“Oh, the bells, bells, bells!/ What a tale their terror tells/ Of Despair!”

So there I am, working industriously on the bound session laws, when I hear a…jingling.
I stop typing.
Yes, it is definitely a jingling–a merry, if slightly nerve-jangling, jingling. I listen for the tiny sound of reindeer hoof-steps…no, that’s not it, and it’s not even October, besides. The jingling is coming closer, growing louder, and I pop my head out of my office door. And what to my wondering eyes should appear…
I gasp, loudly, and pull my head back in.
A peasant skirt. With tiny bells along the bottom.
Now, I know what you are thinking. You are thinking “Oh, Alexa, leave the poor woman alone! Obviously she is a Belly Dancer, hired by one of your higher-ups for some sort of team-building exercise.”
But that is where you’re wrong, because I recognized this woman, and she is not a Belly Dancer, but rather an Editor. From Wisconsin, no less. Perhaps Wisconsin has a large Romanian community?
Well, I don’t care if it does, because my office is near the printers, and every 45 minutes for the rest of the day I will hear that jangling jingling.
Damn her. Damn her to Boho Hell.

In clinic news: I received my paper work from the office of the Fancy RE. The introductory letter contains a paragraph of the importance of having previous medical records transferred at least a week before your initial appointment. Why?

“This information is pertinent to us in order to provide the best possible care and for unnecessary repetitive testing.”

“Unnecessary repetitive testing”? Splendid! Really though, I applaud their candor.
Perhaps we can work something out—I will edit their materials for mistakes like the one above, and they will treat me for free.

And Mollywogger: I see your husband’s nerdiness and raise you my own:

The Nearly Fiance knows that Soup-at-Hand always makes me giggle. I can’t pick up one of Campbell’s cunningly designed microwaveable soup-cups without snickering unattractively. Last night I finally told him why.

“Well, you know Heidegger’s ‘Modes of Being,’ in ‘Being and Time’?”
“No,” says The Nearly, looking pained. “This is going to be really nerdy, isn’t it?”
“Just wait, wait! It’s funny, I promise.”
The Nearly looks unconvinced.
“So, Modes of Being. Well…there’s ‘Ready-to-Hand’, which is Zuhanden, and ‘Present-at-Hand’, which is Vorhanden.” I snort, “And now, apparently, Campbell’s has discovered another one! Soup-at-Hand! Zuppehanden!”
I am overcome by mirth.
The Nearly looks…Horrified.
I can see his mind forming two words:
Donor. Eggs.
Ah, well.

Comments (4)

“Everything’s Coming Up Milhouse!”

I am at my desk by 6:15 most mornings. I like the early part of the day—few people are in the office when I get there, and I can drink my coffee and check a few blogs and start my work serenely. But I will fall on my knees with joy when we gain an hour in October. Lately it has been so deeply dark when I wake up that every cell in my body shrills at me as I walk to the bathroom “What do you think you are doing, exactly? It is the MIDDLE of the NIGHT!”
No one likes arrive at work to the sound of crickets chirping.

But, honesty compels me to say that other than that things have been…good.
For instance:

1. Yesterday I called the Fancy RE’s clinic to see whether the H&IBOML had faxed them my records, as requested. The receptionist didn’t see them in my file.
“But let me check today’s mail and the fax machine, just in case.”
I started to assure her that such strenuousness wasn’t necessary, but she was gone. And then she was back—no records.
“That’s O.K. I’ll just call my clinic again,” I said, trying to keep the weariness out of my voice. When I first called the H&IBOML’s office to request the transfer of my records, you would have thought I was asking them to hand-transcribe my lab and ultrasound reports by the light of a flickering candle before walking barefoot across the city to deliver them to the Fancy RE.
I was not looking forward to repeating that conversation.
“Oh, I can call your clinic for you,” said the Fancy RE’s receptionist.
Then, of her own volition, she checked to make sure my new patient packet had been mailed, and assured me I would have it before Wednesday.
Throughout the phone call, she called me by my name—clearly indicating that she, in fact, knew what my name was. Also, she never once gave the impression that the time she was spending speaking to me was time that she would rather spend mucking out the stalls at a state fair. It was a heady, if disorienting, experience.

2. The Nearly Fiance has had a somewhat dramatic change of heart. Or, rather, it was revealed that his not-readiness, which I had taken to be the same vague not readiness that started after my last miscarriage, is actually a tied-to-very-specific-financial-and-career-related-contingencies-not-readiness. Apart from said contingencies, he is ready (as ready as you can ever be to go from childlessness to…not childlessness) whenever.
So as soon as he finds a teaching job and finishes the first draft of the book, we are Go.
Hopefully this will enable us to get a few cycles in before my MFA, while I am still at this job with insurance that covers fertility treatments (well…the first $5,000 of fertility treatments). During Serious Talk Saturday The Nearly stated that he wants children, whatever it takes to bring them to us. IVF, adoption–he will forge ahead with me whether it takes only one medicated IUI or…not.
I know it is an easy thing for him to say now—there is no way to anticipate how grueling things could be and what it may take out of us–but I needed to hear that from him. The result has been that for the first time, I was able to greet the virtual nursery that is Target on a Sunday afternoon with something like equanimity.

3. I have finally, finally been able to pay off some bills that have been staring me in the face, whispering in Peter Lorre voices “Pay us, or you will raise your children…IN DEBTORS PREE-SON!” The spectre of financial ruin (and accompanying self-loathing) that hovered over me during my freelance years (but doesn’t my double major in philosophy and creative non-fiction put me in high demand? you ask…) is receding, and I am starting to feel almost…secure. Or as financially secure as someone whose primary skill is comma usage can feel.

So, my precious, luscious Internets…
My bloated left ovary with its cysty “string of pearls” may fill me with foreboding by its resemblance to Barbara Bush, but things are looking up, at last.

Comments (2)

Miss Scarlet, In The Doctor’s Lounge, With The DildoCam.

I know there is probably no Blogger-Blog Reader privilege, and even if there were you would have to report anything you heard that indicated a crime was about to be committed, but I am going to tell you this anyway:

I am going to kill The Special GYN.

