Saturday, February 26, 2005

Jeebus Cripes*

What was I saying? Oh, yes: Jeebus Cripes. Got a call from Freedom Pharmacy a few hours ago and am starting to doubt whether I heard them correctly. Could it really be eleven vials of Follistim and six of Gonal-F? And why again am I getting both? And what were the other five items on the order? Oh...what was it...I'm supposed to mix one of them with something else, right? Maybe the Gonal-F gets mixed with the Repronex, and the Follistim gets poked in on its own? And which one in the morning, which one at night? But there were two at night...Lupron, maybe?...but that one starts first...is that the one that goes in my thigh fat?...and what about the antibiotics?...oh, Jeebus Cripes, I'd better call the IVF coordinator and get it all figured out. Or maybe open the big orange folder where she put the instructions and the calendar.

But I can't open the folder yet. Fearful of the folder. Scary forms to sign; what to do with frozen bits if I die, dangers of organs being damaged by drugs...not ready yet. Maybe after some beer. Can drink beer this week. Highlight of week. Can you sense brain rot caused by fear of the folder?

Uuuuuuuurrrrrrrgh.

*Whichever of you beautiful bloggers came up with the above phrase, please know that I worship it and use it in every other sentence, i.e. Jeebus Cripes, J., did you drink up all the Lactaid again? Hope you don't mind the blatant plagiarism and will consider it, instead, the sincerest form of flattery.

Wednesday, February 23, 2005

What am I if not obliging?

As requested, I present:

What I Have Stored in the Downstairs Freezer

or,

The Contents of the Underused Big White Box That Unreasonably Jacks Up Our PG&E Bill



1) Three three-packs of Kirkland smoked ham steaks. Low fat, salty and full of yum. They occupy the entire middle floor in The Bugs Food Pyramid.

2) Five faux-Gladware containers of inconsistent size and manufacture containing a compote of wild plums from the trees in our back yard. Tart but sweetened liberally with sugar and honey, they make an excellent topping for butter pecan ice cream; however, we no longer eat ice cream due to the occasional lactose intolerance thing, and thus the plum sauce languishes in be-frosted loneliness in The Big White Box.

3) Two ten-pound bags of ice, half-thawed and then re-frozen into large contorted blocks after our last summer party. Their value now is as ephemeral sculpture; they will never again be expected to grace a beverage.

4) An assortment of prepared foods from Trader Joe's frozen aisle: spanikopita (bitter aftertaste; I advise against these), pear & gorgonzola pizza (quite edible), chicken gyoza (pretty good) and soy corn dogs (taste disturbingly like the real thing; J. thinks of the four-pack as a single serving and wolfs them down with voracious verve and a dash of yellow mustard, as though he were fourteen and the dogs from Der Wienerschnitzel. Not your typical healthful-but-agonizingly-bland soy product.).

5) Two blue gel ice packs, a bit tacky to the touch due to their intimate proximity to the remnants of a burst plum sauce container.

6) One large Niman Ranch tri-tip. An iron-filled, beautifully textured ode to the grass-fed cow.

7) Seven opaque 32-ounce Trader Joe's French Village yogurt containers, cryptically marked in Sharpie with notations such as "Sun G past OK" and "CEY soup !," which roughly translate from the original Tomatospeak as "Sun Gold pasta sauce, pretty decent" and "Soup of Czech's Excellent Yellows, yummyyummyohsogood!," respectively. Give me lycopene or give me death. If you do not speak the sacred language of the tomato, this still may not mean much to you, and I apologize. They are my personal religion and I tend to evangelize, but I will try to stop short of calling for converts.

Well, that's my report from The Freezer. Tomorrow, perhaps a scintillating catalog of The Shelf Above Our Washing Machine. Sounds gripping, yes?

Tuesday, February 22, 2005

Shall we count the number of swirls in my ceiling plaster? No?

What to write about when I'm stuffed to the gills with snot and apathy? Should I share the fascinating details of my seasonal allergic rhinitis, the engrossing tale of my brother-in-law's two-day visit? Or perhaps a few hundred words on What I Have Stored in the Downstairs Freezer?

Once the grievous Pill-induced vomiting passed and my head and stomach contents agreed to a tentative truce with the new dosage, I seemed to run out of blogging gas. The ongoing inability to breathe through my nose may also have something to do with it, as being perforce slack-jawed makes me feel quite dim and uninspired. (O, powerful god of saline nasal spray, hast thou deserted me forever?)

