Yet Another Rant About Western Medical and Canadian Public Health Care Bureaucracy

On Thursday afternoon we had a follow-up detailed anatomy (anomaly) scan to last Wednesday’s emergency ultrasound intended to assess whether Azulito/a had any visible anatomical abnormalities that would confirm (or refute) the positive test result for alpha-fetoprotein I received last week Tuesday, indicating elevated risk of Spina Bifida or Anencephaly (or other open neural tube defect).

Thursday’s ultrasound was performed by Mary Poppins. Her pleasant bubbly nature is the only kind thing I can say about the entire experience. She started by asking me if I knew why I was there. Suppressing an urge to plant a fist in her throat and rip out a handful of the hair carefully tousled and tied atop her head, I responded with “You have not read my chart, have you?” as I heard the LP shuffle his feet in the chair at the foot of the examination table on which I was lying.

She assured me she had viewed my last ultrasound but that she liked “to hear from patients”. Trying not to roll my eyes and pinning my fists beneath me so as to avoid risk of assault charges, I recited in 7 seconds or less why we were there on Thursday and why we’d been there the week before. I did not get into the fact that this was pregnancy number 10 for us and that the LP and I suffer from what would surely be diagnosed as some form of ultrasound- and pregnancy-loss-induced post-traumatic stress disorder and could be just get on with it already and let me see what the hell she was looking at (she refused to let me see the screen until the end when I got to see the cutesy baby stuff that people who only get one or two ultrasounds always want to see).

I was upset, scared and angry. In my gut I immediately knew things were not going to go well before she even began the ultrasound. Things ended much worse than I could have expected. She refused to let us talk to the doctor, saying he was busy and needed time to compare last week’s report and images to this week’s. She said we had to wait for him to do that, write up his report, send it to our doctor and make time to speak with my doctor once she received the report.

My doctor is still off work sick (this is two weeks now – did she have a bloody breakdown or catch an infectious disease? For heaven’s sake already!). We went to her office immediately after being rebuffed at the ultrasound clinic. First available appointment with my (about to be fired) doctor is February 12, 2015. Perfect. Universe, are you kidding me?

As a child, I loved Mary Poppins. On Thursday, I wanted to pummel her.

To keep what could otherwise be a long story very short, we learned…. Well…. Nothing. Not entirely true. We learned that Azulito/a has adorable hands and feet. How delightful. Is my outrage and anxiety projecting itself between the lines here? I ask because it is leaping up like bile from my gut and lapping at the back of my teeth as I type this.

Don’t get me wrong, Azulito/a. I love your feet. And your hands. And your little button nose. I love everything about you and am doing everything I can to bring you safely into this world. But what I really wanted to know – what the LP and I really needed to hear was that at 18 weeks the doctor – not Mary Poppins – still could not see any abnormalities consistent with a finding of Spina Bifida or other open neural tube defect.

Mary Poppins not only refused to get the doctor for us to speak with. She refused to tell us how big Azulito/a was measuring so we would be able to assess if the growth was on track from last week in a desperate measure to draw assurance from anything she had scanned in the follow-up that the doctor had recommended. Her secrecy triggered many prior ultrasound experiences in which technicians have either acted evasive and refused to tell me or, when the LP has been with me, to tell us anything or the times when the technicians have outright lied to me (the best one being “I just need a moment to find the heartbeat we saw last time”. Yeah, that never actually happened and I knew the baby had died all the while she kept telling me that lie.)

The LP said “if she’d seen something she would have gotten the doctor” at first but I pointed out that with all of the complications we had with the Miracle Toddler’s pregnancy, not once did the technician ever let on a single issue – we were always blind-sided by the report when my doctor would go over it with me or us later. Upon recalling that, his anxiety level shot up, too. This was very different than last week when they were eager to comply with our (in my view, completely reasonable) request to speak to the doctor and the doctor was candid and forthright in saying the scan was earlier than they’d like, technically difficult and not perfect but did not reveal any abnormalities.

I want to believe everything is going to be okay or at least not fatal or near-disastrous. I truly do. But nothing about what happened on Thursday or what’s been going on in my mind since then is making that easy.

I am no stranger to the bureaucracy of our public health care system. I defended doctors in this regime against litigation and complaints for several years. I have hired and worked with doctors, nurses, others in the Western medical field as experts. I get the CYA protocol that underscores every move every professional makes. And that only makes me more anxious. Because everyone likes to share good news. The lips get sealed when the news is less revelatory.