Although—wait, I am not calling her that anymore. She was originally christened Special GYN after my last doctor referred me to my current clinic for the Laparoscopy That Never Was. I asked my doctor if there was anyone Special I should see, and she recommended The Special GYN. After yesterday, I have decided to rechristen her the Hateful & Incompetent Bane Of My Loins. I am breathing heavily with rage even typing her new name—which is why, my chickens, I didn’t update you yesterday. Between the sobbing and the throwing things and the drinking and the babbling of curse words and the planning of GYNicide, I simply couldn’t find the time or inclination to sit down before my computer and write a coherent account of my appointment.

The wanding was the highlight of my day. If that sentence filled you with shock and foreboding, well, it should have. I showed up with a mostly empty bladder, which they tried to work with for about 15 minutes before sending me to drink cups and cups of water. They seemed hell-bent on doing the transabdominal first. However, the tiny young girl wielding the wand was very considerate, and her kind, unpressuring demeanor actually relaxed my bladder enough that I was able to partially empty it (one.drop.at.a.time) before the transvaginal. My half empty (half-full, for you optimists) bladder necessitated much more wanding than I would have liked (55 minutes) but you can’t have everything, you know.
I was told that my uterus is “Very Curvy” (vavavavoom!) and leans to the side, and that my left ovary is “Quite Long.” This is all the wand wielder was permitted to say. What I saw for myself was that my left ovary is HUGE and rimmed with rows of cysts. It looked so much like the online pictures of polycystic ovaries, with their classy “string of pearls” cyst formation that I had to blink as fast as I could to keep from crying. It was day 15 of my cycle, there were more cysts than I had the strength to count, and they were all roughly the same size. I didn’t see my right ovary clearly because at that point I hadn’t yet gotten up the courage to ask the wand wielder to turn the screen towards me. What little I managed to see by stretching my neck looked blurry, not as dramatic and instantly recognizable as my left.

Later, in the office of the Hateful & Incompetent Bane Of My Loins, the H&IBOML bustled in and informed me that my lab results weren’t back yet.
“But…Nurse Parrot already gave them to me, over the phone.”
“Well, they’re not in the computer, and I can’t explain them to you if I don’t know what they are.”
Here is where I made my first mistake.
“Well,” I said, sheepishly, “I actually happen to remember them, if that helps.”
The H&IBOML stared at me.
“You’re kidding,” she said.
“No,” I said sheepishly, and started rattling off my results, with reference ranges.
The H&INBOML looked horrified, and scuttled out of the room. Twenty minutes later, she returned with a printout of my lab results, and sat across from me flipping through them. It was obvious she was seeing them for the first time. She ran down the list, reading each result followed by the phrase “So that’s normal.”
I let this go for the first few, but when she got to “Fasting insulin was 15.4, so that’s normal,” I spoke up.
“Um, actually, and of course I am not a doctor or anything, but other people I have talked to, and the research I have done, all seem to say that my fasting insulin indicates insulin resistance.”
She looks at me blankly.
“…Apparently anything over 10 means there may be some insulin resistance, and over 13 is strongly indicative of insulin resistance.”
The H&IBOML makes an exasperated noise.
“Well, I don’t know about that, all I have are the reference ranges the lab gives me.”
I asked if it wasn’t true that those reference ranges were meant to screen for tumors and such, rather than the subtler hormonal imbalances of endocrine disorders. She looked at me as though I had asked if it wasn’t true that hamsters running inside the earth are what cause it to spin on its axis.
“I’ve never heard that before,” she said.
When she pronounced my free testosterone normal, I asked if it wasn’t supposed to be under 3.6.
“Yours is 1.4,” she said
“Um…I think that is my percentage of free testosterone. My actual free testosterone was 4.4.”
She looks at her notes.
“Yes,” she says “4.4, which is fine.”
“Oh.”
“If your testosterone were high you’d have hair sprouting out everywhere.”
“Ah.”
Eventually she got to my LH/FSH ratio, which even she pronounced “High.”
“It’s less than two, which is good, but still higher than it should be.”
“Isn’t it over two?” I asked politely.
She looked annoyed, and said:
“9.4 divided by 4.5 is–”
“–2.1” I finished, through gritted teeth.
“Oh, I guess so.”
She told me that my ultrasound was very characteristic of PCOS, with multiple cysts. When I asked for more detail, she said “It doesn’t really matter.”
Then she told me she would like to put me on birth control pills, which will “Freeze my fertility in time.”
I asked What About Migraines?
“We’ll have to see. Hopefully you won’t get any.”
I asked about Metformin, and she looked at me like ‘Excuse me, I am a Licensed Twatologist, who are you?’ and said she thought the birth control pills would be fine “For Now,” and when I decide to start trying I should endeavor to get pregnant my first month off the pill, (Oh, O.K.!) because that would be my best chance for ovulation.
I asked the H&IBOML about miscarriage risks and she sighed and said:
“There is absolutely no reason to think that you will miscarry again just because you have before.”
…Except the greater than 50% PCOS miscarriage rate that is increased by previous losses.
The Hateful & Incompetent Bane Of My Loins ended by telling me she still didn’t know what to do about my pelvic pain (the reason I saw her in the first place) because the PCOS “Wouldn’t be causing any pain.”
I think this is when my eyes started tearing up. The H&IBOML looked at me incredulously and said:
“Are you going to cry?”
I reached for a tissue and she said, annoyed:
“What are you crying about?”
I should have said “I am crying because you are an ugly, stupid cunt and the money you wasted on medical school could have saved dozens of starving children,” but I didn’t.
“Look,” said the H&IBOML, “I am giving you my opinion, I thought that is why you came to see me in the first place. Do you want me to write you a birth control prescription or not?”

In my car, in the parking ramp, I checked to make sure my windows were tightly rolled up and there was no one around before I screamed. I grabbed things out of my purse and flung them at the dashboard. Then I picked everything back up, smoothed my hair, and drove out of the ramp, smiling at the parking attendant and chirping at her to Have A Nice Afternoon!
I held myself together until I got into my apartment, when I started sobbing and choking and crumpled onto the floor in front of the doorway curling myself as tightly as possible into the corner. The Nearly rushed over to put his arms around me and ask what had happened, but all I could say was “I hate her I hate her I hate her.”

