Sunday, December 30, 2007

Potatoes and Pee

I laugh, slightly liberated, as I even think to share this story in any public way. But really, it is just too funny to keep locked up.

So I had my septum removed about 6 weeks ago. At last check with my ol' friend the dildo cam, all looks good. We've been instructed to wait another cycle till we ttc. Fine, just fine. "WAIT" has become my middle name.

So this month we were officially "off" and is was the first time in months, I mean months, that our lives were uninterrupted by intrusions into my body. No D&E's, no surgeries, no miscarriages. As a result, we took liberties "enjoying" ourselves, ya know... together. We ended up, in the midst of our fun-fest, having a minor malfunction with our man-protection. {Ummmm, definitely not a true infertile if I still need the sheaths.} Anyhow, it was a minor incident and I didn't really think anything of it.

Earlier this week I started having some nausea and waking up at 4 am and not being able to get to sleep. It happened 4 times in a row. This was something I suffered from when I was pregnant before - sleeplessness + nausea. So while I was up on one of my 4 am jaunts to the world wide web, I took a look at the calendar. Turns out the "incident" happened a mere 3 - 4 days prior to ovulation. Opps. My RE might be ticked at me. I started to imagine how embarrassing that conversation would be. Me, apologizing to my RE for getting knocked up because my husband didn't wrap it up right. Fact is, the U is not ready for visitors yet. She still needs time to get all healed up.

So then obsession starts setting in. I started getting worried and super excited at the same time. I start doing stupid sh*t like googling "cond0m spillage," as if the internet were going to disclose whether or not I had gotten knocked up. It was pretty funny too because all of the websites were geared toward teenagers, so you got these really crazy forum questions that started with "My boyfriend" and ended with "on my leg?" Those were the days.

Then yesterday. Oh man, I had a MAJOR meld down in so many ways. First I tried to start working on job applications. That just got me thinking about how my life has been at a stand-still for the last year, and how can I apply for jobs when on paper I appear to have stopped living for the last 6 months. My failed attempts to start applications ended in a crying fit, with my dear J. attempting to console me. Then at about 6 pm I started to get the chills. The nasty 24 hour bug my family has been single-handedly distributing around south eastern pennsylvania had finally found me. By 9 pm I was in bed with a fever.

Even with the fever I was able to sleep ok, with the exception of J. sitting up, gasping and letting out a big yelp at about 3am. Strange. In the morning I woke up with a headache and still kind of sweating out the fever, but feeling on the upswing. While still in bed, I asked J. what that crazy dream was all about that made him scream in the middle of the night. He said, "Someone was strangling me." I said, " Really, who?" He hesitated and said, "It was you." I am not really sure what I am supposed to think about that, but ok. I had a dream that my students were jumping off a cliff and I didn't care. I also had lots of potatoes in my pockets. Ah, dreams - at least I will have something to talk to my new therapist about this week.

So the idea that I may have gotten knocked up was still nagging me, even though the nausea was nearly definitely related to the fact that I was fighting off that nasty stomach bug. Problem is, I am scheduled for an endometrial biopsy tomorrow and I am pretty sure that shouldn't be done while pregnant. Plus, I wanted to be able to drink heavily on New Years with a clean conscience. So I decided to run out and get a test while J. was on an errand. It was just be too foolish and neurotic to reveal to him. There are just some things about myself I prefer he would never know. One of those things happens to my love of peeing on sticks.

It is about a 10 minute walk to the drug store. On the way there I considered how foolish I was being. I envisioned one line. I wondered if it was actually possible for you to convince yourself that you were pregnant. It was busy at the store. I chose the more expensive tests that I had had early positives on before.

Here is where it gets good.
So it is mid-day and I am only on 11 dpo. Do I wait till morning? Hormone concentration will not be strong in the afternoon. It had been about 2 hours since my last trip to the girls room. Earlier this month I had a bad OPK test - a dud. So I decided to pee in a cup and dip the stick, so as not to waist the goods.

So I am on the can. I pee in the cup. I dip the stick. I deposit the cup and the stick on the radiator in front of me and reach for the TP. While reaching for the TP, I bump the cup and my remaining "products" fall to the floor !!! GROSS!!! Now I am laughing, almost hysterically at my foolish behavior. I am thinking I am pregnant when I am totally not - and I knew it. Here I am dropping cash of way too expensive tests. And now, dropping pee all over my bathroom floor??? I have gone overboard. But by going overboard I think I came back around full circle again. And somehow all those shinanigans made me feel better. I felt really ok when the test was negative. I really did. Because I am not ready yet, emotionally or physically. Because I would have felt absolutely terrible if I would have gotten pregnant and it would have ended in miscarriage. It would have been my fault for not being patient and giving my body time to heal. I also would have really struggled to explain this to my RE...

So now, for the first time in a long time, I feel kinda good. I feel like I have 6 weeks free. 6 weeks to get my shit back in order, to make some realistic plans. We'll try in February, like we said we would. And we'll just have to see how it goes from there.

Saturday, December 29, 2007

How do you begin to un-stall?

How do you begin to un-stall.
How do you start anything when everything stopped months ago.

There was so much more to me. I used to read theory, I used to write, I used to go to community meetings. I was an activist.

But now, I try to begin over and over again. I try to dust off my old teaching philosophy, so I might begin a new one and I just stare at it blankly. I read the first sentence and it means nothing to me. I used to think about education all of the time. I was consumed by it. Now I read the words I wrote and it seems like it was someone else all together who wrote it.

There are so many reasons.
*We bought this house. Rehabbing it started to eat away at our life.
*I started working as an adjunct. Battered and severely underpaid - it is hard to get excited about your job when you can't even make enough to pay back your student loans. As an adjunct you are a peripheral employee, with no tangible ties to the school other than walking through the doors a few times a week. You do not get the privilege of knowing other staff, of getting to know students long term, or of job stability.
*The students. East coast students are a totally different breed than the midwesterners I cut my teeth on. I have had some lovely students here - but none are as invested in their education as my kids in Illinois.
*The funk which is my {un}reproductive hell. It is the razor that made the first cut. As the months went by all of the thread around it just started to unravel, until there was this gaping hole where my life, my interests, my passions used to be. I need a patch.

I have none.
My mind is like gum that you have been chewing for too long. Not very elastic, not very tasty, and nearly impossible to revive.
I disappoint myself every day by not getting a damn thing done.
I do not even come close to resembling the person I was a year ago.

Friday, December 28, 2007

Post Xmas Round-up

*The aforementioned reunion was a minor disaster. I stayed home with an actual headache. J. stumbled in early, at midnight, and drunk as a skunk. The "buffet" never materialized but 2 Manhattans and 3 Jamesons did. He barfed all night and through the next day. Poor thing.
Post Xmas Round-up
Perhaps J. and I have become more grumpy, but it seems like each year christmas gets more and more sad and less and less fun. Now, for all you xmas crazies out there - calm down. I like to decorate my tree, hang my stockings and bake cookies. But the day and the eve are little more than torturous shuffles from one families dinner to the next. It is implied by both families that our absence would create a considerable tear in the familial fabric, but when we are actually there we feel lost and bored-- as though our presence is not needed at all. I think, in part, it is because we do not have children.

So we went to the in-laws on the Eve. We had a quiet day, a quite meal, a sedate round of present opening and a quiet game of cards. His family is so still some times I think I should take all of their pulses. There is the obligatory go around the dinner table to tell what we are thankful for. I am very, very, very nervous about these moments of sharing, so I just come up with something very superficial. If I really talked about my year, it would end with me breaking into tears. Instead, J.'s mother graciously mentioned our year of hardships, and herself, almost started to cry. I am more impressed by my MIL ever year. Even with our differences, she is so sensitive to me and J. I wish I had more to add to that - but that just about sums it up. We did open our own gifts from one another when we got home that night, and that was really fun. J. bought me a really cool necklace that I was eying up. I can't believe he remembered.

Christmas morning we got up early to head to my folks house. The festivities there are typically a veritable clusterf*ck - everything from screaming children, drunk uncles, huge rack of prime rib, fighting sisters and those who always hold up present opening by arriving at least an hour late. But this year, it was so different. Two years ago my dad had a blowout with his oldest sister. Their absence, and the absence of their children and grandchildren cut the attendance from near thirty, to about fifteen. So scale is the first big difference.

