Friday, October 29, 2004

start spreading the news. . .

I'm leaving today. . .

To make a brand new start of it.

New York, New York.

First though, I have to get through 4 hours of Halloween craziness at school. Then, pray that there's not too much traffic on the way to the airport. (It's a long weekend here which always means tons of people trying to escape the city).

But my bags are packed and I'm ready to go. I have my accordian file with all my medical records in my bag. My mother-in-law picked up my HSG films from the DC clinic yesterday and fed-exed them to our new RE. It only took her 40 minutes from start to finish (including driving time). So why couldn't the DC clinic be as efficient as my mother-in-law? Apparently Nurse Helpful doesn't have access to Fed-Ex. I think thats a load of crap, but at least she finally faxed 18 pages of our files to the new doc after numerous phone calls, e-mails and groveling by my husband, so we should be in good shape when we have our appointment on Tuesday.

And besides looking forward to meeting our new team, can I also mention that I am totally psyched for bagels and decent chinese food, and true brunch experiences? And shopping and seeing my friends, and being able to converse with strangers in a language where I actually know all the verb tenses? And riding the subway? And walking the streets? And just hanging out? Because I am.

Will hopefully come back feeling just as energized as I am this morning. Will hopefully have some good news to post with regards to getting this baby-making underway.

It's up to you- New York, New York.

Saturday, October 23, 2004

i can see clearly now

I found out something interesting today.

Guru only does surgery in September, December, March, and June.

So that's the explanation for giving us an IVF start date in March. Six months away is still six months away, but I feel immensely relieved upon getting this new information. It means that Guru wasn't just picking a month at random (unlike my former RE). It means that we will really start meds in February and go for the gold in March barring any unforeseen circumstances.

Of course, I'm hoping that there's a way to fit us in in December. I've already figured out that my next cycle will start the day after we meet with him. And so, if I could only start BCPs right away and then my meds, I figure I'd be ready to go by mid-December or late December. I know it's far-fetched of course. And don't worry, I'm not banking on it. I'm sure Guru is already all booked up for his December surgeries. But how amazing would it be if it did happen? The best Christmas present ever!

But March is good too. March is great. And I figure if I've been patient this long, I can wait a little while longer. Really, I can.

So now all I have to do is locate those missing files so that the new RE can see that my ovarian reserve is in tip-top shape. That I'm raring to go. And maybe one of Guru's patients could do me a huge favor and cancel his sperm retrieval surgery, the one scheduled for mid to late September? I know it's a lot to ask, but hey, anything can happen.

missing

My blood work is lost. My husband lost it. I figure it had to be him since I am oh-so organized and anal and type-A and have every single piece of paper relating to infertility organized in a nifty accordian file.

I first discovered my lab report was missing from the file when my husband came back from his consult with Dr. Blecch in September. Before he left for his trip I specifically told him to have Blecch make copies of our lab reports and to bring the originals home. When he came home- no originals. He left our papers with Blecch. When we discovered that my records were missing from the files, my husband assumed that he had given Blecch my results too. "They must have been all together." Impossible. My filing system has my records in a different section than my husband's.

We called and called and asked Blecch to send the originals to my in-laws. They arrived on Friday- not the originals at all, but fuzzy copies. And fuzzy copies of my husband's hormone levels only. My lab reports were conspicuously absent.

We think (we are praying) that Dr. Hope has copies of all of my bloodwork and that he didn't immediately put them all through the shredder when we broke up with him. And we've asked him to send all of my medical records to the new RE in New York. But we've asked him to do things for us before that didn't happen. Hence the break-up.

The new RE wants/needs my day 3 bloodwork before our consult with him next Tuesday. And as luck would have it, my next cycle begins the day AFTER we meet with him. So if my lab reports are truly missing and Hope doesn't have them (though why wouldn't he, right?) or if he doesn't send them in time(a more likely scenario)- we're that much more behind in getting started.

I'm so frustrated I could scream. I hate losing things. And losing my Day 3 hormone level report right now feels like just about the worst thing ever. Okay, I know there are worse things, but I'm a firm believer in "a place for everything and everything in it's place" and right now I'm having a hard time remembering which doctors have which papers. Too many doctors involved. Too many tests, too many results.

