Religion and Politics

I know these two topics are the controversial issues that should be avoided in most discussions, but I feel they are important conversations to have, so I'm going to make an attempt to explore. Starting with my own religious upbringing; my mother was raised Catholic, my father was Lutheran, they eloped and didn't attend church until I was 5. We joined a Congregational church that was close to our house and became active in the church community. My father served as a Deacon, my mother joined the women's group. I sung in the choir and eventually became a Sunday School teacher. When I was of the age to start classes for confirmation, I was denied entry as I hadn't been baptised. My parents let me chose my godparents (I chose Myrtle's parents) and I was baptised at the age of 13, just one week before my confirmation. I have since converted to atheism (I could start a whole new blog about that...) but I feel it was still necessary to have that religious exposure early in my life to have the perspective I have today. I have a lot of respect for those who find a role for God in their lives, but it just doesn't fit with where I am now.

My parents are pretty open minded people, and they made an effort to set that example for me. When I was 12 and wanted to watch the moving Dirty Dancing, my mother had to explain the abortion issue with me. She presented it as what it was; didn't reference if it were good or bad and didn't offer her own opinion. When a gay couple moved next door, my parents also gave a matter of fact description (which was much like Phoebe's song on Friends "Sometimes men love women, sometimes men love men, and then there are bisexuals, but some just say they're kidding themselves...la,la, lah, la-la") They didn't offer any commentary. My father was a registered Republican, while my mother is a Democrat. During the 1992 election campaign, they made me watch both conventions to determine my own party affiliation.

Somehow I don't feel that I could be that patient or tolerant. Maybe it a reflection of our changing times, but it we do have a child, I'll lay it out to him or her; you will be pro-choice, you will support LGBT rights and you will register as a Democrat. However, when it comes to religion, I don't want to be that determining. I would like him or her to have adequate exposure and arrive at their own conclusion. I will hope that he or she would chose atheism, or at least chose a religion that doesn't condemn me and Husband for being atheists.

A few weeks ago, Myrtle and I were speaking on the phone and were trying to wrap up the conversation. We each had tried to explain why we needed to hang up and get on with our day, which only let to talking about a new topic. On the third attempt to close, she mentioned, "I know this is awkward to ask you, since you don't believe in God, and it requires you to provide 'spiritual guidance' but I wanted to ask you if you wanted to be a godparent first, otherwise I'll ask Helen (a college friend)". My first thought to myself was to acknowledge that I couldn't accept. How could I perform in the capacity of providing spiritual guidance when it's something I don't believe in? How wrong would it be for me to stand in a church and agree to this commitment with my fingers crossed behind my back? I don't want to be disingenuous just to accept a title if I don't really deserve it. I have imagined that my role in providing spiritual guidance to little Myrtle would be if she wants to question the existence of   God and learn about atheism. Can you be an anti-godparent?

I politely declined her offer and shared our conversation with Husband later that day. He was really pissed at me firstly for not discussing it with him (he is absolutely right, I should have) and for turning down the offer apparently, I could refuse. He was annoyed when none of his friends back in England selected him as a godparent (presumably because of the distance; again my fault) and saw little Myrtle as his only shot. I questioned which was more important to him, the title or being true to his beliefs? However the doubt was creeping in my mind and I was regretting answering so hastily. As Myrtle's parents are my godparents would it not complete a circle to be little Myrtle's godparents? Myrtle is the closest thing I have to a sister and was bestowing a great honour to me. Should I not have been so selfish and set aside my own beliefs for the benefit of those around me?

I arrived at my own conclusion and I accept the consequences of my words. Interestingly, I conferred with some of my religious friends who felt that being a godparent was more of a social role as they felt that they didn't necessarily receive any spiritual guidance from their own godparents. I also consulted a few atheist friends, and a few thought I should have accepted. "God is abstract, but people are real," one told me. I also realised how much heavier the regret will be if I don't ever have a child of my own and I passed on being a godparent.