In short, I am scared. And deeply enraged by the inhumanity of the system in which we are forced – because there is no alternative to the public health system where we live – to accept “care”. If I did not need these people as much as I do right now, I would be writing a scathing letter of complaint to the Colleges of each of the medical professionals by whom I feel utterly and repeatedly let down right now. But for now, that is not in the cards. I hope in time good news will overshadow the bad and I will let go of this outrage, hurt, silence, terror and anxiety and those complaints will go by the wayside.

I know, making them might improve things for others. That’s what my mother would say were she still alive. But I don’t need to be a crusader here. I am barely making it through each day when the stress levels are as high as they have been lately. Besides, I am not convinced another complaint or two or twenty-seven would make one lick of difference in the long run. Experience has taught me that is just not how those complaints work. The doctors and others who get them suffer momentarily, but their Colleges do nothing or next to nothing. And systemically, nothing changes.

And on that sour note, I end the hostile portion of this post.

Now on to something a little sweeter. A note to you, our dear baby. We love you, Azulito/a. Please be okay.

What is next? We attend the Perinatology Clinic next Wednesday, February 4th, for a Level II Ultrasound and to speak with one of the perinatologists there (I will not leave until that happens) about the positive screen, elevated aFP and whether that ultrasound and the ones this and last week suggest any neural tube problems. If so they will offer us amniocentesis. If not I hope this ends our current foray into yet another experience I would not wish on any expectant parent.

A Long Week

* pregnancy mentioned *

I am sorry for not keeping up to date with others’ blogs this week. I also apologize for not updating my own sooner. I have had a lousy week physically (more on that below) and I’ve been scared, exhausted and swamped at work. Things are feeling a little less horrible in this moment (because I haven’t left to go to work? because everyone else in the house is still sound asleep and will be for hours yet? because I haven’t tried to get dressed in something in which I don’t look frunky (chunky and frumpy – the only way I can accurately describe this stage of my body’s changes in pregnancy)? it could be any of the above or a combination of them.)

I will start with some great news. I can find Azulito/a’s heartbeat on both the rental Fetal Doppler (which I’ll be returning in a couple of weeks to avoid a second month’s charges) and the one I bought for Mandy’s pregnancy, which sadly ended almost immediately after I got the device. The rental one has a 3 MHz probe and the purchased one a 2 MHz probe. If anyone is shopping, always go with the 3 MHz unless you are really large physically. Last summer I could not get a 3 MHz Doppler in Canada; now you can. For the same price I paid for the inferior model. Of course.

Baby’s heart rate has been between 170 and 175 over the past week on the dopplers. I’m now 11 weeks and something (3 days? I should know these things. It’s early, sorry.) but baby may be measuring 12 weeks and something if the pattern s/he has established is continuing. I hope and pray it is simply because a regression at this point would put me over the deep end. Next ultrasound is our Nuchal Translucency scan on Monday, December 15, 2014. I’m scared. The LP is scared. We are trying to be hopeful.

The fear stems in part from our long and checkered recurrent pregnancy loss past at a general level but more immediately and much more vividly it has ramped up over the past 10-12 days when I’ve had a slew of increasingly alarming histamine-like reactions to this pregnancy. Last week Friday (December 5th) Dr. Braverman increased my Neupogen by 50% because my white blood cell count had dropped almost in half (not good given my immune issues) and increased my Prednisone from 20 mg to 40 mg per day and on Wednesday morning this week, based on symptoms that would not relent and were interfering with my ability to function, he suggested we increase it to 60 mg for two weeks (so until December 24th) and then taper back down to 40 mg after that point.

The fact that the first Prednisone increase and Intralipid treatment on December 5th did not alleviate my symptoms scared the pants off of me. My immune system has clearly flared wildly after the natural drop in hCG that began around 9 weeks. The first two nights on 60 mg of Prednisone, I was wide awake at 1:50 am and never fell back asleep. My heart was racing during the day at points and I felt like a caged animal at least 50% of the time. An exhausted caged animal with a boat load of legal work to do. Not ideal.

The week has been grueling, to be frank. Last night I felt a little better in terms of the racing heart and night-waking (I actually slept until my alarm went off at 3:50 am). Now I just feel frunky. And stressed out about work. Ugh.

