My least favourite holiday

Ugh. Maybe it’s because it comes after Christmas and everything after Christmas but before spring is a bit of a cold, grey bore, but I’ve always hated New Year’s Eve. No New Year’s Eve has ever lived up to the hype for me.

Midnight countdown? Bah, I’d rather sleep.
End of year reviews? Been there, done that.
New Year’s resolutions? Why bother?

And no, I’m not just bitter because my in-laws are visiting. But they are. They’re not so bad, actually. Don’t tell anyone, but I actually kind of like them. So long as they don’t expect me to stay up until midnight on Saturday or watch any lame “Best of 2005” shows on TV.

So I won’t be making any New Year’s resolutions this year. But I suppose I can stop kvetching long enough to wish you a Happy New Year – as long as I can do it while the sun still shines.

The rest of the (IVF) story

Yesterday, I told you the long and raw back-story to our infertility struggles. The good news is, today’s story is a lot less painful to read. And it has a happy ending!

Now that I’ve blown the suspense…

We started our first IVF cycle in May of 2001. In addition to ramping up the dose of follicle stimulating hormones, there was an additional week of self-injection to ‘suppress’ my own hormonal system, giving the clinic complete control over my body’s reproductive cues.

When we first considered artificial reproductive technologies, the idea of the self-injections terrified me. I’m not afraid of needles per se, but I was very squeamish at the idea of doing the injections myself. I never could work up the courage to inject into my belly, but I did become a pro at finding the perfect spot on my thigh to inject. To this day, the smell of alcohol wipes brings me instantly back to our treatment days.

And let me interrupt myself to explain that even beyond the emotional turmoil that goes with infertility treatments, it is nearly impossible to have a normal life during an IVF cycle. You have to be at the clinic first thing in the morning to get blood work and an ultrasound done. (Finding a parking spot is hell. Getting to work even remotely close to on time is impossible.) Then you are on tenterhooks all day, waiting for the results. (The nurses used to laugh at me. They’d call and say, “It looks good, we’ll see you in two days.” And I’d say, “How many follicles? What were their measurements? What was the exact estradiol count?” And I’d obsessively chart everything on an Excel spreadsheet saved in the same file as all my temperature charting from the old days.) You have to be home every day around dinner time to do your injections, or take them with you. (Post for another day = funny places you’ve done your injections. My winner? Bathroom stall of Taco Bell.) And you have no idea when your retrieval will actually be. Maybe in six days, maybe in eight. We’ll see. Probably in two days, but maybe three. As you can see, IVF is neither for the faint of heart nor for the control freak.

I figured that after two cycles of monitoring my response to injectible gonadotropins through the IUIs, the clinic would have a pretty good idea of what to expect from my ovaries. Apparently not. The ‘ideal’ cycle produces somewhere between four and eight high-quality eggs, according to our reproductive endocrinologist. As we got closer and closer to the date of egg retrieval, ultrasounds showed my ovaries filled to near-bursting with ten, then twenty, then thirty ova. I produced so many eggs that my estradiol (estrogen) levels skyrocketed and they had to ‘coast’ me for four days without stims, hoping the levels would drop a bit before retrieval.

When they finally did the retrieval in mid-June of 2001, I expected to be facing a surplus of embryos from my multitude of eggs. Due to the poor quality of Beloved’s sperm, the clinic employed the specialized technique known as ICSI, where one sperm is microinjected into an egg – which, of course, cost us an extra $1000 or two. I was badly shaken when we got the call later that day to tell us only ten eggs were viable and even more upset when we found out later only three embryos had survived to the end of the first day.

Three days later, we were back in the clinic to have the embryos transferred back to my uterus. Because of my relatively young age (almost 31) and fertility history, the clinic would only transfer two of the three embryos and agreed to cryo-preserve the third. With my two ‘babies’ tucked safely back where they belong, Beloved and I went out to lunch on our favourite patio and began the hellish time known in fertility circles as ‘the two week wait.’

