The Box of Denial

On Sunday, I finally did something I kept meaning to do but couldn’t bring myself to: I unearthed The Box. The pretty patterned one I’ve been hiding for an inordinate amount of time given our predicament; the one I’d started filling with my “battle gear” several years ago. Filled with shiny covers and brimming with the promise of delivering the ultimate goal: a healthy, sustained pregnancy. When I first started buying some of these books, about 5 years ago, I told myself that it was just “in case” – I didn’t really need them because I wasn’t really that serious about getting pregnant just then (newsflash: that’s totally not true – I was just kidding myself. Flat-out D-E-N-I-A-L. Unsurprisingly enough, I’m sure.).

I was embarrassed to admit that I wanted to have a baby – or just how badly – and that the “magic” wasn’t happening. It would’ve been easy to glow with happiness if I’d gotten pregnant – then, only then, was it “safe” to admit how much I’d wanted it. But no such happy event for us. While everyone, it seemed, around us was getting pregnant again and again, I pretended that it wasn’t even on my radar – filled with the growing pain that only receded when it was punctuated by even greater heartache as people around me started dying (five in the space of two years, in case you’re wondering).

As time went on and all the other crap in my life came to a head, the unspoken issues that continued to keep us in our childless state became buried for a while – and so did the box of books. Periodically, I stealthily added another title – maybe something I picked up at a discount store or a used book store. Always when I was alone. Why? Because the books – just as the deceptively beautiful box they’ve been housed in – were something that needed to be hidden. Almost as if, just by being out in the open, it was a jinx – or inviting the prying eyes of others who wouldn’t possible understand in the boon of their own fecundity.

The truth, I finally realized this weekend – in one of those panicky-painful moments that make you get so choked up that even tears freeze before they can fall, so despairing and raw is the emotion – is that I was ashamed and in denial. I kept thinking that if I ignored the box and all the problems inside it, then like the mental trick for putting something out of your mind, it would just disappear.

Ridiculous, right?

But then, if like me, you’ve never been pregnant and are in the Mojave Desert of fertility (the cringe-worthy age bracket of 35-44), it’s hard not to panic. And I mean full-on, ripping-out-your-hair-biting-your-fingernails-to-the-quick-screaming-crying-sleep-depriving PANIC.

On Sunday, right before I went in search of the Box of Denial, I had a no kidding panic attack. I started sweating, my heart was pounding like a jackhammer, and I felt like I was either going to throw up or faint. I wrote in my journal. I tried to watch a bit of tv to distract myself. I tried to talk myself off the ledge. For what seemed like an eternity, I felt like I was going to let out a guttural, animal-like scream just to relieve the tension that made me feel like I was having a heart attack.

I’ve read – or half-read – a couple of infertility books in the last couple of years. One of them was so dysjuncted that I found myself having a hard time following the chronology of events. Another one – that I’m still trying to work my way through – keeps making me feel like gasping in exasperation and rolling my eyes.

The one that I’m actually responding to, though, is a book called Making Babies: A Proven 3-Month Program for Maximum Fertility; co-authored by Sami S. David and Jill Blakeway. To say that it makes me want to pick up the phone, book two respective appointments and get on the next flight to NYC would be an understatement. I started reading this book Sunday evening – and it’s definitely been eye-opening. It made me feel so, so incredibly vindicated about not sticking with Dr. Greedy McMoneybags (the RE we didn’t like but that, in the last couple of months, I was almost tempted to make a new appointment with – how’s that for despair??). As I continue reading, I feel both reassured AND freaked out: we waited too long; we don’t have convenient, easy, or even reliable access to the type of medical care (both Western and Eastern) of the kind that the authors favor: medical detective work.

I know from a lot of blogs and/or IF community forums that many women are frustrated by doctors who are proceeding too slowly for their liking – and if such delays are caused by greed (hey, let’s run a few thousand dollars worth of unnecessary tests, k?) or trying to disguise what is really actually a lack of knowledge, then I agree. However, so far I have found that the approach these two authors believe in is so much more in keeping with what I need and want (but am, honestly, petrified to consider because of my “advanced” age and previous DOR diagnosis): investigating the root of the problem(s) and looking for the least invasive way to fix them.

