The drug dealer calleth

The scene: A San Francisco apartment, August 2007, 8:30 am. A woman (mid-30s) is trying to leave for work when the phone rings.

Woman: Hello?
Caller: Hello, may I please speak with Aspiring Baker?
Woman: This is she.
Caller: This is Your Insurance Company's Pharmacy Department. May I verify your date of birth?
Woman: Well, no, actually, because you have called me.
Caller: Yes, and we need to verify your date of birth.
Woman: Uh huh. But how do I know you're who you say you are?
Caller [testily]: Because I am.
Woman: In this age of identify theft, I'm sure you can appreciate my hesitation to reveal my date of birth to a random caller. I wouldn't give you my social security number, either.
Caller: [more testily] I didn't ask for that.
Woman: [conciliatorily] Right. But surely you can understand why I wouldn't want to give out personal information over the phone when you have called me.
Caller: [resigned] May I verify your zip code, then?
Woman: Yes.

Now, I recognize that I'm a little cranky these days, but really -- what corporation in this day and age -- particularly one that's subject to HIPAA -- thinks that someone who answers the phone is just going to verify their date of birth?

Said phone call subsequently revealed that the insurance company will send via UPS seven -- count 'em, seven -- drugs to my home. They are:

- Lupron
- Gonal-f
- Repronex
- Novarel (HCG shot)
- Estradiol
- Medrol
- Progesterone

They even include all of the syringes and alcohol pads. This is going to be fun!

Now we're both on the Pill!

Well, okay, only one of us is on the pill. But who can resist a Sixteen Candles reference? (Bonus points to anyone who can name the line following this one...*)

Got my period yesterday, started birth control pills today. I expect to start shots in about three weeks and do a retrieval/transfer in about six.

The next big question: provided eggs are stimulated, retrieved, fertilized, etc. -- how many embryos to transfer? The minimum is one, and the maximum is two. The issue: if I hope to avoid twins, and if each embryo has a 20 percent chance of implanting and at least a 20 percent chance of miscarrying, and if IVF has a 30 percent chance of twins, how much do I need to pay a statistician to figure this out for me?




* It's: "You gave me birth control pills? Do you know what that can do to a guy my age?" Such a good movie.

Signs point to no

Looks like I'll be starting the birth-control pill this weekend (just what I always dreamed of!).

7 Reasons Why/Not

(Scroll down because Blogger is being silly)

Reasons why	/Not
Breasts are tender	but not necessarily any more tender than any other day 25 of my cycle.
Temperature was really high today	as it has been many other times when I was not pregnant.
I was pretty tired over the weekend.	So?
I've felt sick to my stomach the past couple of days	and also have a little sore throat, which isn't typically a pregnancy symptom. Plus, if morning sickness is kicking in already, I'm going to be the first woman on record to naturally conceive septuplets.
Lots of weird dreams	which means I've been getting lots of good REM sleep.
Cranky!	Again, so?
Cramps	In a theoretical universe where you're trying to keep things in your uterus, motions to expel are not so good.

Back in the saddle again

If you knew me, you'd probably be surprised to learn that I am superstitious. I am extraordinarily logical and practical; I've been accused more than once of being unemotional at times when emotions should have been front and center. What can I say? I'm a Myers-Briggs ESTJ, all the way.

But it was superstition that guided me to the sperm bank yesterday morning, to commence my 18th two-week wait. After all, yesterday was my father's birthday, which was a good sign, and if I got pregnant, my due date would be the second anniversary of my first miscarriage. That has to be two good omens -- a coming full circle, if you will. Plus, even though I'm not religious and only learned about this tradition a few years ago, the number 18 is lucky in Judaism.

And so yesterday, after journeying to my favorite farmers' market and watching sea lions frolic under the San Francisco Bay Bridge, I wandered into some stirrups and got shot up with some guy's spooge.

To be frank, I am ambivalent now about this decision. On the one hand, my timing was good (felt ovulation sensation all day), and I am anxious to get on with this baby-making process. On the other hand, I'm a little on the fence: I traditionally abstain from a lot of TWW exercise (at the advice of multiple acupuncturists), and I'd sure love to go running right now. I'm not at the weight I thought I'd be when I tried again, and part of me wanted more time for a break.

What's more, I had planned to do a little ceremony for embryos 2 and 3. I planned to bring the ultrasound photos to the beach, write a letter, and say Kaddish for them before I tried again. I feel like I'm supposed to do that. But instead the photos are sitting in an envelope on my desk along with some positive HPKs (gross, I know, but don't pretend you wouldn't do the same thing! Please?).

