Monday, March 26, 2012

In Which Our Heroine isn't much of a heroine. She's just tired.

I haven't much to say except that I am tired.  I could sleep for days on end and not feel refreshed, I think.  Vacation can't come soon enough.

But why am I so bone-weary?  I work, but not the way residents used to.  (We won't get into how I feel the new duty-hour restrictions ruin my education.)  Yes, I am working nights currently, and thus switching between nocturnal and diurnal lifestyles very few days.  But I have frequent days off, and yet I am still so tired!

It's frustrating.  I want to feel refreshed and eager to meet the day. But what I actually crave is to curl up in bed and sleep.  I feel emotionally drained as well.  That's multifactorial -- part of the mixed blessing of caring for my patients, and partly related to Operation Baby with its cycle of pain, worry, despair, and hope.

Yet sleep is no escape from infertility.  Last night I dreamt that they told me our new surrogate couldn't be the surrogate because her mother had just ruptured a cerebral aneurysm and so had her brother so she needed time to her family.  Of course Mama Phyll and Mama reinterpreted the dreams positively for me.  But to me it means I am clearly stressed.

And what if medicine isn't right for me?  I know so much less than my colleagues and feel too exhausted to improve myself through reading.  I get incredibly anxious every time I have to see a new patient.  Clinic doubles my systolic blood pressure.  I am generally more stressed when I "do" medicine than when I "do" books.

What if I am supposed to be a professor of literature?

I know I was influenced by Mama.  It's not news that I wanted to be like her and that I wanted to please her.  But I made a conscious decision to pursue medicine even knowing this.  I chose medicine to help people.  Literature is wonderful, and I am happiest and most comfortable with my head in a book, but it doesn't help people in the same way.

So where does this leave me?  In whom do I confide?  Do I even confide in anyone?  I suppose as a "married woman" I should be confiding in my husband.  But he thinks he works far harder than I, and he is completely unsympathetic.  (Plus he doesn't understand, as nobody can who hasn't been a resident.)  I can't confide in Mama because she can't imagine anything better than medicine.  She doesn't have an unenthusiastic cell in her body.

So we will see.  One day at a time, I guess.  And residency is finite.

I just hope I want to be a doctor at the end.

Tuesday, March 20, 2012

Brief explanation

If you are reading this blog (and in that case -- don't you have something better to do?  Something real to read?) you obviously know we are in the waiting game.  Unfortunately, we are also of the kinehora, tfu tfu tfu, hamsa hamas hamsa Very Superstitious persuasion.  Meaning, if, be'ezrat Hashem, things go well, I can't write about it.  Apologies in advance.  You are welcome to apply deductive reasoning, however.

But no results yet.  So Schroedinger's Surrogate is, according to quantum mechanics, both pregnant and not pregnant at this moment.  Or perhaps she is carrying a cat?

This is your brain on infertility. And a worrisome update.

Perhaps the most frustrating and debilitating aspect of infertility and loss is the inability to focus on anything else.  My body goes to to hospital, interviews and examines patients, answers questions right or wrong for the attending.  But my head and my heart are consumed, and with all my mental and emotional energy devoted to the babies I can't have, there is nothing left.  I barely read about my patients.  I miss important parts of their assessments and plan.  I know I am not the physician my patients depend on me to be.  Certainly part of this stems from being an inept intern.  But I think if I could learn not to let infertility take over, I would at least do better than I am now.

But how?

I am praying that we don't end up back at Square One.  It turns out that two of the four frozen embryos didn't survive, so if this FET over and player loses.  I am preparing for the worst and have already renewed access to ovum donor profiles.  I'm hoping to convince Husband that we should consider adoption, but am not optimistic.  The surrogate can cycle again almost immediately -- checked with Northwestern -- so the rate-limiting step will be finding a donor.  If only my sister were twenty-one!  They won't let her at eighteen, I don't think.  And Husband will be stuck repeating his entire workup.

Maybe this will be a moot point and I will find out good news.  Mama is convinced that everything will go perfectly and keeps telling me I am too much of a pessimist.  I am simply an optimist with experience.  And the experience of being forced to agree to termination while watching my baby move around on ultrasound, and listening to its heart beat is one I NEVER want to repeat.

So yes, I have a contingency plan which (for irony's sake) I am calling Plan B.  First step: supraphysiologic doses of frosting or ice cream.  Second step: spending large sums at the bookstore.  Third step: Plead with Husband to consider adoption.  Fourth step: Find some way to survive two weeks in Israel, where our best Israeli friends are expecting and everyone else already has babies.  That part is still a work in progress.  Would it be rude to seclude myself in our room re-reading Jane Austen the entire time?

Then, of course, there is the possibility of success.  I don't even know what I would do in that case.

