Judgy Wudgy Was a Bear

These days, I find that if I stay manically busy, it's all good. I feel genuinely happy and lucky. Maybe even happy-go-lucky.

But the minute I am alone and activity slows down to a hum, it's harder to stave off the thoughts. All of them: anger, impossible sadness, confusion, dread, fear, envy. It's like I live a double emotional life.

So, because I am not a total moron and understand that this is not necessarily a healthy way to go about my days, I sighed and opened up my insurance list of in-network therapists and decided to make some calls again and see if I could find someone reasonably competent. I can't remember if I wrote about it here, but last time I did this, it didn't go terribly well. One woman actually nodded off during our session, after asking me what IVF is. Yeah.

Anyway, this time after a few unencouraging calls (one woman said "I am advanced in years" and then asked me the same question twice in a row), I heard back from someone who sounded like she could work. She knew what IVF is, is located nearby and confirmed she still accepted our plan. Our first appointment was today.

During the visit, as I spilled my sad story to lay the groundwork for a possible ongoing relationship during which she might say some magical thing that will teach me how to live in this new world order, I said I was truly lucky to have H. And then she said: "But apparently not lucky enough." And I played it cool, but I have to tell you it took my breath away.

I mean, beyond it sort of being laced with judgment, as a statement from a therapist definitely should not be, it made me think for a minute. Is it true? Is it possibly true that I think I haven't been lucky enough? I tell myself that the millions of people who try and succeed to have a second child aren't told they are pressing their luck. But maybe when you struggle, you are supposed to take what you get, if you're lucky enough to get anything (which I know some are not). Maybe that's the whole point.

I called her out a bit, at the end. I asked her if when she said that, she maybe thought that this "problem" I'm presenting with isn't really a problem, per se. She said we all experience things differently and who is she to say what is a real problem and what is not. Which sounds to me like a way of dancing around the question of whether she thinks it's a real problem. 

The session was only $16 out of pocket, but I am wondering if I should go back. Maybe coping in silence is better, in the end, than being told you're greedy. Even if it's true.

I Carry It in My Heart

The New York Times reported today on a study carried out by Dutch scientists on fetal microchimerism. In this phenomenon, cells from the fetus escape from the uterus and disperse throughout a mother's body. They have identified Y-chromosome cells in mothers decades after pregnancy with sons, and now believe that fetal cells can be present in a mother for the rest of her life. They can have varying effects on a mother's body, even becoming part of her organs' function. Studies of mice have shown fetal cells to become part of cardiac cells, even become beating heart cells.

The witty headline writer called it a "pregnancy souvenir."

I knew it.

“I carry your heart with me (I carry it in my heart)
I am never without it (anywhere I go you go, my dear; and whatever is done by only me is your doing, my darling)
I fear no fate (for you are my fate, my sweet) 
I want no world (for beautiful you are my world, my true)
and it's you are whatever a moon has always meant and whatever a sun will always sing is you

here is the deepest secret nobody knows
(here is the root of the root and the bud of the bud and the sky of the sky of a tree called life; which grows higher than the soul can hope or mind can hide)
and this is the wonder that's keeping the stars apart
I carry your heart (I carry it in my heart)” 
― E.E. Cummings

The Anger Stage

I talked to the psychologist yesterday, and even though I still think she could have been more professional, even though I still think the tone of our meetings was not constructive, it seems like maybe we may have dodged a bullet when this arrangement fell apart.

And now, ladies and gentlemen, I have arrived at the angry stage of my surrogacy failure.

The psychologist told me some new things about the surrogate, let's call her M, that are troubling. That one of the first things out of M's mouth during their individual meeting was that no agency would accept her because "this is my body and pregnancy, and no one is going to tell me what to do." Suffice it to say, this is not how she presented herself to me. M also told the psychologist that no one would mentor her in her business, because they "don't want to mentor the competition" (I guess the millions of mentors out there are always from different industries from their mentees in her imaginary world). And apparently her choice to home school was not because she deems herself a more suitable teacher for her children, but due to conflict with her school system. All of this, the psychologist said, was conveyed with a certain belligerence. A sense that she is perched on a moral high ground, not only on the termination point, but in life in general.