Part of me feels it's bad luck to say I'm not 100 percent excited about this cycle, that I'd still like to hop on the treadmill and find a way to fit into my skinny jeans. But the logical part of me believes there's nothing I can think that will change the outcome of this cycle. After all, being totally gung-ho hasn't had an effect in the past, so why should the reverse be true? At the moment, I think I need to stop my quest for self-improvement and tendency toward self-doubt and just try to be.

From PostSecret

This image from PostSecret resonated with me even before I saw this comment that went with it:


" Sent: Sunday, July 29, 2007 9:09 PM
Subject: "You aren't being punished..."

Not sure if this is the correct email to comment on a post card or not but....

All I can say is thank you. I just recently suffered a miscarriage and have felt for weeks like God was punishing me for something I had done. You have been the only person who knew just what to say."

Still trying to decide about an IUI later this week.

Decisions, decisions

The problem with lists of pros and cons is that such lists don't usually assign weights to the options. Everything is equal. Which makes this list of pros and cons a bit flawed.

On doing an IUI this cycle (it's day 8):
Pros:
1. I'd like to have a baby.
2. I might avoid IVF.
3. I could get this show on the road earlier.
4. Physically, there is no reason not to try -- I'm in good health, don't have any contraindications that I can think of.

Cons:
1. The chances of success are low.
2. Particularly since I haven't taken any fertility drugs this month, and it's too late to do so now.
3. Absurdly, doing an IUI this month will probably cost me more than doing IVF in two months.
4. Supplies of my new donor are very low, so it would make sense to try to maximize his seed.
5. I haven't done very much acupuncture lately.

Of course, if I try this month and don't succeed, it has no effect on my IVF plans. But I'm getting impatient.

Any thoughts?

Small blows

It is not getting easier.

At times I think I'm fine, I'm handling this so well, I am a trooper. I rock. Then new information knocks on my door and punches me in the face.

Sunday my period arrived in full force just before I attended a friend's baby shower. In addition to the in-utero fetuses in attendance, a new mom brought her newborn to the shower. I remember when the mom, the pregnant friend, and I were all knocked up at the same time. We were going to go out for pregnant ladies tea, only I nixed it, wanting to wait to see a good heartbeat. I made it through the shower pretty well, but I look miserable in the photos.

Yesterday it was the news that another co-worker is pregnant. I suspected this woman might want to have another baby, and just yesterday I saw her walk by and thought she looked pregnant, so I'm not entirely surprised. Then today the news that another co-worker's wife is expecting -- more news I anticipated. This is now past the time that I would have shared my news. I would have been part of the pregnant people club. Instead I'm part of the one-person club that has to leave the office to walk around the block and keep myself together after someone whispers to me that his wife is pregnant.

When I was a kid, the street next to ours always had block parties for the Fourth of July. I knew kids on that block but always felt left out, wishing we had parties on our street. Thirty years later I feel the same way. As my co-worker mentioned something about how much your hormones rage during pregnancy, I wanted to say, I know -- I've been there. Of course I haven't been there, really; I've spent about 12 weeks being pregnant in my life, less than a trimester. But when someone tells me their news, I feel this urge to share mine, to be recognized. After reacting probably not as enthusiastically as I should have with co-worker number 2 today, I pondered opening up to him. Instead I'm writing a blog post from my desk, wishing my block would just throw its own party already.

Numbers

Women don't often discuss their weight. I was once at lunch with a group of male co-workers when, to my amazement, one of them began asking the others what they weighed. Nearly all of them chimed in, and none seemed to really think anything of it. I sat silently, in awe. Can you imagine being a table of women tossing out their weights like it was their batting averages? Not so much.

For most of my twenties I weighed more than 200 pounds. I am five-foot four and a half, and I wasn't that big because I was big-boned; I was that big because I was fat. I weighed around 225 in the mid-90s, and by my early 30s I had dropped to about 210. When I was 32, I began losing weight. I didn't diet, count calories, or have surgery. I started watching my carbs a little bit, ate more protein, stopped snacking so much, and started a running program. When I turned 33 I weighed 161. I dropped to about 150 six months later, and I've hovered around that weight ever since. I ran a half-marathon on my 34th birthday; I ran a second one a week later.

When I was heavy, I thought there were ways I could hide it. In college I always left for classes early, so I could hike to the third floor and pant without being noticed. At my first job after college I developed a habit of not turning my head to the side to talk to people; I thought they'd notice my double chin if I did so. (Um, they probably noticed it anyway.) I avoided an office river rafting trip because of the whole bathing-suit issue. I hated summer business trips because I'd get sweaty. I hated having to scoot by someone on public transit because of how big I was.

