Category Archives: Second Thoughts

An introduction

I have a daughter.

She was born on Saturday, 18 June, at 5:07 p.m. at 39+6.

She was 7 lb, 12.5 oz at birth and 21 inches long, with a head circumference of 34.5 cm. She was nearly identical to her big brother’s stats at birth (7 lb, 15 oz; 20.5 inches; 36 cm).

Her first name is the same as this author.

And her middle name, which is a family name on both sides, is the same as this first name.

Her labour was nearly identical to E’s. I was unable to sleep on Friday night because I had contractions that were long enough and frequent enough (every ten minutes or so) to keep me awake. When I got up on Saturday morning, ate breakfast, and had a shower, they dropped right off again and were sometimes forty minutes or longer apart. By lunchtime they were back to being ten minutes apart, but they were long enough (a minute) and strong enough (I couldn’t ignore them) that we thought we should make sure labmonkey and Pea were on their way in (although I told labmonkey I thought she had time to go to her appointment with the bank first).

Around 2:30 p.m. my midwife called to check in as I had spoken with the student midwife that morning. I told her what the contractions were doing and she said to page back either when they intensified or got closer together.

Around 3 p.m. I decided to have a shower to see if that made a difference, since the one that morning had stalled them considerably.

While in the shower they started coming every 2 minutes apart. By the time I was dressed again they were shorter but still very close together and intensifying.

I paged the student midwife and told her in no uncertain terms I wanted to go to the hospital RIGHT AWAY. This was a difficult phone call as I had a contraction in the middle of it and E. was freaking out that suddenly we were leaving, so he was trying to hold on to my legs and crying while I was on my hands and knees on the bed coping with the contraction.

labmonkey and Bean arrived and we basically threw E. at them and went out the door. (E. was fine as soon as we left and had a wonderful time with them).

Despite having a birth plan with only one item- DO NOT have the baby in the car- there was a point in the twenty-minute drive where I thought we’d left it too late. I was starting to get a lot of pressure. The contractions were still two minutes apart and very intense. Q. did a fantastic job getting us there (he said afterwards, “I’m so glad I bought the German car with the powerful engine”).

I had a contraction as we parked and got out of the car and was then determined to get into the hospital and into the elevators before the next one came. Q. said I made quite an impact on everyone milling around outside the main doors. I can vaguely remember hearing someone say, “Ooh that woman is having a baby today!” as I willed myself to keep walking.

I had another contraction in the elevator and two more before we could get into a room. As we were walking down to the room my midwife said to the student, “We’d better page the backup midwife right now”.

We got into the room and the student midwife offered to check my dilation. I was happy to do this because there was a part of me that was worried I was still going to be at 5 cm and the contractions were becoming really hard to cope with.

I was at 9 cm. This explains why the car ride was so horrible- I was in transition.

We decided I had just enough time to get into the tub, so my midwife filled it. I got in, they managed to do the admissions bloods in between contractions, and probably within eight minutes or so my body started trying to push. I didn’t want to give birth in the tub so I had to get out again and I had one horrific contraction while standing before we could get me back to the bed.

By this time the backup midwife and her student had arrived, so I had four midwives plus Q. to support me. They were checking P’s heart rate regularly and reassuring me that she was doing well and that everything was normal.

I think I pushed for around twenty minutes- this was more intense than it was with E. and I found it really hard to control what my body was doing.  When she was born there was this pop and explosion of liquid and I was terrified that it was blood and I’d torn badly, but it turned out that P. was born in the caul and that explosion was the sack breaking open at her birth. Q. said afterwards it was a bit like a horror movie because she was flailing like mad as soon as she was born to try to get out. The midwives were very excited and said it just made her that much more special.

I ended up with one tiny cosmetic tear, much like with E., that my midwife stitched just because otherwise it wouldn’t join back up. After the birth I was incredibly cold and they kept bringing hot blankets (I remembered these with E.- they are the best possible thing at that time). The placenta delivered without difficulty and was intact. P. came up onto my chest straight away and we delayed cord clamping. We said yes to the Vitamin K shot, no to the eye drops, and yes to oxytocin to help the placenta detach.

E. at birth squawked a bit and then had a long period of “quiet alertness” where he took everything in. P. came out MAD and she stayed mad until we were finally able to establish a decent latch. She wanted to get nursing straight away and became increasingly frustrated when she didn’t immediately demonstrate mastery of this skill.

“Fiesty!” said one of the midwives.

Two other comments: “She doesn’t really look like a newborn at all!” and “She’s so alert!” were identical to what they said with E.

