Money and Peace

For the most part I can get over the fact that I need medication to decrease my risk of miscarriage, but the thing that I have a hard time not feeling angry about is when the thing that prevents me from doing all that I can is money.  Not that I don’t have the money, but that this stuff costs so much.

There is very little insurance coverage out there for fertility testing and treatments.  We were very fortunate to have had just about the best infertility coverage you could find when we were going through thousands of dollars a month in treatments.  We only had a $20 prescription copay (those injections were thousands).

Since we currently have no worthwhile insurance coverage (thanks, Obama), money has been what has set our limits, and that is very frustrating.  If it wasn’t a factor, I’d just be all like let’s do IVF again.  It’s our option with the highest chance of success.  I probably wouldn’t have said that 6 months ago, but I’m more determined now that this can have a happy ending.

It still may not, but I do not want to have to give up and quit and try to move on because I couldn’t afford a medication.  I thought that was going to be the case up until this morning, in fact, although I hadn’t entirely decided to give up.  Just a month or two until I could come up with the $93 to refill my Femara.

Someone told me that Femara is only $7 at Costco.  WHAT.  How can that be possible?!  I had to check into it.  I can afford $7.  Long story short, it’s true.  I refilled my double Rx for $7.56 this morning.  Today is the day I’d need to start taking it.

I would’ve been crying and jumping for joy if I didn’t have a peace about it.  I’d come to realize in the past few days that God isn’t trying to prevent me from trying to have another baby, he’s just helping me to be patient about it.  “Wait” is the word that has come up again and again in the last 6 months.

So with that in mind, I hope that I can continue to feel peaceful and patient this month.  I want to concentrate on Advent (which, coincidentally, means “waiting”) and Christmas with my family and not OPKs and symptoms.  They need to take a back seat.

 

P.S. While looking for scripture to have B read when we light our Advent candles, I came across this:

Therefore since we have been justified through faith, we have peace with God through our Lord Jesus Christ, through whom we have gained access by faith into this grace in which we now stand. And we boast in the hope of the glory of God. Not only so, but we also glory in our sufferings because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us.
Romans 5:1-5

So look at that: I shouldn’t ever feel stupid for continuing to have hope.  This is how I’m able to still have hope.

When Will it Stop?

I guess I somehow had this expectation that after my baby was born, I would feel healed (as much as I can be) from the 3 previous years.  This is definitely not the case, it turns out.  Things that hurt before still hurt.  Things are still hard and still remind me of my pain.  I know I will always love and miss my babies I’ve lost.  I know over time, like years, it will probably heal enough I won’t cry about stuff.  But I just thought that would be now, and it isn’t.

It’s like I can’t snap myself out of that place where I was, like I’m still in it even though I’m not.  I worried the whole time that I’d feel this way, that I’d feel disconnected and like Meg being here isn’t real.  I guess I don’t feel that way all the time, but enough of the time.  I feel horrible about it, like I don’t love her the way that I should.

My postpartum appointment isn’t until the 21st, but I will say something about the disconnected feeling for sure.  They can get me a counselor/social worker to talk to, and I really feel like I need it.  I wish I had someone to talk to right now… I’m home for this evening by myself, just me and M.  She’s asleep here on my lap, and I’ve been sitting here crying for the last hour and a half.  Ugh.  Actually maybe I should call them sooner to get an appointment.  I don’t know.

ETA: Then she wakes up and gives me a big smile and I feel better. ♥

People Plus Doctor Equals Baby

Sometimes people make comments implying that my baby was conceived in a normal fashion, or I see that implication on supposedly witty onesies online.  It makes me feel awkward because she wasn’t.  I guess I don’t really feel like people would judge me/her for it, at least I’d hope not.  She’s no different than any other baby/person.  But sometimes it just hits me that the concept of just trying to have a baby is not something that we can do.  I mean, we could, but it’s just so risky that I don’t think I could do it again.  I’ve accepted that by now, but sometimes it’s still hard when I think about it.  Anyway.  Just saw this little thing and thought it was cute/amusing:

Another Good SI Article

Just saw someone share this: http://m.guardian.co.uk/lifeandstyle/2010/may/07/secondary-infertility-increasing?cat=lifeandstyle&type=article

Some of my thoughts on it:

– I really identified with that the author was talking about regarding people assuming if you have one kid, you can have more whenever you choose.  People made comments about how it was about time for me to have another one, or they’d ask if I had “just one?” and then when I said yes they felt some need to justify that “decision” to me, like “that’s probably a better idea in this economy.”  UGH.  And you know, some people choose to only have one child or to have children far apart in age and I’m sure comments like that would bother them a lot too.  People just need to mind their own business!