Surrounded by my own remorse, I did the next logical thing; question the sincerity of Myrtle's offer. It was a 'by the way' as we were hanging up the phone. We would be seeing her in two weeks, she could have asked both of us in person. Was she really just giving me first refusal, or getting my blessing before asking Helen? Myrtle's husband is Catholic and I'm sure it would appease her mother in law to have a genuine practicing Catholic as her granddaughter's godmother. When Myrtle got engaged, she delicately approached me about having Helen serve as her Maid of Honour. I was actually happy to be relieved of the duty, as it would have been difficult due to my busy schedule and the cross country distance. I told her that I know what she and I mean to each other and I didn't need a title to prove it. Myrtle send me a text after she asked Helen to be godparent and acknowledged, "you two are already family, you don't need the title as godparents."  

May you get what you want...

I have a vague recall of an episode of The Brady Bunch where Carol tells one of the kids about a Chinese curse that reads "May you get what you want". I can't remember what the context was, and I haven't searched the internets to see if there really is such a Chinese saying, or if it was just created by the writers. The phrase has been on mind as I contemplate how at one point I didn't want children at all, and more recently, I didn't want to have a baby who would be born in the year 2013. Well, with the delay created by my hysteroscopic resection, It seems that I'll get one of my wants: I won't have a baby born in 2013 (provisionally accepting that if I do get pregnant and won't have a preterm delivery).

So funny, that I thought it was the number 13 that would bring bad luck. Not having a wonderful husband who happens to have male factor infertility, or being one of the 3% of women with reproductive problems who have a uterine septum. 2014 seems to have multiple features in its favour, the Winter Olympics, FIFA World Cup, Commonweath Games, mid-term elections, including the Gubernatorial race in California. I acknowledge that having a baby in 2014 will be tough on Husband, as he turns 40 that year and wished to become a father at a younger age than his own father. I'm so sorry dear, I never imagined this process would take so long and be so hard.

The other wish that seems to be granted is that I'll be able to complete in our upcoming swimming championships. It's a large three day short course event, and our team does well, despite our small size. On the day of my BFP, I spun the gestational wheel to see how far along I would be for the meet. Twenty plus weeks. I may have been able to participate, but would have needed to adjust my times to be seeded in the geriatric heats with women in their 70s and 80s (who are rock stars at these meets, by the way). Now the meet is six weeks away and I can train as hard as I want with the intention of competeting as hard as I want. Is getting what you want truly a bad thing?

Expect Delays

I know I'm not as seasoned as others who have been travelling down the infertility road for a while, but I'm not a newbie either. I've often thought about what advice or words of 'wisdom' I could offer someone who is just starting out on this journey. The answer came to me when I was driving and took note of a traffic advisory sign: DENSE FOG: EXPECT DELAYS. 'Expect Delays' seems to be the perfect expression that captures our experience thus far. It gives me pause to laugh a bit, as I feel that I've tried to be proactive through this process. I started using Clomid early. When we didn't conceive after 6 months (although it had been less than 6 attempts) we started our work-up by testing Husband. It took over a week before he could even schedule an appointment with the urologist. I had to call the office manager directly and express how embarrassed I was that my husband couldn't schedule an appointment at the affiliation where I work. By June, I attended an informal open house and met my RE, but I had to wait for insurance authorisation and didn't have my first appointment until early July. Husband was referred to a male fertility specialist and in August, he was started on Clomid. IUI was deferred for three months to wait for the Clomd to take effect (which really didn't happen) We were ready to start in November, but had a surprise BFP, which unfortunately resulted in a miscarriage. I thought I would only have to wait one cycle before getting going with IUI treatments, but it was discovered that I have a uterine septum which needs to be resected. Fingers are crossed that   I'll be able to schedule my hysteroscopy in February, and then will probably need to wait another cycle to recover. If all goes well, we may be doing our first IUI in April. Exactly a year later from the point when we realised we needed help and started our evaluation.

