Duped by my own progesterone levels

My progesterone levels on day 21 of this cycle were a whopping 59. Clearly, I've ovulated. So in the end, after much trepidation on my part and H's encroaching boredom over my ad nauseum analysis at the potential effects on my cervical mucous, there will be no Clomid for me. At least not for now.

On the one hand, I'm relieved. Obviously. If my cervical mucous is not totally courteous and welcoming to H's little guys now, I'll have no one to blame but myself. I had reservations (which I nonetheless would have been willing to put aside if it would provide me with a real chance of conception), not just about what Clomid might do to my body, but about what such a course of action represents in the bigger picture. My granola-y, hippy commune upbringing instilled in me a deep-seated mistrust of synthetic chemicals that remains hard to dislodge even today.  (Then again, fat lot of good all that organic granola did me...)

At the same time...What the what?! Somehow I've just been tricked by circumstances conspiring against me and my uterus into accepting the status quo. Being totally inert. Changing nothing. Seriously,you guys.  The not-totally-out-but-not-really-doing-anything-not-hopeful-not-hopeless-let's-wait-and-see place? (I know you know this). It's excruciating, and I suck at inhabiting it. I. Want. Movement. Or at least the illusion thereof?

Also, since progesterone levels are out of the way as a source of worry, that frees up my brain to ferret out myriad new scenarios to serve as future impediments to our baby making. I probably certainly have crappy eggs! H hasn't been eating enough avocado to give his little guys the oomph they need! I water skied too much in adolescence! We'll never be approved for adoption once they discover H's weird childhood collection of semi-limbless He-man figures with which he refuses to part! [insert random, illogical, second-guessing worry here].

H, for his part, as if to prove his continued devotion to the there really isn't anything wrong if we don't face up to it! approach seems to have mastered Zen and the Art of Reproductive Uncertainty. He is dragging his feet on supplying a sample for his sperm analysis, because he 'doesn't like doing it'. Whereas, you know, I kind of love the weekly blood tests and regular contact with the transvag invader...  I get it, I really do. But. This is making me want to kick him in the shins. I would try it, but...er...I don't think it's conducive to the provision of said sample (unless maybe that's your thing, in which case, totally no judgement here).

I'm managing to make light of it, but I'm annoyed and frustrated and constantly second guessing myself. How do we move forward with this? (This...nothing). Should we be looking further afield? (Particularly as we're staking our life plans for the immediate future on this). Do we really entrust this clinic to take us forward? I can't shake the feeling that we need to be proactive because we are losing time here. Surely we need to do everything we can NOW to increase our likelihood of this ever working?

That's kinda the conversation going on in my head - and much to H's delight, at the dinner table - this week. I haven't yet decided if any of these questions are rhetorical. 

Thank the gods for big deadlines that will keep me otherwise occupied all weekend. Yeah, sure...of course they will.

I know I should love my own particular progesterone, but right now I have mixed feelings. Also, how eewww is this T-shirt? Source.

Laughter yoga, Bereaved Mother's Day, and the messy truth of life

Over the weekend, as I promised myself I would do, I tried to find ways to overcome the spring blues which I've been battling these past days. This nascent spring summer! is too beautiful not to enjoy, and the perfect opportunity to move beyond the bounds of my comfortable funk presented itself.

Yesterday, to mark World Laughter Day my yoga instructor organized a taster of laughter yoga, a movement with which I have long been intrigued but have not had the chance to enjoy. Based largely on the medical knowledge that your mind and body benefit hugely from smiling and laughing - whether it's genuine or contrived - the laughter yoga movement begun in India is intended as a 'positive manifestation for world peace and to build up a global consciousness of brotherhood and friendship through laughter'. Nice, right? So although I wasn't in the mood, I cajoled myself into an afternoon of merriment with perfect strangers. Because that's the point of laughter yoga from a health perspective: studies suggest that you can actually 'trick' yourself into happiness even through forcing a laugh, and that you should do so as a means to build community too.