Then there is my oldest sister. Her second marriage, to the second a-hole she could find, ended a year ago. But not until after she had produced 3 pretty awesome little rug-rats. She and her brood moved in to my parents home and my sister, as per her habits, picked up with the next douche she could find - one of the dudes that had helped build my parents addition on their house. The guy is ok - but he is young, immature, not real interested in helping to raise my sisters kids, and smokes pot. {I smoked plenty o' reefer as a youngin-- and don't necessarily object to it. But my sister is 36 yo, a school teacher, and has three needy children. She also tends to pick up the habits of her lovers, for fun-- she likes to "become" them. This is not a habit I would like to see her get involved with in this point in her life. Hence, my frowning on it.}

My sisters [omni]presence in my mothers home makes me feel like a visitor in the very same house I grew up in-- a very strange sensation. For YEARS, I was the one who helped do all the x-mas cooking, I was the one who helped my mother slave over the pies and the shrimp and the cheese log. But the house is now partly my sisters house. And she has assumed the chores that I used to love to do with my mom. Additionally, my mother rarely calls for my help anymore-- I think because she perceives that I already have "enough" on my plate. But I want to help. Baking a pie with my mother would be the most normal thing I could possibly do.

So we arrive about 10 a.m.
Bad news. Both of my parents are in bed with a NASTY stomach virus that my sisters youngest dragged home from daycare. It has been clear-cutting through the whole family for a week and finally reached both mom and dad - simultaneously at about 4 am Christmas morning. So the parental buffer is gone. There is no one there to mediate all of our snide sibling behavior. It was awkward and weird and made me realize that with the exception of my nieces and nephews, in my parents absence, there would be very little reason for any of us to ever see each other again. It was a very sad christmas realization.

After my brothers family arrived at their usual 'one hour late' time, we opened presents. My sister passed out the gifts. The kids went wild. I got some nice new bras, that actually fit, and a crock pot that is fit for a family of 6, not 2. My sisters boyfriend gifted the kids with some inappropriately large gifts - like the HUGE air hockey table that will be a problem using in my parents already crowded house. It made me feel really icky and sad-- mostly because they have been so on again off again. Last time I saw my sister, about a month ago, they were off and she had joined match dot com. It is confusing for me to keep track of their status, I can not imagine how confusing it is for her children. Do big gifts mean big love? I just want her kids to have stability-- and she seems so incapable of delivering that.

My sister passed the gifts slowly, leaving her and her boyfriend piles to sit in the corner. After all present opening was done, they held up on their own and oozed all over each-other in their own little private ceremony. I was pretty ticked off with this, first because it was very exclusionary. But also, because the whole time, she totally ignored her kids, while they wanted to share with her all of their treasures. I just wish they would have thought to have there own time, perhaps last night, like J. and I did. They could have easily opened each others gifts before bed on Christmas eve. THIS round is for FAMILY. Not for lovers.

I could just go on and on and on. I could tell you about how my sister never really loved her second husband. I could tell you about how she got knocked up before they were married - on purpose because the VD she had gotten from her first husband had potential to effect her fertility. I could tell you about how "unnaturally" parenting comes to her. I could tell you haw she yells constantly and is one of the angriest people I know. I could tell you about how she seems to resent her children, most of all for being a "product" of their father, from whom she is now divorced. I could tell you about how she is fast to smack them. I could tell you about how she makes fun of her oldest in front of everyone-- her oldest who is the most troubled.

I could also tell you how my sister and I used to be great friends. How she helped support me in college. How generous she has been to me. I could tell you how amazingly wonderful her three children are. How M., the oldest, the tom-boy, is going to be an awesome skateboarder. How she is more physically capable than any kid I have ever seen. I could tell you how A., her second and an overachiever, is the fastest reader in the first grade-- how she is so far ahead that she gets to sit with and help out with the disabled kids in class. And she loves to do it! I could tell you about how little W., her youngest and a total brute, is on of the craziest 2 year olds I have ever known. He is a funny, smart, rough little guy who has that most expressive "Uh-Huh" I have ever heard. I love her and her kids so much. I just wish all of our adult bullshit didn't have to be so much in the way all of the time.

Christmas has come and gone.
Mom and dad successful transfered the plague to my poor husband-- who while out to dinner with an old friend last night was overcome by the chills and nausea.
I have miraculously escaped the plague. {knock on wood}
The best gift of all, my little, monster, man-kitty caught his first mouse of the winter season last night and did not even get blood all over the kitchen!! Way to go Bennie!! Keeping 1339 mouse-free since 2006! (See image of Killer below)

Friday, December 21, 2007

Rounding out the year, appearing as a lazy sac-o-shit

The people at tomorrows reunion, they are J.'s friends. Just like his architecty friends, this group from undergrad were never my friends. In undergrad they were all very exclusive -- and I was never "in" with them. So regardless of our circumstances, this reunion is never a fun affair. But this year, I enter with both irritation and fear-- fear that someone will dump the "your next" or "so when are you two going to get to it" on us.

I have been avoiding social gatherings for months for this very reason. Those statements/questions are like land mines and I have no idea how to avoid them, or how to respond to them. Hence the avoidance. I am totally unprepared to deal, especially with a groups of somewhat superficial friends that I only ever see once a year.

The caveat is the A. is REALLY pregnant. Frankly, I give her serious props for coming out. And we were never close, and they started their family years ago - so somehow, for some reason, I think I am ok to see her. I just know that her swollen belly will get people glancing in my direction, even if only long enough to wonder - "why haven't those two knocked some out yet?"

I have been considering my possible rebuttals to stupid comments/questions. What I would really like to do is be able to spazz out on someone and tell them how my body is a baby killer and how they should think twice when they start inquiring about peoples person shit. Ideally this would be someone that I already have some distain for, so I can feel at least a little good about myself afterwards. I was also thinking it would be cool to have a really witty rebuttal, but I am not witty. Pamela Jeane at Coming2Terms gives a great response. "My husband and I have evolved to perfection. Clearly your family tree needs some work!" But I would totally flub the delivery. More likely is that no one will say anything at all, and I will have to live inside of my dirty, dark, shameful, scary secret for another night. A lot of them live in LA + NYC, so mostly they will want to talk about themselves-- and as long as it saves me an uncomfortable moment-- that is ok with me.

It used to be that I could go to these things and I would feel great about myself. I would respond the the standard bevy of question with answers like: "I am finishing grad school" or "I was just awarded a show in Ireland" or "I am applying for tenure track jobs." But this year, the honest answer is something like: "I had two miserable miscarriages, a surgery to resect my uterine septum and all that has taking a pretty serious bite out of any plans that I ever had for myself. Our chance of having children is still somewhat dicey." WHO WANTS TO HEAR THAT AND WHO IS ACTUALLY PREPARED TO RESPOND IN ANY MEANINGFUL WAY? I know I wouldn't be able to respond to that if I was in their semi-friend shoes. So I have to suck it up and pretend like I was busy being lazy instead of getting violated by the dildo-cam and an acupuncturist on a pretty regular basis. Getting your junk in order is a full-time job. Between the scheduling and the inordinate amount of internet research required to advocate for yourself as a patient - I am not sure how I got anything done at all this year.

So basically, I got nothin'. I got no kid, no fabulous job, no exciting news of travels to far off places. Instead, I got a crash course in uterine anomalies and I got real used to having a magic wand jammed up my hoo-haa.

But no one knows that, or will know that. So I just look like a lazy sac-o-shit...

Wednesday, December 19, 2007

Self. Help.

I have failed yet again. This time to be diligent enough to hire a trained professional to help me manage my mental health. I tried, I really did. I called 2 different therapists repeatedly. Then I just kept playing phone tag with them and we both gave up. Fortunately, I have migrated from desperately sullen to flat and unmotivated. Not really a step up, but perhaps sideways-- and a bit less painful. It is as if nothing gets my goat (umm, except pregnant ladies.)

I have already decided that when I do finally carry a successful pregnancy I am making a screen print that just says "IF." And I will screen it on every shirt that I wear with a swollen belly. Fertiles will not get "it." And those who have struggles will. But then again, I am not really IF. I am an IF poser. I have no IF cred. Well, I did have 2 miscarriages - that has to count for something?