– Whenever I read stuff about infertility (or in this case secondary infertility) being on the rise, a big contributing factor is inevitably because in general women are having children later.  It does make sense, the longer you wait the likelier it is you’ll have more issues, but it just seems to perpetuate this idea that infertility is something that only “older” moms struggle with.  NOT TRUE.  I’ve been struggling with this since I was 22, and I’m 26 now.  They think if you’re young there shouldn’t be anything wrong with you, which in itself leads to a lot of grief.  It can happen at any age!  I just wish more articles would mention that.

– There was a lot in this article I very much can identify with, like how with secondary infertility you can’t avoid babies and pregnant people as much because your child puts you into those situations–taking them places with other children, where there are other moms.  You have to deal with your child being alone and not having a sibling, and your child asking for a sibling.  You have to deal with everyone around you having second and third babies while you’ve had none.  And for my situation, on top of that last one I also had to deal with everyone having a baby who lived while mine weren’t.

– “…I couldn’t avoid the sense that we were not yet all here, that there was a person missing.”  That is EXACTLY what it feels like every day, and it’s even worse when you also feel like there are 5 other people missing too.

– I also understand the author’s disbelief that IVF was not only an option but a good choice for her because she already had one child.  It does make it harder to understand why your body isn’t working right when it’s worked right once before.  But that’s the route we ended up on too, and I also can’t believe that the baby in me is actually there and real.  I expect, like the author says, I will still feel that way now and then after this baby is here too.

– I really loved the last paragraph, it made me teary.   I also have always found it comforting when I see a mom with children with a bigger age gap, thinking maybe she’s gone through the same thing and I’m not so alone.

A Good Article on Secondary Infertility

From: http://www.resolve.org/diagnosis-management/infertility-diagnosis/secondary-infertility.html
RESOLVE is a great website, but I hadn’t seen this article until the other day.  I thought it was a really good read for people unfamiliar with Secondary Infertility and for people experiencing it (like me!).  I identify so much with a lot of the things it describes in this.

Secondary Infertility

Definition Secondary infertility is defined as the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications.

Do I have secondary infertility? Infertility is defined as a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages. 　
Infertility is a medical problem. Approximately 40% of infertility is due to a female factor and 40% is due to a male factor. In the balance of the cases, infertility results from problems in both partners or the cause of the infertility cannot be explained.

Should I see a specialist? Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year and are under 35. If you are over 35 and have been trying for 6 months, you should consult a physician. If you are over 30 and have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if you know that your partner has a low sperm count, do not wait one year. Consult a specialist, such as a Reproductive Endocrinologist or urologist, or in some cases your OB/Gyn.

Why is this happening? When a first child is conceived with ease, you may feel completely off guard by the difficulty of having a second child. Take charge and talk to your primary care or ob/gyn physician. Secondary infertility is very common, but not often talked about. RESOLVE is here to provide the resources you need.

The emotional side of secondary infertility Physicians, too, may downplay the possibility of secondary infertility in their previously fertile patients and encourage the couple to “keep on trying.” The emotional experience of secondary infertility often is a compilation of the distressing feelings of anger, grief, depression, isolation, guilt, jealousy, self-blame, and being out of control. You may feel guilty for experiencing normal grief and worry about how your current emotional state will affect your existing child. The powerlessness to produce a sibling for the existing child often produces feelings of sorrow, as does the inability to perpetuate the parenting role. You may feel distant from friends as those who were a great source of support when parenting the first child are now linked to sensations of pain and jealously.

Sadly, couples with secondary infertility tend to receive less social support from others than couples who have primary infertility because the infertility is unacknowledged, the pain associated with infertility is invisible as the couple has a child, and there is no concrete loss in the family. In addition, couples experiencing secondary infertility may be recipients of criticism by others who think they should be grateful for one child and that it is foolish to go to extremes to increase family size. Of course, a couple can be extraordinarily thankful for their existing child and still long for more children.