My stomach has also been upset by all of the drugs. I started taking Pepcid this week too and got off of the baby aspirin at my request (Dr. Braverman approved). Aspirin can mess with histamines so I figured it was best to take it out of the equation since I am staying on the Lovenox in any event.

As a result of the second jump in Prednisone dosing, I have to return to New York two days earlier than originally planned, miss two full days of work when I’m super busy and miss my family for 4 days right before the holidays. Don’t ask if I am happy about this. I threw a massive snit on Wednesday and Thursday morning when I had to rearrange work, personal and travel schedules for this and deal with my fear that I would do all of this, spend all of the extra money required to do it, and Azulito/a could still die.

Yesterday I asked Dr. Braverman to tell me the plan with respect to medication dosing going forward so I can avoid these last minute dashes across the entire North American continent to get medication I cannot get prescribed in pregnancy here. Did he answer me? No. Am I happy? Would you be? I explained that I want to avoid travel that is both very stressful and very costly as well as completely unnecessary if he could tell me what to expect more than 15 minutes ahead of where I am at any given moment. I was nicer than this makes it sound. Of course. I am going to re-send my email with a question mark at the top of the forwarded e-mail this morning. That’s my most passive aggressive e-mail move, by the way. If I ever do that to any of you, you can rest assured I’m peeved.

I wish this blog were more cheerful lately. Pregnancy is not my friend, despite my myriad efforts to befriend her. I desperately wish my immune system did not take such umbrage at me trying to carry forward a little life. I wish I knew what to do to appease this rampant immune system. It has been a long haul and I’m not even through trimester number one. I have had more than one pity party lately.

It is truly overwhelming to have things go so sideways recently when I thought we had things under control. I feel like a quintessential failure as a mother, as a woman. My body is not built to stay pregnant. That hurts. It hurts way down deep inside in a way that defies language. Please believe me when I tell you that it is painful in a cut-to-the-core kind of way. I would not wish this on anyone and I have the utmost empathy for others who struggle not only with ANY pregnancy and infant loss, recurrent loss but now immune-related fertility and pregnancy complications.

In short, this stuff is rough. And it hits you at so many levels. That part is hard. Maybe one day I will find words to explain. For today, I just own that I never expected this pregnancy to be as challenging as it has become – not just physically, but emotionally. And I offer a warm hug and a compassionate nod to those of you who haven’t even made it to this point yet. That part is hard, too. One day, for each of us, I hope all of our efforts and endurance pay off.

On that note of hope, I wish you all a good weekend.

Death, Fear and Impotence: A Rough Week

It has been a particularly rough week. The past 8 days have filled me with a deep and persisting sadness and a sense of anxiety I cannot shake.

The downward spiral started with the news last Thursday morning that a close and beloved friend had died – suddenly, unexpectedly, far too young – and left behind the two – just as suddenly and unexpectedly lost and shattered -individuals she loved most in the world. Her husband (like mine, many years her senior). Her son (the sole surviving twin of her one successful pregnancy).

My friend’s funeral was yesterday. I don’t even know where to start with all of the thoughts and feelings I have experienced in the past 8 days let alone at the funeral. The hardest part for me was witnessing how utterly devastated and devastatingly lost my friend’s dear husband – her soul mate if ever there were soul mates – is. He barely made sense when he spoke. His body looked as broken as his spirit must be. My heart shattered all over again. Life can be so cruel.

So cruel.

On Monday a good friend and fellow patient of Dr. Braverman found out her 9-week pregnancy was at an end. Her baby had died sometime in the preceding week. We have much in common. We are the same age give or take a few months. Her protocol is almost identical to mine. She transferred two embryos – as I did – three days after I did in mid-October. Only one of her embryos survived – same as me – despite both being PGD tested and chromosomally normal. My friend has lost numerous babies (first and second trimester) and has never had a living child. My heart broke anew when she told me. A part of wanted to curl up and die.

A bigger part became deathly afraid that I would be next. That fear has not left me despite some astute observations about the differences between my friend and I, the key one being I have carried a child to term. We know that at least once my body was capable of doing that.

Since Monday morning when I first heard from my friend about her devastating loss, I have tried to reschedule my next ultrasound from next week Monday to sometime this week. I could not get in. I tried seeing my doctor sooner than today in case she could requisition a stat ultrasound. I could not get in.