But back to my failed quest for help... I did find the self-help in the isle of my local used book store. I didn't crack one of the books open, rather, I spent about 20 minutes photographing all of the covers. There is a distinct aesthetic to self-help books that I think is really fascinating.
This is the book I was hoping to find, but alas, I fear it does not exist...

Tuesday, December 11, 2007

I am not Infertile enough

I didn't start seeing my RE till I was already 5 weeks pregnant. It had not been recommended that I even see an RE after my first loss, but I just didn't feel right. So I showed up for my first appointment feeling weird, like an intruder. When the nurse was doing my intake she exclaimed loudly in the hall, "She shouldn't even be here!"

Six months later, I just returned from the same office. The receptionist no longer needs me to check in. I remember on my first few visits how she knew all the women who came in, their names, their history, their cycle length. I was an outcast. I was pregnant. But then I lost it. And I started making the weekly visits. And the receptionist learned my face, my history, my cycle length.

My appointment today was an in-office hysteroscopy to take a look at my U. post-resection (I had a usterine septum, like a wall dividing my U. in two.) I sat in the waiting room feeling sick to my stomach, scared of what this appointment might reveal. Then, out of nowhere, I felt like a blanket was laid over me. I felt calmer. I breathed slow. I repeated in my head - "No matter what you find out today, you will be ok." And it was ok.

The camera slid into my murky womb, just 7 days past the start of my cycle. The site of the resection still appeared wounded, bruised. There was a rather large piece of white tissue dangling off the area. This was most likely what caused the bad ultrasound last week - the tissue was gathering clotted material around it. My RE spent some time nudging the tissue with the camera until she was able to knock it off. Not the most comfortable procedure, but glad to have it dislodged. The shape looked good. The two tunnels that used to lead to my tubes were gone and there was a wide expanse of space between. I feel hopeful.

We will be tracking my cycle this month for ovulation, progesterone levels and taking blood to test for any immunilogical issues. None of this was ever checked before because I arrived to my first appointment, like I said, 5 weeks pregnant.

So that is what I am saying. The wall is down. The standard tests are commencing. I am just waiting. Waiting to heal. Waiting for my husband to depart and return from his trip. Waiting for February, so we can begin again. I am not that infertile, I hope. I am in another kind of limbo - between the fertile and infertile worlds. Split down the middle like my uterus used to be.

Sunday, December 9, 2007

Managing My Spoiled Identity

I have begun investigating pregnancy failure through reading. “Motherhood Lost: a feminist account of pregnancy loss in America” by Linda Layne has been a great resource. To name just a few subjects I am particularly drawn to: the umentionable or “culturally sanctioned non-existence” of pregnancy loss, the assumption of the “natural” process of pregnancy and birth, and how societies frame “womanhood” around reproduction (or production).

Layne speaks very directly to this notion of "spoiled identity." This term seems to so clearly sum up what I have been going through in the past year-- attempting, though often failing, to understand who I am if children are not part of my future. When your vision of yourself is so tightly wrapped around this one thing, who are you when that very thing starts to fail?

I would like to summarize some of the text's writing about the “fetal subject,” as I think it helps to frame an explanation of why women have such a profound sense of loss from miscarriage, no matter how early it occurs. The book looks specifically at new reproductive technologies that have developed in the last 25 years and how those technologies impact the construction of fetal personhood. The author summarizes that these technologies, that provide us with visual and aural experiences during pregnancy, have altered the way in which we think about, bond to and experience the embryo/fetus. Specifically, bonds begin earlier and earlier, and the assignment of personhood, by others and ourselves, on the embryo/fetus has shifted. Additionally, with the introduction of in vitro fertilization, social construction of the “baby” may even begin prior to implantation. We gather information about these liminal being throughout pregnancy. Each step takes us closer to, not the self of the embryo/fetus, but the “personhood” we construct – an image, an amniocentesis, hearing the heart, learning the sex. There certainly are unmediated experiences, in particular, movement of the fetus, but I just wanted to raise some of these questions about the fetal subject and our mediated experience. I think they shed light on how and why it is that woman are so deeply impacted by loss. A fetus or embryo represents not just a mere cluster of cells, but the beginnings of a life-long relationship with an individual we have yet to even know. With technology, we have access to detailed information about the progress of our unborn child, earlier and earlier-- making that unborn child "known" or "real" earlier and earlier in its development. {This is not a criticism, just an observation}

The text also acknowledges the interplay of the Judeo-Christian, American narrative of progress and (re)production - "the ethic of meritocracy." If you work hard enough, you can do anything! These normalized, idealized narratives, when applied to other goals are often valuable and even true. But when self-imposed upon the issue of fertility, the author refers to this as the "management of a spoiled identity." In many cases, working hard has nothing to do with carrying a successful pregnancy. So when we think about self, and identity, we must consider that some people are "naturally" incapable of fullfilling the one thing which is socially considered a "natural" characteristic of their gender. In some cases, woman can not give birth. And because of that natural fact, the sound of a fetal heartbeat, the sight of a swollen belly, is a mere reminder of the moment they learned of their own failure, again, through mediation (the absence of a heartbeat) or worse yet, through a catastrophic late term loss.

And last, a quote that speaks directly to the taboo that surround both loss and infertility, summing up why some days, I wish I had never told anyone but my husband of our problems:
“The liminality of women who do not complete wished-for pregnancies and superliminality of the dead embryos/fetuses they bear helps to explain why pregnancy loss is a tabooed subject in our society…. Taboo is defined as a “prohibition put upon certain people, things, or acts which make them untouchable, unmentionable, etc”…. Since the mid-1970’s, American women who experience pregnancy loss have found themselves at the nexus of two set of strong, opposing cultural forces. On the one hand, they are subject the taboo surrounding the dead fetuses, and the interdiction on death and any other unpleasant topic that challenges the myth of perpetual linear progress. On the other hand, women’s experience of pregnancy and pregnancy loss is influenced by the increasing prominence of the fetal subject in the public imagery in the last 25 years."

There is little that brings comfort after a pregnancy loss. It is unmentionable, unacknowledged, un-mourned, misunderstood, misconceived, brushed aside, real to you, but rarely to others. Peggy Orenstein's Essay "Mourning My Miscarriage" really helped me at a time when I could not understand most of what I was going through.

Thursday, December 6, 2007

6 months of forgetting

Memory triggers are a bitch. I hate that I am making a movie association here, but now I know where the idea for "Eternal Sunshine of a Spotless Mind" came from. I want to forget the last 6 months, so I can walk in peace to work, so I can get off the train at 8th street, so I can concentrate on something other than this living nightmare. {My 6 months is a cakewalk compared to most, but it has been a shitty ride none-the-less.}

I teach mornings downtown two days a week. I love my walks to the train in my 'hood', then from the train to school through center city. I love the calmness as I leave my house, and the bustle as I arrive. But now my daily walk is peppered with memory triggers, past places of loss-related incidents. I am unfortunately habitual, so I fear there is little chance I will ever succeed at changing my pattern as a method to relieve me of these triggers. And if I can walk another route, what if that route gets dirtied up with a whole new set of loss-related incidents?

There is one place in particular that snags me every time, pulling me into my own shitty reality. It is a weird little corporate mini-park right across from where a skyscraper is being constructed. It is paved with rust colored stone and always uber-sanitized. At the end of the summer, or maybe it was just a fall day that was too hot, I talked on the phone with my pregnant friend L. there for hours. I tried over, and over and over to explain to her what I was going through. I hindsight, I have terrible feelings of resentment for what she said to me that day. It was an immensely complicated situation that caused the rift. She was unwilling to back away from her position, even though she knew her actions were causing J. and I great pain. In the end, she not only was incapable of understanding why I was in pain, but chose to reveal our very private situation to a colleague who I am have considerable dislike for.

So while I never cared for that place much to begin with, now it serves as a near daily trigger-- pulling back into my persistent and unrelenting pain.


AF came one day late and flowed like a bitch. Everything has calmed down a bit, with the exception of the fact that my period is single-handedly destroying the environment! I have been wearing pads (gack!) just to make sure there is nothing preventing the exodus of that (hopefully) nasty clot. Where is my hut when I need it?


Last night, over a beer, I asked J. if he wanted to "try" this month if we got the green light from the RE. He said, "Can I think about it?" I am guessing he is not ready. And that is ok. I need to learn patience.
I am signed up for am in office hysteroscopy on Tuesday to see see the results on my surgery... Headache, begin now.