In addition to the kinds of breathing exercizes that are part of traditional yoga, and various absurdist activities in which one really couldn't help but laugh in the end, completely and authentically, our instructor shared some of the science behind the practice. We were taught how laughter-on-command can ease the stress of lots of little situations we all encounter in life; you know those moments that make you grit your teeth and set your muscles tighter and generally growl inwardly? The example used was hitting a red light in traffic. Just laugh hysterically at the light, she said, and you'll soon find it no longer holds the same toxic grip over you.

Since I don't drive, and (being routinely 10 minutes late for everything ever) I have come to accept that such small delays are not the mortal enemy, I don't much have a problem with red lights. But truthfully friends, (bad Sadie! I know!) for the briefest of moments, my infertility-addled brain actually wandered to the possibility of applying that same hysterical laughing technique to the legions of pregnant bellies which seem to accost me on a daily basis.

Hhhmm...guess that wouldn't really be in keeping with the laughter yoga mantra that we are always laughing with, right?

Of course I would never do that. Not really. I'm not going to live up to the archetypal, misogynistic evil-cackling-madwoman-who-never-fulfilled-her-maternal-instincts-and-is-therefore-dangerous bit that our culture still nurtures. Because, well...obviously. That would be too easy.

Anyway, where was I?

We also learned that on average, children laugh 300 times per day, where adults laugh on average 15 times per day. Just, wow....something is clearly getting lost along the way, so whatever we can do to restore it, even if I'm the first to indulge in the occasional bout of duvet diving, can't be a bad thing.

Sometimes laughter really is the only medicine. And you know, with my belly muscles pleasantly straining after one and half hours of mandated laughter, I actually felt not just emotionally lighter, but physically euphoric for several hours afterwards.

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It was only on my return home later in the afternoon, after a long and lovely walk, when I learned through several bloggy friends that yesterday was also International Bereaved Mother's Day. At first I wasn't sure what to make of that perhaps cruelly random juxtaposition of days to simultaneously mark such seemingly opposing sentiments: laughter and dead babies. Then I thought, actually, it's quite true to life. And maybe they're not as opposing as they might first appear.

Much as I once might have implored it to - much as I feel at times that mine has - life has not stopped since S died, since we started on this scary, uncertain road of infertility. Much to my own surprise, and despite the brokenness from which I once thought I would never recover, I have gone on laughing (though you'd be forgiven for not believing that if you stumble upon this blog on any given day). I cry, I laugh, I breath. I am alive and he is not. I owe him the full life - to accept, inhabit, embrace it - that he cannot and never will have. And despite the realities of birth and death, we remain connected. I try to remind myself of those things every day.

There was one thing about yesterday which somehow, serendipitously, brought all these sentiments together. The laughter yoga class was held on the grounds of a beautiful medieval convent which remains in use today. It is filled with tranquil gardens designed to bring peace, to foster the contemplation of life's great mysteries (or at least so it seemed to me). Just being there was a special experience. And the lawn on which we sat and moved and breathed and laughed among strangers was also home to this beautiful flowering tree. A memory tree.

The sign under it's branches instructed us to: Tie a ribbon on the tree and remember someone special.

And the next time I visit the lawn to sit and laugh with strangers, I will do just that.

When the sun came out, so did they (along with an onslaught of self-pity)

I'd forgotten how sheltering the icy embrace of winter could feel. We had a long, cold, and in many ways miserable winter this year; which meant that except for the intrepid dog walkers in our neighbourhood, everyone pretty much stayed indoors.

But this last week has been beautiful, sunshiny, balmy.

And with that lovely weather, an army of happy young families have emerged from hibernation. Beautiful little children squeal as they learn to ride their bikes. Soft, mewling, wide-eyed infants discover the world outside as they are wheeled past in strollers pushed by laughing moms. Heavy winter coats are discarded to reveal swollen, mesmerising pregnant bellies.

And here we sit. Watching it all go by.

Spring is in full swing and today I am feeling further than ever from our hoped-for changes in 2013. I'm tired. Isn't spring supposed to be rejuvenating?