And so I called the Fancy RE’s clinic, and then the H&IBOML to have my records transferred, and now am waiting for the Fancy RE to send me my intake paperwork.

Yesterday evening, at a bookstore, I found a book on insulin resistance. In the diagnosis section, it recommended having a fasting glucose and insulin level drawn. Fasting insulin levels over 10, it said, are indicative of insulin resistance. Perhaps I will photocopy the page, highlight that paragraph, and send it to the H&IBOML along with a tersely worded note:

Dear Hateful & Incompetent Bane Of My Loins,

Please refer to highlighted portion.

Suck my cock,
Alexa

Comments (7)

The Cowboy Died.

Total Testosterone: 32
Normal! Elevated would be around 50! Secretly, when the nurse tells me this, I am not surprised. As ridiculous as it is, I kept thinking If I have high Testosterone levels, wouldn’t I have been better at Gym?
Then I got the rest of my numbers…

Free! Testosterone: 4.4
(% Free! Testosterone: 1.4)
The reference range for Free! Testosterone is .7-3.6. The only place Google found levels like mine were in messages from MEN who were concerned about their high free testosterone levels.
But then my percentage of free testosterone is in the low normal range…for an adult male.

I interrupted the chirpy nurse’s assertions that “Everything looks good!” (perhaps she is not a nurse at all but actually a parrot/myna bird or similar? “Free testosterone 4.4! SQUAWK! Everything Looks Good!”) to say “Look, based on my bloodwork, it seems obvious that the next step is going to be an ovarian ultrasound. I have an 11:15 appointment with The Special GYN tomorrow—can we just go ahead and schedule an ultrasound for tomorrow afternoon, since I’ve already taken the afternoon off work?”
Nurse Parrot lapsed into a shocked silence and then murmured that she would check with The Special GYN, but I would probably have to “Actually see the doctor” first (Ooh, Snap!). She hung up, no doubt wondering just who I think I am, getting stroppy with her and ordering my own ultrasounds. It must be all that testosterone!

20 minutes later, Nurse Parrot called me back to say I have an ultrasound scheduled for 9:45 a.m. (which—correct me if I’m wrong–is not actually in the afternoon, as requested, and will necessitate me taking most of the morning off work as well.).
Now, here is why I need your help, Internets—and I need it before tomorrow morning:
My bladder possesses a level of shyness bordering on Social Anxiety Disorder—I have never been able, with any regularity, to provide samples for Doctor’s appointments, and almost didn’t get a job with my current company because of the pre-employment drug screening (which requires you to provide a urine sample within 90 seconds–in order to prevent prospective employees having time enough to substitute/doctor their pee samples. It took me five tries to do this, and after my 3rd failed attempt I left a message on the voicemail of the company’s human resources representative saying sarcastically that I hadn’t realized the ability to urinate on demand was so highly prized in a member of their editorial team).

The point of all this is that Nurse Parrot has instructed me to come with a full bladder tomorrow—they wish to do a regular transabdominal scan, followed by a transvaginal as necessary. I will be instructed to empty my bladder at the clinic prior to the transvaginal scan.
This is not a possibility. It is just not—I have been in this situation before, when pregnant. Despite needing to urinate so badly I was in physical pain, I could not empty my bladder. I ran water, I thought of lakes, streams, waterfalls—finally the WandMonkey stood outside the bathroom door and reminded me that she had other appointments, and I emerged, defeated. She was subsequently unable to locate my ovaries because my full bladder was “in the way.”
So, tomorrow’s Dildocam operator is going to be mad at me, one way or another.
But which would be preferable?:

A. Go to appointment with full bladder, as instructed, enabling WandMonkey to do only a transabdominal (and less effective, I imagine) scan
B. Defy instructions and risk infuriating WandMonkey by appearing with empty bladder, rendering transabdominal scan impossible but allowing clear view of ovaries through transvaginal scan

I am leaning towards the latter, but could use some advice. But do not underestimate the reticence of my bladder by suggesting ways to trick it into performing. It is too wily for that, I assure you.

On an entirely unrelated note, did anyone see America’s Next Top Model last night? I found it quite instructional that the girl who was eliminated was cut despite being obviously one of the most attractive contestants. It did not escape my notice that on two separate occasions she appeared before the judges wearing a peasant skirt (on another occasion she wore those horrible “Gauchos”—short widely flared pants that look as though they were stolen from a tiny, tiny sailor). While her peasant skirtedness was not mentioned by the judges as a reason for her elimination, I cannot help but find it significant that none of the less attractive girls who were spared were dressed like witchy fortune-tellers. Let this be a lesson to us all.

Comments (5)

LH Ain’t Nothing But A Number.

For those of you playing along at home, here is the annotated version of yesterday’s laboratory results:

FSH: 4.5“Splendid!” says Dr. Google in his deep, authoritative voice, “Anything below 6 is excellent.”
LH: 9.4—Dr. Google shifts uncomfortably in his chair. “As you see here, I prefer an LH below 7. In addition…well, your LH is more than twice your FSH, giving you a LH/FSH ratio of 2.1/1 .” He sighs, “My colleagues and I agree that a ratio of about 1 is normal. Your elevated LH and high LH/FSH ratio are quite suggestive of PCOS.”
TSH: 2.12—The good Doctor gives a brisk nod. “Mid-level normal is 1.7, and we like to see something below 3—your number seems well within the acceptable range.”
DHEAS: 246—A small furrow appears in Dr. Google’s brow. “Women with PCOS generally have DHEAS levels above 200. Elevated androgens such as DHEAS are a characteristic of women with the syndrome.” He brightens. “Happily, your levels are not above the reference range, which means we can rule out adrenal tumors!!!”
Prolactin: 9.1—Dr. Google gazes fondly at my Prolactin result. “It’s beautiful,” he says in a hushed voice, “Just beautiful.”
17 OHP(hydroxyprogesterone): 88“I hate to repeat myself, but remember what I said about androgen levels in the higher ranges being indicative of PCOS? This is in the higher ranges.”
Fasting Glucose: 80“This level seems perfectly normal to me,” Dr. Google says, shrugging, “A few of my colleagues may find it a little low, but you can’t please all of the Internets all of the time.”
Fasting Insulin: 15.4—Dr. Google looks disappointed, and I hang my head. “With such a lovely, low glucose number, I guess I expected something different,” he says, reproachfully. He leaves the room. On my chart, he has written: “A fasting insulin of 10-13 generally indicates some insulin resistance, and levels above 13 indicate greater insulin resistance.”