It explains why the psychologist entered into our group meeting with an assertiveness toward the surrogate that I found in the moment, without this recently acquired knowledge, to be unprofessional. I still think she could have controlled herself a bit and tried to create a meeting of the minds, or construct a new understanding for M on the necessary mindset for a surrogate -- and maybe M could have stretched herself to make it work. But it makes sense why she approached it the way she did. She said she's screened hundreds of surrogates and no one had ever presented herself to her the way M did. Yikes.

What doesn't make sense is why M would try to be a surrogate in the first place. It offends me that, by making this all about her, she is flouting the real pain and angst that couples who arrive at surrogacy are experiencing. We need someone who can put her own agenda aside and make a healthy baby by listening to the parents and the doctors, and then, in turn, get paid for her efforts. It's not like we were going to suggest an experimental treatment on her, or ask her to give birth in a treehouse. She needed to let go of control and trust us too.

The conversation with the psychologist was healing in a way, because after I got the email from M, my first instinct was self-flagellation. Surely, I thought, there must be something wrong with me, because no one -- no one -- has this kind of luck repeatedly. I must be attracting bad luck and bad people, or otherwise f-ing things up with my PTSD-laced behavior and communication. It turns out that it really was just the bad luck of choosing someone who presented herself as a great candidate to me, but let her borderline personality hang out with the psychologist (Which, by the way? Isn't very smart. Did she not get that this person represented our interests and could block the whole thing?).

I still had to pay the psychologist yesterday. Her bill was $699. I couldn't even write the check -- I had to have my husband do it. Do you know what I could have done with $699? This is in addition to the approximately $8k we already invested in this surrogate.

[I had a whole rant here with additional specific and angry points about what went down with M. It made me feel crappy and petty to have it out there. Tearing her down, even if my points are legitimate, is not going to make anything better. So I'm deleting them, but I have to say it made me feel better to write them out.]

But there's still this: gallows humor. While writing the check to the psychologist, my husband offered that he could draw stick figures in the memo line. Perhaps stick figures in compromising positions. He didn't do it, but I love him for suggesting it.

Foiled Again.

Have you ever wondered if you're cursed? If you kicked dogs in a past life? If someone is trying to tell you to stop, just stop, for the love of grace, stop?

We got so far this time. So far. She came out with her husband in June. Things looked just ducky with her medically. We liked them both personally. Then the psychologist came in for that screening and fucked everything up.

The main issue was around the possibility of termination. This is such a deeply personal, not to mention politically charged issue, and I cannot handle the possibility of this post turning into a commentary on that, because I deeply respect the nuances of this issue. But here's what I will say. If you're thinking about surrogacy, make sure you know exactly where your potential surrogate stands on this issue. Moreover -- and here's what we didn't know -- make sure that, even if you feel with 100% certainty that you would never, ever terminate, no matter what, even if someone's life depended on it, make sure your surrogate is willing to give you the final word on it in your contract. Even if you agree in theory going in, the final word should optimally be yours, because you can't predict how you might feel in the moment, if a doctor tells you your child might suffer. And also, you need to know that even if she says in her contract that it is completely up to you, that she would terminate at your request for any reason, to choose surrogacy is to revoke the certainty that you can make that decision about your baby. Because even if she gives you the power to decide in your contract, in fact there is no court in this great land that can make someone terminate a pregnancy. In the one devastating case out there in the news, the surrogate said she was open to terminate, but then changed her mind when the fetus was diagnosed with a severe syndrome. And it just gets sadder from there.

I wish I had known all of this. Even though the surrogate and I were on the same page up to 99% of the matter, it turned out there was a gray area where my husband and I were a bit more liberal. Where we wanted the reassurance that ultimately, that would be our own decision to make.