S's anniversary is fast approaching, and as with previous years, I suspect the anticipation will be worse than the actual day itself ( the 17th, when we always try to find something special and peaceful to do). Still, the grief is weighing heavy on me right now. It's hard not to take stock, look back over the last three years, and wonder what they have brought. Some things are better, clearer, but mostly we have the same uncertainties as before. The same feeling of being stalled while everyone else goes on with their lives. I'm fairly certain that, as far as S goes, we are amongst the only ones who even remember anymore.

And what about project sibling? Well, we are (finally) really happy with our current care, and have pretty much decided that we'll move forward with this clinic. Obviously that's a good thing in and of itself, but it also means that we'll be left in limbo with everything else that much longer. H can't actively pursue any of the job leads he's been feeling out, each of which which would surely involve a big move (out of region, or even out of country). Not that there are so many leads to be had these days. We don't seem to have much luck in that department either. That likely means that come September, we'll have to take whatever jobs come our way and put the career advancement, (not to say the putting down roots somewhere), on hold indefinitely. 

Something funny also happened to me psychologically once we got on the ART train: I think I gave up any hope (illusion?) I had previously held that our bodies might ever do this on their own. Even though accepting a doctor's advice - starting with medicated cycles and then moving straight to IVF - has in no way altered the brute biology that we've been dealing with all along, I feel like in acknowledging the situation, my very organs have closed shop and left the building. (Perhaps now is the time to find reassurance in the doctor's oh-so-heartening opinion of my multiple conceptions/losses?). Totally, wildly irrational, I know. But there you have it. Though on the plus side, I'm not even thinking in terms of a two week wait anymore, and there is a certain liberation in that I guess.

So. yeah. Everyone seems to be thrilled that this fine weather has at last arrived. I don't blame them, I just don't much feel a part of their forward looking ebullience right now.

I am well aware of the narcissistic depths of my self-pity here, but....When  is anything good going to happen for us? Don't we get a turn? It just feels like no matter how hard we work to make things better, no matter how much we try to go on being optimistic and hoping our big break is around the next corner (a pregnancy to hope for, a career break, the resolution of our immigration issues) nothing much changes.

I'm sorry I'm being such a Debbie Downer. I know it's just a bad week day (please let it only be a day). It'll pass and I'll be back to my usual sass, finding something to be excited and hopeful about. 

But now? As the sun shines, I'll be wearing my sunglasses. Not just to keep out the glare of the sun, (or to disguise the rogue crying jags that seem to strike from nowhere), but also that of all those shiny happy people who seem to have come out of the woodwork.

Spring is in the air, if not in my step.

Because he'll be amazing

While also gearing up for exams, H is in the midst of marking term papers for his 80+ students this week. It's a not insubstantial task, this pile of paperwork; but somehow he manages to pour limitless stores of commitment, passion, kindness and genuine understanding - not just for the intellectual exercise, but for the young lives behind the often clumsy, sweet, and occasionally unintentionally humorous essays. It is more than just paperwork for him.

Some of these students he has taught since they first entered university. Some he is supervising as they prepare their dissertations, their first substantial pieces of independent research. Some he is helping to prepare for their steps into graduate school and the wider world beyond.

He guides. He invests time and concern. He encourages.

He swells with pride, a little, when they succeed. He cringes with angst when they falter, hoping it doesn't sting too much.

This gentle, patient, loving soul I married.  

Yes, fatherly. It is fatherly guidance and concern and encouragement he pours into these tasks, these students.

I hope they know how lucky they are.

I hope that one day soon, he'll be imparting that fatherly touch not just on his students, but on the tiny life we will grow and nurture and one day set forth into the wide world.

To learn and think and falter and laugh and write clumsy essays of their own.

World's best teacher,  Dad-in-waiting. Source.

Avocado, coconut and lime smoothie

Time for a break from all the assisted reproduction/medicated cycles/baby making talk. My head is spinning with thoughts of what the future holds and so for now, I'm going to do what I often do best with overwhelming situations: hide my head in the sand for a bit longer let things take their course until Wednesday when I go in for my progesterone levels. Let's talk about more mundane and pleasurable things for a moment.

