Trisomymommy

Hopeful

Two years ago this month, I was pulling out all the stops for a successful frozen embryo transfer. I took a lot of time off from work, treated myself to professional massages, got a pedicure, tried acupuncture, ate pineapple, went off coffee, meditated, did yoga, prayed. It all worked and that’s how the Miss B came to be.

This time I wasn’t nearly as motivated. I wanted to get pregnant, but it wasn’t with the same desperation I’d felt before. I hate to feed into stereotypes of the crazy infertile, but I was heading down that road in 2005. But this time, having already made it to motherhood, I didn’t feel like my identity, like my whole life plan, was at stake. I knew in a somewhat abstract way that I wanted to have at least one more kid, that I’d like to have them close together in age, and that I should start trying before I got too old, and yet I also had reservations. If this worked, what would it mean for Miss B? For my career? For my relationship with T? What if the next one was all colicky or something? In the end, we weighed all of factors and decided to go ahead.

I didn’t exactly go at it with the same gusto. I did all the shots dutifully, but I think I forgot a pill here or there. I didn’t take time off or pamper myself or have anyone stick needles into my forehead. I thought to call the acupuncturist but then forgot until it was too late, so then I just rationalized that the intramuscular progesterone shots in the hindquarters could be construed as a kind of acupuncture. I continued my coffee consumption unabated. I scheduled the transfer for Friday the 13th.

It seems to have worked. I’m happy but not celebrating. I’ve long since passed out of the blissful naiveté that allows me to assume that being pregnant means having a baby. It is merely a prerequisite, necessary but not sufficient. Still, I’m hopeful.

Look what he did

I went to see my reproductive endocrinologist (RE) today for the first time since he got me pregnant nearly two years ago.  After B was born, I was supposed to call him right away to tell him the news.  They need to know for their stats exactly how many of their IVF cycles result in pregnancy and how many of those result in a live birth, so I had promised to let them know the outcome.  I procrastinated for a long time and kept not calling.  It was complicated, of course, to call the guy who had created this pregnancy and who had, last time we spoke, recommended amniocentesis as a matter of course, advice which I had ignored.  But eventually I did call and left a message with one of his staff members saying that I'd had my baby, a girl.  I felt that I had to tell them about her extra chromosome, but nobody asked about that and I remember struggling to figure out how to bring it up.  I'm not sure why it seemed so important that they know.  I didn't feel accusatory or anything, but they were just so... involved.  My RE and his team had retrieved the eggs, selected the sperm to inject into those eggs, watched as the cells divided, decided which embryos would be transferred, frozen, and so forth.  They did not cause the DS, but they were there when it happened, and it felt incomplete for them to hear only that I'd had a baby.  So after the staff member congratulated me for having a healthy (her assumption) baby girl, I cut in with, "She has down syndrome."  She said something cheerful and we hung up. I have talked with the RE himself since then and he has always been very upbeat.

I like my RE.  He's understated, professional, and his waiting room is free of baby stimuli.  Back in 2003, before I got referred to him, I was seeing my ob/gyn for the initial infertility workup and it would take all of my emotional strength just to get through an office visit.  The waiting room was always full of pregnant women (complaining, no less) sometimes with their toddlers toddling along, or women with tiny newborns coming in for their 6-week post-partum checkup, and the tables were covered with pregnancy and baby magazines to keep us all happily entertained.  The waiting room of my RE's office is completely different.  It has the standard news magazines, a notebook with the RE's academic publications, information about support groups, no visibly pregnant women, and no children, ever. 

I'm sure that there are a lot of women going to the RE who already have kids, but I like to think that there is an unspoken agreement that we don't bring our kids to these appointments.  If at all possible, we make other arrangements out of respect for the emotional ordeal the other women there may be going through, an ordeal that we know well enough.  On the other hand, you might think that bringing the kids along would be a positive thing to do.  Maybe the women in the waiting room would find it encouraging, you walking in with a big sign that reads, "Look what he did for me!"  I doubt it, but maybe.