So there you have it. Thanks to all who commented and emailed, especially Cass, reluctant monarch of all things Polycystic and Ovarian. After reading her comment I called my clinic back to ask Wherefore My Testosterone, anyway? and was told that it is still Pending, but should be ready Thursday. Apparently it is like the old rabbit-killing pregnancy tests—they inject a Cowboy with my blood and then split him open to examine his testes. Or something. Anyway, it takes a long time.

Other Monday Night Highlights:

I made the mistake of telling my mother and brother about the results.

My brother’s reaction was to make a noise of impatience and say “At least you don’t have Cancer, or something.” (Though if I did, I would doubtless be treated to the same dismissive eye rolling and something like: “Only stage 2? At least it isn’t stage 4. I don’t know what you’re so upset about.”)

My mother urged me to remember the power of Positive Thinking, and reminded me that I was Not A Doctor. And that the Internet Isn’t Reliable. I reminded her that the act of transferring information into an electronic format does not, in matter of fact, actually alter said information–A laboratory reference range is not “unreliable” simply by virtue of being on a screen rather than in a printed abstract.

After listening to my explanation of PCOS, she asked if it was genetic, and I said it might be, and she nodded in a satisfied way. “I probably had that too, before,” she said, characteristically.

The Nearly Fiance returned from a weekend trip and I hadn’t cleaned the apartment like I said I would, and Something Always Seems to be Wrong With Me, and unfortunately by the end of the evening I was sobbing into a glass of straight gin (but with an olive, to give the illusion of it being a proper drink).

Eventually the night took a turn for the better, when if was time for me to go to bed and I got to lay still in the dark and have The Nearly pet my hair and murmur things, but well, some of the spring seems to have gone from my step today, if you know what I mean.

Comments (3)

The Results Are In…

I do not meet with The Special Gyn until Friday, but I couldn’t wait anymore and called the clinic this morning. The nurse I spoke to chirped “Everything looks Normal!” and would have ended the conversation there if I had not asked, though clenched and grinding teeth, for the Actual Numbers, rather than a breezy and vague assessment. So she read them to me, and, correct me if I’m wrong, but They Do Not Either Look “Normal.”
{I have been off the progestin-only pills since last cycle in preparation for these tests, so no effect on the results from those.}

On Day 5:

FSH: 4.5
LH: 9.4
TSH 2.12
DHEAS: 246
Prolactin: 9.1
17 OHP(hydroxyprogesterone): 88
Fasting Glucose: 80
Fasting Insulin: 15.4

So, fellow graduates of Google U…what’s your diagnosis?

Comments (3)

Seeing Stars, and Reaching for Them.

You know how losing consciousness in a popular retail clothing establishment just before an unexpected meeting with a high school classmate can make you take a long, hard look at your life?
You don’t?
Well, maybe I’d better start from the beginning….
I have bouts of hypoglycemia at the most inconvenient junctures. [The first time I spent the night with a man, he did not awake to see me draped seductively with a sheet and sleeping, my delicate features suffused with a roseate glow, but instead found me ashen-faced and curled at the foot of the bed gumming at a Glucose Tablet.] My most recent attack was precipitated by my own foolishness, namely eating a bagel for breakfast at 8:30 and then neglecting to have lunch by noon.
I was in the dressing room of a well-known clothing chain, let’s call it Kumquat Dictatorship, trying on dresses for an upcoming wedding. Pulling something unflattering off over my head, I noticed I was shaking and weak-fingered, my normally pallid chest flushed and sweaty. Gracious, I thought, Is it hot in here all of a sudden, or is it just—WHOMP! (sound of head hitting dressing room door as I crumple groundward).
Some moments later, I staggered to my feet, both alarmed and relieved that my temporary loss of consciousness had gone unnoticed by Persimmon Ogliarchy’s dressing room attendants. I mopped the dampness from my now corpse-like face and struggled into my street clothes. Too weak to contemplate the fastening of my bra, I shoved it in my purse. A brief inventory:

Eyes: Glassy
Lips: Dry; Cracked
Hair: Disheveled; Smooshed on one side
Face: Unmadeup; Corpse-like (see above)
Nipples: Evident

I burst out of the dressing room and directly into a former classmate who shall remain unnamed (largely because I have forgotten what her name was). She is one half of a set of twins I went to daycare with for years and years* We were acquaintances throughout junior high and high school as well, though not close ones, due to the rarity with which I appeared on school property. There, outside the dressing room, she is wearing a Nectarine Police-State nametag and offers to take the clothes from my arms. You do not recognize me, I command her silently, You will let me pass.
“Alexa?”
“Oh! Hi!”
Is She Twin X or Twin Y? I remember that one of the twins had a mole on her cheek. There it was! Left cheek, near the lip. Regrettably, I do not remember which twin was be-moled.
“So, how are you, Ms. Peterson,” I say, hoping I sounded coy and not merely ignorant of her first name.
She is fine. She is a lawyer and only working at Grape Autocracy temporarily, as she has just returned from working with a prestigious human rights group in Korea, and is deciding where to go next.
“Do you remember my sister?” she asks.
I assure her I do.
“Well, she’s in the Peace Corps in Madagascar!”
I murmur my appreciation.
“So,” the Mystery Twin asks brightly, “What are you doing back here?” She eyes my nipples and her gaze travels to the still trembling fingers at my clammy throat, “I thought you went away to college in New York!”
I mumble something about Sarah Mawr, the high cost of living in Manhattan, how, actually, I really like it here, now, less competitive, more time for writing, etc. etc. etc.
“Have you written anything I might have read?”

