The High Tech Way

37 weeks

Hard to believe that I am here already, to the place where they don't stop labor and consider you full term if you have the kiddo now.

When I was pregnant with Jack at this point in time my ankles and feet had already been so swollen for months that I couldn't wear any shoes but flip flops. My hands were numb constantly from the swelling and my occupational carpal tunnel syndrome. 

And I was afraid all the time that something would go wrong. And I was afraid of labor. I think I'd spent so long being disappointed in our fertility journey and heard so many horrible stories that I didn't think anything could go right.

A few months after we lost our Will (our trisomy 18 baby conceived by IVF), an online acquaintance who had conceived with her lone embryo during her second IVF went post due. I thought at that point she was home free.  But one morning she didn't feel her baby move anymore and when she went into the doctor's she learned the baby had died.  Horrible horrible horrible.  And the thought of that just stuck with me through my pregnancy with Jack.

Because when we started trying to conceive we learned that just getting that double pink line wasn't enough. We had the miscarriage.  Then we learned that getting past that critical first trimester wasn't enough.  That you CAN get a bad amnio diagnosis, even though the odds are tremendously against it.  And then, through this poor woman's experience I learned that even when you are beyond that point, even when you are days away from delivering, it's still not too late for everything to go to hell.

So I was in a bad mental place when I was pregnant with Jack. A place of anxiety and nightmares. Seems like I kept hearing more stories of late term losses that just fed it further.

Once Jack got here the world changed because I was finally a mom to a living child. Jack made that happen. He made that true.

This pregnancy I am healthier because of him. I carry him around all the time. (although these days carrying him up the steps is enough to make me groan).  My arms are skinnier. I have more of a basketball look than the overall fat look. I feel healthier.  Some woman at the pizza restaurant told me "you look great."

Now, my ankles are a little swollen and my hands occasionally get a little numb, but it is so much less than last time.

While all the bad things that have happened have not gone away, some good things have happened in the meantime.

And mentally this time I feel like I am not afraid of labor. I am not afraid of a c-section. I am not nervous about my ability or lack there of, of taking care of my newborn. I feel more confident about myself and ability to handle all these things.  And as for the breastfeeding, I feel like I have a better idea of what to do if things don't go well at first and where to go for help.

How old is too old? Part two

Still thinking about this question in light of the many responses to Tertia's post including her own, and also the responses to this one. And I've also been thinking about the older parents I've heard of or known.  Now, keep in mind that I do not know the 60-year-olds. And I only know, know of or have met a handful of people who fit into this category.

In general I've decided that for those who haven't succeeded yet in having their baby the answer is older-than-they-are-right-now.  It just makes me want to cry to think about the hour glass running out of sand before someone has finished running through the course of treatment and exhausted their options.

Many people have said -- and I don't necessarily disagree with them -- that the answer may have more to do with the ability of the parent to care for the child in the long term.  If that is an argument against older parents then I think a similar argument could be made against parents who bring sextuplets to term.  Two people can't care for all those babies on their own.  (Which is the similar argument used against the old parents. Specifically that the old parents are too old and tired to take care of the baby or babies and will be really old when the kids graduate from high school or college or get married.) Both the old parents and the parents of high order multiples have most likely relied on assisted reproductive technology (ART) to conceive their babies.

And I thought of something else too.  I think there is a big double standard on this in that the male partner's age is not scrutinized to the same degree.  I was thinking particularly about David Letterman and his son Harry.  Letterman didn't seem like he would ever have a family, but since having that boy it is clear that the kid is the light of his life.  Since then he asks all his guests who are parents all about their parenting experiences and the cute things their kids have done. He is INTO it.  He loves that kid so much, and because of that I think Harry is such a lucky boy to be so adored by his Daddy.

How old is too old?

Since a 60-year-old New Jersey woman gave birth to twins recently, lots of people have been talking about how old is too old to have a baby.

Tertia has this post about the topic, and even a survey where so far most of the people have said over 40 is too old.

I am now 42.

I used to think 40 was the cut off because that is when I think it gets hard even for the fertiles to conceive.  To me it seemed like nature's cut off age for women.

But once I tried and tried and failed and failed and lost time after a layoff and lost time trying and lost more time trying with doctors and 40 approached, going beyond 40 didn't seem too old anymore.

Jack was born when I was 40 although he was conceived when I was 39 (and would have been born when I was 39 if he hadn't been frozen for seven months first...)

I did the IVF for the current pregnancy when I was 41 and will be 42 when I give birth.