I'm now in week four of my new gluten free diet and I have to say that there hasn't been much of an adjustment. I'm not a big bread/cake/muffin person, and I've found awesome ways to incorporate starches and flours typically found in Asian and African cooking, so my experimentation with international cooking has become more and more the norm. Fun! I've lost weight, (which wasn't my goal but it certainly doesn't hurt), and am feeling generally a bit lighter and more energetic - yay!-  so I think there's something to this, whether or not it will aid in the improved functioning of my lady parts.

My only real challenge has been breakfasts. I'm not really a breakfast person, per se, so I have a usual rut of going for a slice of wholegrain toast and peanut butter, or oatmeal, both of which are now off the proverbial table. I have a stomach that is extremely vocal and vociferous in its demands for regular nourishment - I'm talking disruptively so.* So skipping breakfast is not an option whether I'm hungry or not. Since going gluten free though, I've had to rely on lots of smoothies to keep me going and my fruit choices are growing rather monotonous.

I need to be more adventurous: enter the avocado. I loooove avocado, and at my favourite Vietnamese restaurant in Toronto I always used to order their avocado shake, so I thought I'd attempt something along those lines. I also had a half used can of coconut milk in the fridge, so I chucked that in, and a star was born. Oh my lord, you guys how has it never occurred to me to pair avocado and coconut before now? I want to eat this for breakfast, lunch and dinner, in a variety of combinations. Breakfast this morning was this smoothie using half an avocado and whatever else I had in the fridge/fruit basket. It has the added benefit of being vegan (which I am not, but cutting animal fats down to such brilliant effect is never a bad thing).

Avocado, coconut and lime smoothie

•  1/2 a ripe avocado
• one kiwi fruit, peeled and sliced
• 1/2 cup of coconut water (or milk, if you want it thicker)
• juice of 1/2 a lime
• a handful of mint leaves
• shaved coconut if you want some texture

Throw all this stuff in a blender and tell me it's not amazing.

*  In university I had one morning lecture that I couldn't reschedule to a more civilized hour, and once, in a hurry, showed up without having eaten. My stomach was typically clamorous that day, to the extent that the lecturer stopped talking at one point, glared at me three rows back, and asked if I'd like to step out for a snack. At which point I wanted to hide under the paltry little writing board attached to the arm of my seat, and made a mental note NEVER to attend an event of any kind without first feeding the beast. I really am ruled by the whims of my stomach.  H finds something oddly adorable in my (foodsexnow!) complete deference to my lizard brain, but I'm not sure others see the charms.

Prescription: a long and winding road

That kind of sums up how I feel about our appointment at the subfertility clinic yesterday.

Starting off with the good stuff, I liked the feel of this clinic very much. When we were called in to see the doctor, having hardly waited at all, she had all the relevant information (including my misplaced bloodwork) to hand. She has already been in contact with the lovely OB/GYN regarding his investigations, and they appear to be genuinely well coordinated and organised here (unlike the nightmare that is my GP's office, and I am oh-so-relieved to not have to get further investigations handled there but at the subfetility clinic itself). Unlike our horrible experience with the last subfertility clinic we consulted, these guys will continue to monitor me closely with each new cycle, and develop a protocol accordingly. All good.

It's the current protocol they're suggesting that leaves me feeling a little deflated. In sum, she believes that my odd pre-menstrual spotting and general weirdness these past few cycles may indicate they have been anovulatory. On the one hand, I'm glad someone is finally paying attention to my concerns over this (shocker: I may know my own body as well as any doctor!), rather than fobbing me off with the usual 'these things can happen' auto response. But this also means that she wants me to complete two cycles with closely monitored bloodwork to first decide if I'm ovulating at all. If, from my progesterone levels, it appears as though I may not be, she then wants me to start three rounds of clomid. And then if, after three cycles, we haven't yet conceived, she'll refer us on for IVF. Once that referral is made, they promise a maximum wait of 18 weeks before an actual IVF cycle would go ahead.