I found myself thinking back to the RE who never even suggested an IUI (even though I’d never taken Clomid in my life or had a previous IUI) and wanted to go in, guns blazing, telling me the only way we’d conceive was with IVF + ICSI (most expensive treatment outside of external issues such as egg donor or surrogacy – quel surprise!) and that he was planning to use the most aggressive protocol. Meanwhile, my anxious questions about side effects were met with something between a disinterested shrug and dismissive snort – answered as “just some minor bloating”. (Yeah, I didn’t really buy that, either.)

So now I’m in a bit of a weird, uncomfortable situation: on the one hand, I’m enjoying this book – as much as you can while feeling a metaphorical gun being held to your head – and learning about things I, quite frankly, didn’t have the faintest clue about; on the other hand, there’s that nagging voice inside my head saying you don’t have time to mess around anymore; should’ve thought about that years ago. I’m trying to calm myself down and think that investing in their suggestions may take time, but without doing so, I may not only be subjecting myself to repeated treatments in the future that may or may not succeed (to say nothing of the financial, physical and emotional trauma that IVF really represents) but also setting myself up for a lower chance of success than if I actually make the commitment I was starting to make at the end of 2012 before another part of my personal life went to hell in a hand basket last year.

Is it crazy to press the pause button at this point in my life? Is it insane to think, let’s take 3 months to really focus on our health, to consider Eastern medicine (acupuncture, Chinese herbs etc)? Do I want to do this for the right reasons or because I’m scared: scared of the uncertainty, scared of not knowing where to turn at this point, scared of the whole impact of IVF?

The two warring halves of my brain keep being locked in what feels like a deadly tug-o-war: between the “do it, DO IT NOW!” panic side and the peacenik that wants to try and approach this with a modicum of conservatism, meaning in this case to not overlook less invasive treatment options. Did I mention, previously, that no one has actually bothered – at all – to explain any of my labs to me, except to inform me that as a DOR “candidate” for IVF, I’d probably need donor eggs in the foreseeable future? That no one asked me about my cycles, about whether I’ve ever done a BBT chart (I haven’t), that no one bothered to actually do more than 1 set of labs to see if the values were consistently the same; that no one actually checked whether my pituitary gland was/is functioning properly at all, whether my progesterone levels are “normal” in the different phases of my cycle? Initially, I was told I didn’t actually ovulate, ever, at all – based on a single, solitary blood test. So is it really surprising that what I want, what I’m looking for, is an RE who’s going to put all the cards on the table – not just the ones with the highest dollar amount?

And…with that I also realize that I’m driving myself crazy. Last week was a bit of a haze – I was under the weather, feeling emotional even though I’m not yet anywhere close to my next period (which I no longer dread so much as I resent and pretty much hate it). Wrapped up in sweaters and blankets, feverish, I threw myself a pity party by watching Sex and the City. I cried when Charlotte had a miscarriage; I cried when she tried to put on a brave face at Miranda’s son’s first birthday party…until she came face to face with the silver Tiffany’s rattle her first husband had bought before she found out about her fertility issues. Got angry at the scene where this one woman swears by an acupuncturist and highly recommends him in between saying something about how all the IUIs and IVFs had driven her crazy – which made me think: really, how nice it must be to (a) not have to worry about the money part of ARTs (which, let’s face it, is a HUGE consideration) and/or (b) living in a big city where you’re not only spoiled for choice, whatever the type of medicine, but also nowadays in the case of New York City in particular, actually have IVF coverage if I’m not mistaken.