I would have known this if I had used an agency. And I would have used an agency if money were no object. But it is an object.

Basically the psychologist handled this issue very, very badly, and I think that was a greater obstacle than anything else. The beginning of the end. Her unprofessional and glib approach created an air of defensiveness and distrust among the four of us that we never recovered from. And as an aside, I now need somehow handle her $700 invoice when she may have ruined my chances of having another baby.

That wasn't the only thing that happened. The surrogate got nervous after that conversation, but we always felt better when we talked about it openly. Then our financial picture changed a bit. My husband had been doing extra work to fund this operation and that got shut down unexpectedly early. So we were on hold for about a week sorting through that obstacle. And then the surrogate complained that she didn't want to use a lawyer for her contract review that my lawyer recommended, and it felt like maybe she was going to push back on everything. And our communication started to break down. And then last night, she dropped the bomb on me via email at 10 p.m. She is out. I think she is not used to this kind of complication when it comes to making a baby, and it terrified her.

And now I need to figure out how to live in a world where I have embryos that never see the light of day. Because I think I'm finally, finally seeing that this is never going to happen.

The possibility of yes

It always arrives, anew. It unfolds like petals. After March 2014 I thought it might be gone for good. But it's here again.

It's the glimpse at the night stars and the feeling that maybe there's a thread from this world to infinity, to fate, to something bigger. To magic. To a preordained happy ending. It's the sense that maybe everything you thought, you feared, could be wrong. It lets you daydream, even if it's just a little toe dip in it. Dickinson called it "the thing with feathers." Hope.

It helps that we're doing this in summer, when life is all around again, all joy and forward motion and yes.

Our surrogate (hopefully) and her husband arrive this weekend, and the process of getting to our last try begins for real. I thought I would be more anxious than I am.

I went to spinning class tonight (because, damn, it feels good to take care of myself again), and while I was short of breath and pushing and feeling the rush, Florence Welch sang to me that it's always darkest before the dawn.

Could it be?

A Day in the Life of My Brain

E! News: Next, Kim Kardashian opens up to E! about her long struggle to conceive baby #2. 

Really? Her long struggle? She doesn't know about a long struggle. If she'd needed surrogacy, she could have paid for it from her change jar.

I am a bad person. If I were evolved and decent, I would be happy for her. I would welcome her into the infertility and loss clan with open arms.

But why couldn't my struggle end happily? Why am I cursed? Will the curse continue with this next round? Or is it like starting fresh when you use someone else's uterus?

Maybe we're crazy for doing this. What if we spend all of this money to get to transfer and it doesn't work? Then we'll be stressed about money and still without a second baby. Will I regret doing it?

Maybe we should forget it.

Maybe we should adopt.

Adoption is hard.

I want to adopt my own embryos.

I can't just leave them there. It's not fair to H. We are stewards of his biological brothers. This is a lifetime bond and he deserves a shot at it. It's not even our decision to make. They exist, and we need to give them a chance.

Most people don't have to spend $50,000 to have a baby. Why me? It is so unfair.

I'm a prisoner. There is no escape but to move forward. I don't even dare to hope that this might end happily.

Where's the chocolate?

Taking Care of Me

When you're after a baby and circumstances make that difficult, it's pretty common to let yourself go a bit.

I finally woke up to the reality I'm sure everyone else could see: the weight I was holding on to was much more than pregnancy weight. It was the weight of thousands of tears, of seeking small comfort in sugar, carbs and wine. It suddenly dawned on me that I was holding myself back with this pattern of instant gratification. And I stopped doing it, cold turkey.

I don't think I've had a bite of refined carb in two weeks. I'm still allowing myself wine in moderation on weekends and the occasional special event during the week. And I feel fantastic. I'm noticeably thinner and have more energy, and my skin breakouts (another topic for another day) have cleared considerably.

Before H, sticking with a PCOS-friendly (low carb/sugar) diet was a way for me to feel in control and stay healthy as I tried to conceive. I slipped after he was born, then started conceiving naturally -- so I guess it registered that maybe it was unnecessary. Then came the miscarriages and the medicating with food. But it's a new day. My body is mine again, and I need to take care of it.