When I was heavy I always felt there was a smaller person inside. My self-esteem was horrible, and though I always felt awful about my body, the idea of losing weight -- I probably thought I should weigh around 130 -- was insurmountable. That's why I am probably more amazed than anyone that I've managed to keep the weight off. I still don't know exactly how I did it and what prompted me, but it's among my proudest accomplishments. Not just the weight loss but the keeping it off, because it's said that 95 percent of people who lose that much weight gain it back in two years. (The National Weight Control Registry tracks people who've kept off weight for longer periods of time; I reached a milestone when I'd kept my weight off long enough to become eligible to join it.)

It was absolutely incredible to me the first time I tried on something in the Banana Republic women's department and it fit. I'd bought men's XL sweaters for years, but I wasn't able to dress as I wanted because the apparel industry is so incredibly backward when it comes to meeting the needs of its potential customers. (Do you know how much more money I would have spent on clothing in those years if I'd found something that fit me, was age-appropriate, and that I actually liked?) When I first started shopping at regular-size stores, I felt a bit disloyal to my former self, who had written angry letters to the CEO of J. Crew, asking why they didn't carry anything beyond a size 14. (Now they've expanded to size 16 -- whoopee. I meant two-digit sizes starting with the number 2, people.)

I've kept my weight off over the years not by dieting like a mad woman -- I've previously mentioned my penchant for baking -- but by exercising and weighing myself religiously. I believe the body has certain weights it can naturally maintain, and 150 seemed to be that for me. (220 was, too.) Even though at 150 pounds I still have a belly and would never be described as skinny, I decided that I could handle 150, plus or minus 3 lbs. So when I got up to 156 recently, after the second miscarriage, I decided I had to deal with it. I spent two weeks doing the first phase of the South Beach diet, eating only vegetables, protein, and nuts. My energy sucked, but I got enough to eat, and I lost 6 lbs. I originally thought I'd stay on the diet for a while and try to keep dropping weight; I have this fantasy of getting down to 145 and fitting into a pair of jeans I could wear back when I was running half marathons.

Instead I spent yesterday eating candy and pizza. I'm going to start eating better soon, like maybe tomorrow. But things are hard enough right now without feeling perpetually in denial. I am working on convincing myself that weighing 150 pounds is good enough. Sure, it would be great to weigh 145 before getting pregnant again. It would be great to weigh 130. But 150 has been good enough for more than three years. What's different now?

Blessed events

There are three invitations on our fridge right now. One for the wedding of my 26-year-old cousin, who's having a very large, presumably extravagant (and heterosexual, if that's not obvious) wedding; ten bucks says she's pregnant before she's 30. The second is to the lesbian wedding of a friend with a toddler; she conceived on the first try, and for their wedding gift, they're asking friends to contribute to an IVF fund. Not because they need to do IVF for kid #2, but so they can use one partner's egg and the other's uterus. The last invitation is to a baby shower of a close friend who's expecting twins after struggling with infertility for a while. When I was pregnant, I imagined attending these events with a nice little second-trimester belly. Instead I have my usual grandmotherly figure.

Is it any wonder I'm a little cranky these days? This summer was supposed to be a break, and in some ways it has been: I haven't touched my basal body thermometer, haven't gone to acupuncture, and even spent two less-miserable-than-expected weeks on the South Beach diet (more on that later, maybe). In other ways this hasn't been a break at all, because the very nature of a break makes me anxious. The longer I wait, the longer I wait. I probably won't be pregnant again until I'm at least 37. Given that I got pregnant at 35 and 36, and given that I've always wanted two kids, this freaks me out. I worry that if I do get pregnant, it may be my only pregnancy -- if I'm able to maintain it.

It's also not entirely a break because of the hoops I need to jump through to prepare for IVF -- blood tests, copious forms, choosing the next sperm donor, etc. My doctor's office wanted me to see a psychologist to discuss my feelings about "third-party reproduction." This nearly made my head explode: for some reason no one has required me to see a therapist for the 17 cycles of third-party reproduction and two miscarriages I've already experienced. Why is it different now? (Since I already have my own therapist, I'm finding a way around this, but the very idea of this enrages me.)

To get started with IVF, I need to call my doctor's office when my period arrives. From there, I take birth control pills for a month (that'll be fun!), then start the other no-doubt-delightful drugs in anticipation of an egg retrieval about 6 weeks after my period arrives. At the earliest, an egg retrieval could happen in late August. Until recently I thought I'd wait until the end of the summer to get things going. But this week I realized that this break isn't a break; it's a stagnant pause I never wanted. Maybe the best way to stop feeling pissed off and sorry for myself is to accept that I'll never be ready for another miscarriage. I'll never want to do IVF. Maybe going to Paris before I get pregnant again isn't as important as just getting this goddamn show on the road.