It will all work itself out (I hope) as I plan to harass Hope's receptionist until I am 100% positive that my report is in the new RE's hands. But I only have a week to do it. A very busy week it shall be.



Thursday, October 21, 2004

blah, blah, blah

I haven't written in awhile because frankly, there's nothing to write about.

We broke up with Dr. Hope last weekend and I think it went okay. We were polite, explained why we were leaving him, and asked him to forward all of medical records to the new RE. They haven't arrived yet, but I'm hopeful that they are en route and will be there when we meet with him in a couple of weeks. We'll check with the new RE's office in a couple of days and if they haven't yet arrived, we'll pester Dr. Hope some more. I'm hoping he's man enough to not take our desertion personally and will send the records without any further prodding from us. We'll see.

So, I leave for New York a week from tomorrow and have made plans with friends for brunches, dinners, shopping excursions, and cheesecake at Juniors. I think I may even be able to squeeze in a trip to my former polling place to vote on election day. It'll be a busy trip- but one I'm looking forward to for a million reasons. It'll be great to be back in my favorite city on earth, not to mention finally meet with our new docs and hopefully get moving on having a baby.

I'm not sure that there will be any news worth writing about before I go, but I'll definitely be back after my trip with an update on how it all went.

Sunday, October 17, 2004

cut to the chase

The more I think about it, the more I wonder why Guru told my husband that he thinks we'll be able to start IVF in March.

I'd be more understanding if we hadn't already had most of our tests done, if we weren't up to speed on the procedures, if we didn't have scheduled appointments with Guru and the new RE in a couple of weeks, if we weren't so dead-set on having a baby and having one soon, if we hadn't researched all of our options again and again and again.

But six months away is just that, six months away. And the more I consider that timeline, the more it seems too long to wait.

I just heard the news (on one of the message boards that I frequent) that an "aquaintance" of mine just found out she was pregnant with twins. I'm thrilled for her, and her pregnancy gives me hope. She and her husband were dealing with severe male factor, they did IVF/ICSI. It worked the first time. But, if I remember correctly, she e-mailed me to tell me of her husband's diagnosis a month or so after I learned of my own infertility back in July. We may have already met with Hope by then. We were probably already thinking that September would be our month.

I hadn't realized that this woman was moving along so quickly. Didn't even know that she had started taking drugs, had had her egg retrieval, that they were able to find viable sperm in her husband's testicles.

Who are her doctors, I want to know, that diagnosed and treated them so quickly? That had such successful results the first time around? And why is Guru urging us to take the slow boat? Everyone is different, I know, but I can't help but envy this woman who got to do things the way we all wish we could- boom, boom, boom, pregnancy.

I'll have the chance to talk to Guru in a couple of weeks and I'm definitely going to ask him about his timeline for us. I imagine things get hectic around the holidays (doctors and nurses and technicians on vacation and all that) and perhaps his team is booked through the New Year and beyond. If it's a scheduling issue, that's one thing, but if it's something else, well I have no qualms about telling him that I was ready yesterday.

I do believe that he is the best doctor for us, so I will listen to what he has to say. I'm not planning on jumping ship (again) due to my own lack of patience. But if it can happen sooner, why not try it sooner? That's all I want to know.



Friday, October 15, 2004

what i know now

Since Wednesday, the staff at my school has been attending a conference for educators here in DF. We finished around 3:00 yesterday afternoon, and a group of us headed to a bar in my neighborhood for tapas and sangrias.

One of the teachers asked me how old I was, how old my husband was and I told her: 31 and 33. She asked if we were planning on having children. And I hemmed and hawed over my answer, wanting to be honest with her because she had just shared the intimate details of her recent separation from her husband, but in the end deciding no, that I don't want people at work to know about this. At least, not yet. And so I told her that we probably did, but we'd just been married a year and were giving it some time. What a load of crap. The confession made me feel guilty in two ways. One, for telling a bold faced lie to someone I really like and hope to become better friends with. And two, for feeling like infertility is something I can't talk about openly, honestly.