Now, no doubt, you can see the decline in fertility.  Same protocol for both IVFs. First one yielded 18 eggs and 8 perfect embryos.  Second IVF two years later yielded just 6 eggs and only 5 embryos, not all of them perfect.

Still, it worked with my own eggs.  So I've changed my mind. 40 is not too old.  I'm not sure when too old. Pretty soon I think. But not yet.

Massage for infertility?

Speaking of massage, back when we were trying to get pregnant I did all kinds of Google searches to find out if massage might be able to help.  I didn't really find anything. Certainly nothing like the studies that show acupuncture can increase your chances of success.

Because we did not do acupuncture during our first IVF, I went to get a massage on one of the days in between our egg retrieval and embryo transfer.  I told the massage therapist what I was doing. I don't know how much of it she understood. But she was awesomely sweet and gave me a crystal she'd bought a while back.  She said when she had seen it for sale she knew she was supposed to buy it for somebody and when she saw me she knew she was supposed to give it to me.

The massage itself relaxed me, which is always a good thing.  But I don't know if it contributed to our success in getting pregnant.

Of course the cycle was successful, but a bad amnio diagnosis followed. We terminated and started to get ready for an FET.  That's when I headed to the acupuncturist, thinking that this was my last chance.  We didn't have a ton of money for multiple IVFs and I wondered if my embryos were just too old to have any of them be good. 

My acupuncturist was awesome.  One of the things she recommended was a femoral massage, which is something you perform on yourself.   It is supposed to increase blood flow to the uterus and ovaries.   ONLY DO IT PRE-OVULATION OR RETRIEVAL and not in the second half of the cycle when you might be pregnant.

Here's a site that shows fertility acupuncturist and TCM doctor extraordinaire Randine Lewis's instructions on how do to femoral massage on yourself.

Daycare costs vs. kitchen costs

Last weekend we closed (i.e. paid a lot of money) on the kitchen cabinets and countertop at Lowes. It took about two hours to make the changes we wanted and finish the deal. During this time we learned that our sales guy there had four kids: an 8 year-old girl who was from an IUI, 4 year-old boy twins from an IVF, and another 4 year-old boy born less than a year later who was a surprise and from a "natural" pregnancy.

Our guy Mike said that they spent $19K last year on daycare, which is more than we paid for the countertop and cabinets last weekend.

Mike had his own kitchen business for 18 years but said he got tired of chasing people for money. So he decided to give working for Lowes a shot. His wife works at a local university. I'm not sure what kind of work she does. 

Point of this? It's always amazing when I just encounter other people who have gone through this stuff. Much of the time in the real world I feel like a total minority in the infertility game, except for my friends online.  But apparently we are everywhere. I wonder how many other people I've encountered who have been through it and who I will never know about.

Happy days

After a long long time of waiting and enduring disappointment after disappointment, it is very sweet to enjoy some success.  When that means a pregnancy after infertility and loss, as so many of us know that often means a sense of complete disbelief about the pregnancy itself and paranoia about things that could go wrong throughout the nine months (or however long we get) -- a time when other women just bask in the glow of gestation, plan nurseries and buy baby gear and clothing without any qualms about jinxing themselves.

However, such pregnancies after so much waiting and pain are so sweet too.  I've been happily following Carol's at "(what if this is) As Good As It Gets?" (pregnant with twins after using donor eggs) and Thalia's at "Thalia's Fertility Journey" along with the bumps and paranoia on the way. They are all too familiar (the embryo is measuring too small.  I can't possibly be pregnant, I'm just getting fatter, etc.)

Never really want to offer congrats until mom is holding her healthy baby (my own insane superstitiousness not wanting to jinx things), but I'm so happy for these two.

IVM?

Have you heard of IVM?  This looks like an interesting technique that could help a lot of couples, especially if it indeed is less expensive than IVF. Don't know how good it will turn out to be or not, but here's the article I saw about it.

It involves retrieving the immature eggs earlier and then using the fertility drugs to grow them in a petrie dish.  It would eliminate the chances of OHSS and reduce the meds the woman would have to take. Sounds pretty cool, and they say the success rates are similar to those for full IVF.

Looking back and looking forward -- Happy New Year

It has been a long time since I've had to rely on dial-up internet connectivity, and let me just say it really sucks.  It has been excruciating, as you can tell by my lack of blog entries.  Days at a time passed by without me turning on my computer.  After a few days I found it faster to connect to many things from my cell phone, but I could not connect to everything. I could not use my favorite blog reader. I could not look at this email account. So I am so behind on what is going on.