In the time leading up to my cycle, I had become a regular on the IVF Connections bulletin boards. The mythology of the time advocated eating pineapple during the two-week wait, because the enzyme bromelain was supposed to improve the odds of implantation. (Other mythology revolved around the presence of bubbles in your urine, if I remember correctly. Only when you’ve been there can you imagine how desperate you become to find some order in the randomness that is infertility.) So, in those two weeks, I ate enough fresh pineapple to shred the inside of my mouth.

Ten days after my transfer, I woke up feeling loagy, like I had a flu. I ended up going back to bed, which was very rare for me. By late afternoon, I was feeling so bloated and uncomfortable that I was having trouble drawing a deep breath. I called the fertility clinic to check in and the doctor on call told me to meet him in the emergency room in half an hour.

I had developed ovarian hyperstimulation syndrome (OHSS), a common but potentially dangerous reaction to the extremely high levels of estradiol from the many follicles I produced. OHSS causes fluids from the bloodstream to leak into the abdominal cavity, which causes the bloating and breathing difficulties, and in severe cases can lead to kidney shut down and blood clotting. My case happened to be fairly mild (Nancy documented her hospital stay from OHSS on her blog) and I was told I could go home after a few hours, but would have to go back to the clinic every day for monitoring.

I was on my way out of the ER when the doctor stopped me and told me that in addition to the other blood tests he had ordered, he had requested a pregnancy test. He told me he was confident that the results would come back positive, but it may yet be several hours. Did we mind if the call came late in the evening to confirm? I’m surprised anybody but dogs could understand my supersonic squeal of assent.

Turns out not only was I pregnant, I was very pregnant. My levels of hCG, the ‘pregnancy hormone’, were very high for only nine days after transfer. So then came another hellish wait for the first ultrasound, populated by daily and then every-second-day visits to the clinic to monitor the OHSS. When we finally had our first ultrasound, I had been conditioned to expect more bad news. I was convinced the baby would either be lost, or ectopic. Turns out I was wrong.

Both babies were fine. Both. Both embryos had taken, and I was pregnant with twins.

I was in love with the idea of having twins. My father was a twin, his father was a twin, my mother’s father was a twin. Two babies, an instant family. I loved the idea.

Our elation was short-lived. Two and a half weeks later, we went back for a follow-up ultrasound, and they couldn’t find the heartbeat of the second baby. We had lost one of the babies at 9 1/2 weeks.

It was really a hellish ride. We still had one baby who seemed to be thriving and on target, and yet we had lost another. People didn’t seem to understand why I mourned this lost baby almost as deeply as the one I had miscarried the previous year. And of course, I was sick with worry for the surviving baby.

But don’t let me paint too morose a picture here. I was thrilled to be pregnant, and pregnancy treated me well. And through it all, I never really doubted that some way, some how, Beloved and I would be parents. I just knew it, in my soul, as I’ve never know anything before or since.

By the time we made it to our next ultrasound two weeks later, I was beyond anxious into the dark netherworld of neurotic. We saw a perfectly healthy baby growing right on schedule, and could actually see little arms and legs waving happily. I cried so long and so hard in sheer relief that the ultrasound technicians gave us free pictures and cried along with me. I was still crying when we got home nearly an hour later.

The final scare in that pregnancy was at the 18 week ultrasound. We found out beyond doubt that our little baby was a boy, and a healthy one, except for one concern. He had an echogenic cardiac foci , a bright spot of calcification on his heart that was thought at the time to be a possible indicator of Down’s syndrome. An amniocentisis would have confirmed or ruled out Down’s syndrome definitively, but the odds of miscarriage through amnio were the same as the odds of the baby having Down’s, one in 100. In the end, after a few sessions of genetic counselling, we opted to wait it out and hope for the best.

Tristan Louis was born three days after his due date on March 7, 2002. He weighed nine pounds and was 22 inches long. He was, and continues to be, perfect in every way.

The big infertility story

I’ve been thinking for a while about telling you our infertility and IVF story, and I figure now is as good a time as any. Most of you are busy eating leftover turkey and shopping for deals at the outlet stores, so we’re into light blogging mode.