I was in an unbelievably good mood yesterday thanks to the consult with Guru. We have a plan now it seems, a realistic one. One that sits well in my stomach and doesn't make me cry with the sheer improbability of it actually happening.

My husband met me at the bar when he got off of work and when everyone else had left, we stayed for another sangria and talked alone about our days, about Guru.

I didn't realize how angry I was at our DC clinic until we started talking about the things we'll say to them when we break it off for good. Because we are going to break it off for good. I realized that despite the clinic's claim to work with patients from all over the world, they were especially unaccomodating with us in terms of scheduling our appointments and recognizing that when we fly from 2000 miles away, we want a little more than a brief consult. I think of all of the unanswered e-mails I sent, the questions I had answered only vaguely, the reluctance for anyone on that team to commit to a plan of action for us, and I boil.

I realize how my urgency to get pregnant, to get started with our treatment blinded me in some ways to the fact that the doctors we were working with weren't the best doctors for us. And I wonder where we'd be if I hadn't tapped into the blog community, the RESOLVE message boards to learn that there are people out there who specialize in male factor infertility, who are responsive to their patients, who are respectful of their patients who travel from far away in the hopes of getting the best care available.

I also can't help but wonder if things are going more smoothly with Guru because of our experience in DC. I know now what to ask for, what to demand in terms of patient care. I know now what to expect. I'm more educated about infertility about the treatment options and the diagnostic testing and I know what needs to be done and when it needs to be done. With Hope, I was following along blindly, snatching at any promising offers he made because I just didn't know what was realistic and what was off-base. And now I do. I'm no expert (though I might be by the time this is all over), but I certainly am no longer wearing my rose-colored glasses as I navigate the system.

While my husband and I were talking last night, he tried to figure out when our baby would be due if we did IVF March. DIf I get pregnant in March, I corrected him. It might not work. The eggs might not fertilize, the embryos might not implant, I could miscarry. That won't happen he said and I told him that it might, it could, it was probably more likely that I won't get pregnant than I will. And I explained that I wasn't trying to be pessimistic, but realistic. Reminded him how devastating it was to pee on a stick every month all of those months ago when we were "trying." And how much more devastating it would be to pin all of our hopes on one procedure, all that money and time and energy spent, only to have a negative result. I can't do that to myself, I told him. I can only hope for the best and expect the worst.

I think he got it.

So, this weekend, we write to Dr. Hope and tell him that we are no longer in his care. I'm hoping that we're not too chicken to explain all of our frustrations with his practice and that we're not too bitter to tell him that despite those frustrations we really liked him, his nurse. But (and I won't write this part), we just like Guru better.

Thursday, October 14, 2004

the consult

My husband had his phone consult with Guru early this morning. I was extremely nervous all morning, waiting for my husband's call, worrying that somehow things would go awry, that we had put all of our faith in Guru being the answer, only to discover that he was no better than our guy in DC.

But it went well.

Guru had all of our medical records in front of him (minus the ones that Blecch's office failed to fax)and my husband had a list of questions that we wrote out last night as well as the lab report from his ultrasound.

Based on all of the available information, it looks like we'll be able to start IVF in March. I'll start taking drugs in February and we'll do the microdissection surgery and egg retrieval in March. It's a little farther away than I had hoped, but still in the realm of the not-too-distant future. And unlike Hope's prediction that we'd start in September, actually seems realistic to jaded old me.

My husband set up an appointment with Guru for the time we'll be in NYC and that feels promising- three birds with one stone: the RE, the urologist, and the lab technician for the chromosomal testing.

We still need to decide whether or not to repair my husband's varicocele. Guru thinks that if we go forward with that surgery, there would only be a 10% chance of upping his sperm count. He also thinks that (based on the bloodwork), my husband has sertoli-cell only syndrome. Blecch told us that with sertoli cell, we'd only have a 5-15% chance of finding sperm, Guru thought it was more like 30-50%. Much better odds, I think. And odds that I can live with.

So, we're moving along in thie journey towards being parents, slowly but definitely surely.

Two more weeks until we meet Guru in person. I can't wait!