How strange that 2006 is coming to a close. It went by very quickly for me, but January seems like an eternity ago.  Back then I was still exclusively pumping for Jack and was not ready to slow down.

The other day I was sitting in the living room with my mother, her husband and David. And I asked what their big accomplishments were for 2006.  I asked this because I think at this time of year I tend to focus on what I still need to accomplish without basking in the glory of my achievements.  And it can be kind of a self esteem builder to list those achievements -- self esteem that is useful when making new goals for the new year again.

I don't have a full list because we've been so busy (and also so sick with horrible colds, and so sleep deprived from all sleeping in the same room) but here are my big ticket items.

1. Exclusively pumped (breastmilk, because he would not nurse) for Jack for six months and pumped for him for a total of 10 months. 

2. By the end of the year, excelled at work, surpassing my colleagues in number of bylines and number of sources in stories.

3. Began a job search relying only on previous networking, asked for the the things I wanted (telecommuting, being able to take the job with me to the east coast when I moved), and was offered such a job by the end of the year. I started there at the beginning of December.

4. Planned (emotionally, financially and so as not to interfere with other events) another IVF. Did the cycle, which has so far been successful (I am 10.5 weeks pregnant -- I think everything is still OK in there.  No more morning sickness, but bigger and sorer boobs.)

5. Lost 20 pounds on Weight Watchers in the first six months of the year and started exercising again. Got to my pre-IVF weight.  (The pre-trying-to-conceive weight is still far away.  We will have to wait for another year to get there again.)

6. Started reading blogs, and started writing this blog.  I started it for a few reasons.  First, I wanted to write something different than the news stuff I write on a day-to-day basis -- to find my own style or voice that wasn't dictated by my profession's style.  Second, I wanted to write something close to every day.  And third, I wanted to share my IVF experiences and beyond (exclusive pumping) in the hopes that they might help someone who comes after me here.  So far it has been an amazing experience in more ways than I had imagined.

These were some of my biggest accomplishments for the year, and I am kind of amazed that I've been able to pull them off.

Now, there were many other goals -- the kind I make every year and make incremental progress on every year, but never a dramatic change. The top one of these every year is to become more organized -- have a neater, cleaner house; be prepared for birthdays and holidays well in advance; cook healthy, yummy meals with some stocked in the freezer for when we don't feel like cooking; have all the clothes in my closet ready to wear; get rid of the piles of stuff to-be-done, etc. 

I always make tiny strides in these things.  I am way better than I was 20 years ago.  But I'm no Martha Stewart.  In fact, ever since I saw that first Martha Stewart special on PBS so many years ago, 15? 20? more than that? I have despised the woman.  I can't even get to 1 percent of what Martha does so watching her has only made me feel inadequate. I have steadfastly avoided her -- boycotted her TV shows, her books, her magazines and even scowled when anyone mentioned her. 

Indeed, I was not upset when she was convicted and sent to prison.  Although at that point I did start to feel sorry for her.

But a month or two ago I had a thought.  That was that rather than resist Martha Stewart and her perfect ways, I should try to embrace my own inner Martha Stewart. That doesn't mean I will try to emulate or become Martha. No. Instead I will just not resist Martha-like impulses within me.

I told David about my Martha Stewart 2007 goal.  He said, "Why Martha Stewart?  Why don't you try to embrace your inner Cindy Crawford instead?"

(Thus, these are certainly not my most serious resolutions, and I will not feel deeply ashamed if I do not accomplish them to the fullest, but my first two are: 1. Embrace my inner Martha; 2. Embrace my outer Cindy.)

Happy New Year everyone.

Ultrasounds, HPTs and anxiety

My new job has kept me alternately busy and tired in the last week, and away from this blog more than I would like to be.  Being the new guy is exhausting. You don't know the simplest things, like who will be evaluating your work and what things they will look at when they do it.  So you are just sort of guessing and asking a lot of questions of people who are already very busy.

I hate being the new guy.

However, it does have the advantage of keeping me busy enough so I'm not spending every waking minute worrying about whether this pregnancy will continue another day, or whether it may have already ended. 