By the time I extricate myself and reach my car I am feeling panicky and unfulfilled. Why am I not in the Peace Corps in Madagascar? Why am I not at least writing, now that I have been freed from the economical constraints of the pursuit of New York real estate? What am I doing, anyway? Whatever will become of me?

The upshot of my hypoglycemia-induced epiphany is that I have decided to recommence the collecting of rejection letters.
I will submit! (sounds like I should be cowering naked at the feet of a whip-wielding dominatrix, doesn’t it?)
I have, in the past, had a habit of sending pieces of my writing to publications I am certain will not accept them. This began after the first time I submitted my work—to my shock, the essay was accepted immediately, but I was so dismayed by the quality, or lack thereof, of said essay that I kept my publication a secret. From then on I only sent things to The New Yorker and similarly unlikely venues–the theory (a bit unsound, obviously) being that at least the humiliating prospect of rejection is tempered by the relief of knowing my writing will never be subjected to the cold, cruel light of print.
But no more.
If I can’t be beatified in the minds of hungry Madagascarian children, at least I can make an effort to write something of which I am not ashamed (i.e. something that Miss Rothschild will not mercilessly ridicule) and send it to an appropriate journal for publication.

Watch This Space for the hijinks that are sure to ensue! By which I mean, of course, many drunken blog entries rife with dire and self-pitying speculation about the viability of my hopes, dreams, etc.
So, nothing new.

*[From the time I was 4 until I was nearly 13, I went to daycare at six in the morning, Monday through Friday—during the school year I walked to my classroom from daycare at the appropriate time and returned to the center in the afternoon, to be collected by my mother at six in the evening. During the summer it was 12 stultifying hours in a row. The daycare center I was enrolled in was called, unimaginatively, but with a terrible accuracy, “Extended Day.” Obviously their marketing department had been affected adversely by Reagan-Era lay-offs.]

Comments (3)

Oh, Help.

So, I had my consult with The Special GYN yesterday. After it was over, I managed to contain my fury at the uselessness of it all only by telling myself that I could have my real consult with you Internets when I got home—because you’re all licensed medical professionals, right?
First though, a word about the waiting room. I was prepared for the rows of pregnant women rubbing their bellies as if expecting genies to float suddenly from their uteri, but not for this:
Pregnant: (One hand rubbing belly, one hand holding squirming toddler/baby) I don’t know how you do it…
Other Woman: (One hand hushing crying newborn, one hand holding squirming toddler/baby) Hahaha! Some days are better than others…
Pregnant: Did you plan to have them so close together?
Other Woman: Hahaha! Well, I’m Irish…

Excuse me? I’m Swiss, so why aren’t my cycles more like clockwork? I have yet to see a mechanical bird come shooting out of my vagina at precisely timed intervals to tell me when I’m ovulating. But never mind all that.

I waited in the exam room for the doctor for what seemed like at least an entire menstrual cycle but was actually 35 minutes, by which time I had:
1. Gone over my notes
2. Taken off my gown and put it on again with the opening in the back
3. Rifled through all the file folders containing instructions/information about various procedures, and read their contents
4. Written part of a song about gynecological exams to the tune of “It’s only a Paper Moon,” that started “Its only a Paper Gown
5. Taken off my gown and put it on again with the opening in the front

I hope to Jesus they don’t have cameras in those rooms. When the doctor arrived I flipped through my notebook, cleared my throat, and gave her everything I had–A reproductive history in bullet points, a list of tests I thought might be useful, questions I hoped to have answered, etc. When I finished I gave her a moment to catch up with her frantic note-taking.
“Wow,” she said finally, “You’re really organized.”
I hopped onto the table and she did a lightning-speed pelvic. Just before it was over, she asked, “Do you think you could tolerate a finger in your rectum?” and as I was mulling over my answer to this delicate question, OH! Gracious! There it was.
She snapped off her gloves and I sat up flustered, wondering if I’d at least get flowers the next day.

“Your exam does not impress me as indicative of a woman riddled with endometriosis.”
Ok…good, right?
“I see a couple of women like you in here every month…”
Less good…
“…And I think you produce an excess of prostaglandins.”
I jumped in.
“Yes, I figured I probably did…isn’t that one of the effects of Endometriosis?”
Flip of hand.
“Like I said, I see at least two women exactly like you every month, and when I do the Lap, I find something in 50% of cases. So we can do the surgery, if you want it, but there is only a 50% chance of finding anything. I think you have primary dysmennorhea. But I would be happy to do the Lap if you want to have one done.”
“Well, if you don’t think…”
“The sudden weight gain suggests other possibilities.”
“I’m not hairy.”
“I see you know where I’m going with this.”
“You’re thinking PCOS.”
“Yes, although you don’t impress me as a PCOS patient either–as you said, you aren’t hirsute.”
What do I have to do to impress this woman? I am exceedingly blond, and ethnicity plays a large part in hirsutism with PCOS—for instance, Asian PCOS patients are almost never hirsute.
“If it is PCOS, we can put you on continuous birth control pills and take you off them the month before you want to get pregnant, which would increase your fertility.”
….And my migraines…
“So, if I don’t have PCOS, and it’s just the prostaglandins…how would you explain the anovulation?”
“Oh…(actually scratches head) “Good question…I don’t know.”
“And the fact that I have miscarried both of my pregnancies?”
“Just Bad Luck, maybe.”
Too bad I’m not Irish like the woman in the waiting room. I hear they’re very lucky.

So I went in this morning after fasting to have the following tests:
FSH, Glucose, Insulin, LH, Prolactin, Rubella, TSH, Testosterone, DHEAS, 17OHP

Apparently the results won’t be in for 10 days—does that seem long to anyone else?
Also, Special GYN had no explanation for the phenomenon I noticed while I was charting wherein I would get positive opks around days 15 and 26, separated by negative opks, and each followed a few days later by a modest temp rise. After four or five days my temp would go back down, and when this happened the second time, my cycle ended.