I’m still a parent. How do I cope? Unlike in primary infertility, couples who experience secondary infertility already have a child’s needs and welfare to consider. It is important for parents to demonstrate to their child that problems are dealt with and not buried. It is naïve to think that a child will remain unaware of her parents’ grief just because the parents do not talk about it or address it directly. In fact, if there is an absence of information, children resort to egocentricism and magical thinking to interpret events. For example, the child may be worried seeing the mother go to the doctor, getting shots etc. or the child may think her parents are dissatisfied with her if they are upset and anxious. The young child does not have the cognitive capability to understand her parents’ actions and feelings as separate from herself, and, therefore, needs an explanation for her parents’ melancholy. In addition to helping the existing child appreciate the parents’ emotions, parents must help the child identify his own experiences and feelings.

Guilt about not providing the existing child with a sibling is a common experience of couples suffering from secondary infertility, as they feel they are failing their child. Many couples idealize the sibling relationship by believing the siblings would be emotionally close. Of course, there is no guarantee about any sibling relationship, and the existing child should not be burdened by the loss of this idealized relationship. It is crucial for parents to acknowledge and mourn the loss and then to legitimize the existing family. Families come in all shapes and sizes, even size three.

It is a cruel irony that the more positively parents feel about parenting, the more painful is their experience of secondary infertility. Many parents have expressed ambivalent feelings about their child growing up because they fear they will never re-experience the pleasure of the early years. In addition, parents may become overly protective and attentive to their existing child. In the face of loss, parents want to hang on to what they have and love. Of course, these parental feelings must be kept in balance with the growing child’s needs for separation and independence.

Finding Resolution The resolution of secondary infertility brings many variables into the decision making process. The couple must focus on the desire to parent a second child and the time, energy, and finances involved in pursuing medical treatment or alternatives such as adoption. These conditions must be weighed with the needs of the existing child in mind. Couples often are concerned whether or not they will continue to be good parents in light of the emotional and financial stresses associated with treatment. Sometimes, in grieving the loss, couples find there are advantages, such as more time and more resources, associated with having one child.

Couples often need assistance from professionals and/or support groups as they struggle with the turmoil of secondary infertility. Grieving what might have been is not an easy task, and couples often benefit from the contributions and support of others grappling with the same circumstances. If the grieving process extends for a long period of time, and symptoms of depression exist for more than six months, the help of a mental health professional with experience in reproductive medicine should be sought. With respect to secondary infertility the ultimate goal is to grieve the loss of a child, decide to pursue medical treatment or alternative family building options, or to embrace the established family as it exists. With resolution comes the reclamation of life.

Need a Pick-me-up

Good riddance, 2011.  This next year MUST be better.

So things are sucky right now, although I’m doing relatively okay.  No major breakdowns or anything, just feeling depressed.  Not only did we not catch any of those 3+ eggs, but, and I’ll spare the details in this venue, I had a very painful and miserable several days.  And then yesterday I went to the doctor and had a bunch of giant cysts, which was expected, but my ovaries hadn’t been hurting so I let myself hope there wouldn’t be any.  So I have to take this next cycle off, no meds.  (My nurse said to do something for myself.  Go eat some chocolate.  So yesterday I spent all afternoon making a chocolate cake with chocolate mousse filling with dark chocolate ganache.  Minor consolation.)

There are two reasons why a break like this is hard for me: 1. My unmedicated cycles are 35+ days long.  My medicated cycles are as long as it takes me to ovulate on an unmedicated cycle; and 2. I have to worry about whether or not to avoid ovulation time or not.  If I get pregnant without meds, the chance of miscarriage is way higher.  The last time this happened, we didn’t want to risk it.

This time, I want to do absolutely nothing.  Meds haven’t helped anyway, although those miscarriages were for different reasons.  But still, I just don’t care anymore.  You always hear these stories of people finally getting their baby unexpectedly from a break cycle.  Maybe that could be me.  My son exists, so I know it’s possible for me to have a baby on my own, as unlikely as it otherwise seems.

Ramble ramble, point being I always think of this song when I want to feel a bit more optimistic about my day:
http://www.youtube.com/watch?v=3UczfZfCwU0&ob=av3e
(Again, I wish I knew how to imbed videos!  Maybe you can’t.)