It's been a week and three days since our six week ultrasound and this weekend I have not been feeling pukey at all.  This makes me so worried.  And it's when the crazy me takes over, thinking that I can somehow determine whether everything is OK or not by looking at the darkness, or potential lack thereof, of the test line on home pregnancy tests.  This exercise also gets expensive too.  And it usually just makes me more worried and more inclined to buy more of the damn sticks.  I am starting to realize, after so many many years of this, why some people call them "devil sticks." I always used to think that was a silly term, but now I'm starting to think it may have some merit.  Those sticks are crazy-making and budget-busting, and ultimately provide no answers about the ultimate outcome.

Tonight's stick seemed a little lighter than the one from two nights ago, and as I was sitting with Jack before putting him to bed I kept thinking about this pregnancy in the past tense.  How it would have been nice to have another baby.  How it would have been nice to be pregnant at Christmas.  How it would have been nice to -- well, you know what I mean.  I felt like I needed to get my heart used to the possibility that it may be over -- you know, and then if it turned out well I would be pleasantly surprised. 

I've thought about contacting my RE office and asking to do the next ultrasound tomorrow instead, or Tuesday. (It is currently scheduled for very late on Thursday afternoon.) But as I was wandering around the web this weekend I saw this old post from Julie about a momentary Zenlike approach she had to her own first trimester scans during her successful pregnancy. Her posts during this time were filled with the same kind of anxiety I find myself feeling now.  If only anxiety could be counted on as a predictor of ultimate success...

The daughter of our across-the-street neighbors stopped by late this afternoon, the one who found out about a month ago that she was already 3 months pregnant.

She wondered if we knew the outcome of our IVF cycle.  (She knew about it because she was the first person we'd asked if she could babysit Jack on the day of the embryo transfer.)  I hedged and hedged and said not really. But David old her the truth and showed her the picture of the ultrasound from six weeks (which truly required as much squinting as looking at a 9 DPO home pregnancy test).

And Elizabeth was full of excitement and congratulations. She is in her mid-20s, and was pregnant for more than 2 months without even knowing about it, so she and I approach pregnancy from different perspectives. She does not have personal experience with pregnancy loss, so it was hard for her to understand my reticence to joy and celebration. I told her my pukeyness had faded to nothing in the past few days, but her enthusiasm did not waver.

On Friday afternoon I made an appointment for the first trimester prenatal genetic testing screen, also known as Ultrascreen, and a CVS for the second Monday in January.  And I also called my previous OB's office and left a message about getting an appointment there. Could it be by the mere act of calling the Universe's attention to the fact that I saw a heartbeat on an ultrasound 10 days ago by my arrogance of scheduling such appointments that I have doomed this pregnancy already.

I guess it's good that tomorrow is the second Monday of my new job.

Odds of getting killed while attempting to summit Everest same as odds of having a healthy baby through IVF at 41.

David and I have been watching Everest: Beyond the Limit, a new reality miniseries on the Discovery Channel about a handful of Everest expeditions earlier this year.  David read that book, Into Thin Air: A Personal Account of the Mt. Everest Disaster by Jon Krakauer that came out in the early 2000s I think. It's about a disastrous expedition in 1996 where many were injured, permanently disfigured, or killed. 

David says the book points out that your chances of dying in an effort to summit Everest are 1 in 10.  (Interestingly, this is about your chance of making it to a healthy baby if you do an IVF between the ages of 41 and 42 -- my group.  I still have my fingers crossed, and so far everything seems to be going OK.  I'm still feeling pukey.)

Many people leave their families behind in their attempt to summit Everest, apparently thinking it is worth the risk of injury or death to make the try.  Some of them don't come home to their spouses and babies.  I just don't understand that.  Are they so sure that they will beat the odds that they are willing to take the risk?  Or is the risk of losing a lifetime with their families worth it to them? 

Which makes me think of poor James Kim's family.  So many of us in the San Francisco Bay Area have been holding our breaths, happy when the wife, Kati Kim and her daughters were found alive after more than a week stranded in the freezing Oregon wilderness. (Mom breastfed her kids, one 4 years old and the other just 7 months old to keep them alive.)  But we continued to hold our breaths as the search continued for the courageous James Kim who went off on his own to seek help for his family.  I did not know them but I am still in a state of disbelief about yesterday's news, that Kim was found dead.  So so sad.

And it makes me even angrier at these Everest guys.  I would give up that kind of grandstanding personal glory fantasy adventure IN A SECOND for a lifetime of mornings with my giggling husband and son.  There is no comparison.  I just don't get what those Everest guys are thinking.  Maybe that's why David is so hooked on the show.  Maybe he is trying to figure out the motivation too.   Maybe we are missing something obvious here?