What's Going On Up in There?

It's so mysterious, this female reproductive system of mine. As prescribed, D and I made love this morning and I stayed still for 30 minutes after as I imagined the journey of the millions of little spermatazoa, excited by their sense of the egg(s)--their destination. All day long, I've been walking around thinking: Did they make it? Did more than one make it to more than one egg? If three made it, will all three attach to the lining of the uterus? What's going on in there? I want to go to a lab, hop on a table, and have them look inside and show me what's happening. It's hard to believe that such life-altering, momentus things might be happening (or not) inside my body while I walk through the mundanities of my life--doing dishes, feeding the cats, sitting in meetings . . .

Flex Spending Revelations

A few months ago, our Communications Director, J., said that she had something small to tell us. "About the size of a lime," she said. She revealed that she was pregnant, and my heart fell. It's not that I wasn't happy for her--I really was. It was just that I felt like every woman my age or just a little younger in the office was a mother. We recently had a spate of pregnancies in my office--one development person, two staff attorneys, our deputy director, and an administrative assistant. The joke was that the pregnancy was contagious in our office. I would always think in my own mind when I heard this: "Except I'm immune." So when J told us, I felt like I was the only one who was struggling with this.

Well, I'm not. And this is how I know.

Our office offers Flexible Spending Accounts (FSAs) that allow you to set aside a certain amount of money for health-related expenses pre-tax; meaning, you put money into an account through paycheck deductions that reduce the amount of taxable income you earn. It's a great tool if you manage it well. One year, I had about $1200 left in my account and I convinced my dermatologist to give me a prescribed chemical peel ($1000) and stocked up on band-aids and cough syrup. Last year, I missed the deadline so I didn't have one. You can use the money for co-pays, expenses not covered by insurance, eyeglasses and supplies, counseling, and over-the-counter medical supplies.

This year, I wanted to estimate correctly, so D and I counted up all of the chiropractor visits we expected to make, the crown he wanted to replace, the prescriptions that we thought we might need at $20 a pop, and . . . then I remembered that if I got pregnant, there would be a load of expenses. How to estimate THAT?

Well, we're planning to find a midwife and see if we can do a home birth, so I knew the expenses would not be easy to determine with a web search. I decided to confide in J, who has also chosen to deal with a midwife for prenatal care and to have a home birth, and ask her for an estimate of what she was paying. J and I aren't close, but I like her and I trust her. When I went to her office to talk to her, she immediately confided in me that it had taken years for her to conceive. She did the whole fertility treatment dealeo . . . innumerable visits, shots, medication, etc. She said it took quite a toll. She said this pregnancy was a long time in the making. She spoke of how hard it was to see all of her friends get pregnant one after another. She talked about the expectations that people had of her, assuming that she was waiting until her career was more established before choosing to have a baby. She told me that she didn't talk to anyone about this while she was trying.

I was grateful to hear all of this. I was grateful that I wasn't alone among the people I knew. I wonder how many other women I know are struggling and not talking. I think it would be helpful to talk about it. I have to admit that on some level, it feels like a giant female failure to not be able to get pregnant easily.

At any rate, we did get to discuss expenses, and while I'll write about this in another blog entry, I should say that the estimate for a home birth (including prenatal care from the midwife) is about $7,500. A lot less than I thought it would be, and it seems that Cigna might cover 80% of that. They better, cause I think that's probably a lot less than what it would cost in a hospital.

Drugs

A few weeks ago, I started getting a series of calls from Cigna saying that I had ordered some drugs and where did I want them delivered. I'm like: "what drugs? I didn't order drugs! Put me on your 'do not call' list." Then I find out that the drugs my doctor prescribed were supposed to be delivered to me, and Cigna was calling me to confirm delivery address and get my credit card number for the copay. Fed Ex next day delivery to my office the next day allowed me to start this course of treatment this month. Thank you Fed Ex. Except one more problem: they didn't send the pre-filled syringe of hCG that they were going to--the shot that releases the eggs. Apparently it's a controlled substance and they only fill it upon a written scrip. So I call the doctor back, and they say that Cigna is notorious for this kind of screw-up; of course they mailed the scrip. Cigna just always loses them. So I ask to speak to the doctor to see if I can figure out whether the rest of the drugs (the clomid, the ones pictured here) will boost my chances enough so that I can risk maybe not doing the shot this month, or whether the hCG shot works in tandem with the rest of the drugs such that I should fork over the $90 out-of-pocket expense. The doctor's assistant got back on the phone after about 15 minutes and said that the doctor just happened to have an extra shot in the office and they'd administer it for free. Bingo. So, off to the doctor I go again, shot in the butt, and I'm off. Doctor advised us to make love that night, and then again Friday morning. (The math is just crazy: shot releases the eggs in 40 hours; sperm lives for 72 hours; egg lives for 12-24 hours unfertilized; sperm takes 30 minutes to reach an existing egg...) Unfortunately, I was so exhausted from work and running around all week that I just could not muster the energy for seduction. Thankfully, D knew what he had to do, and while it didn't work out that night, he dutifully performed the next morning. We were prescribed one more try on Friday morning (several hours after the eggs are supposed to have been released), and I've already arranged to go into work a little late, so we're cool. Pregnancy test on December 1, and if we're not successful, we try again in December. It's super exhausting to deal with all of this, but I feel like we're taking the right steps.