(Gremlin. Ugh. Still working on that…)

Needless to mention, I’m trying to stave off another pity party to coincide with the PMS that, I believe, has RSVPd for sometime next week. I’ve been feeling cranky all day, but I know that’s due to the mute terror I feel without knowing, really, how to find the kind of doctor (and I’d settle for a general one to start out with) who can actually be bothered to look at the person, not the dollar signs. Old-fashioned, you say? I know time is of the essence – believe me, I never thought I’d be one of those “biological clock” women, but there’s nothing like someone putting a question mark on your ability to have biological children that’ll not just make that clock tick but turn it into a dinner gong. Yet, personally, I’d rather have someone who isn’t all about turning you into a pin-pricked receptacle for toxic medications that may or may not turn you into Godzilla, Attila the Hun, Jack(ie) the Ripper etc. from the ensuing renegade hormone spin cycle.

Translation: I don’t want someone to waste my time but also not recommend a course of action before or without investigating other less invasive/costly options. I’m not saying that there’s a chance in hell we could conceive without the previous RE’s “recommendation” for IVF with ICSI (and I use that term lightly, since he might as well have been holding a gun for the amount of choice his “recommendation” left room for). But that book made me so glad, despite our continued struggle, that I didn’t agree to put my life, my body, my health, into the hands of someone who probably wouldn’t have had time to fit me into his busy schedule if I’d thought I was having symptoms of OHSS or some other serious side effect with the treatment.

So here’s my question: how far are YOU willing to go to have a baby?

Is it just about experiencing pregnancy for you? How important is the biological connection to your child(ren) to you/your spouse? And how far would you travel, how much would you be willing to spend, how many different doctors, supplements, medications, procedures would you be willing to endure to get to the sought-after goal?

I’m not being facetious – I really want to know. Because I’m thinking, is it really any crazier to travel out of state – or, even, the country – in the quest of motherhood than it is to contemplate being held ransom to the tune of $25-50K if you have to contemplate domestic infant adoption?

Fostering an Idea: The Sign

Anyone who was a teenager in the 90s will be very familiar with this song – and it’s the first thing that popped into my head after what just happened.

But let me back-track for a moment so you can understand – once I get to the point (eventually) – why this moved me to write a second blog post today.

It may surprise you to learn that my husband and I were not the kind of people who talked about babies before we got married. Or as newlyweds even. I mention this only in passing because I recently read a story somewhere about someone who basically started her TTC journey either on her honeymoon or as soon as they got back – and I honestly couldn’t have imagined doing that, even in hindsight. In my family, we don’t marry early, and we don’t procreate early – everything is done in stages, none of which is even contemplated before you graduate from college. Alternative choices are not an option – and, quite frankly, it would never have occurred to me to choose a different path.

Of course I had no idea that, apparently, somewhere along the lines my connect-the-dots was missing some very crucial ink blots…

Ahem.

When people ask me how long we’ve been trying, I find myself laughing mirthlessly (confession: it’s out of a combination of panic and embarrassment because I don’t have a good answer) since I can’t really pinpoint when we really started – and we haven’t done so consistently. The reasons are many – peppered with family strife, death, moves, etc – so that if our “attempts to conceive” were mapped on a graph, they’d probably look a lot like someone who’s having some minor heart problems. Erratic may be a slight understatement.

But here’s what I can tell you: I’ve been ready to become a mother for almost 8 years now. I always assumed – stupidly, naively – that like for everyone else around me, things would just sort of “happen”. I mean, we did everything “right” – neither one of us is a raging alcoholic, we don’t smoke, gamble or use intravenous drugs; we’re upstanding, tax-paying people with a nice house. In other words? We’re parents without babies. SIGH.

If I had a dime for the many, many times that I’ve drive down a road and caught myself listening to music, thinking – what would it be like to have children in the backseat? Would they sing along? Would be laugh, would they fight like siblings do, would my heart swell each time I caught a glimpse in the rear view mirror? I’d be halfway to paying for a cycle of IVF.