P., like E., has a lovely round head because she didn’t have time to get squished during delivery. Her Apgars were 9 and 10. The critical issue of whether or not the kidney is functioning was resolved that first night with proof of a wet diaper. The rest of her newborn exam went well.

We opted for early discharge, like with E., so we were back home by 8:15 p.m., early enough that we told labmonkey to keep E. up so he could meet his little sister. E. was wildly excited (there were many kisses on P.’s little head) but did manage to go to sleep that night when we finally packed him off to bed just after 9:00 p.m.

Q. and I were all set to learn from our mistake with E. about not sleeping on the first night when the baby is tired, but P. apparently missed that memo and went straight to “cluster feed every hour for the entire night”. She did this again last night before finally falling asleep at 3:30 a.m. and sleeping until 6 a.m., which was the first chance I’d had to get some sleep since Thursday night. All that effort has meant my milk is in already and I’m hoping for some more settled nights at some point in the near future.

It’s been an emotional couple of days. We went through so much to get here, as you all know. And now she’s here, she’s safe, and she’s real.

Our daughter.

(Feel free to email me at rescogitataeATgmailDOTcom if you’d like to see pictures.)

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8 Comments

Filed under Anxiety Overload, Joy, Me? Pregnant?!, Midwives, Second Thoughts

News, unexpected

A couple of weeks ago I went back to my clinic.

I know, I know.

I wrote here about how we were done with the clinic. DONE. Never returning.

I meant every word of it too.

And then, right around the same time that I reached my conclusion, the Ontario government announced that they were going to honour their promise to fund one IVF cycle (for any woman under 43, regardless of family status).

I will admit, that gave me pause.

I thought about it. I really thought about it.

And then I decided that their announcement didn’t change things, even if they had everything in place to start funding before the end of the year (which is a big if).

I realized that I wouldn’t go back to the clinic even if they PAID me.

So what changed?

Well, remember that cycle where I cut out dairy before ovulation and promptly ovulated on day 18?

The luteal phase from that cycle felt weird. Different from the last two.

And when I hit 12 dpo, and my temperature still hadn’t dropped (which it had never done before) I got curious.

IMGP5560

At 17dpo, I went back into the clinic.

The betas followed:
17dpo: 594
19dpo: 1476 (doubling time 36 hours)
22dpo: 5851 (doubling time 36 hours)
25dpo: 13914 (doubling time 57 hours)

They never called me (at my request) with the fourth beta as by that point I had taken up residence in Crazytown over the prospect of multiples, because the betas were higher than either of my two previous pregnancies (including the one that started as a twin pregnancy) and they were doubling faster. You were spared all of this angst because one of my sisters was on vacation, and I needed to tell her before I posted on the blog as both my sisters read it. When I managed to link up with her via Skype (the day before the fourth beta) she helped me pack my bags to move out of Crazytown, as she’s a scientist and she can crunch the numbers properly and I trust her. I knew that another fast doubling time would send me back over the edge, so I opted not to know.

Yesterday was the ultrasound.

And we saw this:

IMG_41631

ONE baby. Measuring 6w2d. With a heartbeat of 114.

It is still early.

I have been here twice before, with only E. to show for it.

But it looks like we’re getting one more shot at this whole family of four thing.

We’ll take it.

11 Comments

Filed under Cycle Madness, Me? Pregnant?!, PCOS, Second Thoughts

Clarity (Part Two)

One of the books I read this month was Selfish, Shallow, and Self-Absorbed: Sixteen Writers on the Decision NOT to Have Kids.

I have quite a lot I’d like to say about the book, but right now I only want to look at one sentence. In her essay “Babes in the Woods”, Courtney Hodell describes the point in her life when she did attempt to get pregnant, only to discover that it wasn’t easy after all, and ultimately decides not to continue trying.

Of that moment, Hodell writes, “I wasn’t relieved, but I wasn’t sorry either.”

That sentence resonated with me. It has burrowed down into my soul.

The last two cycles, I have had moments where I thought I could be pregnant.

It is theoretically possible, after all. I am tracking my temperature. I know when I ovulated. I’m not in a sexless marriage.  I know when these events overlap.

I’m not very good at recognizing what my body normally feels like post-ovulation, because I am not yet used to this entire concept of having a luteal phase that isn’t supported by progesterone and Fragmin and prednisone and the rest of the chemical cocktail. (It still boggles my mind that I can just write the words “the last two cycles” because I now HAVE cycles.)

So I have had points where I’ve wondered.

And then my temperature takes a nose dive one morning, and I know I am not, and Hodell managed to so perfectly encapsulate how I feel in that moment.