Limbo

Yesterday, we took H to the library for story time. My husband (who works from home) wanted to go too, because they were doing a special tour of the conveyor belt book return system and, well, he's a guy and likes such things.

On our way downstairs for the tour, there was a gaggle of moms talking about how wild the boys in the class were, and how one of them should know because she has three of them. You can imagine where the conversation went. She should have another! She'd get her girl! Oh she hadn't decided on a fourth yet.

Decided. A fourth child. A question of will, not of chance. Not of daring and struggling or pain and suffering.

R and I met eyes. I explained later that I encounter some form of that conversation at least once daily. He shrugged his shoulders as he does. What can we do? That's how it is for most people.

I'm tired, guys. I'm just tired of it all. Tired of waiting, and wondering. Tired of still wanting something that's so hard. Tired of this horrible position I'm in, of having the first half of what I want in the freezer, and a horribly unclear and difficult path ahead for the second half -- yet no alternative. What can I do? Let them go? It's impossible. I have to do it. And I'm terrified.

Mostly, what scares me at this moment is that the clinic will say yes to the truly lovely potential surrogate we've found, whose records they are reviewing. And we will go down this path with her and spend all the money and then something will happen -- she won't get pregnant, or she will and we'll bring her into our reproductive den of doom. And then we'll have less money and still no baby.

That line of thought leads me to adoption. From there, I'm with the embryos, and knowing for sure that if we adopt it will bring us joy but also horrible pain over letting those embryos go. And possibly regret, and possibly some low-lying resentment toward the adopted child. Which obviously cannot be allowed to happen. Around and around we go.

And then I wish we didn't have the embryos. And then, horrible guilt over that thought. Then anger over being in this terrible predicament with no one to bail us out. With nothing to do but keep going and take the risk.

When I look at H and feel a sense of loss over the early childhood/pre-school years I can see evaporating before my eyes, I don't know if I should feel hopeful that we might do it again, or if I should cling more closely to this time, because it's the only experience of it we'll have. The answer is probably both, but the way I experience it is pure and painful limbo.

Modern Medicine

About a year ago (I am still too traumatized to look at dates or otherwise dive too deeply into the day), I was rushed to the hospital where they had to do a second D&C to remove the remaining pieces of my poor, broken baby.

My broken heart is another matter. Those pieces are still coming back together.

I want to mark this unfortunate anniversary with a comment on our health care system with regard to OB/GYN care. Miscarriage -- and other unfortunate complications of pregnancies -- is incredibly common, yet there remains a huge disconnect in the way providers address women who present with it. Warning signs are dismissed. News delivered insensitively, even harshly. Hurtful offhanded comments made. The entire (hugely relevant) emotional experience of miscarriage remains largely -- notwithstanding the rare, evolved obstetrician -- ignored.

I have been handed ER discharge forms referencing "fetal parts." Been told it's probably nothing. Given advice about it being meant to be, and told to "just try again." Last year, I called the doctor with a huge warning sign the day before I hemorrhaged at home and bought myself an ambulance ride, and was told to "monitor it" and call on Monday for an ultrasound. I still think about how nice it would have been to avoid one of the most significant traumas of my life by being brought in, calmly told there was remaining tissue and brought to the OR without drama.

And then, perhaps the most significant indignity of all, the one I shake my head at every time it pops in. After the second D&C, they brought my loopy, exhausted, shattered self upstairs to the maternity floor to recover. They put an ice pack in a newborn diaper for me to use. I heard cries through the walls. I had to see that fucking hospital channel that tells you how to take care of the baby you just had, if you were lucky enough to bring it out alive.

Get it together, doctors.

To every girl who has been there, may your own moments have made you a little tougher, a little wiser, a little kinder, a little better. "In the midst of winter, I found there was, within me, an invincible summer." -Albert Camus.