Now, I want to stress that The Special GYN was very polite and listened to my long spiel at the beginning, taking notes and asking questions–she wasn’t evil, or unconcerned. Maybe I don’t have endometriosis. Maybe there is nothing wrong with me at all, except for the horrible luck of the Swiss. But I was hoping for something more definitive. And she has left the lap decision completely up to me, and of course I don’t want to have one, so if she doesn’t think it’s likely to find anything…I don’t know what to do. I agree with her about the prostaglandins—they could explain the pain, and possibly the miscarriages. But what would be causing the elevated prostaglandins? For treatment of the excess prostaglandins, she suggested Advil during my period. Well, I get pain all sorts of times, not just during my period, and Advil doesn’t touch it, so…I wasn’t “impressed” with her, on that one. In addition, for the past three days I have been having very sharp pains in my left ovary, which is unusual for me. The Special GYN wrote “cyst?” in her notes when I told her about it, and then said it was “probably nothing.”
And what about the anovulation?
I am beginning to think it would be faster for me to go to medical school in order to treat myself.

Comments (4)

Saturday Mornings: Pro or Con?

Pro:

Everything Bagels
Iced Coffee, Black

Con:

Busy Quarry that has taken up residence between my temples

According to the man at the bagel shop, “Iced Coffee Season is Over.”
Of course his acute sense of temporal appropriateness did not deter him from wearing a tie (circa 1987) cleverly made to look like a piano, but ah well. Consistency is a hobgoblin, or something.

The fact that I am writing this post in my office, surrounded by stacks of final pages for The Code of Criminal Procedure while outside attractive, non-hungover couples gambol in parks with shiny-coated golden retrievers.

Comments (2)

Miserable and Boring Post.

Hello Internets, I am not doing so well.
A friend wrote to tell me she is unexpectedly pregnant, a friend who has struggled with infertility herself, and though I have tried to write her a congratulatory email in response, all I have managed to do so far is sneak off to the bathroom at work three times to cry as quietly as I can in the stall furthest from the door. Today is Cycle Day One. Apparently the lovely Ms. Pru is right—all I need do is blog about its absence, and my period will come. Sort of like in college, when we discovered that if you are waiting for a train to show up, the fastest way to make it materialize is to light a fresh cigarette. I suppose I should be grateful that my cycle was only 37 days long, but I’m not. I was purposely preventing pregnancy, so getting my period should not make me feel as though my most cherished hopes have been crushed, but it does. A few weeks ago, the office of The Special GYN rescheduled my appointment from September 1st to next Tuesday, the 13th. I thought that would be fine–my cycles have been so long I probably wouldn’t be ready for Day Three tests before then. But now it looks like Day Three will be Sunday. I called The Special GYN’s office, but they won’t order the tests before my appointment, they said I would just have to wait until next “month.” I called my old doctor, who referred me to The Special GYN in the first place, to see if she could run the Day Three tests, but she doesn’t “do that” and doesn’t work weekends anyway. Oh dear, I am getting all worked up. Time for another bathroom run.

So, where was I?
I thought I was comfortable with the modified plan The Nearly Fiance and I made recently, vague though it was. But I’m not. The Nearly Fiance is not ready to specify when he wants to start trying, and the lack of a timeline makes me jittery and despairing–more than the waiting does. A lot is in flux for him right now—just finished his thesis, is about to start looking for a new job, working on a book, etc. He has also decided not to go for his Ph.D in art history, and is thinking seriously about architecture (not the thing itself, but rather he is considering going to school for that instead of art history). So there is a lot going on, I understand that. But…
After my miscarriage, he suggested we start trying again as soon as I had healed for a few cycles and completed a few projects of my own. A few months after that it got pushed back to 2006. And then he decided he wanted to finish some other things first and wasn’t ready to say when he might be ready. Last night he started talking about two years from now as being on the early side of possible.
A few months ago, at my insistence, The Nearly quit his job to concentrate on his thesis–because all I want for The Nearly is for him to achieve the things that are important to him. I, myself, want two things—to write a book and to raise a child (I also want to teach, and it would be nice to have someone to share my life with, but a book and a child—those are the two things I need to do in order to be a beatific old lady who dies with a murmur of fulfillment). The book will get written, because it is up to me–I have control over the work I do in that pursuit, and control over when I do it. I could wait for a bit, happily, (for the most part) to have children, concentrating on other things, if only we had a plan, but we don’t, and if we did I would probably worry that we would get there only to have The Nearly Fiance change his mind. He keeps saying, rather disingenuously, that if I can’t wait, he will support me leaving him in order to have a child on my own, but of course that isn’t what I want. Yes, my plan at one point was to use donor sperm to have a child by myself, but that was before I met The Nearly, whom I love. I spent most of last night in tears, and it bothers him that I have become so obsessed with matters reproductive, he says the girl he fell in love with wasn’t like that.
And it’s true, I suppose, I have changed. The miscarriage heightened everything for me. And there are moments I have no idea why I want a child so badly—3 years ago I went from “Someday I will have a child” to this weird, deep longing that I don’t understand. I never believed in any sort of “biological clock,” or that maternal desire was a function of biology at all, but I had a huge hormonal shift 3 years ago—my migraines began, I morphed from a 97 pound waif into a 140 pound voluptuous creature. And I started wanting to have children in a way I never expected. And now, the two miscarriages, the exponentially worsening physical pain, my long and irregular cycles, the fact that in all of my combined charting time (admittedly, less than a year) I ovulated only thrice—all of these things combine to make me incredibly nervous (terrified, really) that I have only a short and finite amount of time in which to accomplish what I want, and I am watching it fly quickly away from me. And I feel horribly alone.

P.S. I am sorry I am not my usual witty and scintillating self.

