on freakout mode.

It's all about time now. I am fairly certain the results are going to show that PCOS is large and in charge. Which means I will need to find an RE. Which means I will have to call my OB for a recommendation and maybe a note from the teacher that would get me in ahead of the line. Which means that if I don't get the blasted results until tomorrow late afternoon, I can't call Dr.B until Monday. Which means that I will spend the weekend wondering about whether Dr.B can help me, when would I be able to see someone if he can't, and whether there will even be any hope of me getting a due date sometime in '08. So if you are in the neighborhood this weekend, you might want to lock your liquor supply up. Just sayin'.

Monkey

If you ever wondered why I call her Monkey, behold the explanation. (Note to self: good job on saving all those pixels it would've taken to render a whole thousand words. Now try not to ramble with the rest of it.) She is off to Kindergarten in the morning. Officially a big girl. She had been saying for a bit that she is not ready to go because she will miss her teacher from preschool and her best friend from same. The friend and her family came over yesterday, and the girls had a great time. Right up until it was time to go, when the friend literally cried. Monkey obviously thought she should therefore be crying too, because clearly the crying was the measure of the friendship, in the international units of childhood devastation, I guess. She ran up to me, climbed on, and stuck her face in my shoulder. There even were some sniffles, but she couldn't make herself cry for real. Don't get me wrong-- she was plenty upset that her friend had to go, but the tears didn't come. Instead there was a bit of a smile, and an immediate attempt to hide that smile, and a bit more of a smile because she knew she was busted. Yes, she is a big girl, too big to really cry over her friend going home. And today she said she was ready and excited to go to Kindergarten.

I have a confession to make. Sometimes, as I wonder around the internets, reading the mommy blogs, I feel like I am the funny one in the bunch, calling my daughter Monkey. In my defense, this is one of her actual nicknames, stolen, ahem... appropriated from my sister as it was. But also? What else would you call a child who can spend hours on end like so:



She can also spend hours on end drawing. I think she drew her way, and to some extent ours, through the first couple of weeks after A died. For a while after she stopped drawing him. About a month ago she started again.

She draws from a place other than the one from which she speaks, and she herself sometimes seems surprised by what she comes up with. So much so that sometimes upon some consideration she even changes the description of what she says is in the picture. When she just finished this picture and declared it to be a gift for JD, I asked her to tell me what it was, although I was pretty sure I knew. It's me and my brother, she said, and mom with the baby sister in the carriage. Do you know what a wave of love, grief, and gratitude feels like? Like you can breathe the wave itself in, like you can keep breathing it in, drinking it in, becoming it. This wave, it started before I even got to ask the question, and it buoyed me for days afterwards.

By the time JD got home, though, the picture was of her and her best friend of male persuasion and then mom with the baby brother in the carriage. The sledgehammer-like subtlety of the original description is, I am sure, not lost on anyone. I wonder whether somewhere in the part of herself that can't express these things yet she didn't change that description to not put undue pressure on her parents. Which I appreciate, intentional or not. I am not sure I would deal very well with also having to explain to my daughter why there is nobody living in my tummy yet.

I will never have a picture of all my kids together. As long as I have these drawings, though, I can make myself believe that we are going to be ok.

All the cool kids are doing it

I believe they call it viral something or other, but the point is, Slouching Mom put forth a challenge yesterday, although I first saw it at Niobe's this morning (for my blogroll is alphabetical) whose entry rocks hardcore-- on content, rhyme, and rhythm. And lo, the word went far and wide, and it was good.

So here is my attempt at a 26-word poem where every word starts with the subsequent letter of the alphabet. I admit, upfront, to having to use a thesaurus to complete the last line. Blame my ESL issues, or call it cheating-- completely your choice. And please, go check out the others.


Long Ago

Advancing back,
Circling drain.
Every fight gets harder.

I just kill love,
My need of presence
Quietly replaced.

Stoic, tense. Unwise?
Vapid waif, xyloid yowling zoetrope.