If Only It Were This Easy

I just got an email from Target with this subject line:

Baby Sale at Target

Are babies for sale? Because I am definitely interested, and -- in contrast to the Lilly Pulitzer offering -- I would actually line up for this.

In real life, things are a little tricky. We may have found a surrogate, but every step feels precarious.

Not a Weight Loss Plan I Recommend

One of H's teachers commented this morning at drop-off that I am looking great -- thin, but not too thin. Have I been working out?

Nope. Just lost the dead baby weight.

I said that in my head. Don't worry.

An Involuntary Mission

Here's what kind of everyone needs to know about me. This quest for another baby, this never-ending mission? It's not voluntary. It doesn't feel like an optional choice to me. I have four PGD-screened embryos with the same genetic makeup as H in a freezer right now, and the drive to bring one of them home where he belongs feels as obvious and vital to me as taking in air several times a day.

I get it. I've been at this for a long time. People are sick of hearing about it. I'm sick of hearing about it. I'm sick of talking about my reproductive plans publicly. I didn't ask for this to be my "thing" in life. But it is what it is, and it's part of me, and I need to talk and write about it to understand how to think about it. To keep my prefrontal cortex from malfunctioning. And I need to keep going. I need to try until there are no more options. Because I still -- despite all the evidence to the contrary that's presented itself over the past four years -- I still believe he's out there.

So you don't have to understand or agree with my willingness to put my embryo inside another lady and go broke in the process. But just know that that choice was made for me when five embryos tested healthy in November 2013. 

One Year Later

These are the moments that still break my heart:

It was still cold, snow everywhere, and we bundled up early in the morning to get to the appointment. The three of us. I couldn't find child care so my poor H was along for this terrible ride.

We had just gotten H a booster seat, and before we left he told me he wanted to give his old convertible seat to the baby.

I was still careful, shielding my obviously pregnant belly as I walked across the ice to the car. I was so nervous, and yet ready to have it over with, to know what, if anything, the high AFP meant. I thought they'd find something with the placenta.

On the way to the hospital, Pharrell's "Happy" came on the radio. I loved the song, and hoped that hearing it in that moment wouldn't ruin it forever. At some point my husband changed the station and "Route 66" was on, a song we had all just heard on the soundtrack to the "Cars" movie we'd watched together. One of the last happy moments of the pregnancy.

The ultrasonographer called us back from the waiting room, and as we walked back she asked if I had to use the bathroom. H answered instead: "No, thank you." We all laughed.

H's face as everyone else realized what was happening...so innocent to the horror unfolding. Unaware he had just lost his brother.

Coming back home to the business of it. The calls to doctors and the insurance company. The search for someone who could do the surgery. Essentially being told good luck by my OB's office, whose high-risk doctor, the only one skilled past 13 weeks, was on vacation. Having to slog through all of the moments to come.

Telling H there was no longer a baby.

Standing in the hospital bathroom before going to the OR, saying goodbye, and I'm sorry. Terrified of the pre-surgery warnings, wishing I were with my H, having a fun day in my beloved city.

Realizing how old my second boy would be today. Wishing I knew if he liked oatmeal, or was quick to smile like his brother. Wishing I'd had the chance to be his mama too.

***

Marking a year since the death of your baby is a lonely exercise. There is no way to get others involved without striking them as melodramatic. Once again, I'm the only one who can carry this.

I wish I could tell you that the past year has changed me for the better. That I've somehow been enriched by the epiphany of grief and suffering. There may be some of that, but mostly it's been a matter of making it through days. And on some, I thought I'd break. So there's this: I survived.

It does help that this year's March 18 feels brighter and warmer than last year's. After every winter, a spring.

Sliding Doors

One year ago today, I had my last regular doctor's appointment as someone who thought a baby would come out of it in the end. I just looked at the calendar, at all the appointments typed in with ignorance about what was to come. Is that blissful? I'm not sure.

I remember waiting forever for the OB, who was off seeing other regular pregnant people, maybe delivering a baby. A typical day, and I was another typical patient. Until I wasn't.

