xmlns:og='http://ogp.me/ns#'> Hesseology 101: October 2010

Friday, October 22, 2010

Waiting gracefully

I got a little hyperlink-happy in my last post, so this time, I'll restrain myself and only include one: the Facebook page for GracefulWait, the infertility and infant loss support group Colin and I are helping launch at our church.

God began leading us in this direction earlier this year when we attended an adoption informational seminar offered by Bethany Christian Services. A couple shared their story about how God blessed them with a daughter and son through adoption and explained how they formed and infertility support group at their church while waiting to be selected by the birthmothers. The group started out small and over time grew into a large community-wide ministry, far bigger than they had initially expected. Leading this group not only helped them pass the time waiting for their children, it also gave them the opportunity to comfort and enjoy fellowship with those who were experiencing the same struggles.

Hearing this couple describe how God used their heartache to console others while also blessing them in the process gave me the greatest moment of hope I've experienced thus far during the past two and a half years of not being able to get pregnant. It was an epiphany of reassurance, a spark of light promising a reason for the pain and tears and irrepressible feelings of loss. Realizing that I could do something with my grief, instead of wallowing in it and getting frustrated with my inability to fulfill my desire to be a mom, gave me purpose and a sense of relief that my life wasn't meaningless. (I know this sounds awfully melodramatic, about as angsty as something you'd read in Twilight, but that's how I felt at the time.)

So Colin and I introduced ourselves to this couple, Don and Pam, at the Bethany meeting and asked them for advice on starting a support group. Since then, Pam has called and shared tips, mailed us some great materials they used at their meetings, and emailed encouraging notes. We are so thankful to have another couple who has walked the same road we're on support us in getting this group off the ground.

To further aid our efforts, I ordered a booklet from Stepping Stones (Bethany's ministry for infertility/infant loss) full of helpful suggestions on starting and promoting a support group. The authors emphasized the importance of choosing a suitable name for the group to make people feel welcomed and comforted. This turned out to be a challenging undertaking, as I couldn't for the life of me come up with anything but inappropriate, borderline-crude names, such as:
  • Fertile in Spirit
  • Unplanned Non-Parenthood
  • We're Not Drunk; We're Infertile (see 1 Samuel chapter 1)
  • WTFF (Waiting To Form a Family)
  • Families Under Construction ... I'll leave out the abbreviation
Fortunately, the task of naming the group wasn't mine to fulfill. Coincidentally*, while we had been talking with one of our pastors about starting a couples infertility/infant loss support group, another woman at the church had been working with the care ministry to form a women's infertility/infant loss support group. Also coincidentally*, she had previously been involved in a Bible study with one of the women from our small group. (*coincidentally = God was obviously orchestrating this)

Kelly and I met for lunch and discussed our ideas, sharing our stories and explaining what had brought us both to this point of wanting to create a ministry for this group of people we identify with. That was a few months ago, and at this point, we've had two women's meetings and will be holding a couples meeting in two weeks. Already, it is clear that people are being blessed through this ministry, and I pray that it will continue to bring together women and couples so that we can carry each others' burdens and share the love and comfort of Christ.

Our group is called GracefulWait. Kelly, who has been a huge Godsend to me personally, came up with the name and created the Facebook page as a resource for those who want to get involved. It's a much better name than anything I could come up with, and it poignantly captures the purpose of the group: to help one another as we wait for the Lord to build our families. The problem for me is only He knows how long that wait will be, and I'm not a particularly patient person.

Interestingly, one of the topics at our college Bible study leaders meeting Thursday morning was about having an eternal perspective and believing in God's promises of a future life with Him. Then in our college small group we're leading, we covered the chapter in A.W. Tozer's Knowledge of the Holy about God's eternity and how He exists outside of time. So He's certainly not beating around the bush with this lesson about the importance of recognizing our trials are temporary and the need to trust Him during our sometimes seemingly endless wait.

Friday, October 15, 2010

It's hard to understand

Today was supposed to be when they'd do the embryo transfer, the final part of the procedure that starts the waiting period before they do the pregnancy test. Instead of sitting around worrying whether or not it worked, I'm sitting around worrying if we'll be able to start over again in a few weeks and licking my wounds after hearing a bunch of pregnancy announcements this week. TGIF indeed.