I am not relieved.

But I am not sorry either.

I am content in my life.

I will always, in some way, miss the baby we lost, but it is harder and harder now to imagine any family that is not my current lived reality.

I think I would welcome that most unlikely of situations, a natural pregnancy. I think I would rearrange my head and my heart to make sense of such a world. I think I would be able to adjust my vision of our future.

But it would no longer be easy.

We are complete.

We are happy.

And I think I can say this now and really, truly mean it:

I don’t want a second child enough to ever go back to the clinic.

Acceptance.

I never thought I’d reach it.

But I’m here now.

5 Comments

Filed under Choose Happiness, Cycle Madness, Second Thoughts, Three's Company

Masquerading as Normal

31 days this time.

And that, my friends, is within the doctor-approved normal range!

But before we get all excited, let’s look at what my chart showed (imagine you can see my chart here, because I’m too incompetent to figure out how to provide a web link. Not that you need to see that, but I’m rather proud of my temperature raise post-ovulation.).

Ovulation on Day 21. Late, but just squeaking into the normal range. I was ridiculously excited by this. Ridiculously excited.

I stayed excited right up until 9 dpo, when my temperature made a slight, but significant dip.

Surely, I thought, it’s not dropping already.

It was.

It dropped again, significantly, the next day, and I had a lot of spotting that afternoon. And AF was there in full force by the next morning.

I called it a 10 day luteal phase, but the tenth day wasn’t ideal, not least because Q. and I had gone away for a minibreak staycation while my parents looked after E. This would mark exactly the SECOND time Q. and I have left E. with my parents for a night. The last time was in November 2013 (when my mother famously locked herself and E. out of the house the following morning, which, if you know how the locks work in my house, you would know that’s quite a feat. Luckily we were still in the city and were on our way home when she called).

Anyway. Last weekend. Just us, a fantastic hotel room, some musical theatre, a great dinner, a bottle of wine, and my most unwelcome hanger-on.

SERIOUSLY, body. You choose THAT MOMENT to decide you couldn’t be bothered with a reasonable luteal phase? After YEARS of inaction?

Ahem.

It was still a great staycation, and even with all the fun of the previous day (musical theatre! tasty dinner!) I think the best part remains when we got to read the newspaper IN BED THE NEXT MORNING UNTIL 11:30!!!!!!!

I did all the puzzles.

I don’t think I’ve done that since E. was born.

Possibilities:

  1. My body is still figuring itself out and this time my LP could be longer.
  2. Something isn’t right with my progesterone levels (or the balance between estrogen and progesterone) and I have an LP defect that would send me to a fertility clinic if I weren’t already at one.

I’m going to withhold judgment until I see what happens this month, but you know I’m expecting more problems. Because that’s just how my body rolls when it comes to reproduction.

In the long run, a 31 day cycle with a 10 day LP is just fine and dandy. It’s only an issue if I want to get pregnant.

And maybe I still want to get pregnant. I’m not sure these days.

So I’m opting to stay off the birth control, delay returning to the clinic by at least one more cycle, and wait to see what happens.

But if my body repeats what it did last cycle, I won’t have to wait that long.

And that in itself is terribly exciting.

1 Comment

Filed under Cycle Madness, Food, PCOS, Second Thoughts

Just Say Yes

I know I’ve been really quiet lately. Partly it’s because it’s summer here and E. skips his quiet time quite a lot so we can go out and enjoy the sunshine. Partly it’s because I’ve been working on job applications and my parent job for the nursery school (I left all the work I had to do until the end of the year and then had to really put some time into it in the last couple of weeks).

Mostly, though, I think it’s because I’m still where I was two, four, six months ago, and I don’t feel like repeating myself over and over again. I have enough of that in my own head.

I’m getting close to the point where I’m supposed to go back to the clinic to set up the timings for an IVF cycle in August, and I am still evenly balanced.

I want to go in.

I don’t want to ever go back.

I want a second child.

I want our life as it is to continue.

I really thought by now things would be clearer to me, but they are still as clear as mud.

Here’s a really interesting ad for a full-time, permanent position in the field I think I’d really like at the university where I could actually commute to it and still drop E. off at school.

Yes.

Here’s the chair of my department, wanting to know if I want to teach an online course for them next summer. Oh, wait, now it’s two online courses. Two full-year courses, taught in a compressed fashion.

Yes.

Here are all my pills and supplements that I have to take every day, and all the protein that I have to eat, if I am going to give another IVF cycle its best possible chance.

Yes.