In lieu of baking a baby -- some other options

Just because one can't bake a baby doesn't mean one can't bake!  They are called hamentaschen or אוזני המן but I just like to call them "delicious!"  We bake them to celebrate the holiday of Purim.  Added plus: both the "oven" and the "eggs" are much easier to procure and much cheaper than surrogancy.  (Recipe to follow when I have a chance to translate it into English.)

So many cookies!

Filled with stawberry preserves...

...and Nutella +/- coconut.  Yum!

...lemon curd...

Semolina cake, similar to a basbusa

Sunday, March 11, 2012

Some advantages of being unable to carry a child about which you might not have thought

Most people can list some "advantages" of being forced to outsource pregnancy: no weight gain, no stretch marks, no flabby belly, no morning sickness, no heartburn, no caffeine or alcohol restrictions, and no labor.

But why focus on the obvious?  There are so many other advantages and so many things we CAN do!
 - We can empty Kitty's letterbox -- no need to worry about toxoplasmosis.
 - We can pinpoint exactly the moment of conception to forever embarrass our children.
 - nobody can ever say our future children weren't wanted.
 - We can deliver the ultimate guilt trip: "Before you were even born you were so expensive we could have travelled to and from Israel 54 times."  And yes, I am talking about round-trip tickets for two.
 - I am spending an exorbitant sum trying to make a baby, but I don't have to purchase prenatal vitamins!
 - Instead of prenatal vitamins, I got to continue taking raimpril and now losartan to treat my hypertension.  if I were pregnant, I'd need to take labetalol instead, which is a) less convenient because it requires BID or TID dosing and b)lacks benefits unique to ACEis and ARBs, such as renoprotection.  We wouldn't want a mommy on dialysis!
 - If things work out one day, I will get to show my newborn(s) off to an entire airport and a plane of lucky passengers.
 - In the meantime, I get to obsess on a daily basis about my loss and my infertility.  Anybody can do internship in a normal emotional state.  Only the truly tough can do it with 90% of her heart and her brain elsewhere.

Friday, March 9, 2012

In Which Our Sorry Excuse for a Heroine is Frustrated.

I think the most frustrating aspect of infertility w gestational surrogacy and egg donation is my absolute lack of any control and of any participation in the baby-making process.  I don't even feel like the embryos-on-ice sitting snugly at Northwestern Hospital are mine.  They are more related to Husband than to me, after all.  What did I do but fill out paperwork?

And now the nurse coordinator advises against Surrogate taking a home pregnancy test .  Honestly!  At least could I control how I learn about the results of this cycle?   Is even this forbidden me?  Did it occur to the nurse coordinator that I don't want to find out from her on the phone -- her with her always cheerful voice, which if we don't end up with a pregnancy is going to cut like a scalpel?  But then, no matter what I will find out on the phone.  I don't even get to do the test myself.  And this frustrates me so much, the complete removal from the baby making process.  I feel like a fake girl even more than I already do as a Turner's girl.

I wish rereading my affirmations would help...

Sunday, March 4, 2012

Sadness comes in waves

Its odd -- I can be suddenly overjoyed at the fact that Abraham Verghese replied to an email, or that I made my mentor proud, or that a patient is improved because I treated him/her appropriately.

But equally suddenly I can enter a deep despair.  A good friend shares a baby-bump picture on Facebook -- day is gloomy.  Find out another friend is pregnant -- bring on the choco-therapy.

Why can't I just be content with what I've got?

At least I had a really nice conversation with New B today at my lovely Auntie's birthday.  We ended up talking about Operation Baby a bit, and she was so incredibly understanding.  I haven't met many fertile women who so easily understand.  She practically voiced my every emotion.  But the most comforting part was that a) she understood how painful this can be and b) she told me that EVERY one of her friends who wanted children ended up having them, one way or another.

I must hang on to that.  If I truly want children, I can eventually make it happen.  I hope?  I sometimes think about the possibility of never having children.  That is what Mama doesn't understand -- there is a very real possibility of never having children.

What do I do then?  What is my purpose?  What is my legacy?

When do we plan on having children? And a question for the intended-parent and surrogate community

The latest answer to when we plan on having children:  "We mistakenly chose to name our firstborn Godot, so it's going to be a long wait."

One of these day's I'll parody Godot again, infertility-style.  But it's been a while since I read Beckett and I didn't particularly enjoy him, so I don't remember quite enough for today.

And a question for the intended-parent community:  Is one expected to be present at the embryo transfer?  I'm exhausted, and Husband and I always fight when we go to Chicago, and I work Friday night through into Saturday morning.  And going alone when Surrogate is going with her husband seems awkward.  Plus, flights are expensive.

On the other hand, is there an etiquette to this?  Am I expected to go?  Motherhood involves plenty of inconveniences and so does pregnancy, so why should I complain?  Also, Surrogate seems really to want us present.  And I feel less as if I'm taking advantage of her if I must inconvenience myself a bit too.

Anybody out there been in this position?  Advice appreciated!