This feels like a long and circuitous route to what I increasingly fear will be our only shot at a biological child. With this protocol, we're looking at four + cycles before even getting on the wait list. That means I'll be approaching my 39th birthday before we can even think about moving forward with IVF.

And then there's the rationale for this course of action: You've had three pregnancies, so you can actually conceive quite easily. (Easy obviously being very much in the eye of the beholder here).

I know it's terribly sulky and irrational, but right now it's hard not to feel like we're being penalized for having had three losses. Although I do realize that we're lucky to be able to conceive, to even ever have the chance to try on our own, (and although I know some women who have never had the experience of seeing a positive pregnancy test may find it difficult to relate), I would hardly call three miscarriages a spate of good fortune; yet, in terms of assisted reproduction, that's how the medical profession sees it. In terms of making babies that are too fragile or poorly built to even survive in the comfort of my perhaps openly hostile and not at all comfortable womb, as we all know, I am actually quite talented.

Logically, I know this makes some sense, this wait-and-see approach. (Doesn't it? Feel free to jump in if you have other ideas; I'd actually be grateful for the insight.) But there are so many things for us to have to process with this. I'm worried terrified about my age being an increasing factor with each passing cycle, so there's that. H's 'good' sperm analysis results have always been borderline good, so we know we don't have ideal conditions in any case. I admit that I continue to have substantial reservations about crazy juice medicated cycles; about the havoc they could wreak on my already wonky system, about their sperm killing properties (c'mon, we all know Yahoo answers is a perfectly reliable source of medical information). Also, seriously...we've been trying for three years. There comes a point when no amount of humour or prosecco can sustain a truly fulfilling sex life - or our sanity - through an indefinite period of super sexy no pressure let's have fun! timed intercourse. Our marriage, our emotional wellbeing and our psychological integrity need a break already. Please?

H and I are still thinking through how we feel about this, and whether we want to take any further steps in another direction; we have the time to contemplate these possibilities, it would seem. I also think this doctor is quite cautious in terms of wanting to go the least invasive route, which I can understand. However, with our history I don't think we really feel in a position to err on the side of caution with our timelines. Is it totally insane that my brain already calculates that, even should a pregnancy occur for us, we'd also have to factor in the time for another loss and the recovery that would entail? Well, yes it is insane, clearly; but there you have it. A serious mindf*ck

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I thought of using this picture to illustrate (all too literally because I'm lazy and uncreative with my metaphors) what it feels like - today at least - to be looking into our baby-making future:

It was taken several years ago on a summer hiking holiday we took in one of our favorite corners of Austria, a small town on a crystalline alpine lake, nestled in the countryside between Salzburg and Innsbruck. The area is home to an infamous stretch of circuitous, thrill-and-vertigo-inducing alpine road. The road is winding and you never know when the next curve will fly at you, seemingly out of nowhere, so you've gotta keep your whits about you. You're way high up, it's scary, and occasionally nausea inducing. Frankly, it's sometimes downright dangerous. Apropos, no?

Well anyway, then in the course of sifting through folders of old holiday albums on my laptop to get to this, I was reminded that about thirty minutes after the photo of the road was taken, as we reached our destination, there was another image. This is the view that greeted us:

Will the view at the end of the road make it all worthwhile?

OK, I'll give you a moment to groan inwardly at the schmaltzy, juvenile sentiment of this photo montage. Just go with it people; I'm trying hard to look on the bright side right now. I need to keep nurturing my invincible spring. Or, uhhm...maybe move to the Alps? I'll figure it out and get back to you.

All's well that ends well...

...but maybe for the moment we could let up on the constant onslaught of endings and beginnings and surprise new endings. Pretty please? I feel a bit like I'm emerging from a tumble dryer, and I'm having trouble keeping my thoughts in order these days.

As a brief postscript to my swearing, venting rant last week, I want to thank you all for your commiserations; your own swearing and incredulity on my behalf, virtual angry fist shaking, copious use of exclamation marks (on an occasion which surely called for them), and general sympathy gave me the raging energy that fuelled the twenty minute living room dance party (to Muse, The White Stripes and The Ramones, in case you're interested in the playlist*) which eventually allowed me to blow off the last of the accumulated steam.