I try to quell those thoughts because, well. You know – it’s painful. It feels like you keep picking at a scab, not letting it heal. And while we’ve still not made any progress with really making a decision in regards to IVF – partly because finding a new RE will involve going out of town, and the logistics of coordinating that are daunting to say the least – I’ve also told my husband that I wanted to make time to sit down and talk about alternative family building options. (Of course, finding the time to actually sit down and have an in-depth conversation with him is kind of hard when he works all the time – and I how can I give him a hard time about it when the truth is that I love him for being a diligent, hard-working man that I adore and respect?)

When I was younger, I always thought I’d want to adopt. Now, I feel bruised and battered – partly because, as someone dealing with DOR and facing the very real possibility that biological children may not even be an option for us (and I can’t even put into words the raw pain that this is causing me on a daily basis), it suddenly feels like it’s not a choice, not an option – but something you’re forced to consider because you may not be able to have a child any other way. Unsurprisingly, I have a hard time coming to terms with my conflicting emotions on this subject.

Worse, though, is I know now that adoption isn’t as straight-forward as I’d believed in the past. If, as I’d naively assumed long before we got to this point, it was just a matter of saying “yes, please!” and being open to adoption – I’d have no problems with it. As long as I can have a healthy baby, I could cope with one that’s not biologically ours – regardless of gender or race. But I was in for a rude awakening. Adoption can be far more expensive than IVF – which, in itself, boggles the mind – and seems poised as a sort of popularity contest of sorts, almost like a cattle auction. The other day I was reading a brief paragraph about how domestic infant adoptions usually run between $20-40K (yes, thousand – as in, five figures) – but can be even more expensive. I’ve seen numbers quoted that were closer to $50,000 – which is more than both of our cars, brand new fridge, washer & dryer etc. cost when we bought them. It’s years worth of mortgage payments – money that is then no longer available for college tuition or other more immediate family concerns.

(Did I mention that this is for domestic adoption? As in, right here in the good old US of A? We’re not even talking about international adoptions, at which point you obviously have to factor in travel and accommodation – so that, at least, I understand why the bottom line would be augmented by things that aren’t strictly related to the adoption itself.)

At the risk of putting my foot in it, I think that’s preposterous. I don’t agree with it, and I think there’s absolutely no justification for it whatsoever when you’re dealing with domestic adoptions. I know some people are willing to do whatever it takes to get a baby, any baby, by any means necessary – but for me, that’s just not something I don’t think I’m even willing to consider, especially in this day and age when you see adoption agencies vying for prospective birth mothers by promising them free iPads and/or iPhones (unreal!) – unsurprising, really, when you think about how much money they (the agencies) are making off of the whole transaction.

But I don’t want to get into that too much because I’m so angry that, in dealing with IF, you’re constantly penalized for a medical condition (that isn’t even recognized as such – which is why only 12 out of the 50 states even have IVF coverage, and most insurance companies also don’t cover ARTs) for which you are not responsible. Suffice it to say that, unless we magically find someone who wants to give us their baby, this avenue is closed to us – because we definitely will NOT be going through an agency and mortgaging ourselves up to our eyeballs for this.

The alternative, then, is to adopt from foster care. Which, if you’ve ever watched anything on tv at all or read anything online, you’ll probably know two things (a) there are far too many kids in foster care, which is nothing short of tragic; (b) adopting from foster care can be extremely difficult and traumatic for both the child and the adoptive parents. Again, I don’t really want to get into details here – mostly because I’m not an expert and I don’t know much of anything about it – but it’s something that’s been on my mind lately. I thought about whether I could see myself adopting a child that wasn’t a baby, perhaps not even a toddler. Could I see myself “mothering” an 8 year-old? What about a 10-year old? Because the reality is, of course, that everyone who is forced to consider adoption wants a baby – so the sad reality is that the children who remain in foster care the longest are always the ones who are already older. It’s heartbreaking – but I struggle between what I think about the situation and asking myself what I can realistically take on. And, of course, what my husband is willing and able to deal with.