It’s a long story, so much so that I’ve divided it into two posts, and even then decided to hide most of it beneath the fold. Like any good story, this one begins with heartache, but ends in joy. I mean, you already know how it comes out, and a lot of you know the details already. The trouble is knowing where to begin.

I remember Boxing Day 1998. Beloved and I were on the 401 heading back to Ottawa after spending Christmas in London and Windsor with our respective families. We were talking over some of the early details of our wedding, planned for July of the coming year. I don’t know how we got on to the topic, but I clearly remember talking seriously about when to have kids for the first time. There had never been any doubt about the ‘if’, but the ‘when’ had been a big question even though we’d been together for almost four years at the time. In that conversation, we officially decided to start trying for kids on our honeymoon.

I can still remember the feeling of elation, of expectation, of hope. Finally, finally, being a mother was within my grasp.

We almost waited for the honeymoon, but not quite. I remember being in Paris and not drinking much wine, because we had been busy and I was hoping I might be pregnant by a couple of days. When it turned out I wasn’t pregnant that July, I was only disappointed that I had given up a lot of indulgence in the name of a maybe-baby. Little did I know the road ahead.

Toward the fall and winter of that year, I started to buy the occasional pregnancy magazine. Every time I was a day or two late, which seemed to be every cycle that fall, I’d buy a pregnancy test and start imagining how I’d break the news to my family. First it was over Thanksgiving Dinner. Then as a birthday present for Beloved in December, and when not then, as a Christmas gift to my parents. I dreamed up elaborate ways to announce my pregnancy. When I was denied the chance to tell my mother I was pregnant for her birthday in February, I finally made an appointment to talk to my GP about fertility. That month, for the first time in my life, my cycle stretched out to six weeks, and I was crushed when my period finally came.

My GP listened to my story and referred me to the Fertility Centre at the Ottawa hospital. I was a little freaked out by the fact that she didn’t pat me on the head and tell me not to worry, but at the same time confident that whatever was wrong would soon be easily resolved by the ‘experts’.

In hindsight, our referral was processed in an impressively short period of time, but as each month came and went without a pregnancy, it seemed much longer. After a battery of blood tests, a semen analysis (Beloved’s, not mine) and a hysterosalpingogram (an x-ray of my reproductive plumbing), we had a consultation with a reproductive endrocrinologist. She told us that in fact there was nothing wrong with my physiology, but that Beloved’s sperm had such low morphology (poorly formed sperm) that she estimated our chances of conceiving a child naturally at less than three per cent. She said that the sperm were of such low quality and quantity that even lesser treatments like an intrauterine insemination were unlikely to work and that her best recommendation was for us to move directly to in vitro fertilization.

To say we were devastated would be an understatement. That afternoon, I had a prior ‘date’ with a friend planned to play a little catch. I was so blown away by the diagnosis that I couldn’t even tell her, one of my most cherished confidantes, throughout the three hours we were together. It was only when we were sitting in the car and I was about to go home that I finally found the words. And the tears. A river of tears.

I couldn’t cope with the concept of being infertile. Infertility is so much more than a clinical diagnosis. It means giving up on a dream you felt entitled to your whole life. It is standing on a precipice with a yawing future devoid of the children you already felt were a part of you. It is losing what you never had but always expected.

I was tormented by the fact that our infertility was ‘male factor’. I wished it were me, simply because didn’t want Beloved to be burdened by the guilt of responsibility. As much as the infertility was hurting me, I could only imagine how much worse Beloved must have felt.

In those early days, there were two main obstacles to pursing IVF. The first was money. Beloved had just barely finished his diploma and I was working in a mid-level government job. We were renting a townhouse, living paycheque to paycheque and had no money behind us whatsoever. The drugs would be reimbursed at a rate of 80%, but we’d have to pay the procedure out of pocket at around $7,000. On credit.

I remember the seminal conversation with my wise mother. She asked me, ‘What else are you going to spend your money on?’ And she was right. If anything was ‘worth it’, this was worth it.

Except, the other obstacle we were facing was the fact that even if we could scratch up the $7,000, there was only about a one in three chance it would succeed.

