Tuesday, February 24, 2009

Crappy News

J’s sperm count, as of yesterday, was 0.01. This from a guy who, three years ago, had enough sperm to get me pregnant unassisted. It’s been dropping since then, but we’ve never seen anything like this.

For the past four months, J’s been giving himself HCG shots. The idea (assuming I’m getting all of this right—biochem isn’t my best subject) it to stimulate the pituitary into producing more male hormone, which will in turn kick-start the testes into doing their job. But after four months there’s been only moderate increase in the male hormone and the testes seem to have given up. Our RE (who is one of the best in the country) assures us that the HSG cannot be responsible for this—it’s probably just the end game for where his sperm count’s been heading all along.

The RE is going to add FSH into the mix, which might help. It also might not. And we won’t know anything for several more months.

I’m so disappointed. I’m not sure how much of the disappointment is due to the ever-increasing likelihood that J is not going to be the biological parent of my child (of course, I might not be either—we’re just not there yet) and how much of it is due to the fact that we have made no progress with our treatment, meaning that it is unlikely we’re going to be doing another cycle anytime soon. Every year, I tell myself THIS is going to be the year that we finally learn whether we’re going to have a child. I just want to KNOW!!!

I wonder if I really am prepared for the news that J’s spermy days are truly over. I think it’s easy to be blasé about it when it’s just out on the horizon and you don’t actually have to make any decisions. But the truth is, part of me just wants to give up and start donor sperm now. Sigh. If ever anything has taught me patience, it’s infertility.

Of course, I’m also upset because J’s hormone imbalance is a health problem as well. It can lead to poor muscle tone, low bone density, etc. I want him to be fixed, dammit (not in the kitty-cat way, but in the burly manly way). I want him healthy.

And we’re having a huge fight with insurance over this. At first they denied coverage altogether, claiming that the hormone treatment was for “IVF support” and our IVF coverage has been exhausted. We appealed, and then they gave us half-coverage, labeling it “fertility,” but not necessarily IVF. We had decided to let it go. The HSG is pretty cheap, and we figured we’d fight that battle after I was either pregnant or we’d given up on that. (After all, when you’re not trying to get pregnant it’s hard to claim your treatment is “fertility” related.)

But now that J has to take FSG, we’re looking at a huge expense if we don’t get covered. So we’re going to have to file yet another appeal with our insurance company. And they’re going to take another five weeks to get back to us.

Christ. This is so fucking frustrating.

Thursday, February 19, 2009

Where Are You on the Infertility Age Spectrum?

I have two friends entering the IF rollercoaster, both of whom I referred to my RE’s office (J’s snarky comment: “Oh yeah, because they’ve done such a great job getting us pregnant!”). One friend is 43; the other is 32. And I just turned 37, so I’m right in the middle. The differences between our reactions to the IF are stark and I find them interesting.

My 43-year-old friend, T, just got married two years ago. The way she sees it, she came late to the party and now has a chance to try for a child, but she knows she has to work with what she’s got. When she came to me for information on IVF, she seemed totally at peace with it. It’s not that being a mother is less important to her, or that she’s calm about the process itself (shots and hormones and surgery, etc.). But she has known for years that time was running out. For her, infertility is not a disease—it’s a hurdle she faces because of the way her life has played out. She understands that the odds of IVF working are long, and that she might have to use donor eggs. But she’s decided to take her shot at it, and if it doesn’t work she’ll do what she can to adopt.

I don’t mean to make light of her problems. I’m sure she’s scared and hurting. But I almost envy her lack of trauma over the idea of infertility itself. I think of my first year of infertility as a “lost year” in my life, which I can barely see through the haze of shock and desperation I was going through at the time. And it wasn’t like it happened all at once, either. For most of us, it takes a lot of treatment before you know how bad your infertility is, before you realize that you could actually reach the end of the road without a baby.

I know that’s how I was. I didn’t consider us “infertile” when we first went to an RE to check things out. After all, we’d conceived once on our own, so surely all we needed was a little nudge. And our tests came back fairly positive, so we assumed that the trip to the RE was just a little glitch in the parenting road.