From joining the forum and connecting with other bloggers, I know my experience is not unique, and there are many others who have been waiting much longer. Delays seem to be an inevitable part of this process. Cysts happen. Inadequate response cancels cycles. Meds don't arrive in time, lab work gets missed. Finances constrain. Holidays and provider vacations push treatments back. It seems that if it's not one thing, it's another. Just as natural conception requires a series of events to occur and align at the right time, the same can be said for assisted reproduction. Learning to be patient is probably one of the most difficult skills to acquire during this trying time. It reminds me of the final scene in When Harry met Sally. After professing his love to Sally, Harry explains, "and it's not because I'm lonely, and it's not because it's New Year's Eve. I came here tonight because when you realize you want to spend the rest of your life with somebody, you want the rest of your life to start as soon as possible." 

Pregnant Women are Smug

DISCLAIMER: Firstly, not all pregnant women are smug, and if you survive infertility hell and become pregnant or are an adoptive parent, you have earned the right to be smug. The title references a song from the folk duo Garfunkel and Oates who are sort of a female version of Flight of the Concords. They sing about everything from the ease of accessing medical marijuana, the inability to perform a good hand job and unexpected pleasures whilst go-kart racing. This particular song was inspired when one member was visiting with three pregnant friends and one asked her "So, what do you even do all day?" Perplexed by the question, but before she could even respond, the Smug Pregnant Friend (SPF) interjected, "I can't remember what I even did before I was pregnant, as it all seems so meaningless..." I highly recommend watching the Youtube Clip of their performance if you need a good laugh, and can relate to having an SPF who seems to reference her pregnancy every chance she can (you know, just in case you forgot) or who subtlety implies that her life is superior to yours now that she's great with child.  Again, not all pregnant women are smug, but it's great that someone called out the ones who are.

I first discovered Garfunkel and Oates and this song while randomly flipping channels and stumbled on their featured performance on Comedy Central's Half Hour Comedy show just a week or two before I flew out for Myrtle's shower. I watched the clip on my phone before the shower started and I sung the song in my head at times during the shower. To be fair, with the exception of one moment, Myrtle really wasn't smug at all during her pregnancy. When she came out to visit, she explained that she takes her prenatal vitamin during dinner and placed the bottle on my dinning room table and asked me to remind her to take it. Well, on the first night we went out to eat and returned home around 11 pm, when she discovered that she hadn't taken her vitamin. Her first response was to blame me for not reminding her. I simply pointed out that it wasn't time sensitive like birth control pills and she could just take it now (and shut up). She protested that she couldn't as she had already brushed her teeth (?) and she continued to chastise her husband and mine individually for not reminding her about her vitamin. Geez, were we going to have to prompt her to feed the baby once he or she arrives? Seriously, why couldn't she just have quietly taken the damn vitamin. She was one more mention away from having the line "Maybe the Dingo ate your bab-ah" thrown at her. Maybe I was being over sensitive, but I suddenly felt like such a loser for diligently taking my prenatal vitamin when I wasn't even pregnant.

Anyway, this post was inspired by my interaction with the most smug pregnant woman that I have ever met, which considering how many pregnant women I interact with everyday is saying something. I was attending Husband's company holiday party. I feel this requirement should be included in the marital vows: Do you take thee in sickness and in health and agree to spend an awkward evening with a bunch of people that you don't know, don't have any common interests and the food may or may not be any good? I had wandered over to the food table where I was soon joined by two other women. One was approximately 6-7 months pregnant and she looked as if she was in her mid, if not late 40s. My first thought was that she probably had many years of infertility issues and now was finally expecting her rainbow baby. The other woman was gushing all over her pregnancy, so the pregger gave her all her details. This was her third and she was 44. When she mentioned the ages of her other children, I quickly did the math in my head. She had her first when she was 39, second at 41 and now third at 44 or 45 depending on how old she would be at the time of delivery. Wow, thanks to science, I thought to myself, but was wrong again. She went on to describe that all her conceptions were spontaneous. When she and her husband first tried, they succeeded on their second or third attempt. When that baby was a year old, her Ob/Gyn advised her to try as soon as possible if she wanted a possible second and she conceived that month. They debated about having a third for a while, but once they made the decision to take the plunge, she stopped breastfeeding and conceived two months later. Now I was truly impressed, I don't think I've ever had a patient with two spontaneous (and successful) pregnancies after the age of 40. I could almost allow her to be a little smug with that accomplishment. However, she took it to a whole new level. "I'm living proof that you can do it," she started to explain "You can wait to start your family later in life." If she didn't already comprehend how rare her situation was, she expressed how oblivious she was, "I don't understand how people struggle with fertility. You just have to understand the science and get the timing right."