One in three.

All that money, all those needles (oh, how I feared the needles), all those hormones and all that disruption to our lives, and no guarantee of success.

And once again, we decided that if anything was worth it, this was worth it. We made an appointment to tell the clinic we wanted to go ahead in the early summer of 2000.

And then, on our first wedding anniversary, July 3, I peed on a stick because I was four days late and I never learn.

And I was pregnant.

For the summer of 2000, I felt like I was living in a dream. I felt tired but wonderful. My feet never really touched the ground. My due date was in March of 2001, and I found out one of my very best friends was due the very same month. It was fate.

Except fate is a cruel mistress. One afternoon in late August, three days before my first OB appointment, I went to the washroom and there was blood. Not a lot, but enough. I was scared. I managed to get an appointment at the after-hours clinic, and while I was in the waiting room, the cramping started. They tried to find the baby’s heartbeat, and when they couldn’t they told me it was probably too early. Lots of people had spotting. And, the nurse said with sympathy, even if it is the worst, there’s nothing we can do for you.

I cried all night long. I was still crying the next day when I asked Beloved to take me to the emergency clinic because I was in so much pain. Nobody told me that a miscarriage at 13 weeks would involve contractions, and I was terrified on top of being in pain and heartbroken. The emergency room staff were clinical and unmoved by my near-hysteria. They said the earliest ultrasound they could schedule was in five hours, and told me to go home and take some Tylenol and wait.

I passed the remains of the baby into my underwear, in my bathroom at home, alone. Trying hard not to look too closely at the lost little soul no bigger than half my fist, I scooped up what I could into a plastic container, because I had the idea that if I brought the fetus back to the doctors, they could tell me what happened. The only thing that kept me from a complete breakdown was the idea of protecting Beloved from my hysteria. I had to be strong for him.

Of course, the doctors had no answers for me. They said the baby was small for 13 weeks, so had either died some weeks before or had been falling behind in its growth. No matter, really. It was over.

We went back to the fertility clinic, and our reproductive endocrinologist opined that maybe we should try intrauterine insemination (IUI) after all, if I had managed to get pregnant given Beloved’s sperm counts. I imagined my ova like some giant Death Star in my fallopian tubes, gathering up wayward sperm.

By this point, getting pregnant was my all-consuming obsession. It was all I thought about. Each day, I would open my eyes and wonder how long until we could be parents. I would roll out of bed and dutifully chart my temperature, watching for that tell-tale dip in body temperature that indicated the beginning of monthly fertility. After sex (every two days, just like the books recommended) I would rest with my legs up the wall, a pillow under my hips, trying to coax lost sperm in the right direction. For two weeks I wouldn’t drink alcohol, ingest aspartame or deli meat or soft cheese, hoping that this was the month the miracle came back. And each month I would obsess over the toilet paper, watching for that first tell-tale smear of muddy blood, the dream dead for another two weeks.

I tried not to be bitter about other people’s pregnancies. I’ve never been the sort of person who begrudges someone else their rightful joy, but even seeing mothers out playing with their children was like rubbing salt into an open wound. The year in between our infertility diagnosis and the start of our IVF cycle was one of my darkest. The loss was hard to cope with, but the hope nearly killed me.

We opted for IUI with superovulation, meaning I would inject myself with follicle stimulating hormones to produce more than one egg, thus improving our chances for conception. Our first IUI ran through December of 2000. My period came, indicating the failure of the cycle, on Boxing Day at my sister-in-law’s house – two years to the day after our decision to have kids as soon as possible.

We tried another superovulated IUI in February of 2001. My anxiety was ratcheted even higher for that cycle, because I was desperate to be pregnant before facing the due date of the baby we lost to miscarriage. But, it didn’t work out that way. After that second IUI failed, we decided to stop piddling around with intermediary procedures and go big or go home.

We decided to spin the big wheel and try IVF in the spring of 2001. And I’ll tell you about it tomorrow.

Holiday review

I’m back!