Monday, December 3, 2007


Either the world is smaller than I ever imagined, or something terrible went on in the 18944 zipcode in the mid 70's. How could it be that I have an SU and one of my oldest friends, who I have known since I was 6, has an BU? And how is it we are just learning this about each other right now? This is a crazy world...

Yesterday I was looking for an email from my friend Jen. I searched her name in my email program and along with her emails, my old friend Nae-Nae's (what we called her when we were kids) popped up. I had not heard from Nae in a while. It had been even longer since we spoke - perhaps as long as 3 years. In our last conversation that I recall, I had phoned her to congratulate her on her pregnancy, which my mother had informed me of. I started to gush "Congrrrrr" and she stopped me. She was not pregnant any more. I didn't know what to say. I am sure I said I was sorry. But I can't remember what else.

So I stumbled upon her email address and remembered that my mother had said she recently gave birth. I thought about how long it had been since we had the brief conversation about her miscarriage, and that she had only recently had her son. I knew she had moved, her Husband had started a new carrier, so I thought it may be possible that they had just waited. But I wondered if perhaps she had never shared with me the extent of her experiences. There would not have been reason to. I was living pretty far away and we had not been close since we roomed together in the late 90's.

So I dropped her a line, wondering if a new mom had much time for emailing. I sent the brief "hello, are you there" note. She replied within 2 days (not to too shabby for a mommy with an infant). She told me about her son, going to school and a few other major events. I responded the same, but added in my story of miscarriage and my MA. I got the most ASTOUNDING response! ASTOUNDING.

Crazy girl, that Nae - she bypassed email altogether and just picked up the phone and called me!! Who does that? It is so awesome. She told me her story - here it is in the very, very condensed and probably somewhat inaccurate version... Nae has suffered 4 miscarriage in the last few years. The kicker, being told she has 2 uteri during an internal ultrasound. It all sounds so freaking familiar-- who trains these dumb-ass radiologists anyhow? Turns out, after the obligatory MA misdiagnosis, and many losses, she found out she has a BU with small septum. She finally found a great DR. who put her on baby aspirin and progesterone, got her pregnant, and kept her pregnant! YEAH NAE!!! The BU is not really suspected in the losses, but rather an autoimmune issue. She delivered her beautiful son via c-section 3 days past her due date with her little dude hanging out breech. Regardless, she gets it. I can't believe it! Someone I know gets it.

You rock, Nae! Your generosity and willingness to so quickly pick up the phone and share your experience with me is overwhelming. I am so sad you had to go through that, but am so grateful to know that someone else understands what I am going through. THANK YOU, THANK YOU, THANK YOU, THANK YOU.

xoxo ~ megadeth

Sunday, December 2, 2007

Peek-a-boo period and a sad man friend.

Peek-a-boo period
My period is meant to arrive tomorrow had my body not been laproscopically and hysteroscopically invaded nearly three weeks ago. I have been having some pretty nasty cramping and a bit of spotting-- very unlike me. Hopefully the crimson tide will wash up a big, nasty clot, or whatever that mysterious black spot was on my ultrasound last week. I had the surgery at a teaching hospital. Perhaps it is a Junior Mint? (remember that Seinfeld episode?)

and a sad man-friend.
My very special man-friend arrived home from his re-union and said, "I am glad you didn't come along."

Normally, one would be alarmed by such a statement, but in this case he was glad I had the foresight not to submerse myself into the grad school pals reunion-- the one where our friends M & J are 6 months pregnant. Ugh, a whole weekend of non-stop baby-talk action and the occasional 'your next' glances. I would have never survived.

I had just started to be not hysterical about our first loss. It was fourth of July weekend. It was hot and we were plastering the hell out of the front room of our broke down house. The room looked like a block of swiss cheese, with a little lath thrown in. We foolishly thought we could get it patched, skimmed and primed by Sunday night. We were so wrong.

Plastering away. Did I mention it is friggin hot? It's mid-day. J.'s phone rings. A call from a good friend of his from grad school. The guy who I argue with all the time because although he acts like a nice guy, he is really a misogynist and treats his wife like a child, not a partner. She likes it. It is all pretty nauseating, but I tolerate it, because they are his friends. But they are not mine.

Small talk ensues. J. says, "What, like a bean, I don't get it? A peanut?" He is so clueless. YO, J. take off the blinders. That's cutsy lingo for baby. They are trying to tell you in some obligatory, 'my brain is turning to baby-mush' code that they are knocked up! Get with the program!

I start to hyperventilate, then run upstairs, embarrassed at how quickly and physically I react to the knife that was just jabbed, one more time, into my heart. I hide in our bathroom and almost pass out because I am crying so hard i can't even breath. Hiding is no use, our bathroom is as porous as the front room-- gaps in the drywall do not make good sound barriers.

This is my recount of M & J's pregnancy announcement. She was 6 weeks pregnant. I was 5 weeks past my first loss.

After the second miscarriage J. told this couple of our problems. J (the grad school dude) was kind and sad for us, and that was nice. They know what we have been through, but not in any detail, because my J. doesn't do detail. But no one else at the reunion this weekend knows that we are struggling with this. So I dodged a bullet by staying home this weekend-- knowing full well that they, in their absence from our dilemma and blurred by their pregnancy bliss, would not be able to refrain from drooling baby talk for the entire 36 hours. And that is just what happened. So J. came home feeling pretty sad.

J. deals with this far less. Feeling the sadness of our situation may very well be part of the many random thoughts he has from day to day. But he doesn't have to think of it every time he calls the Dr., every time my mom calls, every time he has a cramp, every time he goes to the bathroom, ever time he opens a browser window. He has the privilege of the slightest distance.

This weekend there was no distance for him. He was ambushed. Even though I never want him to feel pain, in a way, I am glad he went to the baby-talk weekend reunion. Because he knows better today, how I feel every day.

Saturday, December 1, 2007

How do you define infertility?

I can get pregnant.
In four months time I was twice pregnant.
But I lost them both.
And I still don't know if my U. will ever work well enough not to reject an embryo.

So if you are a woman who gets pregnant but can not carry that pregnancy to term, are you infertile?
Or are you just someone who suffers from Recurrent loss?

Are there rules to this?

Back to the business at hand - BU & SU Primer

I want this blog to tell my story, but also be a resource for those who may have just found out that they have a uterine anomaly, like a Septate or Bicornuate Uterus. So I will just take a minute to provide you with my knowledge -- which you should know is based on my own experience and research. I am not a Doctor, though sometimes I feel like I know more than one about my condition.
  • Bicornute (BU) and Septate Uteri (SU) can look nearly the same on the inside. The interior uterine cavity is divided in two by a kind of wall, which can be made of a vascular or non-vascular material. The wall can sometimes extend through the entire length of the cavity, bisecting it completely. Other times it may only partially divide the cavity.
  • Bicornuate and Septate Uteri look very different from the outside. A Septate uterus has a "normal" or domed FUNDUS (the fundus is the top of the uterus, opposite the cervix). A bicornuate uterus has a cleft fundus, following the contour or the interior. A bicornuate uterus looks heart-shaped both inside and out, while a septate uterus has a "normal" shape outside and a heart shape inside
  • Bicornuate Uteri are less common and have a relatively good reproductive track record. Issues range from breech positioning to incompetent cervix. I have read that 2nd trimester is the time to be most attentive, when the the fetuses weight is resting on the cervix, not the pelvis.
  • Septate Uteri and the most common MA and have one of the worst reproductive outcomes of the MA's, but if threated properly can become statistically normal in pregnancy outcomes. Treatment involves a Lap/Hyst - where a surgeon can physically see the outside of the uterus to ensure it is not cleft, while at the same time, cutting away the septum hysteroscopically. It is an out-patient procedure with about a week recovery time. Doctor's will give you the OK to TTC anywhere from 1-3 months post-op.
  • Bicornuate uteri are sometimes, but rarely operated on. This procedure is a major surgery.
  • Ultrasound is an exceptionally poor diagnostic tool for determining the difference between a Bicornuate and Septate Uterus.
  • MRI can be effective at diagnosing the difference.
  • Lap/Hyst is the only SURE way to know what you got.
  • A diagnosis of Bicornuate is the "catch-all". If you are told this is what you have via ultrasound, do not proceed with TTC. Make yourself an appointment with a reputable RE and request an MRI followed by a Lap/Hyst.
I had/have a uterine septum. I was told I was BU after a first trimester loss. Found out I was SU by MRI after second loss. Resected Nov. 14, 2007. Still waiting to find out if it was a success.

