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?

The Ghosts of Yesteryear

This seems to be the year of epiphanies for me – lately they seem to keep tumbling around my head like bales of hay, suddenly so obvious and unavoidable that it begs the question: what took me so long to realize this?

I had a late night. I didn’t sleep well. I stumbled out of bed much later than I’d planned and just about managed not to break any appendages in search of coffee – before which you might as well not even talk to me because I will most likely eat you alive. Once my brain cells appeared alert enough to be entrusted with operating heavy machinery (aka driving), I made a brief dash out into the real world to run some errands. I kept zapping through my playlist because nothing quite seemed to fit right – I wasn’t feeling melancholic (yay!), wasn’t in the mood for country, didn’t “feel” the overwhelming ooomph of techno. I finally stopped on a completely unlikely selection for a bright, sunny Saturday morning: Happy Phantom by Tori Amos. It’s on the only album of hers that I own called Little Earthquakes, which I’ve owned and “abused” since I was a college student and an incurable insomniac in my dorm introduced me to her music. (At least I think it was her – I really can’t remember who it was. Who can remember all the people they met in college dorms? They don’t even have name tags!)

The important thing is that, usually, when I play Tori Amos, it’s a bad sign. It’s my personal soundtrack for break-ups, heartache, disappointments of a magnitude so excessive that their tremors couldn’t be measured on the seismic scale. I’ve had moments where I’ve played the same song probably a dozen times in a row because the semi-melodious and somewhat discordant strings of notes combined with lyrics that are open to interpretation (and beg the question of just how much alcohol and/or narcotics were involved in their creation) have always been perfect for my most morose moods. I don’t like to cry in public or even in front of people I know if I an avoid it and I figure that it’s better than drowning my sorrows in a more destructive way. Sometimes music just helps hone in on the epicenter of the pain, which you can then excavate after lamenting on your misfortune, cursing whoever or whatever it to blame (since, obviously, you’re completely without fault – duh). 

Happy Phantom, though, is a “kicky” little tune – it really seems to skip and hop around so that you can almost imagine someone’s fingers dancing across the keys of the piano…which, as I was listening to it in the car today, coincided with passing a pond, on the outskirts of which a duck or other fowl was surrounded by a whole smattering of tiny, downy little chicks. Awwwww!

They were so incredibly cute that I almost stopped to admire them – but thankfully had the presence of mind to remember that (a) it probably wasn’t the best idea to suddenly brake and swerve to admire this display of the Animal Kingdom version of universal fecundity from which I continue to be excluded; (b) I really didn’t want to give Mama Duck/Goose or whatever feathered friend a heart attack while trying to snap her head around in a 360 degree rotation like the Exorcist, trying to make sure all dozen or so chicks were accounted for before the Crazy Woman careened too close for comfort and turned them all into pate.

And there it was – BAM! Another epiphany. (Sidebar: I finally understand Emeril Lagasse’s need for vocal expressiveness. I bet after the 3rd or 4th time when he thought of some genius way to spice up a boring old baked chicken thigh, he realized that this kind of repetitive epiphany was deserving of a loud exclamation.)

In watching the cute little chicks against the song I was listening to – all too familiar, I’m afraid – I suddenly realized that I felt like a ghost. It was the most curious feeling – not like an out of body experience, of course, but it was like I finally found the right way to express what I’ve been feeling for such a long time. For far too long now, I’ve been feeling like a bystander – in my own life, but also in life in general. I feel like I’m standing still while the world around me moves on – without me. I bemoan the life I once had, the dreams I still refuse to give up on (I’m stubborn that way) but that I sometimes wonder, in the dark when it’s just me and my own thoughts: am I just deluding myself? Am I in denial, refusing to accept the inevitable conclusion that it’s just not going to happen for us – or maybe not meant to? I feel, for lack of a better way to express it, like a ghost of the woman I used to be. I feel invisible – and not the good kind where you can sneak around and pinch people or flick someone who annoyed you. (I may have smirked briefly while contemplating the potential. But I’m thinking? Ghosts probably can’t drink coffee or eat ice cream, and that’s a non-starter for me.)

And then, of course, by the time the sun started to turn orange much later in the day, the Happy Phantom started feeling a little less perky. It may have had something to do with trolling through other blog posts – one of which almost caused an instant heart attack when I read on a fellow DOR blogger’s post that menopause is expected within 2-3 years of a primary ovarian insufficiency diagnosis. I tried very hard not to panic because (a) I don’t actually know if diminished ovarian reserve and primary ovarian insufficiency are the same (although writing it now, they sure sound the same to me – nerts!), (b) there’s really nothing I can do about that RIGHT. NOW. You know, other than freak out and scream WHY THE HELL DID NOBODY TELL ME THAT???

So my choices at the moment are:

1. Freak out, start bawling, contemplate life as a barren woman before I even hit 40 – at which point I’ll have such a huge midlife crisis that it’ll make RuPaul look like a Soccer Mom.

2. Panic and start dialing. Oh, wait. Who do you call? This clearly isn’t a case for Ghostbusters (hah, I just realized I could’ve made a totally pithy connection with the whole Happy Phantom thing – but can’t think, must panic!) and I don’t exactly have an RE on speed dial. Did I already mention that before. WE DON’T HAVE AN RE! I AM FREAKING OUT NOW! THIS IS ME FREAKING OUT!!!

3. Take a deep breath and look for the Valium. Oh wait, that’s right – I’m not actually a pharmacy. Or a doctor with a prescription pad. Double Nerts!

4. Take another deep breath, tell myself that drugs aren’t the answer – alcohol is! (Which should be an indication of the level of desperation I’m experiencing, since my alcohol intake is roughly 1 drink per YEAR. (What? I’m going to waste money on booze when I could buy new shoes? Me thinks not!)

5. Attempt to calm down and not hyperventilate while reminding myself that NEITHER drugs NOR alcohol are the solution to any of life’s problems – especially since neither are going to do anything for those shriveled raisinettes masquerading as my ovaries. (I should come clean here and admit that I have absolutely no clue what my ovaries actually look like.)

6. Start crying because there’s no ice cream.

7. Sober up and think about an action plan.

8. Go back to crying because there’s no ice cream. Or chocolate. Contemplate eating the baking chocolate before remembering that it tastes like coal bricks might. (I have no way of proving this, btw.)

9. Play Tori Amos for the rest of the evening and curl up in a fetal position, trying not to think about the irony of twisting my body into a pretzel in a replication of something that I’m trying to accomplish inside my body, not with it. I’m not installation art – although if it’s going to sell enough tickets to pay for IVF, I might just consider it at this point…

10. Take a breath. Sigh. Cry. Curse. Cry some more. Write about it. Think about it. Cry even more.

And make a damn decision, once and for all.

So we’ve come full circle to playing Tori Amos and hating doctors who fail to fully inform us of all the ramifications of our conditions – and once again establishing that, in MY house, chocolate isn’t a luxury, it’s a necessity!