Today, I have done one thing, and one thing only, aside from lolling around snuffling: I applied on-line for a job. It sounds like a good job--a really good job, even--but as callous injustice likes to find a way whenever I fervently will otherwise, it turns out that my most-reviled-ever boss is now directing the IT group at this new company with the shiny, pretty, precious job. I do not know if he loathes me with reciprocal vigor, as I am generally rather diplomatic with bosses, but I cannot picture him getting the resume from HR and saying, Hot damn! Bugs wants this Project Manager job and she's just the gal to run with it! Can't wait to work with her again--after all, we got along sooooooo well all those years. She'll be a shining star in the IT Department firmament!

I am really starting to worry about employment. We have money enough to get through till September or so, but I have only seen a spare handful of jobs come on the market for which I am qualified. Does nobody need IT group managers anymore? Higher-level generalists? All I see before me are endless seas of job descriptions with extremely limited scopes, each requiring one expert skillset and a pair of blinders.

I'm also experiencing the dawning realization that, if both job and baby ever happen, J. would end up being the primary caretaker, and I think it might just break my heart a little bit to be separated from them, each and every day. J. is the natural choice; he can work from home. I can't. Woe is me.

Have you noticed that I'm big on the self-pity thing these days? Please cyberslap me if you think it will help me snap out of it.

Thursday, February 17, 2005

The Porcelain Bus

I have not slept since Monday night. During this time, however, I have learned the very interesting fact that birth control pills really do work! Unfortunately, for me they work by causing intense headaches, vomiting and insomnia, negating every sexual thought and impulse instead of, you know, doing that whole hormonal thing. Not that we were using them for their pregnancy prevention properties, but still it's nice to know they're effective if we ever don't want to have kids.

Night one, Tuesday, I took the pill, a little yellow one called Necon, with strawberry-rhubarb pie and tortilla chips a well-balanced dinner. We went to bed a couple of hours later and, just as I was finally drifting off in the earliest of early a.m.'s, I was jolted wide awake by a thudding abdominal pain and the desire to chuck. I woke J.--he loves it when I wake him up out of deepest sleep by asking if he's awake--and ascertained that he "s'fine, gobagdasleep." Which seemed to rule out food poisoning, as we'd eaten the same, um, dinner.

Through deep breathing, moaning and tossing enough to keep J. awake with me for the duration, I managed to avoid the actual vomiting. By noon, I was enfeebled but no longer nauseated, and proceeded to eat half a loaf of Trader Joe's whole wheat poppyseed bread, lightly toasted.

Night two, Wednesday, I valiantly tried again, this time swaddling the little yellow disc of evil in my first bite of bland pasta. I ate the whole plate, good girl that I am, and by the time we were ready for bed, I predicted, quite blithely, that I would sleep just fine, sweet dreams and see you in the morning, love. Yessiree, I was confident. So when I noticed the first niggling traces of nausea, I tried to tell myself that all was well and it was just in my head. And I drifted off.

For about ten minutes. Because, at 1:12 this morning, someone took a rod of aching pain and stabbed it into my forehead, just above the right eye. And, simultaneously, filled my stomach with burning, churning bile.

Again, I tried not to chuck. When I've been nauseated in the past, I've always made a concerted effort to get it out as quickly as possible, even occasionally hyperventilating over the toilet bowl as a means of hastening the inevitable. But those were the days when nausea was the result of a few too many greyhounds or kamikaze shots, a mild poison that really belonged in the toilet instead of in me. However, as the whole purpose of taking these pills is, I'm guessing, negated if they are thrown up half-digested, I concentrated my very best efforts on keeping it in.

All to no avail, naturally. No, I was a late-boarding passenger on the Porcelain Bus, a penitent at the proverbial White Altar. A puker-up-of-the-pill.

I am feeling marginally better now, twelve hours later, with the other half of the poppyseed bread lodged quite comfortably in my gullet and a can of diet ginger ale by my side. Dr. Meow was out of the office all day today but finally got back to me half an hour ago. After informing me in a very serious tone of voice that I had experienced a "very rare" (?) reaction, he phoned in a lower-dose prescription, which J. has just gone to the pharmacy to pick up.