Please feel free to post comments to me if you are new to the whole MA thing and have questions. I know how scary and confusing it can be.

Thursday, November 29, 2007

An upnote - a few people get it right

I am a negative person by nature. Not something I am proud of, but it is what it is. I think it is important when I spend a few days dwelling, that I then step back and consider what is not so bad.

In particular, since I have bee more recently obsessed with the loss of my fertile friends, I want to spend a moment thinking about a few people who I can count on right now, and who have been exceptionally generous-- listening to me, and supporting me over the last few months.

1.) My two old college pals S. + H (ha, ha... like the stamps). We drifted apart while I was living in the midwest, but we are finally starting to rekindle our friendships-- and for this, I am so grateful. H. lost her mother in 1998 under really tragic circumstances. Because of this, I think she has a good grip on how to talk to those who are going through something that is both painful and private. And S. is currently breaking up with her decade long partner. We are both in that place right now where we never thought we would be. A bit of a living nightmare. Selfishly, I am glad to have friends that can relate to what I am going through, even if our circumstances are different.

2.) My two great friends, S. + A, from grad school who live out in Seattle. S. had a miscarriage the same time as me (the first one). They had been TTC with a known donor (DIY) for about 4 months. She is pregnant again, but understands how hard it is - both because of her miscarriage, but also because as a same sex couple, TTC is harder. Now they are waiting on an amnio after recent blood test came back at 1 in 3 chance of downs. My heart goes out to them. They are that couple. The couple that really should have kids.

3.) My mom - god, I never thought I would say that, and I may change my mind next week, but she has been really great. She loves a good challenge, especially one with drama, lots of medical terms, and a chance to dole out sound advise to a child. She slips up know and then, but for the most part, she is rockin' the house with the support. Way to go, Peggy!

Wednesday, November 28, 2007

Beers in the afternoon and the epidemic of pregnancy

Yesterday was rough. And since all of my friends are either knocked up, new parents or lame, I decided to treat myself to a burger and a buzz after teaching my morning class (no worries, I did not have to go back to teach:)

MMMMM, Guiness os so good. It sustains me in the winter. I am not a huge beer fan, but the dark stuff is so smooth and delicious. So I had a great lunch, alone-- which I seldom do, but always enjoy. After, I stopped in at a few local boutiuqes and picked up a few x-mas gifts.

One store is a DIY place, handmade stuff and the like. Now that I have decided to ditch all my friends (ill, I hate myself) I have become slightly more gregarious. Even with that, I am still pretty introverted. Regardless, I struck up a conversation with the co-owner of this store. Turns out that we live VERY close to each other and she lives across from this woman that I know, but never really got to cultivate a friendship with. I was siked. Yeah me, some new neighbors, our age without kids! So I asked about M. (the woman we both know) and she says, "Aw, she's great. She just had a baby, like a month ago." And I say, "Wow, I guess I haven't seen her in a while. That is soooo great. Umm, I better go."

It is a freaking epidemic. I have been ambushed. I am totally surrounded. Not only my friends, but my potential friends are already all dirtied up with baby talk. Am going to have to start hanging out with 20 year olds? What does a girl have to do to score some DINK friends?
(DINK = Duel Income, No Kids)

Post-op appointment was shady - BLURG!

Had my follow up appointment for my septum resection yesterday. It didn't really go as I hoped. So of course now I think that I either forecasted it, or caused it, by my recent feelings of despair.

My RE did an ultrasound. In the former location of the septum there was a big black splotch. She thought it could be a blood clot or residual septum. I am keeping my fingers crossed a clot and hoping I can pass it during my period.

I lost it. Of course.
I talked to my mother later in the day and she was shockingly supportive and understanding. At one point where I was telling her how this is straining my relationships with friends, I said something to the effect, "Well she doesn't have a magic wand shoved up her twat twice a week and get nothing out of it." My mom just took it. She also gave me some really good advise. She said that I need to give myself permission to focus on this right now, having a baby. She said that the job applications can wait. She said that the trip to Egypt can wait. It just felt good to hear someone say it.

Tuesday, November 27, 2007

Self-alienation feels so right

A list of reasons why I have decided I am totally cool to not have any fertile friends in the form of a list of things that have been said to me in the last few months by by these same fertile friends:

L: It just seems like this is another reason why women get pitted against each other. I can't help it that you can not get pregnant.
Response I would given in hindsight: I can get pregnant... over, and over and over and over. But my body kills them. Big freakin difference.

C: I am disappointed and pissed that I can not use a midwife because of my epilepsy - Can you tell me the name of the Dr. who gave you bad advise so I don't go to him?
Response I would give in hindsight: Don't come to me with your sob stories. Lesson number one - having kids is nothing like the bull-shit lines we've been fed since we were kids. I know that all too well. Not everyone gets the glow, the perfect birth, etc. Some of us don't even get the kid. So suck it up, go to your OB and don't bother me with questions I can not answer. Remember, while you were getting knocked up, I was getting fetus #2 vuc-u-sucked from my womb.

L: I know exactly what you are going through because when I was in my thirties I wanted kids like crazy but there was just no partners around.
My response: Well, actually, it is nothing like that. There is a big difference between not having a partner and your body being physically malformed in a way that prevents successful pregnancies.

N: You can have one of my kids. Take your pick.
My response: I think they might be a little attached to you by now.

C (at a social gathering): Pregnancy is really just on inconvenience. I am just tired and hungry all of the time.
My response: Chin to chest. Don't make eye contact with anyone. Block it out. Inconvenience? Is she kidding? F-off.

Goodbye friends. You can get updates from my husband, but I would rather you did not care, because I know that ignoring you is shitty. I am a total asshole for this. But it is the best I can do, even if it is nasty at best.

Monday, November 26, 2007

Sinking, sinking, sunk...

I like to think I do a pretty good job of keeping my chin up. I have had a lot of ups and downs through this whole process (we all have). One of the more distinct moments was when my diagnosis was finalized. I knew that the septum and a pretty large adhesion were preventing me from carrying a pregnancy. It was a moment of clarity. I remember calling my husband on my cell, weaving a dodging a small army of pregnant woman, for the first time with a huge grin on my face. It was a septum.

Even leading up to the surgery I felt pretty good. Scared, but good. A septum could be "fixed." Rumor has it your uterine cavity is close to "normal" after a resection. We'll see about that.

Now the surgery is over, and I feel like I am just bottoming out. I thought I would be happy, but I find myself unsure all over again. What if I had a successful resection and I still can not have kids? God, I am even scared to write that down in fear that it will come true! I just have this wretched forecast in my head. You know the one-- where my thirties are consumed almost entirely by my inability to have children. I am way past down, I think I am sunk.

Even worse, I truly believe that none of my friends or family are capable of helping me. I decided, with great certainly, that I am really ok with alienating all of my fertile friends. 1.) I don't want to feel sad and angry every time I see them. 2.) I don't want to feel guilty about that sadness and anger. 3.) I don't want to be constantly reminded of how self-consumed I have become. 4.) I don't want them to have to tip-toe around me, editing themselves. 5.) Alienation is just speeding up the natural process of what children will do for our relationships regardless. They will have kids and we will not. Their lives will change drastically, and ours will be the same. 6.) I can hardly take care of myself-- I have no more energy to expend on tutoring them on how to deal with me. Besides, I don' believe there is a way to deal with me. 7.) I don't want them subjected to the same thing I am now, and unsupporting friend. They can't figure out how to deal with me and I have no clue how to deal with them.

"Normal" people are allowed to be happy for their friends, supporting them through pregnancy and child-rearing. But that has been taking from me. Along with two potential children, now my friends have been eaten by this whole mess too. And today, I don't even care. I just want to be alone.

Based on the above drivel I have decided to see if my insurance will cover therapy. I have never had therapy before, but based on some of the more disparaging imagery that seems to pop in in my cap these days, I think it might be a good idea. I have tried to go to some support meetings for recurrent loss, but unfortunately, they meet on the nights that I teach. So instead, I'm headed for the couch...