One bright spot in this mostly overcast week was Justin's acceptance into med school. I'm proud of my little brother for his hard work, perseverance, and most of all, his faith that God would guide him through this process. And he'll continue to depend on the Lord to give him wisdom about which school to go to (I'm sure he'll get accepted at several) and to give him strength for surviving the rigors of med school and residency, hopefully minus any Grey's Anatomy-type drama.

Being a good journalist, I figured I should report some medical news (albeit more than a week late) regarding Dr. Robert Edwards, the co-creator of in-vitro fertilization who was recently awarded the Nobel prize for medicine. Being a good hypochondriac, I thought I'd share what I found out about endometriosis cysts and IVF, which, from what I could determine after 15 minutes of Google research, seems to confirm what my doctor said: A cyst can cause complications but for the most part doesn't appear to affect IVF outcomes. Since Dr. Edwards' award probably has greater news value and broader appeal than journal articles about cysts, I guess I should focus my discussion on the former topic.

Dr. Edwards, a physiologist, and his now-deceased colleague, gynecologist Patrick Steptoe, developed techniques for fertilizing human eggs outside the body in the 1960s. Their work led to the birth of the first "test tube" baby in 1978 and about 4 million IVF babies since then.

Called a "milestone in the development of modern medicine" by the Swedish institute that awards Nobel prizes, IVF has sparked ethical debates about issues like the storage and destruction of human embryos since its introduction and continues to draw ire from certain religious groups such as the Roman Catholic Church, which stated that Edwards' award was "completely misplaced."

Now I'm no ethicist, and I don't feel up to the task of delving into that moral morass, though it's interesting to read Christian forums like Stepping Stones that discuss these ethical considerations. Obviously we wouldn't be doing IVF if we thought it was wrong, and we're trying to make God-honoring decisions as we go through this process. What caught my attention regarding this news about the Nobel prize wasn't the morality of IVF or the question of whether or not Dr. Edwards deserved the award, but how it brought infertility into the media spotlight and elicited some negative remarks about those who choose to go through fertility treatments. As what you would expect from the NY Times readers' comments section, the responses to their article on Dr. Edwards contained several inflammatory statements about infertile couples, such as "they should just adopt" and "maybe infertility is nature's way of controlling population levels."

These types of comments demonstrate a lack of understanding and empathy, which unfortunately isn't confined to the world of anonymous comment threads. I've got tons of ideas for another blog post all about the well-meaning yet dumb things people have said to us regarding our infertility, so I won't blab on much more about it. But I wanted to include a quote from a commenter at the Stirrup Queens blog (and you thought me talking about my uterus and ovaries was bad; wait 'till you read what these ladies have to say about their female parts). This is part of Megan's response to the post, "Will a Nobel Prize Change the Way People View IVF?":
Perhaps this event will lead to more discussion, less mystery, and in some people an acceptance of a practice that’s lasted long enough for children of IVF to become parents themselves. But to a majority of people (ie, the people who likely don’t have any issues with infertility) it’s still mysterious and “different” and they’ll quite possibly continue to carry negative views on something they’ve never experienced and don’t fully understand.
I know that many people can't understand the pains of infertility because they haven't been through it, or possibly don't know anyone who has. There are certainly some people I can't completely empathize with because I haven't experienced their struggles. I've never been diagnosed with cancer; I haven't lost my husband; I've not had an unplanned pregnancy and faced the heart-wrenching decision of raising my child in difficult circumstances or relinquishing them for adoption. All I can do is pray for those people and strive to be sensitive to their grief, and that's what we ask of others who have not had trouble conceiving.

Thankfully, there is One who can truly empathize with us because He knows us better than we know ourselves. And that brings great comfort to all who are hurting – that is, everyone.

Thursday, October 7, 2010

A blip

Chalk another one up to our list of Things That Haven't Happened in the Timing We Expected While Trying to Have Kids.

After the first ultrasound on Monday, when I found out about that pesky cyst, I figured my next appointment would be pretty critical in determining how and if we proceed with IVF. The little freak-out on Monday turned out to be beneficial in that it prepared me for the unwelcome possibility of needing to cancel the cycle. The ultrasound yesterday showed the cyst was getting bigger, and, more importantly, that the other follicles weren't.