I'm very much hoping that there will be no bus trip for me tonight, and that tomorrow I can ingest foodstuffs outside of the grain family. But if I have to take the ride again, at least I have my wonderful J. to annoy in those long, dark, nauseated hours.

Tuesday, February 15, 2005

Bleeding edge

I've always been a skeptic. Never one to believe in things that I couldn't see, touch, feel or smell, or things that simply didn't make sense right off the bat. By two, I had decided that Santa was clearly imaginary--that whole billion-presents-on-a-sleigh thing was obviously bogus--and wondered why my parents persisted in pretending otherwise. How gullible did they think I was? When I was old enough to start losing teeth, I simply handed my father the little bicuspid, bloody and wet, and left my hand out for the pre-ordained twenty-five-cent payout. No Tooth Fairy here; no Easter Bunny, no Great Pumpkin: an atheist from day one, no assembly required.

Starting in the mid-1970's, my very un-skeptical mother edited and published a bi-weekly newsletter "exploring the mind/body connection." It was filled with interesting but mostly unsubstantiated articles on how laughter could cure warts or hypnosis eliminate snoring, or the uncanny psychic abilities of parakeet owners. Mostly I thought the stories very silly, being my father's hard-nosed daughter, but as I was quite mercenary even at that tender age, I willingly coded return slips, stuffed envelopes and saved up my ill-gotten gains from the pockets of the starry-eyed subscribers--paid out by my parents in cans of diet soda, which I was allowed to convert to cash once the numbers reached undrinkable proportions.

There was one story that I did lock onto, however grudgingly, and which was repeated quite credibly in article after article over the newsletter's ten-year lifespan: the power of the placebo. If you believe something is going to work, it is more likely to do just that. If, as the story went, you believed you were getting acupuncture to relieve pain in your left elbow, it didn't matter whether the pins were placed correctly by a master acupuncturist or simply jabbed in randomly by an untrained research assistant: those who went in believing it would work for them had positive results, regardless of the "treatment". (How, exactly, does that belief or optimism trigger the physiological process of healing, or at least deliver some relief from the symptoms? I am fascinated.)


. . .


In the biopharmaceutical industry, clinical trials are usually conducted with multiple means of measuring efficacy. Patients, generally randomized into two groups sharing very similar characteristics of age, sex, stage of disease and treatment history, will be given either the active drug or a placebo. In so-called "double blind" trials, neither the patient nor the doctor knows who is receiving the real thing, and the coded tracking data is kept under strict wraps by the company or university managing the trial. In the end, various reports are made, the data is unlocked and analyzed from all angles, the FDA advisory panel reviews all the safety and efficacy data and makes its recommendation, and eventually the FDA bigwigs pronounce the official usefulness (or uselessness) of the drug.

Almost invariably, and even in studies of serious ailments, a statistically significant proportion of the placebo group reports an improvement in their symptoms (the placebo group almost always reports negative side-effects, also--a whole discussion unto itself--but at least they believe it's doing something). Doctors also frequently report seeing some improvement in patients whom they believe to be receiving the real drug but who are, in fact, getting nothing more than a cleverly disguised IV saline solution or sugar pill. Even the clinical investigators often find an improvement in the placebo group. So the effectiveness of the medication is necessarily based on comparison to placebo in what I think of as as the chemistry versus optimism showdown, and optimism usually has something good to say for itself.

So it seems that the power of belief, or optimism, or faith in medicine (I refuse to call it hope, as I'm still quite irritated with that word) can, in some people, bring about its own reward. But does it then follow that skepticism could bring about a negative outcome? And if that's the case, how exactly does a natural-born skeptic convert? Is it simply innate, and not to be learned? It truly feels like a hard-wired system for me.

My years in the biopharm industry instilled a lot of faith in the drug approval process, though clearly the ongoing safety monitoring program has left much to be desired and is now being revamped in the wake of recent extremely-rare-but-dreadful reactions to drugs like Vioxx or, a while back, Fen-Phen. I have been a carefully informed consumer of everything from ibuprofen and acetaminophen to generic-versus-name-brand thyroid replacement products, comparing side effects, interactions and clinical efficacy. So I was surprised, to say the least, when I found that neither Lupron nor the generic PIO concoctions are FDA approved for use in ART. And the Prometrium safety sheet specifically warns against its use in pregnant women. Not to mention the fact that the birth control pills I picked up today from a deeply puzzled pharmacist are most definitely not FDA approved for the suspended ovarian animation prior to an IVF cycle.