Saturday, November 24, 2007

Having to try so hard for something you are sometimes ambivalent about

A good friend of J.'s was in town for dinner last night. Like us, D. is an artist. She is the kind of person who makes a living by hopping around the world from residency to residency. She is well respected and has also taught in many institutions, only once on the tenure track (by choice). I envy her sometimes for knowing so clearly what she wants, and for being so independent.

D. had arrived from a visit with family in D.C. and talk for hours, really, about how hard it was to be the sibling without kids. And it was not because she wants them, but rather because she longs for adult conversations with her siblings and parents. Basically, she arrived at our house having heard little other than conversations about how great it was that Jimmy went in the potty and Sally makes big sentences, but can't jump as high as the other girls at gymnastics. When you are a person who spends 99% of your time with adults, it is pretty hard to feel engaged with people who spend 99% of their time with children. And vice versa.

I have experienced this in my own family. When I was in grad school I was a rock star. I was so proud of what I was doing and how well I was doing it. It was really the first time in my life that I excelled academically and I wanted to share that with my family. But visits home at the holidays never involved my parents bothering to ask how I was doing, rather I had to endure endless conversations about my sister's wacked out husband, her daughters bed-wetting, and the fact that my sister had managed to get knocked up one more time by a man she was about to separate from.

And the fact is, when I have children I want to continue to have adult conversations, I want to listen intently and care about the lives of my friends who don't have kids. I think there has been a real shift in parenting. My mother always maintained adult relationships. If we were around, we were expected to entertain ourselves so my mother could have a moment of sanity by talking about something other than diaper rash. These days it seems like people are obsessed with their children, but even worse, expect that all of their friends should be obsessed with them too. Back off, give the poor kids some room, let them learn to entertain themselves, make-believe and all that good stuff. By having an adult conversation and dismissing your kid from the spotlight, they might have a brief moment where they learn something about the world on their very own-- and you might get a chance to be you as yourself for just a sec.

I fear that if we never have kids, the gap between me and my friends with kids will become so wide that I can no longer jump over it. I fear it especially when it widens so quickly. I have lost one friend already because she was so unwilling to understand why it was so hard for me to see her pregnant after my miscarriages. Now my other good friends are pregnant and the distance is beginning, only exacerbated by my history.

Does there really have to be an us and them? Can't people with children bother to ask about their friends lives who do not have kids? And can't the people without kids be generous enough to understand that a persons life changes with kids? That you may have to be a little more patient with them...

So here I am, some days ambivalent about having kids because I am scared having children will make my brain mushy-- and on the other hand, having to work so hard to bring a child into this world. I am working really hard for the one thing I fear the most. It is quite a paradox.

Friday, November 23, 2007

Blurg Again!

Years ago my older sister would probably have been the first person I would have gone to with my problems, especially with my miscarriages. But we have grown apart over the years, mostly because she creates a lot of unnecessary drama in her own life, and in my opinion, has failed repeatedly to protect her children emotionally. She also kind of can't stand her own kids, and it is just really sad to see. I accept that I have been unnecessary judgmental of her, but it is too hard to watch her stand in front of a moving train over and over again.

So yesterday, my sister and her daughter and I were building a little house out of popsicle sticks and A. (niece) says, "Mommy, did you tell Dit (me) about Betsy!!" My sister pauses and kinda frowns. A. asks again. I say, "Let me guess, is Betsy pregnant?" Yep, with twins. She got married about 3 months ago. My response, "Well isn't Betsy a little greedy." (Blurg, who am I?)

My sister and I have yet to speak directly about my situation. She gains her intel from my mom in favor of speaking to me directly. I have tried a few times to reach out, even if slightly, but she never takes the bait. Her response to the above conversations was - "well, that's why I hadn't said anything. You know you can have a pick of any one of my three." I say, "Unfortunately, I think they might be a little attached to you by now."

I know she is trying to help, and I am sure her joking response was more of a nervous reaction than anything, but why is it people like us are such freaks that no one ever knows what to say to us? And why is it that 90% of the time I feel pissed or saddened by their failed attempts to console me? Why is it that I feel like I spend more time talking to my friends and family about how to deal with me than actually getting the support I need?

When this all began, I took the approach that I wanted to be a silence breaker. I did not broadcast my problems, but after the second mis, it seemed stupid not to tell the people who care about me what was going on. But now I am starting to see why people keep quiet. It isn't about shame, or feelings of failure. It is because people have no clue what to do with you. Some of my friends have even pulled away from me.

I have almost zero experience dealing with grief, or supporting my friends who are dealing with it. So chances are I would be pretty bad at it too.

Thursday, November 22, 2007


This post has me thinking about women, work and children (and the expectations thereof.)

Just before Thanksgiving one year ago, J. and I decided to start to try to conceive (TTC.) We were in the car. We were on the Pennsylvania Turnpike heading east, toward home. At that moment, everything shifted for me. The way in which I viewed my future began to shift, my goals shifted. I started to back-off of some of the things I had been doing for years, particularly the things that caused stress in my life (mostly volunteer organizing stuff.) I started to look at a bigger time-line-- one that involved a few years pause where I conceived and began to raise our kid(s.) I started to think more seriously about my own health, seeing an acupuncturist for ongoing migraines and digestive issues. I had done everything to plan. Rockin' partner, check-- graduate degree, check-- house, check-- insurance, check-- moving in direction of profession,umm, good enough-- still under the age of 35, check. It was the sequence I had always imagined. And I just assumed I would be quickly rewarded for my diligence.

So this is what people don't get about infertility and recurrent miscarriage. Now that my body is not following the trajectory I had hoped, I am stuck in limbo-land. If I get a tenure track job this year, I risk not knowing for years if my surgery was a success and risk never having children, ever. If I don't get a tenure track job because I fail to assert myself completely because I anticipate having a roomie, and then fail to ever carry a pregnancy to term-- then I am twice screwed-- no dream-job, no kids.

Is there ever a time when a man has to deal with a dilemma? I am sure there are cases when it happens, but does it ever happen because of infertility? J. and I are linked in this process- 100% linked. But his ability to take a job, or hold off is not tied to the success of my U, but mine is. Perhaps that means we are only 99% linked in the process. And that last 1% stinks to high heaven!


Wednesday, November 21, 2007

I Measure My Miscarriages in Bricks

This is a very strange correlation that just revealed itself to me as i was browsing through my photos. After my first miscarriage I feverishly build this brick patio in our backyard to distract myself (yep, I'm a real hard-ass.) My acupuncturist told me to "take it easy" but hauling these bricks around seemed to be the only thing that settled me. It is my most distinct memory from the time of that loss.

In late August, during my second pregnancy, I was told by my RE during an ultrasound that there was no heartbeat. J. came to pick me up. We drove half a block and pulled over. I absolutely sobbed on his shoulder. It was that wrenching, hysterical, can't catch your breath kind of sob. When I occasionally opened my watery eyes, I was looking straight at the image below-- the stacked, but porous wall of a parking garage. It is my most distinct memory from that time.

So I guess you can say I measure my losses in bricks. Hopefully, I'll never have to do it again.

To all of you out there with Perfect Uteri

Just to get it straight - I AM NOT INFERTILE. Well, not really, I think. If it were 1852, I would be infertile. But today we can poke little holes in people and root around with a camera. We can also insert tiny, little scissors into a woman's uterus and snip away the wall that divides it in two, making for a remodeled, and hopefully functioning, unit. I hope it works for me. Right now, it is too soon to tell. So I can get pregnant, repeatedly, but my body is a babykiller.

But here is the point.

I have, since May 2007 to present, suffered 2 miscarriages due to my septate uterus while all of my friends (and I really do mean that) have gotten pregnant on near the first try and taken that pregnancy to term. I am surrounded by a festering ring of fertility. I am the statistic. Girls, stay close. You wanna have a kid, stick with me. I am the percentage, the one you hope you are not. I got the shitty end of the stick - so you go ahead and grab the good end. I can take it.