I tried – desperately would be an understatement – to find baby’s heartbeat on the doppler I bought last September before we lost that baby between 10 and 11 weeks (it does not help that I am 10w1d or 10w2d today depending which date we use to calculate gestational age, transfer or LMP). At the time I bought it that was the best quality one available. It is recommended for use from 12 weeks onward but the vendor indicated and user reviews suggested that many women got lucky at 10-12 weeks. Of course now the same vendor has just started selling a better model that reliably picks up by 10 weeks and can detect FHR at 8-10 weeks in many women (and its on sale for the same amount I paid last year – how’s that for bitter irony?).

I could not find anything but my own heart rate and the whooshing sound of a forming placenta. Trigger back to September 2013, right before the fateful stat ultrasound that confirmed what in my heart I already knew – “Mandy” had died.

In my fear-induced mania I ordered a more sensitive rental doppler – the same kind I used in the Miracle Toddler’s pregnancy with success as early as 8-9 weeks – and paid for expedited shipping. It was supposed to be here yesterday. It still has not are arrived. There may be a curse operating here. Who would have cursed me? Have I offended one of you badly? Please let me make amends – anything if you just remove this damned curse.

On top of all of this a little dog – and when I say little I mean think under 4 lbs though that was not his starting weight – who has wormed (or rice-grained?) his way into my heart is very sick and may be dying. I feel helpless and floundering here too because his human companions (let’s face it, his live-in nurses and chefs) will suffer their own devastation eventually in all of this (death may be protracted here but clearly inevitable) and I am (a) very far away so of zero practical assistance and (b) quite literally immobilized by my own myriad feelings around companion animal suffering and loss.

If I have one wish it is the echo of my friend E’s wish, that this little canine soul escape this world while he sleeps but to that wish I would add that this not happen during the Christmas holidays or the few weeks left leading up to it. I say this not for me but for E and especially for M. There is no good time for death to strike. But the holidays are particularly bad timing. I know. We lost a family pet right before Christmas too. The year after my Mom died. It sucked. A lot.

I have felt angry – eye-poppingly furious even – at God and Spirit and the Universe lately. Why take the lives of these beings who in the case of my friend was the embodiment of living kindness and in the case of my friend’s baby was too new to be anything but innocent? Why you stinking thieving scoundrels? Why? You all deserve a good swift punch in the throat. Or three hundred and ninety seven of them. I may enlist help. Sleep with one eye open scoundrels.

As I type this I feel rage boiling up. I know that feeling well. It is my safe harbour from engaging with the utterly helpless feeling and crushing sadness that has filled my heart and weighed down my soul these past eight days. I feel broken and small and impotent. Above all, I feel impotent. I can do nothing to change the horrible sequence of events that led to these two deaths. I can do nothing to ease the suffering of those who have survived their loved ones.

Yes, I know that there are things I can do. I can offer help (done). I can bring over things to make sure they eat or have food in their homes (in process) I can listen (done). I can cry with and for them (done).

Yet I know from losing my Mom and all of our babies that there is nothing anyone can do to take away this pain or the deep chasm it forges in a survivor’s life. Only the survivors can heal those wounds if they can be healed at all.

And in this moment I feel ashamed wallowing in my own fears of death – not my own but of little Azulito – and yet this is the abyss into which I have fallen and from which despite trying to get grounded and set intentions and practice positive thinking I cannot climb out. I am stuck in a place of intense terror. And at a fundamental level there is nothing I can do but wait to see which way the wind will ultimately blow over all of this. Alas, I am impotent here too.

Life can be so cruel.

Beta #2 at 8dp5dt (13 dpo)

I have been waiting with baited breath all day to get my report on this beta. I had to gamble and order refills of all of my meds except Neupogen (because I ordered lots of it the first time not realizing it was more than a 5-week supply) today without knowing if my betas have doubled otherwise I would have to delay my flight home on Friday.

My hands have been shaking much of the day and I have felt jittery and anxious. I have been waking up at night and unable to fall asleep, which is common for me when pregnant and on prednisone.

The email finally came this afternoon with beta #2. Progesterone results were still pending. Beta was 128. A doubling time of 45.9 hours from 62 on Monday. I immediately felt my heart leap into my throat and I have fought back the urge to vomit ever since.

My only measure of success in my various pregnancies to date (this being #10) is the one success story. My betas were really high and doubled very fast. So when this one did not measure up, I wanted to curl up and die or at least burst into tears and sob all over my desk at work.

I have not done that. I am going to go for a walk and try to calm down and pray that pregnancy #10 will be success story #2 somehow.