 We weren't trying to conceive at that time, but as a professional in women's health, I was extremely offended by her lack of sensitivity and oh, say general awareness. I usually don't reveal what I do for a living at these functions, as I've got into some heated arguments regarding some of the more controversial topics in women's health and I feel that I have to be on good behaviour as these are husband's colleagues. However this time, I couldn't hold back. There are so many fertiles who think that conception should be as easy for everyone else as it was for them, but the fact that this women didn't seem to appreciate that she was the exception to every norm and rule of expected probability that really got to me. I started to lecture that it's more than just science and timing, there are many more requirements; quality sperm and eggs, patent tubes and a functional uterus. Not to mention that even when all these conditions are satisfied, nearly half of infertility is still unexplained. "And what do you do?" She demanded to know my qualifications. She wasn't humbled at all. "Well, I didn't have any of those problems." she said. Smugly.

 I walked away and headed to the bar to numb myself with a strong drink. I would later learn that she's a high ranking scientist within the company and apparently no one challenges her. (Fortunately, she works in a different department than Husband, so I didn't have to worry about any threats to his job) Not only had I stood up for women experiencing infertility, I had earned some credibility among Husband's scientists colleagues. This party might be enjoyable after all...
                             

An Unconventional Relationship

A few years back, one of my older patients asked me if my mother and I were close. I paused before responding, which she interpreted as an answer of no, but I was thinking that it depended on how one defined a close relationship. As I became an adult, my mother and I successfully transitioned our relationship to a genuine friendship, one that is based on love and mutual respect. She is my confidant, the one I turn to for career advice, or when I need to complain about my in-laws. We shared a few private laughs over Myrtle's poor wardrobe choice for her engagement photos. We go shopping together, we bake cookies.  We just don't discuss any personal details.

When I was growing up, I observed even at a young age that Myrtle and her mother seemed too close, which felt a bit awkward to me. As an only child, your life is in a fishbowl, and I felt the need to hide what I could. Not that I had anything major to conceal, but I just didn't have the need to share every detail that occurred during the school day with my parents in the way that Myrtle did. As we both entered into our teenage years, Myrtle and her mother became even closer, which prompted many to wonder how Myrtle would handle leaving home (not well, was the eventual answer) and encouraged me to become even more independent from my parents.

Myrtle was the first to start her period, which was devastating to my pre-teen angst. Menarche would visit me a week later while I was at summer camp, inviting my mother, as well as Myrtle and her mother, to speculate if I made it up a la Nancy from Are you there God, It's me Margaret. Despite my protests of  "this is miserable, why would I lie about it?" I still had the feeling that no one believed me, and I questioned it myself as three months went by and I hadn't had another period. My mother was wondering the same thing and came out and asked me one day, "So, did you get your period again?" I shook my head and she responded, "Oh poor Jane," in a rather demeaning tone, "You haven't crossed the bridge to womanhood yet" and just to be a little more condescending, she tapped my cheek with her hand. Fuck You, I thought, but reached for my best know-it-all voice and pointed out that it was common for girls to have an irregular cycle in their first few years. Ha, I knew my physiology of menstruation even then. More so, I knew there was no point in sharing any information with my mother if I wasn't going to be believed.