Even then, when I thought that going through IUI was just a hiccup in the rhythm of our lives (I’m metaphor-happy today), it was traumatic. I can remember sobbing in the RE’s office when I first was told we would need IUI. I can remember freaking out over the expense ($1,000). And then one BFN after another, and the shock at learning we would have to go to IVF (again, the expense even with insurance seemed so daunting). And then learning about the fibroids, and then the miscarriages, one after another. The decision to have surgery, and the decision to take out the second mortgage and do the shared risk plan. The feelings of betrayal when our RE finally decided—two years too late—to try to treat J’s hormone deficiencies. And the struggle to accept the likelihood of donor sperm as our only option.

So I look at T, who seemed to skip all these steps, and there’s just a little bit of jealousy on my part. She knew going into this that it was a long shot; she knows she might have to use donor gametes. She has a simple plan that will never drag on for years and years.

Of course, I prefer my odds over hers. And yet I wonder what that kind of peace would have been like.

My 32-year-old friend, D, is on the opposite side of the spectrum. (I know, a 22-year-old would be closer to the true other side of the spectrum, but most of the women I know tend to wait until their 30’s to start trying to conceive.) She and her husband have been TTC for over a year, and she’s been charting (TCOYF) for more than half of that. We’ve spent a lot of time talking about what steps she should take. She seems inclined to go to her gynecologist for advice, while I have been urging her to just skip all that and go straight to the RE. (I know that my RE would repeat all the tests anyway.) I can’t tell whether she’s in denial or if I just assume the worst.

But while we talk about the facts, we have yet to discuss how she’s feeling about all of this. And I don’t know how to broach it. I don’t want to say “I’m sorry,” because that’s assuming infertility (and the need for real treatment), and I know she’s hoping that a simple does of clomid might do the trick. And it might, and I really hope it does. Mostly I think she’s not ready to talk about her feelings until she has some answers.

Right now, she’s where I was 3 years ago. And it’s hard to watch that and want to help, but to fear overwhelming her with my own advice. On the one hand, I wish I knew 3 years ago what I know now. I wish I’d known how hard it could be, how long it could take, and even how much strength I would find in myself and my marriage. On the other hand, she already knows some of this—she’s been watching me go through this, after all. And I don’t want to scare her.

So where are you on the spectrum, and how has it affected your perspective?

Wednesday, February 11, 2009

Hiding Out

It's 150 degrees in my office (a common occurance on unseasonably warm winter days), yet I'm sitting in here behind a closed door because I'm hiding from an office baby shower. I'm afraid if I even peek outside my door someone will "remind" me that they're all meeting in the library to celebrate.

This so sucks.

Oh, and today I refused to give my second fan to another pregnant lady in my office. (Pregnant lady of previous fame, posted here.) I can't decide if that's passive aggressive or just plain aggressive, but I'm at peace with my decision. I need both fans, and fuck her.

Tuesday, February 10, 2009

Chronic Pain: or One Reason Why I’ve Been Such a Bad Blogger

Let’s face it: I’ve become a bad blogger. Not just have I stopped posting very often myself, but I’ve abandoned my friends as well, checking their blogs only once a week, discovering important events too late, offering lame advice after the critical moment has passed.

The truth is, I’m exhausted and depressed and trying to escape myself, my life. And while part of this funk is due to my perpetually childless state, a lot of it is due to my chronic pain. So far, I’ve avoided writing about it, because for some reason it embarrasses me. I feel like I’m supposed to be this interesting, vibrant person, full of energy and vitality and activity. For some reason, talking about my “bad back” (is there really no better phrase for it?) makes me feel like a hypochondriac whiner who can’t get off her ass and get her shit together. It makes me feel old, unsexy, unlikeable.