Comments (3)

I Load Sixteen Tons…

It began as an auspicious Thursday. I love my job, really, enough that I bolt lunch at my desk most days and work Saturday mornings. So today, as I parked my car, I felt…peaceful. The Pocket Part is practically ready to ship, the governor is due to sign the called session legislation we need for print, and soon the frenetic production schedule will be slackening. I gave a little sigh of contentment and reached behind the seat for my umbrella.
Hmm. That’s odd.
I dangled my torso into the backseat to look more thoroughly. No umbrella. I looked outside, where the rain was flinging itself dramatically against my windshield.
…Ten long, wet minutes later I entered the lobby elevator, the cuffs of my pants flapping damply against my ankles, my hair formed into cunning, sodden hanks. I exited on my floor and nearly ran into a cabal of pregnant women (well, at least three of them were pregnant) two of whom were wearing peasant skirts (truthfully, one was more of a peasant dress).
It has been downhill from there, unfortunately. Technical mishaps, fluctuating deadlines. If it’s not one thing, it’s a mother, pushing her newborn past the door of my office. I did, however, conjure up the courage to email a fancy RE about possible appointments–Which reminds me:

My upcoming lap consult is with an OBGYN who specializes in laparoscopic surgery—I figured she can run Day 3 tests as well as anyone else and chat with me about anovulation and such. And I sort of thought that an RE wouldn’t want to be bothered by me, as I am not interested in getting pregnant this instant.
But the more I read, the more it seems the best evaluation of my options is likely to come from an RE. Is this correct? Ideally, I would like someone to run a plethora of tests and tell me how long we should wait before we start trying again. I wish someone would say “You have 18 months” or “You must have children now” or “You have all the time in the world.” I know that no one is going to be able to tell me anything that concrete, but it would make things so much less stressful for me (and for The Nearly Fiance) if they could.
Anyway, never mind that. Any thoughts on OBGYNs vs. REs? Am I just desperately trying to postpone my scary appointment? All of this is probably moot, as I am coming up on cycle day 40 and it is looking very unlikely that I will even see Day Three anytime in the near future, but I would appreciate any opinions you lovely Internets might have on the matter.
[EDITED TO SAY: Of course I mean for an initial evaluation, laparoscopy, and discussion of my options. Not for the IUI, etc. when we are ready for them. And the GYN I am referring to does specialize in laparoscopic surgery, remember, but there is no mention of experience with infertility, etc. in her bio.)

Comments (2)

Not Without My Uterus: This Time It’s Personal

{Part One}
{Part Two}

Part Three:

In November of 2004 you become pregnant.
You have morning sickness and cramps every day of your pregnancy, cannot sleep at night, can only eat plain wheat bread, bananas, and strong ginger ale for most of the day.
But you are calm for possibly the first time in your life. The anti-anxiety medicine you have taken before bed since you were 18 is contraindicated during pregnancy,
and when you stop taking it you are ready for horrible, shuddering waves of terror, but they never come. You are doing something important, constructing a tiny spine and necessary organs; you have better things to do than nervously analyze the contents of your own skull.
However, when your morning sickness abates slightly, your anxiety creeps back. Your midwife reminds you that she put you on ginger capsules and vitamin B to cause your morning sickness to abate. You dismiss this as irrelevant and get a second opinion from Dr. Google. When you call your midwife, panicking, she says you read too much. You request an ultrasound.
There is no heartbeat, and the gestational sac seems to be collapsing.
Your HCG levels have fallen from 1244 to 1230.
You miscarry two days later on New Years Day.
Happy 2005!

You do not leave your house or talk to anyone besides The Nearly Fiance for two months. You are heartbroken, and ashamed that you were foolish enough to be so dangerously happy. You are sure everyone pities you, and cannot bear that.
When your period returns no one will take the risk of putting you on estrogen, what with your severe migraines, and so you are put on a progestin-only minipill. The pain and lengthening cycles return—when you collapse with cramps The Nearly Fiancé wants to take you to the emergency room but instead you do some Yoga breathing exercises and drink gin. Your cycles are 31, 35, then 47 days long. You do some research, find a doctor, a specialist, schedule a laparoscopy consult. You begin reading blogs, and start one of your own. You write a long and tediously self-involved account of your suffering, which you call “Not Without My Uterus.” It seems the least you can do. After all, without the stories of other Internets, like her, and her, and her, you would probably still be sitting on the couch in your housepants, gnawing on a block of cheese and watching Law and Order reruns through a thin film of mascara and tears.

The End.

Comments (1)

Not Without My Uterus: The College Years

{Part One}

Part Two:

On your second night in at Sarah Mawr you go to bed feeling unwell. When you awake soaked in blood you think for one confused moment that you have been hit by a stray bullet shot from a gun in nearby Yonkers.
Alas, it is only the first period of your college career. Luckily, you are in a unique pain-management position. The only holiday celebrated with anything resembling religiosity at Sarah Mawr is 4/20 (no one attends classes on that day, speakers placed on the steps of the administration building facing the courtyard issue forth the voice of Peter Tosh singing ‘Legalize It,’ etc.) and, as it turns out, nothing more effectively relieves the pain of menstrual cramps than large quantities of marijuana. In this way, the next couple of years pass with nary a protest from your beleaguered and (clinically) “irritable” uterus.
Now you are, oh, twenty one. You are out of school and have returned to more traditional analgesics for pain relief. (While at Sarah Mawr, you found that cannabis intake impaired your ability to accomplish much of value. The ability to make collages and write limericks is not much prized in the working world, after all.)
You have just been broken up with a man you dated for an embarrassingly short span of time. Your period is late—which could mean anything, really, but you take a pregnancy test that your roommate has in the glove compartment of her car and it is positive.
Oh, hell.
Afraid to actually say the word “abortion” your roommate keeps asking “What are you going to do with it?”
“I’m thinking of trading it for the ability to spin straw into gold,” you say. Wondering if the test could have been defective, you buy another a few days later and it is negative. Whew! Obviously the first test was a mistake! (Looking back later you will sigh for a time when you had never heard of a chemical pregnancy, and thought “beta” was merely a sort of VCR.) Your period shows up 12 days late with unusual violence. You see a gynecologist, who says airily that it was probably a miscarriage. You never told the man you were dating that you might be pregnant, as the positive test came less than 48 hours after he dumped you, and it seems foolish to tell him now. You don’t say anything about it, and more or less never speak to him again.
You notice that whenever you have an orgasm the contractions turn into cramps turn into spotting. You have a period that lasts for twenty-two days and drives you back to the gynecologist, furious with pain, for more birth control pills, this time to be taken continuously. For the first time you venture to ask whether there isn’t anything else they can do about Endometriosis.
“Technically,” says the doctor, “we can’t even be sure that is what you have, as it can only be diagnosed via laparoscopy.”
Hmm…Should you have one of those, then?
“It’s up to you,” says the doctor, “We can’t really do anything more to treat it than we’re doing now, so it wouldn’t serve much purpose except to tell us for sure that yup, you have endometriosis.” You think this is the most ridiculous thing you have ever heard, and say so. The doctor shrugs. You make a phone call and discover your bare-bones insurance doesn’t cover the procedure, and so decline the laparoscopy.