So two nights ago, I started doing a little bit of reading online – wondering whether maybe we should at least talk to someone about the whole process so we can find out exactly what’s involved and so on. I figured that since the likelihood of getting a match even by being amendable to adopt through foster care within less than a year (and most probably 2 years or more) is slim to none, we might as well “hedge our bets” even before we start IVF.

What prompted this whole blog post is a pamphlet that came in the mail yesterday – not 24 hours after all these issues weighed heavily on my mind. We’re not even supposed to get it – it’s a residual from the previous owners of our house from a local hospital that I assume they were patients at. Normally I just put it in the recycling bin because there’s nothing relevant for us – but I decided to flip through it…and on the second page, there was a story about foster care in relation, specifically, to teenagers. If I were religious, I might ascribe this to a whack on the head from a higher power – but even without ascribing to such a philosophy, I still thought…coincidence? Or a sign? Not a sign that I should open my home to a teenager – which I honestly don’t think either one of us would be prepared to do as first-time “parents” – but I thought, what a coincidence that this showed up in mailbox the very day after I was just looking into this subject.

I’d be lying if I said that this was something I can just gloss over and say – sure, no problem. I’ll do it! I know that part of the reason I’m reading up on these things is because, deep down, I’m steeling myself against the fact that I don’t actually know what’s going on with my body – and that, a year after my last AMH test, I’m not even sure if I’m still dealing with DOR or if it’s already much worse…I shudder to think of all the people who completely fail to grasp how the mere thought of not being able to have biological children is absolutely devastating; and how, consequently, the reality would – and is – so horrific that just contemplating it makes me feel like I’m going to throw up.

Sometimes I tell myself – this isn’t the end of our story. We’re not meant to be childless. We’re such loving people, we’re caring, we’re funny, we’re empathetic and compassionate. We have so much to offer. Sometimes I imagine having a conversation with someone who is giving up her child for adoption. I imagine what I would say to her – but part of me always wonders how difficult it would be to “sell” yourself while trying to remain calm and not freak out at the possibility that this person who has what you want most in life can just change her mind at a whim. But when I can disregard the scary bits, I imagine what I would say about us – to a birth mother or to a child we’d consider adopting. I would talk about our travels, our love of music, our pets and our belief in bringing out the best in each other. Would it be enough?

Sometimes I think I could – I want to – give a child what I’m good at. I’m the person who blends into other families as the aunt – the one who helps with homework, chimes in (when appropriate and obviously never overstepping the parents’ authority/boundaries), helps you navigate through the minefield of tween and teen conversations around emotionally charged but important issues. So I think to myself, if we can provide a safe, loving home for a child that hasn’t had one – a child who deserves to be loved, cherished, helped to grow into whoever they’re meant to become…how can I not consider that?

But of course I know that I’m idealizing the situation. Even with as little as I know, I’m aware of how much emotional baggage children in foster care come with. As time goes by and I ask more questions, I find out things that make an already daunting prospect even scarier – conditions like RAD (reactive attachment disorder). I wonder if I can deal with trying my hardest to love a child…and accepting that, sometimes, no amount of effort and love is going to turn the tide. I think my biggest fear would be dealing with a “psychotic” child – and by that I mean seriously deranged to the point of being homicidal etc. – or a child that lies, steals or has serious aggression problems. Because dealing with a child that really, genuinely WANTS to be loved – a child that wants to have a home, a family, wants to learn, wants to have a good life? THAT is something I can give – even if I know, of course, that it would be a journey filled with many, many lessons and a need to learn how to deal with things I’ve never had to deal with before. But I know it’s just not that easy.

I’m still scared – of all of it. Mostly, I’m scared of the mere thought of being – or, rather, remaining – childless. I admire people who choose to be childless because I think it’s so much better to make that choice than to have children if you don’t really, really want them. But that’s just not for us – at least not at this point. I can’t imagine a life without children. So I have to continue to believe that somewhere, at some point, our child will find us – whether through assisted reproduction or adoption. All I can say is that, whenever he or she comes into our lives, our arms will be wide open…