Problem is that people who have kids, and pregnant people, are really bad at talking to people like me. They say really dumb shit. They call their pregnancy a failure because they developed gestational diabetes (the same friend is currently holding her self-incubated son.) Another friend contacted me all upset because she was turned down by a midwifery practice. They will not take her as a patient because she has epilepsy. She is all pissed because now she will have to delivery her kid in a hospital (safety first!) Ummm, guess what. I can't really deal with this. Fact is, your experience will ultimately end in bliss. Mine, repeated tragedy. I don't mean to minimize anyones feelings, but I can only be so generous. Remember who you are talking to, and be sensitive to that. Because, frankly, it hurts like hell-- and in the grand scheme of things, I have had a pretty easy go at it.

So I just stumbled on this today and want to share it with all of you out there with perfect uteri. Here are some really helpful hints on how to deal with people like me (I edited it a smidge). I found it on RESOLVE - which is a national association for Infertility.
  • Don't Tell Them to Relax - no amount of relaxing would have dissolved my septum. Nor will it help other people who are struggling with various known and unknown cases of infertility.
  • Don't Minimize the Problem - Talking about all the petty benefits to being childless is a sucky thing to do. (sleeping in, not getting barfed on, going out for beers)
  • Don't Say There Are Worse Things That Could Happen - Great. I already feel shitty, now you are reminding me to feel guilty about my own pain...
  • Don't Say They Aren't Meant to Be Parents - I don't believe this crap anyhow.
  • Don't Complain About Your Pregnancy - This is the motherload. If I have to explain why, then you may possibly be too insensitive to be anyone's friend. Hope your kid loves you, because you are a piece!
I can not tell you how to talk to me, or anyone like me (but this article might help.) If a friend slowly pulls away from you during your pregnancy because of their infertility - don't assume that she wants your kid. Seeing pregnant people is really hard for me because it is a constant reminder of my own failure. It is not that I want to be you. It is that seeing you reminds me one more time that i have been forced to adjust the very way in which I imagined my life would be. Miscarriage and infertility are a different kind of grief. They are grief that is ongoing, with intermitted moments of hope, and some really painful drops into despair. It is exceptionally hard for me to feel joyful for my fertile friends right now. I do the best that I can.

If you can have children with ease and have never suffered a miscarriage you can never, ever understand what it is like to be me. That is all there is too it.

Tuesday, November 20, 2007

Septum V. Bicornuate in MRI

MRI finally determined that I was not Bicornuate, rather Septate. First is the original MRI. The uterus is at the very center and looks like a heart or a butterfly. The second image I point out the determining factors. I had a Lap/Hyst to remove the Septum on November 14th. Still waiting for follow-up images.

Learning to advocate for myself


Once I was tangled up in all of this TTC, miscarriage, bicornuate mess, I started to realize that I was going to have to learn to be a better patient-- at least one that knew how to advocate for herself. And the way I learned how to do that was through research and support. In particular, the MA Yahoo list saved me a lot of time and heartache by putting me in contact with other women who were going through or had gone through the same thing.

I had suffered the loss of my first pregnancy on my 32nd birthday, May 31, 2007. I lost my second on August 28, 2007 (this was a "missed miscarriage/abortion" which I will get into another time.) After the first loss, I was diagnosed with a Bicornuate Uterus by way of trans-vaginal ultrasound. I had both kidneys (good news, since MA's can be associated with renal anomalies.) After my second, I had to have a D&E and then wait for my hormones to back off and my U to get back to its "normal" be it mildly, jacked-up state.

Throughout the process I was marked by a particular medical taxonomy, a series of associated tags that were meant to help define what it was that was going on with me. Some were part of the diagnosis, some were kinds of tests, some insurance jargon, some... who knows. Here is a short list of the language I was forced to learn so I might understand where I was standing, medically speaking:
  • Unknown, Expanded Problem Focus
  • Threatened Miscarriage
  • High Sev of Prob
  • Bicornuate
  • Fetal Demise
  • Reeval Mod to Sev Prob
  • Recurrent Loss
  • Missed Abortion
  • Uterine Anomaly
  • Mullerian Ducts
  • Uterine Septum
  • Adhesion
  • Laparoscopy
  • Hysteroscopy (See image at bottom of post. That thing that looks like a ray-gun is what they use to look in your U)
  • HSG
So there you are, the beginnings of a whole new language that you best become conversant in if you have been diagnosed with a Mullerian Anomaly (MA). More importantly, you need to know that different anomalies effect both fertility and pregnancy outcomes very differently. Some are just watch and wait situations, others have surgical options with much improved results.

AND HERE IS THE MOST IMPORTANT PART - YOU MUST MAKE VERY SURE YOUR DIAGNOSIS IS CORRECT!! Here is some advise on how to guide yourself and your doctor through that process:
  1. A diagnosis of BICORNUATE can be a kind of "catch-all" diagnosis by a doctor that is likely not well versed in MA's (it's ok doc, you probably only bump into us once or twice a year!) Even if you are told to jump back in the TTC wagon, take a break and find a reputable RE with MA experience to confirm your diagnosis.
  2. Ultrasound is not an appropriate tool for making a concrete MA diagnosis. Sure, it can establish the existence of an interior division in the uterus, but it fails to visualize the exterior contour of the uterus, and this is KEY to a proper diagnosis.
  3. Pay attention to your body and trust your instincts. The way in which your problems are presenting is likely an outcome of your particular anomaly. Are you getting pregnant, but having repeated early losses? More common for SU's, less for BU's. Match the symptoms to the anomaly.
  4. Learn everything you can about MA's, and don't be afraid to show your Doctor how informed you are. Ask lots of questions. Prepare for your appointments as you would a test!
  5. HSG, or Hysterosalpingogram, may be your doctors next course of action. I have been fortunate enough to never have to endure one (heard they can be wrenchingly painful.) HSG may be needed for a variety of reasons, but remember, like ultrasound, this test will only visualize the interior cavity of your uterus - NOT THE OUTSIDE. And the reason why that is so important is that the inside and outside are not required to match. A HSG of a Bicornuate and Septate Uterus may look very much the same. They can only then be distinguished by seeing if the fundus (top of the U - see diagram above) dips to follow the cleft of the interior, or is rounded in shape.
  6. MRI can be a good diagnostic tool, but not always. MRI, if preformed by an experience technician and the films read by a radiologist who actually understands the difference between particular MA's, can reveal the exterior shape of the uterus - particularly the fundus (top of the U - see diagram above.)
  7. The end of the MA diagnostic line for many is a procedure called a Laparoscopy/ Hysteroscopy, also lovingly referred to as a Lap/Hyst. In the procedure a reproductive surgeon uses laparoscopy to see the outside of your uterus, while simulaniously performing a hysteroscopy to see the inside of your uterus. Inside seen, outside seen - DONE!

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Monday, November 19, 2007

What the hell is a Bicornuate Uterus anyhow?

A Bicornuate Uterus is also referred to as a heart-shaped uterus. You may have been diagnosed with this. That diagnosis may have happened during a miscarriage. You may have only had an ultrasound to make this determination. You probably never knew this about yourself. It was probably told you you by a doctor you would never see again. That doctor may have created a rudimentary drawing on a scrap piece of paper for you to show you the shape, then wrote it down, B-I-C-O-R-N-U-A-T-E, then told you to go home and look it up on the internet. They might have tapped you on the knee and said, "don't worry, many women have this and have very uneventful pregnancies. You'll have lots of kids!"

At least this is how it happened to me.

In a follow up visit to see a midwife, I was told we should just try again. Not only that, there was no need to wait, no reason to investigate the diagnosis further. No biggie - just try again.
So we did, and in 2 cycles I was pregnant again. At that point, I was in the begin research Mullerian Anomalies. I was just learning the what, why and how I was born like this (and you can too if you click here.)

Before I knew I was knocked up again I had made an appointment with a Reproductive Endocrinologist - here on and ever referred to as simply, an RE. Arriving in her office pregnant was frowned upon, for the RE is meant to help you get pregnant-- once pregnancy occurs the RE gives you the boot. So my RE was pretty casual with me, said congrats and warned me that we would not be getting to know each other very well. But I felt really scared about this one, and she could tell I was not feeling like this pregnancy was a taker.

A month later during my 7 week ultrasound, the first time I was supposed to see the heartbeat, the shit hit the fan. "Sorry, this pregnancy is not going to work out. There is no heartbeat." So I guess me and this RE were going to get to know each other.