My kind and efficient doctor, whose job I certainly don't envy, had me come into her office so she could explain the sitch in thorough detail, which I will try to summarize succinctly (a tall order, for me). First, she said the cyst could be more endometriosis that built up since my laparoscopy last year. It shouldn't be a problem unless it causes a lot of pain, and that type of thing hasn't been shown to affect the outcome of IVF. Of greater concern was the fact that the other follicles weren't growing much yet. She could have increased the dosage of meds and kept me on them longer, but lengthening the prototypical cycle by a few days has been shown in studies to decrease IVF pregnancy rates. So she wanted us to know our options: We could proceed with the cycle until the meds finally started taking effect or we could cut our losses, cancel the cycle, and try again, hopefully soon.

Her best guess as to why the follies weren't getting much action is because of the birth control pills she prescribed for me the month before. It's pretty standard protocol to do at least one cycle of BC before IVF; it helps many women regulate their body functions, but for others, it can delay follicular growth, according to the doc. It shouldn't be surprising I'd fall into the latter category, considering how sensitive my body is to any sort of hormonal changes. Case in point: I've had to buy a heck of a lot more Proactiv ever since I went off BC 2+ years ago.

Fortunately, my blood test showed my estrogen level was going up, so the medicine was working, just taking longer than expected. We don't know for sure if the meds would work any faster in a month or more, after the BC has worked its way out of my system, but considering how well I've responded to less powerful fertility drugs in the past, it does seem like there would be better odds.

While the doc said she would support us if we wanted to proceed or not, Colin and I didn't need much time to discuss our decision. Obviously, we want to do what will lead to the best chance for success, and, though it sucks to have to wait another month or longer, that's what we need to do.

The need to cancel after going through five days of shots is frustrating and disappointing. We had worked out the October IVF schedule logistically and prepared for it emotionally, and now we have to start over again, who knows when. Even if it's only a month later, that's one more month of not being pregnant and not knowing when/if/how we'll have kids. Another month for others to make pregnancy announcements and us to feel happy and yet left out.

That's the downside. But God has really helped me believe He's got a purpose for this delay, just like He's got a purpose for all of our struggles in trying to expand our family. And He's pointed out a few plus sides to this change of plans:
  • It's better for my work schedule.
  • The doctor knows more info about how my body responds to the meds.
  • Colin has gained experience giving me shots.
  • We won't be finding out if we're pregnant right before our first meeting of the couples infertility support group we're helping launch at church.
  • We only wasted a couple hundred bucks on the meds instead of thousands on doing the whole procedure with decreased chances for a successful outcome.
  • I've got more time to blog.
As my mom put it, this canceled cycle is just a blip, a temporary interruption in our path to parenthood, nothing insurmountable or impossible to overcome. We still face a lot of uncertainty, and are praying that we will be able to try again in November and not have to wait until after the holidays. I'm not a great waiter, so the best thing I can do at this point is to remind myself of verses like Psalm 62:5-6: "My soul, wait in silence for God only, for my hope is from Him. He only is my rock and my salvation, my stronghold; I will not be shaken."

I also need to think of some fun things to do to pass the time and keep me from worrying about when we can do the next cycle. For example, this Saturday, I'll be going shopping with a friend. We won't be dropping $10K this month, so why not pick up a new pair of shoes?

Tuesday, October 5, 2010

First ultrasound, first freak-out

Considering how many people describe the IVF process as an emotional roller coaster, I should have expected our cycle to start off with a steep, stomach-lurching drop. Yesterday, during my first monitoring appointment, the ultrasound showed a cyst and not much growth in the follicles. Unbeknownst to me, I had started the cycle with a tiny cyst (shown in the baseline ultrasound) that the doctors weren't worried about but now appears to be getting larger due to the meds. The nurse said they'd call me with the results of my blood tests, which would show if my hormone levels were normal and help the doctor determine if my dosage should be increased or if we would need to cancel the cycle.