I realize that these products are part of standard ART protocols, and that, most likely, the only reason they're not FDA approved for such purposes is that the drugmakers don't want to finance additional trials proving their safety and efficacy in such a tiny market when they're already universally used in that setting, regardless. Once a drug's approved for sale, doctors can prescribe it for any condition they deem appropriate, and clearly they're appropriately prescribing these drugs in ART. But that doesn't keep me from wanting to see the data, to know the numbers--I'm left with a vaguely guinea-piggish feeling, though I know I'm in the good company of the tens of thousands who have gone before me.

Guess there's nothing left for it but to try to be optimistic that the drugs will work, that they won't harm me, and take it from there. It's a very, very small leap of faith, I realize, but I really don't have the legs for it. They're much better at walking, sedately and skeptically, from one known place to another.

Monday, February 14, 2005

The Plan

We saw Dr. Meow on Sunday morning, and our plan is confirmed.

I start BCP tomorrow and we go from there with the Lupron, Follistim, Repronex, etc. Retrieval should be the first week of April. We'll be doing ICSI and a three-day transfer of up to three embryos, if we are lucky enough to have that many. If we have the great good fortune to have spares, we will freeze them.

Meow is very hopeful, which I find odd. He believes that the problem is likely an enzyme deficiency on J.'s part, one of the thousand that facilitates fertilization but for which there is no test, and that we have a better than 50% chance of the IVF working each cycle since ICSI bypasses the need for this theoretically absent enzyme. When he said we were "excellent candidates," I had the misplaced sensation of receiving an undeserved promotion or bonus, that he must not really know me to say such a thing, but that I'd better not correct him.

Meow's numbers are outstanding and certainly back up his claim, but I am not much comforted yet. Perhaps I will take heart in them later, once I can find two cold stones of hope to rub together for a spark.

Saturday, February 12, 2005

The Call

Well, J. won the wager, though he immediately waived any claims, sensing, I suppose, that now wouldn't be a good time to push it. Dr. Meow called five minutes ago with the unsurprising news.

He called himself, sounding sincerely sorry, and wants to meet with us tomorrow morning to work out the plan for this month and beyond.

Before the call came, I was having a beautiful morning, working in the yard with J., pruning the apple tree and the beautyberry and the crazy, crazy vines. We were laughing and being silly with each other and it's something I will cling to for a while--a moment of release from the whole TTC process, absorbed in something else, and happy.

Friday, February 11, 2005

Is it just a coincidence that Monday is Valentine's?

Apologies. You guys have been more supportive than my favorite jog bra, and I'm not trying to leave anyone in suspense. Well, that's a lie. I guess I am trying to leave myself in suspense, or clinging to the edges of it, anyway. Double apologies.

The call never came, which I'm assuming means that the lab didn't get the results to Dr. Meow before closing. Which means I might hear on Valentine's, the Day of Perpetual Horror Monday. By then, well, the chances are pretty good that The Red Tide will have delivered its first tsunami-like blow. Or not--my cycles are not perfectly regular, but the LP's are usually long, and I'll only be 17 DPO on Monday, which is at the outer limit for me.

Sure, I could pee on a stick, and if I was hopeful at all, I might be driven to do it. But as I still feel so profoundly not pregnant, and since that Sea of White is even harder for me than the subsequent Sea of Red, I don't think I will. So, I may remain in that state of suspense till Monday. Or not, depending on how enthusiastically my uterus wants to shed its thick winter coat in preparation for spring. (Which is in full swing here, by the way. Now is the season when our good friends The Environmental Allergens move on from mold and mildew to the entire California pollen spectrum.)

To pass the time as we sneeze and wait, J. and I are wagering on whether The Call or The Tide will arrive first. J., trying so hard to be positive, is a staunch financial supporter of The Call. I, however, have five bucks and a blow job riding on The Tide. Now that's confidence.