I say yes to everything, to every opportunity, to every possible future, because we’re not yet at the point where I have to say no. I don’t have to narrow yet. I don’t have that job. The online teaching is a year away. I may not go back to the clinic, but maybe I will.

At the same time, keeping all the options open is in itself exhausting. Who am I going to be next year? Will I start a career? Will I do sessional teaching as a job to stay flexible for E.? Will I get the job AND do the online teaching, because it would be utter madness to not get myself entrenched with online courses, even though that would make for a crazy few months? Will I do the online teaching AND have a baby at the same time? Also crazy in the short-term, but a decision that would make sense long-term.

About the only thing I know is I’m not going back to the clinic in August if I get the full-time job and it starts in August because I wouldn’t have the time.

Every day, I choose not to choose yet, because I don’t have to.

One of these days, not choosing is going to be too exhausting.

One of these days, something will become clear, whether it’s my employment options for next year, or how I feel about the clinic, or all of the above.

But it’s not today.

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Filed under (Pre)School Days, A (Good) Day's Work, Anxiety Overload, Life after the PhD, Second Thoughts, Three's Company

(Un)Necessary Prep Work?

I’ve been making a few changes chez Turia in the last couple of weeks.

It started when a friend of mine sent me a link to this soundbite (this is a different link from the one she sent me, but it’s the same story).

Basically, this doctor found in a small study of women undergoing IVF that women who ate a diet that had less than 40% carbohydrates and 25-30% protein had vastly improved outcomes with embryos reaching blast, pregnancy rates, and live births.

I was interested enough to send it to my sister, who’s a trained microbiologist and therefore my sounding board for anything scientific.

She was intrigued too. It’s not the actual study- just a report of the presentation of the findings. And the sample size was small.

But I figured, what the hell. I’d already made some changes to my diet as part of my “be mindful of what I eat” resolution, so I figured a few more wouldn’t hurt.

I’ve swapped out cereal and oatmeal at breakfast for eggs or Greek yoghurt.

I’ve swapped out sandwiches at lunch for quinoa salads, salads with tuna or chicken or hard-boiled egg, or home-made soups that include legumes.

I’ve cut out grains entirely for snacks.

And I’ve pretty much left dinner alone, because I don’t think eating pasta for dinner once a week is going to be a deal breaker. Q. has responded with enthusiasm to my request to include more meat in our dinners on the nights he’s cooking, and I’m making sure dinner on the nights I cook is heavily centred around lentils and other veggie proteins (I have a lot of trouble cooking meat- I went vegetarian before I learned how to when I was a teenager, and I can manage ground meat and chicken breasts but struggle with everything else. Plus I don’t think we should be eating meat every night anyway.)

Maybe it’s all pointless, but it’s worth a shot.

Other things I’ve started doing:

  • taking metformin again
  • taking coQ10
  • taking a B complex vitamin with extra B6
  • taking a multivitamin with extra folic acid
  • taking baby aspirin

And I’m still taking my vitamin D (2000 IU a day).

And yet, I could look you straight in the eye and tell you I wasn’t sure if I would do another IVF cycle, and I wouldn’t be lying.

Does that sound weird?

It feels a bit weird to me, but it’s true.

We had originally thought if we did another IVF cycle we’d do it in May after we got back from visiting my sister and future brother-in-law.

But once I decided I wanted to start taking the supplements and change my diet, we decided to push back into July, to make sure I’ve had the three months needed to make a difference.

We’re still not sure we’ll go through with it in July, but I decided that if we were keeping the door open, I needed to prepare so that if we did try again, we’d know we gave it our best shot.

I don’t want to do another IVF off the cuff, have it fail, and then wonder if things could have been different if I’d taken a couple more months to prep my body.

I realized that not taking the supplements, for me, was tantamount to saying “we’re done”.

And we’re not. We’re on the fence still.

So I needed to start taking everything to keep both options on the table. At worst, if we decide in July or August not to go ahead, we’ve spent a bit of money on unnecessary vitamins.

I don’t like being in limbo, but it’s not for much longer, because we will either cycle in July/August, or we will be done.

At that point the age gap will be five years, which was always our cut off date. And we’ll be almost a  year out from our last FET.

July will be the moment of decision.

For now I’m just taking it one day at a time, sitting with both options, noticing (but not judging) how I feel about things, and hoping that my digestive system will adjust to the new regime soon.

4 Comments

Filed under Choose Happiness, Food, Medical issues, Second Thoughts, Siblings

Decisions

I had a hysteroscopy on Good Friday.

I’d met with the new f/s on Wednesday. Among other things he said he’d like to take a look at my uterus to make sure there was nothing amiss.