Sorry I haven’t posted anything. I’d like to tell you it’s because I was doing something exciting, or was somewhere exotic. I can’t even tell you I was busy revelling with family and friends. Nope, I was just too busy doing nothing to blog.

Ah, sweet nothing.

Can I tell you a secret? In the last three nights I’ve averaged nine hours of sleep. That’s AVERAGE, mind you. Contrast that to the week before Christmas, when I was averaging around six hours sleep. This morning when my alarm went off at a quarter to six, I was so deeply perplexed by the sound of the radio waking me up I had to stop and think about what it was. My boys have had me up before the alarm for probably the entire month of December.

What’s behind this copious amount of slumber time? I have no idea. Simon is still waking a couple of times a night looking for his soother, but for whatever reason they’ve started to creep toward dawn with their morning wake-ups, and whatever the reason I’m happy with the results.

So, did you have a nice holiday? (I am using the past tense because I am one of the five civil servants in the entire national capital region who are actually at work today.) We had a lovely, truly lovely, family Christmas. My brother and his wife were over with my adorable one-year-old son Noah, and my cousin and his mom, his wife and their four-year-old came by on Christmas Eve, along with my parents. That’s my entire side of the family, all in one house. It doesn’t happen often, but I am thrilled when it does.

It was that happy, noisy kind of pandemonium that I love. The boys were wired, the grown-ups were chatting, the salmon and cream-cheese ring and peppercorn chevre were delicious. I love my family, I really do.

The boys loved their Christmas presents. Tristan was so cute; as he opened every gift his voice lifted about two octaves as he said, “WOW! It’s the most best Christmas present I ever got that I always wanted!” Simon said, “Pretty neat” and “Coo-ooo-ool!” every time he saw something being opened. The Wiggles and Thomas the Tank Engine were the heroes of the day. That, and GeoTrax and the Little People ABC Zoo were the big hits. And we played about an hour of Hullabaloo yesterday – highly recommended for the preschool set. Although Simon didn’t quite understand the concept, he did love running around in between us just because he could.

You know what, I think it was one of the best Christmases ever. Not because of anything in particular that happened, but just because it was all good. There were no bad moments.

And there was sleep. Any time there are 11 hours of sleep in 24 hours has got to be good.

Any Christmas stories to share? C’mon, somebody has to be out there to keep me company today!

Christmas tactical error #1

Made my first serious tactical error of the holiday season, and it seemed only fitting I share it with you!

As I posted, today was the kids’ Christmas party at work. There were movies in the board room, junk foods of every description, colouring books and treats and a posse of very excited children. I have to laugh about what Tristan will be picturing in his mind from now on when I tell him I’m going off to ‘work’, that land of endless sugary treats and cartoons.

Simon seemed to like the water fountain (“waterfall”, he called it) the best. That, and the elevator buttons. And exploring the cube farm.

Santa came, but apparently Santa’s helper elf didn’t think through his gifts very carefully. Santa brought Simon the Wiggles Big Red Car flashlight, which has, for the record, the most difficult-to-open packaging I’ve encountered in nearly four years of excessive presents. Simon loved this gift with an exhuberance that surprised all of us.

Santa brought for Tristan a very cool I Spy book, because Tristan loves to play I Spy lately, and Santa’s elf knew he would like something like that. What Santa’s elf didn’t think of was the relative playability of a book, no matter what the subject, versus a singing car-shaped flashlight. So, for five hours we have been battling over whose turn it is to play with the Big Red Car. Currently, Simon is upstairs sleeping with it in his crib, because he would sooner part with his hair than release it from his sweaty little grasp. Getting an almost two-year-old to share is difficult on the best of days; getting an almost two-year-old to share what has instantly become his most prized possession is turning into a Herculean feat of mothering.

If only Santa’s elf had had the foresight to send along one of the five dozen Thomas the Tank Engine related toys that will be making an appearance some time in the next 48 hours. Chalk it up to another parenting lesson learned the hard way!

One of those days

It’s the last morning before the loooong Christmas weekend, and I’m having one of *those* days. While standing waiting my turn to board the bus, I realized that I had left my pass at home. Luckily, the driver waived me on to the bus anyway. It pays to be a regular, I guess.