Thursday, February 10, 2005

Just for fun

J.'s mother, a very silly and delightful little bird of a woman, loves to give odd presents to her three sons and has even started to include me in the semiannual tradition (birthdays and Christmas, without fail). Sometimes, we will unwrap multi-layered packages containing out-of-date calendars, or promotional stickers from the bank that holds their mortgage, maybe an XXXL tee emblazoned on the front with the name of the school at which they teach and on the back the words, "Trainee Counselor."

When she hands out these gifts, she makes sure to tell you, in her chirpy Minnesotan accent, that they are "just for fun." She even wrote "Just for Fun!" on the newspaper wrapping that held my Christmas gift--a copy of The Vikings' Guide to Succeeding in Business Overseas. Which was a lot more fun than the name implied, truth be told.

There are many things in her life that are JFF, even when they're not really fun, just a little strange. After The Parents, as we call them, moved to England a few years ago to teach, we flew over to visit them. His mother decided to make us an all-starch, all-white meal for the occasion: rice, bread, baked potatoes and pound cake. I wondered if she might have misunderstood some new dietary craze, or perhaps have had her teeth bleached that day, but no: it was JFF. When we took the wrong train the next day and ended up with an extra hour in transit to Oxford, she said, "Well, think of it as being just for fun." When the restaurant was out of fresh salad greens and all I wanted in the whole wide world was fresh salad greens but had to settle for boiled chard? "Oooh! Chard! Just for fun."

This ability to see "fun" in the simply odd and the tiresome is her special gift. Though it's probably genetic, I think I will try to borrow that gift for tomorrow, when I go in for my pointless beta. I can just hear that chirpy voice now: "Oooh! An unnecessary blood test, just for fun!"

Now here's a smackdown I'd like to see: J's mother up against Pollyanna. I'm thinking it would be J's mom on a TKO in the 12th round--the Glad Game is no match for JFF, which seems to have infinite versatility.

Wednesday, February 09, 2005

My own personal pity party

As I went into this cycle, that niggling Pollyanna beast told me that, surely, lots of needles and progesterone and monitoring would be just what I needed. You'll see, she said. Even you can't be pessimistic this time. When I responded with my usual assurance that, Oh, fuck yeah, I could so be pessimistic, just watch me, she saw that one corner of my mouth was turned up in a grudging little smile as I spoke, and she gloated. She knew she was right. The novelty of the process had seduced me into hopefulness.

When the FSH injections left me feeling so ripe and fertile, overflowing like an Easter basket, there she was with a little told-you-so grin. When the sperm wash came back looking so supergollyswell, she jumped up and down, whooping. And when I started to feel weird--feel pregnant?--a few days ago, she danced in wild circles and screamed with delight.

And I'll tell you this: Two days ago, when I woke up suddenly feeling so very un-pregnant that I couldn't even conjure up the vaguest hallucination of a symptom, I remembered why pessimism is my very best friend, and why Pollyanna is to be shot on sight with a large-bore rifle.

Wanna play the Glad Game with me? Here goes: I'm glad because, even though in my heart of hearts I don't think I'll ever be pregnant again, I am unemployed and can spend all of my waking hours wallowing in my infertility.

That is how the Glad Game is played, isn't it?



Friday, February 04, 2005

In which J. worries all the way to 2018 and beyond

Since I have been advised by my R.E. against swimming and any high-impact exercise during the two week wait (or, as J. likes to sing it, the "Loooooteal Phase! Yeeaw!"), J. has been kind enough to accompany me on long daily walks around the neighborhood. We spend sixty or ninety minutes wandering north or south, east or...not so much west, actually, as we're about six blocks east of a really sketchy part of Oakland. Sometimes we take to the hills, with their lovely views and pleasant trees, with the wildly theatrical Mormon tabernacle perched up top. Sometimes we stroll quaint streets lined with craftsman bungalows and glean ideas for our own house or landscaping.

Yesterday, to liven things up, we decided that our walk could only consist of streets that we had not traversed within the last two years, give or take. We could cut across more familiar Lanes and Courts and Ways and Circles, but for no more than a block, and only if we would otherwise be stuck. These rules necessitated that we flirt with those neighborhoods a bit to the west, the "transitional" areas where the housing market has not yet caught fire but the local business row is no longer comprised entirely of bail bondsmen, manicurists, pager stores and Dunkin Donuts.