I can make other arrangements, so I have no reason to bring my kid along to the RE’s.  But what if I did bring her?  How would that be received?  I imagine the other women sitting there, grateful to be reading “Newsweek” instead of “Fit Pregnancy” as they wait for their turns in the stirrups.  Maybe they are new to IVF and feeling a little creeped out by high tech conception, and then in I walk with my chromosomally enhanced test-tube baby.  Look what he did for me, indeed.  I do not mean that to sound as bitter as it does – I have no regrets about having had Miss B, in fact, I’m very happy about it.  But despite all of that, I am well aware that my situation isn’t exactly enviable and that it looks much worse from the outside than it actually is on the inside.  The women in the waiting room are not aiming for this. 

After a brief wait, I was called back to see the RE. His first comment was a cheery, “Did you bring your baby with you?”   The cynic in me wonders if he might have had a carefully orchestrated a plan to whisk me through the waiting room so fast that my B would appear to be just a giggling blur.   Or maybe he would like to have met this groovy little person that he helped to create.

I never know how to interpret what people say anymore. 

Again

Every woman I know is pregnant.  I have to keep asking them over and over when their due dates are because I can't seem to keep track of them all.  Ok, maybe it's because I'm just not really listening when they tell me.  Truth is, it's awkward.  I'm awkward.  Some of it is left over from the years of trying to conceive.  Even now, after 13 months of motherhood, I still feel pangs of resentment when I hear about how easily, or even accidentally, my friends find themselves knocked up.  For free.  And of course there's the whole DS business.  They tell me how far along they are and I run through my mental calculations... nuchal fold, triple screen, level 2 ultrasound, amnio, yep, in the clear.  We don't talk about the testing.  I'm not the one they celebrate with when they get the relieving news.   So the little meanness in me that I'd hoped would dissipate after I finally got pregnant finds new life resenting my friends' fetuses' perfect karyotypes.

Just by identifying this feeling I fear I'm overstating it.  It's a small thing that pops up every once in a while, but it's not as if I'm this seething mass of snarky jealousy and resentment.  It doesn't really make much sense given that I'm actually pretty happy.  Life is good, although hectic, and my kid is delightful, although slow.  This is not a tragedy and I'm not miserable.  And yet... when I think of the long term future, well, you know.

I'm thinking of all this because soon I'm hoping to be pregnant too.  I wish I could feel more enthusiasm, but mostly I feel dread for the emotional ordeal that's to come.  Wish me luck.

More

I want more kids.  I know it might seem strange to be thinking this while my daughter is less than four months old.  I should just focus on her right now and worry about adding siblings later.  I should enjoy being released from the ordeal of trying to conceive.  I should give my body time to recover.   I should do some serious financial planning.  Trying to manage another baby while Miss B is still one herself would surely be a strain.  Waiting a year or two is the rational thing to do.

So where does this urge come from?  Maybe it's just leftover from the infertile years.  I spent so long hoping to get pregnant that it became a way of life.  You'd think that having a baby would satisfy me, but somehow the mere possibility of getting pregnant still fills me with hopeful anticipation.  I keep fantasizing that it will happen naturally this time, even accidentally, as if IVF taught my body what to do.  (You, egg!  See those sperm?  Hook up with one and then stick around for awhile.  It's just not that hard.)  Yes, I'm delusional.  I keep having these vivid dreams that I can feel a baby moving inside of me.

Or maybe it comes from my fear for Miss B's future.  Everyday I wonder about her adult life and what will happen to her once we die.  I hope that she will live as independently as possible, have work that is meaningful to her, and find lasting love and friendships, but I imagine that she will need some support and I don't know who will be there for her.  I don't intend to obligate her potential siblings, at least not overly, but I do think that one benefit of having a large family is that people are there for you when you need them.   I just want there to be some other people in the world who will love her and have her best interests at heart.  If she has siblings, it seems more likely that this will be the case.