Also, in light of some of your comments (particularly readers in the US), I admit there's a part of me that feels like a gigantically ungrateful, whining moron. You see, with the system of nationalized healthcare available here in the UK, regardless of the quality of care we receive, there are no bills to be paid, no insurance companies with whom we must negotiate. We pay nothing for any of it: not the doctors visits, nor the invasive procedures using medical technology worth thousands, or even, if we end up going that route and stay within our current county, for up to three IVF procedures. There are small standardized fees for prescription medications, and that's it; all the rest comes from the taxes we pay anyway. I know we are truly blessed to live in a country that considers this to be the right of all citizens, and the responsibility of the taxation system to provide. I know that it is an amazing gift that the considerations over IVF, for us, do not include the usual concerns about the financial burden involved. For all the complaining I have done about my care, I am truly grateful to the NHS - warts and all - for providing in this way. Coming myself from a country with high quality universal healthcare, it's an ideology I strongly support. And no, I don't think that this nationalized system in any way explains the errors or incompetence I've experienced. Because sadly, I've read too many of your experiences and know all too well that healthcare providers often demonstrate disinterest, a total lack of empathy, or general incompetence; public health has no monopoly on this. It's all about finding the right people to fight in your corner, and so far I've had some hits and some (ok, a lot of) misses. No-nonsense Nurse Julie's interest in my case, and the swoon-worthy bedside manner of our high risk OB/GYN are proof of that. I suppose in healthcare as in any profession, those who are truly passionate and excel in their work to the benefit of those around them are rare gems. So OK, I'll stop moaning now, for a bit. Perhaps I needed a reminder of just how good I've got it.

Having got that out of the way, let me bring you up to date on the situation. In a bizarre sequel to said careless-human-error-fuelled rant, and having decided that I would not deal with the incompetent schmucks who messed up my bloodwork in the first place, I booked a follow-up on Friday with the lone voice of professionalism in that office, my favourite, gruff, get-the-job-done nurse. So here's the kicker: when I got to the office, she had reviewed my files, chased down the lab staff, and lo and behold, my numbers were actually there. She scratched her head, while I proceeded to lift my jaw from the floor, so that we could get on with business as usual. Although there were obviously some major filing/record-keeping/human tissue disregarding fuck ups involved, no one has any idea why I was told my bloodwork had gone missing on Thursday, save the possibility of a rogue nurse sabotaging patient records. To be honest - aside from not wanting to contemplate the scary levels of ineptitude and any ramifications therein - I didn't stick around for the answers. Small triumph! I have my bloodwork results! I made sure to get hard copies: lesson learned. So I will not, after all, be seeing the specialist empty-handed.  

Though in the interim, it sure helped to be able to blow off steam here and on the livingroom dancefloor. And now I'll stop swearing too.

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In other news, there isn't any.  And this is kinda the source of that tumble dryer feeling, I suspect.

I find myself wanting to blog, but each time I try to form a post in my head I end up at a loss. The fact is, there is not much going on, though there may be much in the works. We have our subfertility appointment on Wednesday; perhaps it will provide some clarity, though I doubt it. There may be movement on the job front for H, which means there may be another transnational move on the horizon.We may be on the cusp of pursuing IVF, but until we know where we'll be and what we'll be doing, there's obviously not much we can concretely plan towards. Although we continue to try, I think that emotionally, a huge part of me has conclusively given up on the idea of another natural conception ever happening, so I don't really feel like I have that to obsess over at the moment.

Maybe, maybe, maybe...I feel like we're in a state of total limbo, which for a restless do-er sort like me is a challenging place to be; I find it drains my energy in a way that being truly busy never does. And even though I'm kinda unemployed right now, I'm continuing to work with several students privately, so my time is still not my own. I can't take any action, plan anything, prepare for a particular eventuality. No real, definitive endings or beginnings in sight. For now, all I can really do is ride it out.

I guess all my playlists are going to be getting extra airtime in the coming days.

* I have an actual playlist entitled Angry Dance Party. Such is life, though it usually does the trick.