So I’m reading the paper, reading the paper, reading the paper. I look up every now and then to see where we are, and suddenly we’re turning a corner where we aren’t supposed to turn a corner and I realize I’ve missed my stop. I mean, it’s not like I do this every. single. day. So I hop up and get off the bus and have to trudge back an extra half a kilometer to where I was supposed to get off.

I hike through the mall, as usual, trying desperately to think of something to blog about, and I’m in the queue for Tim Hortons when I realize that I also don’t have my purse with me. I halfheartedly hunt through my pockets, knowing they are empty, and sadly turn away from the ambrosiac smell of fresh coffee and warm muffins. (Sob.)

But it’s okay, I tell myself as I drag my ass over to the office. We’re having the Children’s Christmas Party in my office today, and Beloved and the boys will be here in two hours. I can hold off without coffee or food for two hours. (Stomach rumbles menacingly.)

So I’m sitting here trying to think of something to write about (Christmas music? Nope, done. Holiday traditions? Nope, done.) when I realize that I’ve also forgotten the cheese and crackers I was supposed to bring to the kid’s party.

Really, I think I should have just stayed in bed. I’m having a bit of a caffiene withdrawl fit, so excuse me while I go rooting for coffee dregs in the cups left in the office kitchen. Maybe I can combine enough to make a half a cup to tide me over and warm it up in the microwave?

Edited to add: I love my coworkers! Dalérie scrounged up some milkers, I made a pot of coffee and Kerry had Timbits to share. O happy day!

Can I count sleep deprivation as a hobby?

Not enough sleep to form a coherent post today (it took me four tries to type ‘coherent’ properly) so bear with me. Tristan shared his cold with Simon, and because he couldn’t keep his soother in his mouth for the stuffiness, Simon was up and down all night. And so, therefore, was I. Been up, in fact, since the last soother hunting expedition at 4:29 this morning. WHY can’t I sleep when I’m tired? Gah!

Nothing says Christmas around our house like a sick kid. Tristan’s first Christmas, he had been battling an unknown malaise for a couple of days before Christmas. On Christmas Eve, his fever spiked over 104F, and after a sleepless night we spent his first Christmas Day in the ER. Turned out he had a urinary tract infection, poor wee thing. The next Christmas was relatively uneventful, but last year we were in the ER again when Tristan had a febrile seizure the week before Christmas. Keep your fingers crossed for us this year, will you please?

I haven’t lost my child-like love of Christmas, nor have I lost my child-like inability to focus on business with the holidays looming so close. My brother arrives with his family today, and tomorrow the boys come into my office for a children’s Christmas party. Only a few more hours until I can give myself over to the holidays!

A propos of nothing, did you see the debate in Britain on what to call Elton John’s new Canadian husband, David Furnish? If you missed it, the celebrity couple were among the couples married yesterday, the first day that gay marriage was legal in Britain. Since Sir Elton is officially a knight, courtesy dictates that his consort be given a title as well. The peerage has proposed “Laddy David” which makes me snicker with glee every time I read it. I have no idea why it tickles me so, but I do hope they adopt it.

See, I’m really not focused this morning. Too much excitement on the horizon, too much minutia to slog through to get there.

When in doubt, hand the microphone off to the peanut gallery… got a funny Christmas story? Here’s one to get you started.

My dad was a musician when I was growing up. One year he was playing a gig for a company Christmas party (sorry, Dad, if I slaughter the details), complete with a visit from Santa at the end of the party. The problem was that the fellow who would don the Santa suit had been into the Christmas cheer throughout the party. By the time he was supposed to greet the kiddies, he was three sheets to the wind.

It took them a while to get him suited up, during which time the audience grew more and more excited. Finally, the original Bad Santa stumbled up on to the stage, grabbed the microphone and hollered this most festive holiday greeting: “Ho Fucking Ho!” My dad said there was the briefest moment of shocked silence, followed by the whooshing sound of every mother’s hands closing firmly over every child’s ears.

It’s become a traditional family greeting around our place.