Ovarian Amphetamines

A doctor friend of mind coined this euphemism for the drug "Clomid" or "Clomiphene Citrate," the drug I'm now taking to spark egg production. I like to call it my "twin pills," because I'm convinced that now that I'm taking it, I'm going to conceive, carry, and bear twins--or worse. I remember thinking, not so long ago, that I would never do this. And I remember darker thoughts: that women who did were selfish, foolish, and over-consumers of health care resources. In presentations that I would give to audiences about moms who were struggling with drug addiction, I asked folks to consider the moral, economic, and legal issues raised by moms who used illicit drugs, compared to moms who used fertility drugs. Didn't it cost society more to care for multiples than to care for an infant with drugs in its system at birth? Wasn't the harm greater?

But here I am. Taking one of these little pills twice a day for ten days. And hoping for many things at once. Including grace.

Offbeat Mama

I just read an amazing blogpost on Offbeat Mama. The founder of Offbeat Bride, the book and accompanying social networking site that helped me keep my sanity during our year-long wedding planning process, started Offbeat Mama, right around the time of our wedding last May. I check back every now and then to see if she creates a feature, like the Waiting Room on the Offbeat Bride Tribe website, for women who are trying to get pregnant. I don't think she did (yet), but I did find this post, by Ariel, the founder herself. She introduces her own story of problems conceiving with a video by a woman who poses a series of "what if" questions...questions that have been swirling around in my mind about infertility for the past year. I have been searching for something to read, something that I could identify with, around all of this for the longest time. My husband is so certain that it will all work out in the end, he insists on speaking in terms of "whens" as opposed to "ifs." Ariel's story was poignant, and scary . . . I hope I only have to go partway through the course of action she had to take in order to become pregnant. But I've already gone farther than I thought I would in order to conceive.

Two parts of Ariel's post particularly resonated with me:

the weight of the trying and failing got heavier and heavier. After a year of trying to conceive, it's not so much fun. It's depressing. It starts to mess with your head. I started feeling like a core part of my body had become an untrustworthy stranger. A breech of trust with your own body is emotionally brutal.

And this one, which describes so many things in my life about which I've harbored fear and loathing:

IVF was this terrible awful procedure that I'd invested a lot of fear in. It just didn't fit with my identity — who's heard of offbeat infertility? Offbeat IVF? Pshaw. It was the expensive invasive terror that desperate people indulged themselves in. It was like gambling: this thing that you keep tossing money at hoping that this time you'll win but ultimately the house always wins and you always lose. Of course you lose. It makes you crazy, and worst part? It doesn't even work most of the time.

. . .

What I want to say is this: I was wrong. I invested years of my life living in fear, seeing something (in this case Western fertility treatments and especially IVF) as the awful boogey man in my hippie closet, the terrible admission of defeat that would forever turn me into a person I hated myself for being. Ultimately, I was wrong. This makes me wonder ... what other massive fears of mine are completely unfounded? What other things that I see as the worst WORST case scenario could actually lead me to a place of profound happiness? What other paralyzing grief and fear could I release?

Nourishing the womb

D's chiropractor has been giving me all kinds of advice about fertility--he even gave me a book called Wise Woman Herbal Childbearing Year by Susan S. Weed, a bottle of fertility formula (pictured here), and a bottle of false unicorn. I don't know if these things actually work, but I've been taking 20 drops of the fertility formula three times a day for the past month and a half. I feel like I have a more nurturing womb, but who knows? I hope a fertilized egg thinks so and decides to stay.

Indeed, the ovulation test showed a surge just an hour before I was to leave the house and go away for the weekend with my girlfriends while D packed up to head off in the opposite direction to a frisbee tournament. Thankfully, we had given it one try in the morning before we knew the surge was positive. What happened that day, however, I think will bear more fruit, so to speak, in the coming months. We had a really difficult discussion about priorities and our approach to this whole babymaking project that will be helpful next month. And then we gave it another try before I ran off to catch the train. : )

To my delight, D actually drove up the Catskills from his tournament in Philadelphia so that we could log one more attempt during the second fertile day. I love him for that (and so many other things).

I don't want to say "fingers crossed," because I don't want to set myself up for a big disappointment in two weeks, but I can honestly say that we gave it the best try yet.

Now, I just have to make sure that I scale down the stress level next month.