My next beta is Monday, October 27, 2014. In the meantime, I’m back in New York tomorrow and returning home Friday.

I’m sleep deprived and overwhelmed by fear. I hate this. I hate my anxiety and inability to tame it. I really, really do. I wish I could enter a coma for the next 8 weeks and awaken to news that the first trimester was over and everything looked great.

I will update Monday after the beta if I can’t find positive things to say before then.

A Tearful Day of Reckoning and a Transfer Schedule

Today began with a few attempts to extract blood from my veins, resulting in four puncture wounds (two vines if which bore fruit, two of which steadfastly refused). After the vampire routine I met with Dr. Braverman for a sonogram and a discussion of next steps in this FET cycle.

My lining today was essentially the same as it was on Friday. I was disappointed by this but Dr. Braverman was not. He cited a Cornell retrospective study showing no substantive difference in transfer outcomes where uterine lining was between 6 mm and 8 mm or more in thickness provided it demonstrated the trilaminar pattern. Dr. Braverman showed me my beautiful trilaminar lining.

We then talked about transfer dates and whether to transfer our 5-day or our 6-day embryo. Dr. Braverman looked at me and detected the storm brewing behind my eyes. He asked if I was opposed to the possibility of twins. He said that I have been through so much and with all of the travel and related stress I have undertaken to complete this cycle he really wants us to have the best shot at having one live birth out of this. He recommended we transfer both embryos (if both survive the thaw) so long as twins are not out of the question for us. If they are, we will choose the best quality of the two embryos to transfer this time around.

I was surprised to hear the suggestion but realized I should not be considering that Dr. Braverman is not working with your average IVF patient. Also, he reminded me that there are no guarantees. There is no guarantee either embryo will survive the thaw. There is no guarantee they are of good quality. After all, we already blew threw our best embryo in my cycle this May. There is no guarantee that the immune protocol in its current incarnation will work; it may need some tweaking. I may need laparoscopy to diagnose and remove endometriosis. There are entire worlds of what ifs to explore if one is so inclined.

I am not so inclined. I hate the what ifs. What ifs can go to H-E-double-hockey-sticks.

There are so many opportunities to fail. Or to win and then lose. Again.

As best I can recall it was during this moment – when we began talking about transferring two to maximize our chances if one slipping by the minefield of my immune system – in which the watershed broke. Dr. Braverman gave me one of those “you are going to cry on me, aren’t you?” looks and – foolishly – asked if we were okay. The dam gave way and out rolled the flood of tears and sobs that stained my face and shook my shoulders intermittently for hours to come. He said he recognized that look because he used to think it was him. I am sure he has used that line often.

He invited me to call him once I had time to think over what he had said. Among other things he said the risks of a twin pregnancy are no longer substantial if there is no history of uterine abnormality, serious autoimmune diseases such as lupus or serious third-trimester complications (toxaemia, for example). I have a history of cholestasis of pregnancy. He said that is manageable and not something that would ward against transferring two. He again said I could call if I had any questions or wanted to talk about this.

I don’t know that a telephone call is necessary. Maybe for the LP. He has more anxiety about transferring two than I do. After today’s discussion with Dr. Braverman I feel okay about an all-or-nothing approach. I cannot help feeling that the subtext of what he is saying is that he is not confident this will work, at least not if I transfer one at a time. If he goes to Vegas, I bet he blows a lot of cash. This man is a gambler.

What *is* necessary for me is to figure out the web of lessons today holds. I have a strong sense that this was a teaching moment and I have only scratched the surface of what all I am meant to learn from my emotional meltdown. Azulito sees an opportunity to teach me something. What? I don’t know yet.

One thing I have learned already is that I feel like a sham. I am concerned that I have been attempting to delude myself (or you, dear readers) about how afraid I am, how devastated I am by all of our losses and the fear that I will never have another successful pregnancy, how exhausted I am and, among other things, how lonely I feel sometimes in all of this.

I have chosen courage. And courage is what I try to manifest, for my own sake and when I share my experiences with all of you. Yet inside there is an ocean of tears itching to pour across every leg of this journey and a school of fears looking for a conduit in those tears.

Who knew that creating life – and letting go one’s creations when their time to hold a physical place on this plane was not fleeting – could be so terrifying and painful?

Who knew?

I ought to have known. I have been to the land of loss and fear before. Yet this time feels different.