She poked around for a while with the doppler, I remember. I was anxious, she was not. She found the heartbeat in her typical casual way, as if it there were never any doubt. As if no one ever had a doubt. Maybe she always finds the heartbeat. Maybe mine was the only one that stopped beating after she found it.

It feels so far away, and yet it also still feels tangibly close, as if I could reach out and shake it up and shuffle it around and let the pieces fall down again, a million pieces put back together the way they were meant to be. I want to be Gwyneth Paltrow and miss the train this time. Maybe that's why I let myself look back at the calendar just now. A bunch of dates are all that's left of it. The closest I'll come.

Love from Unexpected Corners

I went for a mammogram a couple of weeks ago, my first. I'd been thinking for a while that I wished my fertility centers, like CCRM, required them. There is no proven link between fertility treatment and breast cancer; slight elevation in risk instead seems correlated with the mere fact of infertility, especially among those who have not had children. Still, I longed for some reassurance, especially since I've had some strange breast pain (which is typically not associated with cancer) since the pregnancy/the horror of my milk coming in last year.

On the day I went, I was a bit of a basket case. I guess you could say I've developed some sort of PTSD in the wake of this last, supremely awful pregnancy; I am awaiting the falling of another shoe. How do you carry on after years of living beta to beta, the cortisol steadily dripping through your veins creating a perpetual state of alert? If you're like me, you start worrying about twinges and pain. You ask your new gyn for a pelvic ultrasound in addition to the mammo, to investigate that cyst-like pain you have in your pelvis.

I can't emphasize enough the extreme state of unabashed panic I had myself in before this ultrasound. Being on an ultrasound table with a wand between my legs does not lead to good things for me, friends. I was convinced I would get horrendous news, like maybe my ovary had twisted itself into a ball in protest. I had myself worked into quite a dither. On top of it all, it turns out that when you're not pregnant, it is even harder to get any kind of indication of anything from ye olde ultrasound tech. She was Fort Knox. Said I'd have to wait until my doctor got the report...which could be two days. Somehow I convinced her to get the radiologist to send it that day.

Meanwhile, onto the mammogram. This felt like a walk in the park compared to everything else. The test itself, while not something I'd opt to do for fun, was really nothing. The tech showed me my girls on TV. Then I told her to please tell the radiologist that I've had this pain in that one place, and that I had a pregnancy last year. And then, before I knew it, we were sharing sad stories.

Hers was a late-in-life surprise after adoption, which was the best thing she'd ever done. At 12 weeks, she went in for a routine ultrasound and was given the terrible news. She was alone.

I felt acutely vulnerable, half clothed in my cotton robe, shedding tears. Then she said something I desperately needed to hear.

She said, you have two paths you can take. Don't take the bitter path. Don't shut down every time someone announces a baby. I did that for a while, she said, and it was so disingenuous. It wasn't the real me, and it hurt me while not accomplishing anything.

It felt a bit harsh to hear, like the sound of the truth often does. It was as if she could see inside my shadowy heart. She could see where I've been headed lately. It felt a little bit like a judgment, but I needed to be judged.

She's right. I don't want to be that girl. I don't want to resent, covet, begrudge. I was an enthusiastic liver of life before infertility and loss had its way, and I'll be damned if it's going to take some essential part of me in its stormy path.

So thank you, mammogram lady. Thanks for being honest about your story, and for the little correction you dared to pass along.

The ultrasound, by the way, was normal. As was the mammo. Apparently I've got some dense breast tissue up in there, so I have to go back for an ultrasound just to be sure. But apparently that's pretty normal, too.

PS - On this Valentine's Day, I'm spreading the love by encouraging you to get a mammogram, too. My new gyno (more on her, and the experience of a gyno-only, pregger-free waiting room, later) says the risk is now one in seven, with no family history. One in seven, girls. Think of your seven closest friends. And if they're 35-40 or have family history, tell them to get their baselines, too.