I've thought long and hard about whether I would be feeling the baby urge if Miss B had not turned out to have T21.  Would I be satisfied then?  Is it that she's not enough to fulfill my dreams of motherhood?  I don't think this is the case, but I suppose it's hard to know.  I love her and I love being her mom,  and I expect that we will have a great family life over the years.  I imagine that parenting a typical child would bring some different experiences and different rewards and I want those too.  Why not have Holland and Italy?   Actually, as I write this I find it distasteful because it categorizes Miss B and my potential kids into T21 and NOT-T21 when I'd rather just think of them as individuals.  Any other child would have different traits than Miss B and so would bring different experiences.  This is all rather muddled.  Actually I find I do this a lot.  I go from thinking in terms of her diagnosis to forgetting all about it and just thinking of my daughter and then back again.  I prefer to think in individualistic terms, but of course her diagnosis affects my expectations for her future, so it's complicated.  But frankly, I would like to raise a typical child as well.  I don't think this devalues Miss B at all.

Or maybe it's just that I'm loving this mom thing and I want more and more and then more of it.  Unfortunately I got a late start, so if we want a few more they will have to be very close together.  Very.  Simultaneous even. 

Mother's Day

My mother-in-law came to visit for 5 days.  This was her first visit since Miss B was born and I have to admit that I was apprehensive.  My MIL has a tendency to offer unsolicited advice.  Usually I handle this with admirable grace and poise, at least I think I do, but I wasn't sure how things would go when she started advising me about my daughter.  My MIL is into various forms of alternative medicine.  Now, I try to be open-minded about that stuff, but for the most part I find it unconvincing.  I just really dig the scientific method.  I mean really.  I have this geeky love for it, for its power and rigor and elegance.  She thinks my thinking is too "linear," but I'm like, hey, lines rock.  What else gets you from point A to point B in such a short distance?  Nothing!  So anyway, I tend to choose medical treatments based on whether or not solid research (i.e., randomized, placebo-controlled, double blind research) shows them to be worthwhile, not based on testimonials or anecdotes.  Shortly after Miss B was born, my MIL tried to convince us to do a form of therapy on her that had little research to recommend it.  We decided against it, she insinuated that we weren't doing everything possible for our daughter, we got defensive, and things got a bit...well... strained.  She backed down and said she wouldn't bring it up again, and then brought it up again just to remind us that she wouldn't bring it up again.  So as I was saying, I had been feeling apprehensive about her visit.  As it turned out, it went really well.  She immediately fell in love with her first grandchild.  (It's interesting how much good will I feel toward anyone who responds very positively toward Miss B.)  She took care of Miss B for hours at a stretch and gave T and I our first date night in over three months.  We all got along well and she told me that she thought I was wonderful mother.  It seems to me that Miss B elicits a kind of tenderness in people, or at least in us. 

Sunday was my first Mother's Day.  Although I tend to scoff at holidays invented by Hallmark, I did set aside my cynicism long enough to reflect on my new status as mother.  I hope I never forget how much I longed for this.  Sometimes during the struggle to get here, I would wonder if I was idealizing motherhood.   Now I can say that I was not.  Of course, it is very hard, and the unexpected T21 diagnosis has been rough, but I was right all along about the important stuff, about how much I would love her.  I was right to want this so much. 

Jessica wanted this too, but did not get the chance.  My heart goes out to her family.

Last Shot

In the past year, I have given myself over 500 injections.  We did one fresh cycle of IVF and after that failed, a frozen embryo transfer that resulted in Miss B.  In addition to all of the hormone shots that IVF involves (Lupron, Follistim, the “trigger shot,” progesterone in oil), I injected blood thinners (Lovenox, heparin) throughout the IVF cycles and the pregnancy.  I have Factor V Leiden, a common genetic mutation that makes me prone to blood clots.  Because pregnancy hormones also make one prone to blood clots, I had to keep shooting up until 6 weeks postpartum.  Well, last week I had my postpartum checkup and my doc has cleared me to stop the shots.  This gives me a small sense of closure on infertility, pregnancy, and all of the difficulties of the past year.  My doc also cleared me to have sex (thus replacing one sort of injection with another) and asked, “What are you doing for birth control?”  Uhm… well... how about infertility? And then it hit me that having finally had a baby, I’m back to being infertile.  Doc didn't think that was a very reliable method, but it has worked well in the past and I'd welcome a failure.