As we made a turn down one of these unfamiliar urban streets, looming before us we saw an enormous junior high school with a giant playground, a hundred kids running around, laughing and playing basketball. My mind immediately started to wonder about their test scores, to file away in the back of my brain should we have the need in thirteen or fourteen years. It looked pretty nice to me, especially considering the neighborhood.

Now, I should mention here that, with the exception of one unforgettable year at a "real' elementary, I went to a single school for kindgergarten through tenth grade, when I left for good. It was a public "alternative school"--one started up in 1971 by a group of parents, including my mother, for "highly motivated students". (Its real claim to fame was in having no mandatory courses or homework. If you wanted to make cranberry sauce and do macrame all day, that was AOK.) Anyway, what we lacked in academic rigor we made up for in abysmal facilities. Our buildings were a series of temporary trailers. Our science lab consisted of a miasma-inducing refrigerator with two or three dozen formaldehyde-soaked frogs, one microscope and a sink. For P.E., we had tetherball (one pole) and a handball wall against which we generally lounged and enjoyed the sunshine. There was no cafeteria, no locker room, no auditorium. But since I never knew anything different, I figured it was pretty normal. J., on the other hand, son of two public school teachers, spent most of his formative years in Carmel-by-the-Sea, the tiny, idyllic and stinking rich town best known for having Clint Eastwood as Mayor and for outlawing the public consumption of ice cream in an effort to prevent a Baskin and Robbins franchise from opening up shop. His schools, as you might imagine, were a wee bit different from mine.

So the stage is set for what comes next, when J. says to me, "You know, I don't think our kid can go to this school. The whole play yard is asphalt. Where's the grass? Also, it looks like they don't have a pool, so how will he play water polo?"

As I cackled, I was also a little touched that he was thinking so far ahead.

Thursday, February 03, 2005

A little light cleaning

I am completely spent, in a very good way, after reading your generous, thoughtful, weep-inducing comments. You've bowled me over. That post was a little tiring to write and I can't quite face another one that requires a lot of energy, so I thought I'd fling a few random things together and hope they make soup.

Suppose I'll start with Naked Belly Woman. NBW had her perfect baby boy at her perfect home about a week and a half ago, perfectly on time. No drugs, short labor. All very perfectly perfect. But--and this is where my evil jealous infertile bitchy awfulness comes out--it turns out that she "tore unusually" and has healed up "incorrectly", due to some "bad advice from her midwife." She is heading in tomorrow to be re-cut and re-sutured, with the probability of reconstructive surgery in a couple of months. Sounds pretty thoroughly awful. And I know that it's very, very wrong, and I do hate to think of her disfigured and in pain, but the simple knowledge that not everything went perfectly for the world's most perfectly fertile woman satisfies me somethin' powerful. She may have three beautiful kids, an ideal husband, a lovely mansion of a house and be movie-star gorgeous, but, even for her, the birth didn't conform to the expected perfection.

And as sick as it is, I am now able to think of her and her baby and her whole outwardly perfect family/house/life with much more interest and compassion and enthusiasm. I was even able to respond to her latest email without imagining saying the words in my forced-pleasant, untouchable voice--the one I learned when I worked customer service for a tacky mail order catalog long ago. In fact, I felt genuinely happy for her and her newest tyke, with whom she's bonding and falling madly in love. Maybe now I'll get around to mailing the gift that I've neglected to send for the last week (and no, I'm not enclosing any version of her card).

On a completely different topic:

I turned on the handy-dandy Blogrolling service that is supposed to append "New Post" to any blog with a new entry within the last 24 hours. However, after blithely assuming that it was working correctly and not bothering to check some of my favorite blogs for a few days, tra la la, I realized that it does not, in fact, work for every blog. It works for a variety, including most or all of those hosted by Blogger, but does not seem to work for others, such as those hosted by Typepad. Anyone know whether there's any way to fix this from my end or am I doomed to an imperfect system?

One more thing:

I have been updating my Blogroll but still feel like I'm missing people. And when I've missed adding people to my blogroll, I 1) feel like a heel, and 2) fail to read great blogs. If I've missed your blog, please let me know so I can add it. Alternately, if I list your blog but you'd rather I didn't link to you for any reason, please just say the word.

And finally:

This entry over at April's place tells an amazing story. She wrote it back in August and mentioned it in response to my last post. I am floored by what she went through and how she coped.