During the next several years:
• You start having migraines and are switched from pill to pill in an attempt to find one with enough estrogen to suppress your symptoms but not enough to give you a stroke.
• You discover Dr. Google.
• You start thinking about having children by yourself, with donor sperm.
• You learn, during a brief flirtation with charting, that you only occasionally ovulate.
• You meet, and almost immediately move in with, The Nearly Fiance.

Stay tuned for Part 3–Not Without My Uterus: This Time It’s Personal

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Not Without My Uterus: A Very Special Episode

[As a student at Sarah Mawr, I once had the great misfortune of sitting through a film that consisted entirely of shots of the student filmmaker’s vagina. I found it just slightly less than not at all compelling, and so I will understand if the prospect of reading the history of my uterine failings does not fill you with glee. I assure you that I will not be offended if you choose to skip this and similar entries.]

On most infertility-related blogs there comes a time, usually in the first few entries, when the author takes us through a summary of her reproductive woes. This is useful in providing some context for future rants about doctors, cycles, etc.—it gives readers a jumping off point, a way to connect present fury with past disappointments, present symptoms with past diagnoses. The following is my attempt to do that.

Part One:

On the Sunday morning you first get your period, you fail to recognize it as such, and instead are certain that you face an imminent and perhaps painful death. Despite being the correct age to begin menstruation (one month from your 14th birthday), despite being perhaps the last of your friends to do so, you see the blood on the crotch of your underpants and think “Well, this is it then. I am hemorrhaging.” You go about your day tearful and gloomy, afraid to tell anyone what is happening, mostly due to a fear that the hemorrhage is some rare side effect of masturbation. Eventually you break down and confess to your mother in a studiously calm, now-don’t-get-hysterical voice, that there is something wrong with you, Down There. You are bleeding.
“It might not be anything serious,” you say, “But I thought I should tell someone.” Your mother looks like she doesn’t know whether to laugh or slap you in exasperation.

For the next year you are visited monthly by a force so cruel and unrelenting you cannot help but personify it. A full week of heavy bleeding, and cramps like someone is putting your most sensitive parts through an old-fashioned clothes-ringer. You miss two days of school each month and ruin countless sets of sheets and articles of clothing. During the week of your period, you sometimes faint in the mornings and most afternoons you spend on a cot in a dark crevice of the school nurse’s office, a heating pad over your lower half. You take Advil by the threes and fours, and develop an ulcer. You assemble a collection of hot water bottles more appropriate to a woman 5 times your age. The pain is worse every month, and you wonder why none of your friends seem to notice it. Probably you are weak and overdramatic. Tampon commercials astonish you—as if anything short of a horse tranquilizer could induce you to play beach volleyball during your period! At home, your mother visits you where you lay upstairs with your legs elevated and lets you sip a bit of her Martini through a straw, For The Pain. One Saturday you are at a friend’s house when you collapse in the bathroom and come to trembling in a pool of your own blood. Your friend finds you incoherent, babbling at her to please kill me, please, I cannot stand it for one more—and then you black out again. None of the adults in your life are perturbed by any of this.

The summer before high school you develop severe morning sickness. Every morning, like sinister, gastrointestinal clockwork, you retch until your throat is sore. You lose 5 pounds, which may not have been so bad, except you were only 85 pounds to begin with. Finally, you are taken to a doctor, where you vomit in the waiting room and faint after giving blood. The doctor asks if you could be pregnant. (You have not so much as kissed a boy, and this seems mournfully unlikely). You assure the doctor you are not. He has your mother leave the room and asks again. You laugh, bitterly, and say “I highly doubt it.” He sighs and orders a pregnancy test.
The test is negative, and the doctor throws up his hands, reminds you that there is still much we don’t understand about the human body. Probably it is hormones, an excess of estrogen. The morning sickness goes away on its own three months later, but the cramps become worse, and have become power hungry—no longer content to confine themselves to the week of your period and the few days before, they spread to the rest of the month as well, until you are missing as much school as you are attending. You go back to the doctor and have several excruciating pelvic exams before being diagnosed with endometriosis. You are put on birth control pills, which help but cause the morning sickness to return for a week, validating the doctor’s guess about estrogen causing your illness the summer before. This is probably the last time your doctor will be right about anything.

Over the next few years, the pill manages things pretty well—there is still pain, but no fainting spells, and you are missing only 2 days of school per month. You go off the pill for a year and a half and have only 3 periods. The pain of the last one is so dreadful you go straight back on. Six months later you go off again, have 3 periods in nine months, and then 3 in six weeks. When you have a week of excruciating one-sided pain your senior year of high school, you deal with it on your own with vast quantities of Aleve. You dismiss it as probably menstrual, and do not see a doctor. The fact that you are able to dismiss pain that causes you to double over at your job as a soda jerk and collapse under the ice cream counter, all because it is “probably menstrual” should perhaps be a red flag, but isn’t. Eventually you end up in the ER diagnosed with a kidney stone, and are given Percocet by a young doctor who is astonished by your pain threshold,
Oh now, you say bashfully. It’s nothing.

Stay tuned for Part TwoNot Without My Uterus: The College Years

Comments (1)
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