Monday, October 11, 2004

the beginning of the end

My husband's phone consult with Guru is on Thursday and Dr. Blecch has yet to send us the originals (and our only copies) of our bloodwork results. My husband mistakenly gave them to Blecch at that consult before he realized that there was no way in hell that we would continue seeing him as our urologist. We've called the office numerous times to request that they send the originals back to us. Mostly, we get the voicemail. A week ago, my husband was lucky enough to talk to a receptionist who promised that she would check to see if our records had been mailed and if not would put them in the mail immediately. They still haven't arrived.

If we were depending on the Mexican postal service, I would completely understand this. But we asked Blecch to send the lab reports to my in-laws who live about 20 minutes away from his office. Surely, if the receptionist had really done what she said she was going to do our papers would have arrived quite a while ago.

So tonight I sent an e-mail off to Nurse Helpful in the hopes that she will fax a copy of the results to Guru in time for my husband's consult. It was a tricky e-mail to write. We still haven't confessed to Hope and Helpful that we are leaving them for someone else and so I had to sort of stretch the truth and say that we were seeking a second opinion. I told her we had tried to get in touch with Blecch but had failed miserably and would she be oh-so-kind as to fax off our bloodwork to Guru.

Sooner or later, we're going to have to come clean. We'll have to let Hope and Helpful know that as much as we love them, we can't stand their little urologist associate and are walking out of the relationship. But we want to actually talk to Guru first. Want to make sure he's waiting in the wings for us. Can't break up with Hope and then be left with nothing. Though I'm worried that my e-mail wasn't subtle enough and they'll know. "We like you, but we feel it's time to see other doctors." "It's not you, it's us." "We still want to be friends." No matter what lines you use, it doesn't make it any easier. And I know that stringing them along will probably only make matters worse. Breaking up is hard to do, especially long distance.

Did I mention my husband had his doppler color ultrasound this evening? He did. We'll get the films and lab report on Wednesday. I wasn't in the exam room with him, but I got to hear about the image of his varicocele. Bright red and blue on the screen. At least we'll have that test result in hand in time for the consult, even if Helpful and Blecch don't come through for us with our hormone levels.

Sunday, October 10, 2004

always a bridesmaid. . .

I've actually never been a bridesmaid. But if the adage fits. . .

My husband was made a godfather yesterday. This is his third godchild.

Yesterday afternoon, we were invited to a party to celebrate the 6 month birthday of our friend's baby. (These are the friends who got pregnant a month after learning of the husband's low sperm count.) They're Indian. And traditionally, when a baby turns 6 months old, there is a special ceremony to officially commemorate the introduction of solid food into the baby's diet. Usually, the mother's brother feeds the first bites to the baby. But my friend has no brother. And when we arrived at the house yesterday, she pulled us aside and told us that they wanted my husband to fill that role. So he was briefed on the ceremony which involved him sitting cross-legged on the floor, holding the baby in his lap and feeding her a bite from each of the dishes that we'd all be eating later that day. His forehead was brushed with sandalwood paste, a symbol of purity. He touched the different foods to her lips. (she didn't cry even at the spiciest dishes.) He offered her a plate full of various items symbolizing her future career choice and waited for her to reach for one. (She chose a silver rattle). Everyone agreed that he did a good job. And he held that baby for the rest of the day, only giving her up to me or her mother when he was ready to eat.

Mama (I think that's how it's spelled) is the name for his role. And supposedly, in Indian culture, the mama is like the godfather. He is responsible for half of her dowry when she gets married, is present at all of the important ceremonies in her life. We were shocked and honored that my husband was asked. And when we got home last night, I told him how significant it was that he had been chosen. Wanted to make sure that he understood the importance of his place in this baby's life.

It's not surprising to me that my husband has been chosen to be a godfather to three different babies. Children love him. He's good with them. Yesterday, after watching him with her baby for a while, my friend turned to me and confessed that she thought he seemed more comfortable with the baby than she was. He's going to make an excellent father, she said. And I agreed. Have always known that.