I am alive to my vulnerability and to the vulnerability of Gertrude and Alice, our two remaining embryos. I am mindful of the educated guess our reproductive immunologist has made and we have embraced in following his protocol. I stuff down but know well the risk that a certain percentage of frozen embryos perish when thawed and others fail to implant or flourish even when chromosomally normal. I know that our chance of success if we transfer two is only slightly greater than our chance of failure regardless of how many we transfer, although the spread is greater the fewer one transfers.

I know so much. But I do not know how to tend to my feelings, fears and needs, it seems. Ostensibly, I have sold myself and others a bill of goods. Today I woke up (okay, I did not really sleep last night – a fact I admitted to Dr. Braverman at the start of my time with him today, noting this made me realize I am quite anxious about this cycle and this morning’s appointments) feeling unsettled. Yesterday, too. A storm has been brewing.

It may be the hormones. It may be the steroids. But behind the medications lies a woman – a mother – with a seemingly bottomless well of need for calm, reassurance, hope and faith that we have a real shot this cycle. Today I became mindful that a good-sized chunk of me does not know how to believe that.

I am dead scared. I am so scared I am afraid to admit how scared I am. I am afraid to own the depths and magnitude of this fear. At times it feels larger than life.

Where does this leave me? I feel as though I am or have been a con artist, shamming you into believing I had it together. Trying to sham myself into believing thar. And now we all know that is not true. It is not true at all.

The truth is, I am afraid. I feel tiny, vulnerable and exposed. I feel shaken, not stirred.

What does that mean?

Am I unable to believe this cycle will work as I did in May? It may mean exactly that. I may not be able to reacquaint myself with the innocence I have lost. Although this is our first cycle using an immune protocol (and an aggressive one at that), it does not engender the marvel and illusion of previous firsts.

I do not – cannot – blindly accept that this will work simply because I will it to. I can manifest an outcome and engender confidence until the cows come home. That trick has been played. I don’t believe in miracles happening in my lifetime anymore. I got my one miracle and I am fearful that asking for more guarantees me ongoing loss. This makes no sense. It is not rational. Bu this is how my phrenetic brain seems to work.

What lessons is Azulito trying to teach me today? A friend suggested I ask if Azulito wants to bring a friend along for the ride (vis-a-vis the two-embryo transfer recommendation). That suggestion opened up a world of possibilities for me.

Why wouldn’t I ask Azulito for some guidance about what to do?

Why am I so out-of-touch with how much stress I am and was under about our recurrent losses, this cycle and what happens if it fails (especially if it fails because my womb kills both Gertrude and Alice in one fell swoop)?

Why do I worry about everyone else’s needs and not realize the deep needs brewing inside myself?

This is a recurring theme for me. Has Azulito come to teach me that? I am inclined to believe so. And now I am deeply curious what other lessons lie behind today’s tearful breakdown in Dr. Braverman’s office. I am going to follow my friend’s suggestion and try to ask Azulito directly.

As for what is next, if all goes as planned my transfer will be Tuesday, October 14th. I will start progesterone on Thursday, October 9th. On Friday, October 10th I will be back in Long Island for my last weekly Intralipid IV (after this they are to be done bi-weekly if I get and stay pregnant). On Monday, October 13th I will have a final sonogram with Dr. Braverman to make sure my uterine lining looks good before Tuesday’s transfer. My first beta (hCG blood draw) will be October 22, 2014 (8dp5dt).

In reflecting upon this past weekend’s stay in New York, I would like to extend my heartfelt gratitude and tremendous appreciation to the women who made an effort to meet and spend time with me this weekend and today, those of you who introduced me to others close to you (or not so close in some respects, until this weekend) by whom I have been moved and inspired. You know who you are. From my heart and spirit to you and yours: thank you. I feel truly blessed.

Keep Talking, Falcon

I have been suffering from bouts of raging anxiety since reality came home to roost.  The plan is to start our next FET (frozen embryo transfer) cycle later this week.

My heart is set on a protocol that excludes oral contraceptives and Lupron because both bring on negative side effects that leave me thinking my body is shouting “stop giving me that stuff!”  Not knowing what day this week will be cycle day one (i.e., not knowing on which day I will see red) is a source of anxiety, as are some of the existing commitments in my work calendar.  Combined, they have me concerned about whether I can make the timing of some of my monitoring appointments work.

