Tuesday, May 5, 2015

MY FIRST PREGNANCY - A LESSON IN MANAGING EXPECTATIONS

I had gotten married "late" at age 31 and assumed since it took a while to find my bashert that having children would come when we wanted it. When it didn't come easily I immediately went for help.

After three failed "natural cycle IUIs" and two failed "hormone assisted" ones, I finally got a positive "Beta*" back. I was thrilled - YAY! Pregnant! They told me to come back in 2 days for a repeat. I came back and sat triumphantly in the phlebotomist's chair while they took my blood. My nurse called hours later and took my high down a notch. 

"The numbers are supposed to double, yours still rose, but not double. Come back tomorrow, sometimes it takes a little more than 48 hours."

Still with hope, but more guarded, I pulled up my sleeve to reveal the "good vein" for blood draw. I gave my sample and I waited. The call came hours later, and the number rose by 3, the pregnancy was ending. 

I had to come back the following week to make sure the number was headed to zero. So I did, and the number had risen a little. I asked "Does that mean the baby is fine since the number is now rising again?" No, it meant a special call from the doctor.

The doctor told me he was advising I come to get a shot of methotrexate. I had never heard of this before, but it alarmed my father. "Isn't that a drug they use for CHEMOTHERAPY?" So I called the doctor back, he said that cancer grows like cells do in making babies in that it is the splitting of cells. This is a LOW DOSE and would wipe out the pregnancy, or what was left of it. My special instructions were to refrain from sex (or use a condom) for two months until the drug got out of my system. A pregnancy with this drug present in the body could be dangerous for a baby.

It was my third hormone assisted IUI which failed, so I asked if we were moving on to IVF. The doctor said "No, it worked, you got pregnant, but it didn't stay. So we know you CAN get pregnant through IUI, so we wont jump to IVF yet."

Dejected, my husband tried to get my mind out of failure. He suggested we take a trip since we wouldn't have to plan our lives around early morning monitoring or shots. I needed a spiritual uplifting, so we decided on Israel. Eilat for our physical vacation, and visiting holy sites to help heal our spirits. 

No one knew about this loss since it was so early on, but it had a huge impact on me. It taught me a valuable lesson in my managing expectations in ARTs. A positive "Beta" meant nothing. In order not to get emotionally hurt again, we would not get excited until our numbers would double, then we would be able to breathe. 

Little did I know that level of expectation would change again as we continued down the road towards parenthood.








*"Beta" is the term used for blood test that measures your BetaHCG levels. Also known as Blood Pregnancy Test.

Sunday, May 3, 2015

SURVIVOR'S GUILT

Last year, I was sitting in the Maternal Fetal Medicine department of my local hospital waiting for my 20 week ultrasound. I was very stressed. Many of my pregnancies didn't go well, and this was an important hurdle to tackle.


I was filling out the questionnaire when something hit me...


How many pregnancies have you had? __6_


How many live births have you had? _2__


How many women see these questions and answer them with ease, whereas I am counting on my fingers: my IUI miscarriage that had to be resolved with methotrexate - a strong drug that made me wait 2 months before trying again , my IVF with the chemical pregnancy, my miscarriage of the twins, you get the idea...


I wanted to do something for others who were in this lonely boat to let them know they are not alone. I was thinking about what point in the cycle made me feel most alone, and it hit me -


THE MIKVEH


The mikveh was the time when it was obvious to me that my body had failed me. I heard a Rebbetzin mention that the Gemarah in Ketuboth describes the "impurity of niddah" as a "whisper of death."


EXACTLY! A new life was in arms length for us, but a miscarriage so early on, or a failed ART cycle was just a whisper. No one knew how close I was, and its hard for others to understand the grief of something that was barely alive. The mikveh would be the place to publicize a support group for women.


I jumped through bureaucratic hoops in my little town to get "small pretty signs" up in the mikveh. And then I waited...
Would anyone email?
Would anyone call?
I imagined in my mind that my couches would be taken up by 10 women from my town who I may not know who just wanted to vent. Could it be that I was the only one?


Then I got a phone call "I saw your sign in the mikveh, but I don't want to meet in a group setting. Would it be ok if we just spoke on the phone?"


Sure! Anything to help someone out. We spoke on the phone for two hours. When we hung up I realized that it was a bracha she only wanted to speak on the phone. You see, there was one thing I failed to mention and left out of my story on purpose - that I already had two children through successful ART.


YES, I want to help, but I don't want someone to feel badly that here I was, mother of two, and in my 20th week of pregnancy with twins, meeting or speaking to someone about trying time and time again to have a child.