For some reason, this came as a shock to me, perhaps because I'd only been getting the shots for three days and had just had an ultrasound done four days prior. I knew that cycles can be canceled if the patient doesn't respond well to the meds or delayed due to cysts or other problems revealed in the baseline ultrasound. But I didn't think I'd face this possibility so soon. As a result of my ill-preparedness for that major downer, I quickly became concerned, i.e., I freaked out and automatically assumed the worst: We'd have to cancel the cycle, and because of the holidays, wouldn't be able to try again until January.

Immediately after the appointment, while suppressing the urge to sob and fly out of control, I called Colin, who calmed me down and recommended not jumping to conclusions until we heard back from the nurse – in other words, to be logical about it. Logic is not my strong suit; however, with the help of my friend, Kelly, who has been through IVF, and her wonderful reminders that God is in control of this situation and is working through it for His glory and my good, I got through the couple hours of waiting for the nurse to call without a complete meltdown.

She had good news: My blood tests were normal and the doc wasn't concerned about the cyst. They just wanted me to bump up the dosage of meds to stimulate more follicles.

Today, the nurse called me once again to say the doc wanted to see me earlier than planned to make sure the boosted dosage was working OK. I'll go in tomorrow morning and find out if the follicles are fired up yet. So my prayer request for now would be that the ultrasound will show that the follicles are growing and the cyst is shrinking.

While we don't know yet if the shots are working, we've become pros at shot administration. After a minor mishap during the first attempt, when Colin accidentally used a larger needle than necessary and worried that he'd jabbed it in so far it punctured my intestines, we figured out a virtually pain-free method of injection: I pinch a chunk of skin and Colin gives me the shot, which stings for a few seconds and leaves a little red mark from the needle prick. Then he discards the used needles in the SoBe bottle we're using as a makeshift Sharps container and I scoop us up some ice cream as our reward for going through the whole ordeal.

Thankfully, I haven't noticed many side effects besides a few headaches and some abdominal uneasiness, but then again, my stomach is uneasy half the time, anyways, thanks to IBS-related issues. Colin is preparing for the worst in terms of hormone-induced mood swings, but that hasn't been too bad, either, in my estimation. He might have a different opinion. All in all, the process hasn't been entirely awful thus far. I just hope we will be able to continue and not have to postpone the procedure to a later time.

Friday, October 1, 2010

Green light

Had my baseline ultrasound yesterday and got the go-ahead to start the stimulation medicine today. So this evening, Colin will get the honor of giving me two shots in my belly – what better way to wrap up a Friday date night!

The nurse led us through an injection training session, during which Colin dozed off and didn't perk up until he heard the nurse say something about his prescriptions. He resumed napping once she reassured him that he would be taking oral medications, not shots. Of course, I am not looking forward to getting a couple of shots a day throughout the course of October; however, I feel somewhat prepared, having gone through a few years of allergy shots 1-2x a week when I was younger. I was that nerdy kid who couldn't play outside in the spring due to the sneezing fits I'd get whenever I breathed in the heady scent of Scotch broom pollen. But, as Emily reminded me earlier this week, at least I didn't have to wear an oxygen mask in public places and be shipped off to asthma camp like Justin.

Learning how to use all these injections was definitely daunting, and paying for them wasn't exactly a blast, either. Walking out of a pharmacy with a grocery bag full of meds was a new experience for me, one that I hope not to repeat. The sheer volume of drugs, needles, alcohol swabs, and other paraphernalia was so ridiculous I decided to take a picture of it all laid out on our table. Note: This pic was taken before I got more needles and an injection pen at my appointment.

Impressive as it is, this supply doesn't hold a candle to my mom's Port-a-Pharmacy she makes my dad lug around everywhere. She likes to have this cache of meds on hand for her autoimmune flare-ups and everyday emergencies – you know, like if someone happens to get typhoid fever and needs heavy-duty antibiotics. Big Pharma owes Mom a big thanks, as do I – she has set an amazing example for enduring health issues with grace and patience, an area I'd like to grow in as we proceed with IVF.

A few people have asked me if I'm excited to begin IVF, to which I would answer that I'm as excited as one can be about starting an expensive, emotionally and physically taxing process that has a 50/50 or less chance of resulting in us having a biological child. It is exciting to be moving forward in our path to parenthood and nerve-wracking to wonder if the procedure will work. Beyond that, it is comforting to have family and friends encourage and pray for us during this time of uncertainty. We are extremely grateful for your support.