I'm not sure if this is the right time, but I have something for you, she said. They went to India with the new baby this summer and brought us back a bunch of gifts. But there was one more. A tiny silver rattle, just like the one her daughter had chosen from the plate earlier in the day. When they left for India in May, my husband and I were actively trying to conceive and had no idea that we had any problems in the getting pregnant department. Our friends knew that we were trying and bought us the rattle in the hopes that when they got back from their 3 month trip, we'd have good news to share and they'd have a congratulatory gift ready and waiting.

She gave me the rattle yesterday. It's the first baby thing that I own. I don't feel jinxed by it, maybe because it was a gift and not something I bought for myself. I didn't feel sad when she gave it to me, only hopeful. Certain that someday I will have a baby who will hold it and shake it to hear the tiny bells ring. I'm not sure I would have felt this way a couple of months ago.

You will be parents someday, she said. And now your baby will have something to remember me by.

Thank you, I said. Thank you so much.

And I meant so much more than thanks for the gift. I meant to thank her for believing in us as potential parents, for being so certain that it will happen for us that she was unapologetic about presenting me with a gift that may not be useful for another year or two or three. For wanting to be a part of our future child's life in the way that we are now connected to her daughter.

I showed the rattle to my husband when we got home and waited for his reaction. He just smiled, didn't seem to think that getting a gift for a baby that isn't even growing yet was strange. I slipped the rattle back into its velvet pouch and put it into the drawer where I keep my jewelry.

I'm sure I'll look at it from time to time as a reminder of things to come. Am not worried at all that it will make me think of what I'm missing now, only what I will have in the future. My little silver touchstone. My little jingly piece of hope.

Friday, October 08, 2004

ready, set . . .

It's official. I'm going to New York. We made the appointment with the male factor infertility RE at Cornell for the beginning of next month. Apparently, he's booked until mid-December, but we were squeezed in. Thank goodness. I'm not sure I'd have the patience to wait until December for our first meeting.

The crazy thing is, as anxious as I am to get this whole thing underway, I'm really just looking forward to being back in New York. I haven't been since February and I miss the city terribly. Most of my friends are still there and I'm crazy excited to see them, go to the Halloween parade in the Village, do some shopping, linger over a long brunch on Sunday.

I'm looking forward to meeting our doctors too, of course. And to get my husband's genetic testing over and done with. I'm hoping the consult will be informative and we'll have a better idea of when we can actually start IVF. When I think back to our first meeting with Dr. Hope in July and his insane promise that we'd be starting IVf in September, I'm amazed that I believed him. We hadn't had a single blood test done then, no HSG, no physical exam for my husband. But now, or at least by the time we meet with the new RE, all of our results will be in his hands. I think that makes for a more realistic prediction of our treatment plan than 2 semenalyses and my ovulation charts- all we had in hand when we met with Dr. Hope.

So, I'm looking forward to the trip. Only a couple of weeks away. Something to get me through the increasingly crazy days at work. I'm ready.

Tuesday, October 05, 2004

i love new york

Things are moving along. Smoothly. My husband has his telephone consult with Guru next week, and an ultrasound scheduled here in Mexico on Monday. I've chosen an RE from Guru's team and will hopefully meet with him in early November. So far, I've been pleasantly amazed at how accomodating all the folks at Cornell have been. The difference between our interactions with them vs. the interactions with the team in DC is like night and day. And I really feel like we've made the right choice in switching practices.

I was nervous about it at first. Thought that if we left Dr. Hope, we'd be starting from scratch. But of course that's not true at all. Most of our tests have already been done and we just need to get started. I know that there'sa chance that Guru will want my husband to have a biopsy, but hearing that from him seems very different somehow than hearing it from Dr. Blecch.

Suddenly, I feel like we're in capable hands. Hands that truly understand male factor infertility, hands that will help us achieve our goal of having a baby in a relatively uncomplicated manner. While I really liked Dr. Hope, I just didn't feel like we were a priority for the practice. I think that their expertise just isn't in male factor stuff. And what we need is expertise in male factor stuff. And so I'm feeling hopeful again. Even optimistic.

Of course, I won't know what our timeframe will be, what our protocol will be until my husband has talked with Guru. But based on our communication with him so far, his office so far, I have a hard time believing that he'll disappoint.