No scarring from the D&C.

He happened to have a free spot on Friday, and then he was going to be away for a week, and Q. wasn’t teaching on Friday like he normally would be, so I figured it made sense.

I didn’t realize until I was actually there in the IVF suite that they use the same drugs as they do during egg retrievals.

(Note to readers: if debating between going home accompanied by your husband and son on public transit and going home accompanied by your husband and son in a Zipcar, rent the car. I still feel a bit queasy remembering it, but we got home without any vomiting.)

But it was all easy. They got me settled in the room (thigh stirrups now- much more comfortable- and new chairs in the recovery areas too), I had a chat with the nurses, they started my drugs, and I don’t remember anything else until I was in the recovery room and it was almost time for Q. and E. to come and get me.

The new doctor (it is hard for me to say MY new doctor, because I feel like that suggests a relationship I’m not sure we yet have) came back to tell me the results.

“It all went really well,” he said, smiling. “Everything looks perfect. So just let me know whenever you’re ready to start.”

Here’s the thing: part of me, a significant part of me, was disappointed to hear that.

Because, if there had been something wrong, something that made him think we had to do more to make my uterus hospitable, if surgery had been mentioned, I would have been DONE.

Bang.

No discussion.

The line would be firm.

And we could move on.

***

There is a line from Leslie Jamison’s The Empathy Exams that has refused to leave me.

It comes in the first essay, when she imagines a more honest monologue in the tape recorded notes of her doctor:

Patient wants everyone to understand it wasn’t a choice it would have been easier if it hadn’t been a choice.

And there we have it.

***

“There is no medical reason for you to stop,” Dr. B. told me during our meeting, when he read my chart carefully and listened to me carefully and thought about my case carefully and in no way resembled my previous doctor. No Jolly Santa unicorns and rainbows optimism. No emotional manipulation. Just cold truth and statistics.

35-40% chance of another IVF working.

20% chance of miscarriage if it did work.

Strong recommendation for PGS, although he understood my reluctance given my previous lack of success with FETs and my high embryo attrition rates.

Although he wavered, in the end he recommended a short protocol (unlike my two previous IVF cycles). He said he was tempted to just do what we did in the cycle that produced E., but he prefers the short protocol for women with PCOS. He would rather have a smaller number of eggs but a higher percent mature and fertilized.

“You were thirty when you did that cycle,” he said. “You can do anything with a thirty-year-old. With women in their mid-late thirties, we have to think about it a bit more.”

Translation: although they have told me this for years at that clinic, I am no longer young.

***
“If you decide to stop,” he said, “it will be for socio-cultural or financial reasons.”

Q.’s sister is getting married, down under, in January of next year.

We could go there for Christmas, all three of us, and escape at least part of next winter.

Or we could blow that money (and then some) on another round of IVF that probably won’t work anyway.

Our neighbours flooded our basement (long story).

We think what makes the most sense long-term is to give up on the carpet we installed down there before E. was born, get someone in to rip up the ceramic tiles underneath, and lay a new tile floor with nice tiles that we actually can stand to look at, and then put area rugs over top.

Or we could spend the money on another round of IVF that probably won’t work anyway.

We could save a good percentage of our annual income this year, even though I’m not working.

Or we could spend the money on another round of IVF that probably won’t work anyway.

If we stop, it’s not really for financial reasons.

We can do another round of IVF without going into debt. We can do PGS if we want to.

It feels like we can’t afford it, because it would seem so incredibly wasteful to flush that money down the toilet, but that’s not really the truth.

***

Yes, I’m getting older, and Q.’s getting older, and E.’s getting older, and we’d be looking at a five year age gap, and having a second (or, gods help us, twins) would completely destroy any semblance of a career I might try and build as I’d never recover from having this year off, and then being pregnant, and then home with a baby, and Q. and I have already agreed that if we have a second there’s no way we can juggle that baby between us like we did with E., so if someone’s at home with the baby, that’s me, so I will probably go insane because I wouldn’t want to put that baby in daycare during the first two years but boy do I ever suck at being a SAHM, BUT.

If it happened, we would muddle through.

We would adjust.

Our family would adjust.

I would find some way to balance children and career.

I have doubts and fears and reservations about the wisdom of bringing a second child into our family at this stage, but nothing that would take the choice away from me.

***

Patient wants everyone to understand it wasn’t a choice it would have been easier if it hadn’t been a choice.

Yes.

I wish with all my heart it wasn’t.

4 Comments

Filed under Anxiety Overload, Medical issues, Money Matters, PCOS, Second Thoughts