AF would decide to make her next appearance within that month as I was taking gymnastics classes. Co-ed gymnastic classes, mind you. I only had one option; procure some tampons and learn to use them. I most certainly would not be asking my mother for help. I would figure it out myself. I had a regular baby sitting job every Friday night, so I stole a few tampons as well as the instructions (where was the Internet when I needed it then?) from her bathroom. I quickly got the hang of it, and once I did, there was no going back! In fact, ever the budding gynaecologist, I convinced many friends to erode their hymens with the best invention in the world. I knew I would arouse too much suspicion as the mother of my baby sitting charge would wonder why I needed to use 3-4 tampons within a 6 hour period every Friday night. Fortunately, (thanks to tampons!) I was selected for the gymnastics team, which trained at the high school once a week. Practices at the high school meant access to a vending machine that dispensed tampons! I would steal dimes from my dad's change jar and empty the machine. I wonder if the custodians ever noticed that they had to refill the machine every Wednesday morning...

This was my routine until I was able to drive and shop for myself. However, around my 14th birthday, our family went to visit my Grandmother. We were shopping at the Star market and as we passed the aisle of sanitary products, my Grandmother asked my mother if I had started my period -embarrassingly, right in front of my dad too. When my mother replied "no", my Grandmother suggested that she take me to a doctor. I wanted to yell right in the middle of the Star market "I've had my period for two years, you bitch!", but I quickly realised she probably thought I still hadn't started my period as she didn't have to buy me any pads. Worried that she would take me to a doctor and it would be revealed that I obliterated my hymen with virginity tampering tampons, I came up with a new plan. A month or two later I discovered her shopping list and added 'pads for Jane, please put them in my bathroom'. She obliged and we never spoke of it. To this day, she would likely answer that I started my period when I was 14, and not 12.

As I recount these memories, I'm struck by how one off-hand comment seemed to influence the direction of our relationship and if I do become a parent, I realise how easy it is to screw up. My mother and I would never engage in close personal discussions. We never had the sex talk. Once I went off to University, I became involved in many women's groups and started working at a family planning clinic, so she knew I had found sources for accurate information. When Husband and had been dating for a few months, she wrote in a letter, "have you taken any serious steps yet? I'll be happy for you if you did!" I never answered her, but felt somewhat pleased that she gave her endorsement for pre-marital sex. When she reached menopause, she made a ceremonial attempt to give me her supplies of sanitary products. I laughed to myself, as thanks to my Mirena IUD I probably had gone longer without a period than she just did, but I quietly accepted her offerings and brought them to the clinic for patient use.

I would later discover that our non-disclosure policy works in both directions. Months after the event, I learned from my dad or maybe Myrtle's mother that my mother had some postmenopausal bleeding and was worked up with an ultrasound and endometrial biopsy. "Why didn't you tell me any of this?" I asked, probably more bothered by the fact that I wasn't consulted as a second opinion. "Well," she explained "I really didn't know too many specific details or what was going to happen, and I didn't want to look stupid in front of you." Facing a possible cancer, this was my mother's primary concern...

So maybe our relationship is not one that many would define as close, but I appreciate our friendship for what it is and not what it isn't. If I do get pregnant within the next year, I'm not sure how much about our infertility or treatments I'll reveal. If we come up empty at the end of our journey, I'll likely disclose much of our story, just so she knows how hard we tried to make her a grandmother. I feel that either way, we'll start a new page in our relationship.