Yesss

Buttloads of Menopur has paid off!  I have follicles at 19, 16, 16, 14, 14, 13, 13, and 13.  That’s 5 follicles and 3 more maybes, according to the Dr.  According to me that’s one good follicle, possibly 3, and I’d eat my hat if there were any more than that based on the results I’ve gotten with other follicle measurements in the past.  My estradiol was at 790, and they say it’s about 200 per egg, so that indicates probably 4 eggs.  I trigger tonight, and am only on CD10.  I’m very happy with this, I finally feel hopeful that this cycle could work out.  That is all. 🙂

This bodes well for two sunshines. Not unlike on Tatooine.

I ♥ my RE’s Office

I just have to say that right now.  I loved them the first time I went in there and talked to me RE and he was so nice and promised me he’d get me a baby and he called my son by his name and not some impersonal medical term like “a successful pregnancy.”  The receptionists knew my name within a few appointments, everyone hugged me and helped me get out to my car the day I got bad news, my nurses remember things about me, like my husband’s name and job.  I could go on and on.  It’s just wonderful, and they’ve given me so much hope through all of this.  Someday they will get a really nice card from me.

Today I talked to my nurse (who’s a new one I’ve been seeing for a few months, my “old” nurse I think got moved to the other office) about how I’m not really comfortable triggering with minimally mature-sized follicles because I can’t help but feel there’s a reason the only two times I got pregnant on injectables I had a follicle at 20-21mm, not 17mm.  Before I’d told her I’d only gotten pregnant with a bigger follicle, she asked, “What size of follicle was it for your son?”  At first I thought she meant my 3-year-old, who was conceived naturally, but I watched her flip through my charts to see and realized she actually meant Michael.  Warm fuzzies.

Feeling Guilt

Someone on a message board recently said that she felt guilty because she felt like the grief and everything she’s going through to have another baby is taking away from the happiness she should be having over her toddler right now.  Somehow I’d never put that thought into words, but that is exactly how I have always felt over this.  I went awhile feeling like I’d wasted so much of my concetration on TTC that I wasn’t enjoying the time I have right now with my son.  I changed my attitude over that last spring or so, and made it a goal to spend the summer trying to do a lot of fun stuff with him.  I think I mostly succeeded at that.  I definitely think I’m better at being content with him being an only child for now.  But I can’t stop myself from grieving and longing and I do feel like I should be able to be completely happy right now with my life with one child.  I’m afraid he’ll grow up and I’ll feel like I missed this special time with him because my mind and heart was so often elsewhere.  It makes it harder for me to see him reach milestones, and it makes me miss when he was a baby even more.  I feel like I took the time he was a baby for granted and I was anxious to watch him get older and learn new things.  I had no idea that it would be so long until I’d get to experience having a baby around again.

Keep on Truckin’

Alright, so it was the Novarel plus some high progesterone symptom confusion, and I’m on to next cycle.  God was nice enough to let me get through this not crying and feeling totally depressed and hopeless for a day or two; rather, I feel great.  Can’t explain it at all.  Normally at the end of a cycle I just want to give up, but don’t, and that’s what led to my decision of taking a needle break.  But I got to the end of this cycle and feel all like Bring it on, Needles!  I then started freaking out about my conflicting decisions, not sure which way to go… stick (pun not intended) with injectables or take a break with Clomid?  My Mom told me to read through Philippians, and so I did, and this is what happened:

“Keep on doing the things that you have learned and received and heard and seen in me, and the God of peace will be with you.” (Phil. 4:9)

God doesn’t care which decision I make, He wants me to do what will make me feel the most at peace.  And what will make me feel the most at peace is to do injectables again because it’s routine and I will be able to relax.  If I did Clomid, I’d be wondering how it was working, taking OPKs, wanting to temp, etc.  It might be less invasive, but it certainly wouldn’t be more relaxing.

“And my God will fully satisfy every need of yours according to his riches in glory in Christ Jesus.” (Phil. 4:19)  Honestly, I have no idea why this verse sticks out to me, but it made me sort of feel like God gave me this RE and the injectables are what my RE wants me to be doing right now, so I should be following what “God’s Dr.” wants me to do.  Or something like that.

So I will just keep on truckin’.  And as it says on the music for Get it On’, a staple for my college pep band: Drive it like a Mack Truck.