I got a call from someone else who wanted to meet in person. I got really nervous. I didn't want it to be one-on-one, so I called two of my friends whom I knew were seeing the same doctor I was. We planned to meet at my house. I picked out my BAGGIEST SHIRT, my friend who was also pregnant with twins came early to hide under a blanket. My other friend also failed to mention that she already had one child. We all felt we wanted to be there for others, but wanted to hide that we weren't presently in the same boat. Why did we feel guilty?


I had put my name out there as "THE FACE OF INFERTILITY" in my community, but I wanted to hide my expanding belly. Being in this sisterhood of infertility, I developed a GUILT that I had overcome infertility, not once, but twice, and was about to do it again.


Recently, at a YESH TIKVA (www.yeshtikva.org) event I was attending, I was able to get some peace of mind. The event had three professionals speaking about "Caring for Your Mind and Body Through Infertility." It was extremely informative, but the best part of the event was the mingling before and after.


I was speaking with someone who was going through the journey and when they asked "Where are you in the process?" (a typical question in such circles) I paused. I said "I have done IUIs, IVF, IVF with PGD and FETs." I was being vague because I felt guilty. Then they pressed me "Did any work?" With my head down, I replied, "I have 4 children, my first through IUI, my second through FRESH IVF with PGD and my twins through FET with PGD." They said "That's great, we are about to do IVF for the first time, what is PGD? What can you tell us, any advice?" I told them I felt guilty mentioning my success in this forum. They said, "You shouldn't feel guilty, you are giving us hope!"


HOPE... that's all I ever wanted to give. Hope and support.

I know that some people feel that once you have one kid you are no longer part of the sisterhood, but I am glad to know that there are some people out there who want to hear from people like me, so I am in the process of overcoming my survivors guilt. Thank you fellow fertility travelers from the YT event, you have no idea how you’ve helped me.

Saturday, May 2, 2015

Support Systems - A True Lifeline

In 2012, I was pregnant with my second child. Some of my friends knew the scary drama that came with this pregnancy because I was open about it, I needed the support and their tefilot helped give me strength. 

One friend called me up and asked if I could give her friend, Emma*, strength. I said she should definitely give Emma my number. Emma never called.

A month later, I was standing in shul and I thought I saw her. I wasn't sure, since we weren't friends, but decided to be bold and walk over and introduce myself.

"Hi, you're Emma, right? You were supposed to call me about fertility stuff?"

"Yes, I know, but I figured that you are already pregnant, so how would you be able to help me?"

"Well, getting pregnant wasn't easy for me, it was really hard with different treatments, many failures..."

interrupts me

"Well, I have no problems GETTING pregnant, its just keeping the pregnancies. I have gotten pregnant 5 times already, and I bleed out by week 9 or 10."

In hindsight, I now know why Hashem had her WAIT to reach out to me. 

You see, for the two years prior to that moment I was a dedicated member to an online fertility support community called fertilitycommunity.com (I think they changed their name at this point). The Thursday before this chance meeting in shul, I was reading a thread by a virtual friend about how she had a blood clotting disorder, and that once she gets pregnant she has to take blood thinners in order not to clot and bleed out the pregnancy.

I told Emma to ask her doctors about this at her next visit. She said she was meeting with Maternal Fetal Medicine on Monday. I was surprised, since I thought they only dealt with women once pregnant, but didn't want to overstep. She said she would call me on Monday after her appointment.

On Monday she called to say MFM told her they couldn't help her, but she should see an RE. (What I expected) But she wanted to stay in touch with me.

The following year she called me again, she had mentioned to her new RE about the blood thinners and the next time she would get pregnant they would start the blood thinners, like we were hoping. Good, a new protocol, new hope.

I told her I was supposed to have a frozen transfer on Monday. She said she was scheduled for Friday. Did I need a ride to my transfer. YES! (You see, I didn't like having anyone in the room with me so I could focus on staying relaxed, so my husband wasn't going to drive me.) Emma volunteered to drive me and my 7 month old baby, drop me off and babysit while I had the transfer and then drive me home. It was perfect.

I was so grateful that on the way home I gave her a bracha "In the merit of you driving me to my transfer, may your transfer be successful." AMEN!

I went in for my beta, it was positive, so was hers.
My numbers doubled, so did hers.
I had two sacks, so did she.
I had two heartbeats, so did she.

Every Tuesday she would call me since Tuesdays were her appointment days. I would talk her through things and give her a sense of calm. She said she wouldn't get excited until she made it passed her first trimester without bleeding out. That day came and went and we were both so relieved. 

Having a fertility buddy is such a help and comfort to both, to compare notes and know you are not going crazy. We were both on bed rest, both cervix shrinking, and the babies were born one week apart. Each of us has a set of twins: a boy and girl. These 4 kids have no idea that they were connected way before they came out of the womb, and their mother and I are forever connected. FFF - Fertility Friends Forever.

* Name was changed to protect the innocent.