If I am honest with myself, the deeper fear is the one about this (the entire shebang) not working.  It is about neither of our last two embryos surviving the thaw.  It is about me not getting pregnant and me getting pregnant and losing that baby, too.

I want pregnancy number 10 to be different. I want there to be a pregnancy number 10.  I am afraid that I am asking God and the Universe for the impossible.  And, objectively speaking, in some ways it looks to me as though I am.

I have never been more scared to fail.  I have never been more scared of another miscarriage, not because it will mean another lost baby but because it may foreshadow the ending to this journey that I have never wanted to face.

This is the most terrified I can remember being about anything. It is not a just-woke-from-a-nightmare type fear.  This fear is much deeper, much darker, more insidious and has a steadfast grip.  This fear is in in my bones and in my belly.  It is in every breath, every lump in my throat, every beat of my heart.

This fear is real.

I have an appointment with my hypnotherapist this evening.  I am going to need it to help me explore and address this fear before it eats me alive.

I also see my family doctor this morning.  I have already started taking Claritin on Dr. Braverman’s instructions.  I’m hoping that my family doctor will prescribe Intralipids for me so that I can start the first of my weekly IV treatments as soon as possible and that she will give me requisitions for all of the ultrasound and blood tests for my remote monitoring appointments.

I have fear about this, too.  If she says no, I will not be cycling in the coming month.  I just cannot see how I could make that work and I cannot afford to live in NYC for 3 weeks and be away from work all that time (which is what would be required).  Or at least I cannot imagine doing that right now.  Of course if I have to, we will make this work somehow.  I could ask my doctor for a medical leave from work.  Anything is possible if I have to make it happen.  But for once, it sure would be nice if things went my way on a few things.

On the topic of fear, I drew an Animal Spirit Guide card last that truly spoke to me.  When I tried to look  up a link to complete this post this morning, I found this one and drew *the same card*.  I got chills.

Meet the Falcon:

 

As you can see, the Falcon is telling me to act on the opportunity that is at hand and commit to it without equivocation.  As is likely true for so many of us RPL and IF sufferers, equivocating is something I do well especially about important issues over which I feel conflicted or fearful.  Interestingly, my question before drawing the Falcon was whether I am making the right choice in wishing to pursue the FET/reproductive immunological protocol I’ve selected and starting it  in a few short days.  Falcon has spoken and she has told me to stop equivocating.

I saw a falcon (I first thought it was a hawk but then realized it looked more like a falcon) yesterday when I was out with my niece.  We talked about falcons we have seen recently.  How serendipitous.

The Falcon, according to Dr. Steven D. Farmer, tells me that:

• “Providence is on [my] side, and the opportunity that has been presented to [me] is congruent with [my] soul’s purpose.  Even if [I] don’t feel fully prepared or have doubts in [my] ability to manage the complexities that are inherent in tackling this venture, [I must] dive in anyway.  [I]’ll be pleasantly surprised by the support that will come to [me] in unexpected ways.  All it takes is the willingness on [my] part to continue on a steady course wholeheartedly, while at the same time being open to changes in the direction that the winds are blowing.”
• “It’s very important to stay focused on the goal that’s ahead of [me], while also remaining mindful of the purpose of your mission.  Commit to your mission 100 percent, and fulfill that commitment to the best of your ability.” [Is this starting to sound like a Tom Cruise movie?]
• “This isn’t a time for analysis, introspection, or retreat, but a time for action. As [I] respond to the opportunity that’s before [me], I [must] be willing to adjust [my] course of action as the need dictates, while at the same time moving steadily toward [my] goal.  [I] can deal with whatever concerns come up without being distracted by them and without straying from the path [I am] on.”

Wow.  Thank you, Falcon.  Please keep talking to me, Falcon.  I needed your advice and the reminder to carpe this diem, commit to my decision completely, stay the course, shift with the winds as necessary and – above all – not to equivocate.

And on that note, the final countdown begins.  I hope today’s doctor and hypnotherapy appointments bring assistance and tools to address the medical and spiritual/psychological/emotional aspects of my “mission”.

I am ready.  (I don’t feel ready but I am committing to this 100%. It is mind over matter time, folks!)  Hear me fake a roar.  Roar!

*Non-sequitur alert* I am reminded of Alex the Lion in the Madagascar movies.  (Mental note to self: Re-watch those movies during the two-week-wait.  They always make you laugh.)

Wishing all of you – and me – luck and other good things in the coming weeks.