Sunday, October 03, 2004

secrets

My husband is a Republican. I am a Democrat. As a couple, we've come to terms on our political discord, though the truth of the matter is, we actually see eye to eye on most issues. Not all. But most. He still believes that the war in Iraq is not a mistake and would like to see George W. in the White House for another 4 years, while the thought of the war and George W. make me nauseous. He's a better debater than I am. I tend to take everything personally. I don't argue with cited studies and statistics, but with emotion. And so I tend to lose our dinner table arguments. But I like to think that even though he can't sway me on the big issues, he's able to help me to see both sides of an argument. And in my own emotional way, with examples from my work in The Projects on the Lower East Side, the inner-city schools in Oakland, I can help him to see the other side of things as well.

On Thursday night, we watched the first presidential debate at the Sheraton Centro Historico with a group here in Mexico, the Republicans Abroad. My husband isn't part of the group, but was invited to the event by a colleague of his. We don't have cable at home and both wanted to watch the debate and so accepted the invitation.

There was more press there than Republicans Abroad, or so it seemed. I'm pretty sure that I was the only Democrat in the room until the very end when the former ambassador to Mexico showed up. But the people gathered to watch the debate were a pretty sedate bunch and so there was very little audible response to either Bush or Kerry. No cheers, no hisses. And I was quite relieved.

When the debate had ended, a reporter wanted to interview my husband, but he declined, not wanting his political affiliation to be somehow linked to the university he worked for, so we slinked out while the president of the group was interviewed and others lined up for their turn in front of the camera.

The next morning at work, one of the teachers asked me if I had seen the debate and I told her that I had. I went on to explain that I thought Kerry was strong, but I'm biased in that direction and that I had watched the debate with the Republicans Abroad. I didn't mention my that my husband happens to be a Republican. I tend to let him out himself when it comes up, especially among people we don't know very well.

That night, we went out with some of my co-workers and the teacher who had asked me about the debates was there. She assumed, as most people tend to do, that my husband was a Democrat. And she asked him how it felt to watch the debates in Mexico with a bunch of Bush supporters. She said that she'd never met a Republican in Mexico. And I kept waiting for my husband to say something, to tell her that she was talking to one right now. But he kept quiet and while he didn't actually agree with what she was saying, he was vague enough in his responses to her questions and comments that he didn't let on how angry her assumptions made him.

Later, this same teacher (who I really like, by the way) made a comment about IVF. One of the students we work with was conceived using a sperm donor and we were talking about how he doesn't know his father. I can't remember exactly what she said (I'd had a few drinks by this point), but it was something about not knowing your biological parents, about not looking like your mother. I kept quiet.

The people at school don't know about my infertility. I don't know if its something I'll ever share with them. I just don't feel like I know them well enough, trust them enough to share. Part of it is, that most of them are younger than me. None of them are married or thinking about having kids. The only kids we talk about are our students. The topic of pregnancy, of raising our own kids just hasn't come up. At this point, its hard for me to imagine how it would. My guess is they assume that if/when I'm ready to have kids, I will. And for now that's okay with me. If/when I have to take time off from work for IVF, I'll have to decide whether to tell them the truth about why I'll be gone for so long. I have a feeling I'll be vague about it. Need to see a doctor, have minor surgery, something along those lines.

Since Friday, I've linked these "secrets" in my mind: the fact that my husband supports Bush and the fact that we're infertile. While neither one of these things (I hope) would cost me the friendship of my new co-workers, they both have the potential to make things feel awkward between us, something that sets us apart. I already feel a bit out of the loop having joined the staff well into the beginning of the school-year, haven't bonded with them in the way that they seem to have bonded with each other. I don't want to jeopardize the potential for making new friends. It makes me feel a little dishonest, and I'm probably not giving these people the benefit of the doubt, but I can't help the way I feel, even if it's more than a bit irrational.

We skipped a second work party last night, not because of any of the above stuff I mentioned, but because we both just felt like staying in. I should probably worry more about the repercussions of that decision than who my husband will vote for in November. After all, my vote will cancel out his.