I was a mobile coffin for about a week, then scheduled a D&E. The worst part is that you have these little moments where you let yourself think for just a second that everything is ok-- That the little packet of cells inside you was just playing peek-a-boo, that your ovulation date was off, that the ultrasound machine was busted. Nope, this really was happening to us.

So what I meant to get to is that my diagnosis, done at a hospital during an emergency room visit, with ultrasound as the only imaging, was starting to look like it might be wrong. And what I learned very soon is that the diagnosis of "BICORNUTE" is a kind of catch all for any type of uterine anomaly that appears as though the uterine cavity is divided when seen on ultrasound. Thing is, bicornuate's have pretty good outcomes with pregnancy. More specifically, when they do suffer losses it tends to be second and third trimester. I was having first trimester losses. It just didn't jive.

So I was back where I should have been 2 months prior if any of the small army of OB's, Midwife's or Gyno's that I saw would have even lightly suggested a follow up or second opinion. Here I was, no less than 4 months in to trying to make a roomie. Two were gone, and I was left in limbo. Yeah for our health system!

The Story of My First Mis

J. and I started talking about having children years ago, but we were both still tied up in graduate school, submersed in our work, and not ready to sacrifice our independence. If felt good to think about waiting till the time was right, but we knew children was something we wanted. Despite our wants, I think most of our family believed we weren't the type to have kids. My mother talked incessantly about how we were too selfish to ever have kids, that we had established our lives and wouldn't be able to adjust -- shifting our attention from ourselves to our family. I never really resented that she thought that of us. I just thought it was fun that some day I could surprise her and tell her we were having a baby... And that we did it with our eyes wide open. Not true, I did resent her for saying that. But I knew I could be a really great mom some day. So her slight wasn't going to change my mind.

My grandmother occasionally warned me that my eggs would dry up. And my sister once felt the need to let me know that the rate of birth defects started to raise exponentially after that age of 35, so I better get to it. That was years ago. And I am only now 32.

J. and I joked about how my siblings wanted us to have kids so we could suffer with them. We imagined their envy of our freedom and knew we wanted a few years to be with one another- uninterrupted. J. and I have a very tight bond. We would spend every moment together if we could and very, very, rarely tire of each other. I have proposed to him on more than one occasion our surgical connection. He thinks its weirds. My alternative solution is to make clothes that we can wear together. He is not completely opposed. We don't fight and we share deep intellectual bonds to one another. Yes, I am selfish. I wanted him all to myself for a few more years.

It wasn't till fall of last year till we decided we would make a plan. We had visited friends in Pittsburgh who had a 3 month old. I couldn't stand watching J. hold her. He was so taken by her, and so was I. On the long drive back to Philly we decided. We would begin in the spring.
The funniest thing is I had this ridiculously, conflated plan to get pregnant in a particular month. Here was my thinking: get pregnant in April. Make job applications. Sneak in interviews before I start showing. Give birth in the winter. Have 6 months at home with the kid before my new and amazing and not in Philly tenure-track job starts in the fall. HA! I am such an ass. First I was assuming I would get a job. Second, I was assuming I could get pregnant on command and have the perfect, uncomplicated pregnancy. I could not have possibly been more wrong.

You spend your whole life trying to avoid getting pregnant - and I was really good at avoiding it. I had never once been pregnant, so I wanted to make sure I knew what was about to happen to me and be prepared for it. In the late fall I had a full physical and annual exam to make sure all my parts were in order. When I told my GP we were going to try she just said, " Great! Have fun!" I thought-- easy as that.

I had suffered from poor digestion and migraines for years, so I started seeing an acupuncturist. I had stopped medicating the headaches months prior, because the meds made me feel as crappy as the headache. Turns out the acupuncturist I was seeing, by coincidence, is particularly interested in pregnancy and fertility. So I thought I hit the jackpot when I told her I was there to get ready for pregnancy. With her, I went through learning how to track my temps for ovulation, lots of diet changes, herbs and weekly treatments. Now I know exactly when I ovulate. I have not had a headache in 5 months-- which rocks. But my digestion is still pretty jacked up.

Last, I purchased insurance. In my own stupidity and honesty, I admitted to the insurance company a history of migraine, which bumped up my premium terribly. I tried to tell them that I was no longer being treated for them, but they would not concede to drop my rates. I even ordered all of my medical files from grad school to prove to them that I was no longer being treated, but they only pointed to the "gap" in my treatment since I finished school. A "gap"-- is that what you call having no insurance? Of course there are no medical record for the time I was uninsured-- I could not afford to go to the doctor. I chose the best plan that I could based on my needs. I knew we were going to have a kid so I chose the plan with the best birthing rates and privileges. That puppy sang to the tune of $275 a month.

So here I was. All ready to go-- clean bill of health, fully insured, just tapping my foot until April rolled around. I couldn't believe my own impatience. I bugged J. every month leading up till april. I was constantly up to tricks, trying to get him to let us start early. Unfortunately, in my excitement, I had shared all that I had learned about my cycle and so he knew when I was up to no good. He really kept me in line because he, like me, believed that we would get pregnant and have a kid in no time.

It was an easy thing to convince ourselves of. I felt like I had a million reasons to believe I was exceptionally fertile. For one, I had been pretty responsible with birth control. So there was no reason to believe that I ever had any "accidents" that did not result in pregnancy. I only once had a contraceptive issue and used the morning after pill. I was responsible and in control of my body. Besides that, I am built like a breeder, at least according to the mythologies of fertility. I have big wide hips, big ass and boobs and a tiny little waist. There is nothing tom boy about my figure. That Venus De Milo had me fooled. I thought: curvy body, big hips = baby maker. The women in my family are pretty prolific - so I just assumed it was in the genes. But even more convincing was the rate and speed at which all of our friends were able to conceive. We had heard hots of "hole in one" stories warning us how fast it might happen. So we just figured that we are the same age, pretty health and had no reason to think we were any different.

April (late March actually) finally rolled around. I had been charting my temperatures so I had a pretty good idea of what was going on. Tried, no luck. We rolled in to month number two still optimistic. And after the long, impatient wait after ovulation, I turned up pregnant. The first test I took had a positive line, but it was super light. I spent hours online comparing it to images of other positive pregnancy tests. I toted it around the house all day and looked at it in disbelief. I wondered it we were crazy. We had tentative conversations that week - when would we tell people, what kind of birth did we want, how would we find a doctor. We were hesitant to acknowledge it, though I think that is pretty normal.

On my birthday, the last day of May, I started to spot. I was only 5 weeks, barely even pregnant. I panicked and called a recently pregnant friend who i knew had a spell of spotting. She was helpful, but pretty casual about it. In some cases it is pretty normal. I waited till morning to call the midwife that I hadn't even seen yet. It was hard to get care when you have yet to establish a relationship with an OB or Midwife. The midwives were helpful and ultimately sent me to the emergency room. By that time, I was full on bleeding and knew what was happening to me.

I arrived at the ER on a Sunday morning. I had put off going in on Saturday because we live in Philly, a place where ER's are notoriously busy on the weekends. The visit consisted of about 15 pelvic exams by about 10 different people (exaggeration.) J. had his first look at a speculum, which I think he may have been a little disturbed by. There was a lot of waiting, particularly for blood-work. My HCG level was a very low 25. There was little hope that this was anything other than a miscarriage.

After hours, I was finally taken upstairs to have an ultrasound. I was in a large room with the tech, who would not allow me to see the screen or respond to any questions. She was just there to take the pictures. I knew something was wrong right away. She was doing a regular pelvic ultrasound, when she suddenly jumped way up to my kidneys. I started to panic. Cancer was the first thing that ran through my head. What the hell do my kidneys have to do with my uterus?

Next came the vaginal ultrasound. I was really sensitive on my one side to the point that I winced each time she jabbed me. She spent a lot of time and I could not image what she would need to document so thoroughly. Thorough is great, but this was freaking me out. After she left the room I started to cry again. I was running through a list of a zillion things that could be wrong with me.

Not only was I loosing a pregnancy that I so very much wanted, but I was diagnosed with what is called a heart-shaped uterus-- medically known as a Bicornuate Uterus, part of a group of malformations called Mullerian Duct Anomalies. This blog chronicles my journey through miscarriage and misdiagnosis. I hope it will be a good read for those of you out there who are looking for information, just like me.

J. and I sat on this stoop, and for the first and last time made plans for this pregnancy.