Staying in the Closet

The greatest challenge about going home to visit my parents will be how to navigate any conversation that addresses the issue of procreation. My parents are under the impression that we (namely me) are not interested in having children. That we're too career driven, too engaged to the freedoms of a child free life and resistant to the sweet charms of a young one. When we started TTC, and when I thought fertility was mine to command, I wanted to keep them in the dark so that we can unveil one of the biggest surprises in their lives.  Admittedly, it is a bit petulant on my part, but as almost nothing in this procreative pursuit has gone according to my intended plans, I want to hold on to this aspect. Perhaps it is the only detail in my control. There are a lot of other pragmatic reasons for keeping my parents out of the loop; My mother doesn't always display the most tact and I can envision her blurting out something like, 'Well, you shouldn't have waited so long!'. More importantly, I don't want to endure her asking any inappropriate questions. Myrtle was practically still smoking the post coital cigarette from her honeymoon when she announced her pregnancy, and yet my mother asked  "Did Myrtle have to do anything to get pregnant?" Yes, she had S-E-X, I explained to her, referencing the birds-and-the-bees conversation we never had when I was younger. My own infertility panic hadn't set in at that time, but I did take note to her line of thinking; woman at the age of 36 is pregnant -must have had help. I know my parents have been dealing with their own feelings of jealousy following the arrival of little Myrtle, and I don't want to coat those feelings with added disappointment from an infertility diagnosis. I'd rather let my parents believe that their future grandchild is being denied by my stubborn attitude rather than our biological limitations. Most importantly, I don't want to invite any additional pressure on ourselves. I don't want my parents to wonder if we are delivering news any time we phone. I don't want them to follow the disappointment of failed cycles. I know they would likely offer financial assistance, which would be very generous of them, and not to seem ungrateful (especially if we need to accept their hypothetical offer someday) but it would add another layer of awkwardness. Maybe there will be a day when I share this experience with them, but for now, I need to keep this fascet of our life to ourselves. I think we were offered a pass with a comment from a family friend. Earlier this year, she was recounting that her newly married 38 year old younger sister announced to their mother that she and her husband were trying to conceive. "Idiot!" the friend expressed, "You don't tell the parents that you're trying for a baby -that's asking to have problems!" Husband and I just looked at each other, acknowledging that you don't need to disclose your intentions to have problems, but we were relieved for my parents to hear that it can be customary not to inform the parents.

Closer to Fine

As I had the day off, I went swimming immediately after my sonohystogram. It had been nearly a month since I had been at the pool. Following a two week break for the holidays, I came down with a bad cold and then we entered one of the worst cold streaks in recent history. My swim group meets at 6 AM. Before I started swimming, I never considered myself to be a morning person. I once tried going to the gym before work and nearly fell asleep on the treadmill. However, swimming in the morning is so invigorating, especially when you're sharing a lane with 3 or 4 other swimmers as our coach is yelling at us. Every now and then, we'll be near the end of a set, and I'll hear her call "last one!" (which I should know by now really means the penultimate one), and I'll use every last bit of energy for the final lap, thinking I'm just yards away from touching the wall and easing into a cool-down. Then, she'll announce, "Okay, one more time!" There are some days when I'm able to throw down my best time of the day during this bonus final lap. I head to work carrying a feeling of invincibility and I feel ready to take on anything that will be thrown my way.
During my no good, very bad week, I felt that I was presented with a gut check to determine if was actually fine, or whether I had just been telling myself that I was fine. Once I had granted myself permission to accept that maybe I wasn't really fine, I was able to see what changes I needed to make. The first was realising that I needed to take time off from work, the second was getting back in the pool.  I was finished with my appointment in time to attend the noon swim class. As soon as I dove into the water I was reminded why I love swimming so much. The water felt amazing and the sensation was enhanced by having sunlight on my back. After taking a few warm-up laps, I broke into a sprint for a few yards. It makes me appreciate the feeling that I'm flying. The other great aspect of swimming is that is allows for partial sensory deprivation. I can't hear much when I'm in the water, which means I'm alone with my own thoughts. Particularly if it is a day of interval training, I can do some of my best thinking in the pool. Although I shouldn't have had work on my mind, since I was out of the office for the day, I flashed to some of the events from the week. Co-worker was on my schedule for her new OB visit, which was her way of revealing the announcement. As our colleagues reacted, I stood next to her and smiled, feeling like an unattached bridesmaid at a wedding who wonders if it will ever be her turn. More importantly, I didn't have the urge to hide in the bathroom and cry, as a week earlier, I had feared that I would. I also had a patient who presented with an unplanned pregnancy and needed options counselling and interestingly, it was after completing her visit that I realised that maybe I am truly feeling normal again. My emotional hangover had finally lifted.
I guess sometimes it's hard to understand what really makes us feel normal. Whether it be getting up early in the morning to swim when it's cold and dark, or realising that professionally I am good at a job that can be difficult for me personally at times. I think it's just more important to embrace whatever it is that brings you closer to fine.