Anyway, here’s the scoop: My lower back hurts. Pretty much all the time. It’s been hurting on and off for most of my life. When I was younger (high school, college, even law school) the pain wasn’t constant. I would occasionally throw out my back and be stuck flat on a heating pad for a week. As I got older, the pain became more frequent. During phases when I was feeling better, I would try to build up my strength by exercising, doing yoga, lifting weights, stretching, whatever seemed smartest. This would work for a little while, but then one day something would go wrong, and I would overdo it, and there I would be, flat on my back on a heating pad again, planning how much more careful I would be with my exercise next time. It was a desperate cycle, and in retrospect, a really sad lifestyle.

A few years ago I saw a chiropractor—someone partially covered by my HMO. He told me the problem was my feet (I pronate) and he prescribed me soft orthotics. I’ll be honest with you: I cried when he told me that I would never wear heels again. I had to replace all my shoes, because none of them fit with the orthotics. Soon I found that I could only wear running shoes. So I would wear running shoes to work every day, and leave them on all day unless I was seeing clients or going to court.

But soon the soft orthotics stopped working and I had to go for rigid ones. So I switched to a podiatrist, then replaced all my shoes again because the rigid orthotics fit differently. Again, the orthotics helped for awhile, then stopped working. Over and over again, I found myself just starting to get into shape when I would hurt myself again, and have to completely stop, sometimes for months at a time.

This November, I finally went to see the chiropractor my podiatrist recommended. He seemed really good, but wasn’t covered by my HMO. Then again, the guy covered by my HMO had sucked, and I was desperate. This guy, the infamous Dr. K of my previous post, thinks he can actually fix the structure of my spine. He showed me an x-ray of my neck; I’ve almost lost the curve of my spine there. This means my head is being held several inches too far in front of my body, which is putting strain on my whole spine. He thinks this structural problem (called “anterior head syndrome”) is the source of my lower back pain as well as my shoulder pain.

So I shelled out more than two thousand dollars for a flat-rate plan to fix the structure of my spine. The idea is to do traction 3 times a week for 3 ½ months, reshaping my cervical spine so that my spine isn’t getting pulled out by my enormous, heavy head (that’s how it feels once I’m aware of it). But less than a month into this treatment my lower back completely freaked out. I guess I was too aggressive with the traction, and my body is just so damn sensitive about everything. I remember a day about a month ago where I couldn’t even put my own socks on. That really did me in.

Since then we’ve been trying to get my body back to the point where I can start the traction again. I have a DDS Belt, which is essentially a lower-back traction device. I wrap it around my waist really tight, then I pump it full of air and it expands vertically, separating my discs. So now not only can I wear no pretty shoes, I am having to try to hide this belt under my clothes, even though it squeezes my fat out above and below it. As long as I wear bunchy clothes or sweaters, you can’t really see it, but I feel like a circus freak. I wear the belt at least half a day every day. I thought it was only going to be for a few days, but my recovery has been ridiculously slow.

And that leads to the depression/escapist angle. Because my recovery has been so slow, and I’m so desperate to feel good again. I’ll feel a little bit better for a day or two (as long as I use the DDS belt), tender and sore but not in serious pain, but then I’ll slide back into joint-throbbing pain where I have to take percocet and lay on an ice pack and just pray that it gets better soon.

Dr. K has been a godsend. He’s basically extending my treatment plan so that when we start doing traction again (which we have to do sometime) I can still finish the plan without paying more. He also basically gave me the DDS belt, which is expensive. And he still believes that I can be healed. I wonder whether we’re both delusional.

I’m exhausted and discouraged and after awhile the pain has just worn me down. I’ve been seeing a doctor three nights a week for three months, and I haven’t even really started my structural treatment program. I feel like this never is going to end.

The strange thing is that this has so neatly replaced my IF treatment. Here I am, spending a lot of money, seeing a doctor so often I’m on a first-name basis with him and his entire staff. I’m in a lot of pain, and all I can do is hope that in the end I’m going to get something worthwhile out of it.

And like my IF treatment, I still have hope. Maybe I won’t be crippled or addicted to painkillers (or both) before I’m 40. Maybe I really will be healthy enough to do my own housework, garden, and have sex. (That’s right, I can’t even have sex.) Maybe I really will be able to handle a pregnancy and a baby someday.

Also like IF, I have fear. Because maybe not. And the thought of what I might become is terrifying.