Just as long as it's healthy...

It was taking my usually efficient medical assistant a long time to room my patient. Not a good sign. The patient was a transfer from Kai.ser at 12 weeks and 4 days. This was her fifth pregnancy and will be her fifth baby. Finally, she emerged from the room. "The patient doesn't speak English, so I had to use the translator phones. The husband was annoyed as he offered to translate." [we're not allowed to have family or friends serve as translators] "I explained that we don't need to do an ultrasound today, as she's had two with Kai.ser and he is also annoyed as he thought they would get an ultrasound today and learn the gender. He was particularly focused on the gender." my medical assistant explained. It's always good to know what I'll be facing when I enter the room. The patient had a pretty complicated medical history and the translator was having a tough time keeping up. The husband started answering a lot of my questions, which I let pass, as he was pretty detailed. I could sense the frustration in his voice. Finally when I concluded with her intake, he brought up the fact that the call centre agent told them they would have an ultrasound today [as he or she probably didn't know they were a transfer] and he took the day off from work so he could find out the gender.

Perhaps I was a bit sympathetic, as I took an afternoon off for my most recent OB appointment which involved a 5 minute interaction with a doctor who hadn't looked at my chart and a lab tech who had to stick me twice as he didn't draw for my second trimester genetic screening in spite of the fact that the order was in my hand... How incompetent was this office? Let me count the ways... Anyway, I offered to the couple that I would do an ultrasound as courtesy, but I explained that 12 weeks is too early to accurately determine the gender. The baby was cooperative and I was able to get a good measurement and some nice photos. As I was finishing, the patient asked (in perfectly spoken English) "So, is it a boy or girl?" I reviewed again that it's too early to tell. "TRY." she commanded in a very demeaning tone. I was struck by the audacity of her request and the fact that she understood and spoke English after we spent her entire visit using the translator service. She then added, "My children will be very disappointed as they thought they would be finding out today." "Well." I replied as I prepared to leave the room "You can tell them that you're having a boy or a girl."

I figured she would go home and tell her kids that about the mean lady who wouldn't try to determine the baby's gender and was making them wait six more weeks. Maybe she'll look for another provider. I couldn't believe that after four prior pregnancies she expected to learn this early. I offered that they could do a gender scan at 14 weeks, but they weren't interested when they were informed that it wasn't covered by insurance and would be an out-of-pocket expense. This patient stuck in my head for the rest of the day, as I started to question if my own decision not to know our baby's gender makes me less sensitive. (Although two of my medical assistants who have children couldn't understand why they were so obsessed as she already had two boys and two girls.) I defend my bias by noting that I've seen enough tragic cases to understand that there is more at stake than determining if you'll be painting the nursery pink of blue. Noting the genitalia on an ultrasound is really an incidental finding (with the exception if a parent is a carrier of an X chromosome linked disorder) as the purpose of an anatomy scan is to assess the growth and development of the baby's vital organs. Determining gender doesn't affect the obstretical management. I recently discovered a blog where a woman left her anatomy scan disappointed that they didn't uncover the gender during their scan, only to find out how trivial such a disappointment was when her obstetrician called later that night with the horrible news that multiple deformities were found on her scan. Since we've started using the Pan.orama Non-Invasive Prenatal Test, we have been correcting patients who refer to it as 'The Gender Test'. Co-worker is not so subtle. "It's a genetic screening test, not a gender test. How would you feel if we called you with the news, 'Guess what! You're having a Boy! Snails, Pails and Puppy Dog Tails! Go Team Blue! Oh, by the way... he may have Trisomy 18...'"

Oh, we don't care... Just as long as it's healthy... Despite the fact that this statement embodies what I preach, I find this cliche rather annoying. 'Healthy' just seems like such a vague and generic term in this context. It's more than just a normal set of chromosomes. There is physical health, developmental health, emotional health, psychiatric health... we all want our babies to be perfect in every way. Maybe I still hold a little distain as I hear echos of Myrtle's smug words during her pregnancy, "I'm older than you and my baby is healthy..." as I expressed my intention to do an amniocentesis [this was prior to any fertility treatments and eventual CCS testing on our embryos]. No Myrtle, my proximity to you and your perfectly healthy baby does not offer me any reassurance. Speaking of Pregnant Women [who] Are Smug, I have to give props to Garfunkel and Oats who call attention to the fact that gender and health are not mutually exclusive. "I mean, it's not like you have to chose one or the other." It's okay to have a preference for a girl or a boy and to wish for him or her to be healthy. Although they challenge anyone to admit that she "doesn't care if it's brain dead, or limbless, just as long as it has a penis." (If you're confused, click on the link)

There is one more case that stays with me. When I was working in an inner city clinic in Connecticut, I saw a young patient in her third trimester. She was a bit immature and rather bratty. She requested to have another ultrasound to make sure the baby was actually a ________ (I can't remember what the gender was). I explained that our clinic doesn't perform scans just to determine gender and she didn't have any other indication for an ultrasound. "Well, if it's not a [whatever the gender was], then I'm going to be really MAD!" she threatened. I sighed. Earlier that week, I had helped deliver a full term stillborn baby girl. The patient was 41 years old and this was a surprise, but desired spontaneous conception. "No." I told her "You'd be mad if something horrible happened to your baby and you went home to an empty nursery." Although I had no basis of experience, I added, "As long as your baby is fed, warm and comfortable, he or she won't care what colour the walls are painted. Trust me, when you're getting up at three in the morning for a feeding, you won't care either."

"So we're still not going to find out the gender?" Husband asked as we drove to the anatomy scan. "I could go either way at this point." he quipped. I thought about how quickly we exclaimed 'NO' in unison when the French embryologist asked just after our transfer. How we double checked that the 'gender of baby' box wasn't ticked on the Pan.orama form, and I had Co-worker look at my results first just to be sure our request was honoured. "We've come this far without knowing, we might as well go all the way." I replied. Perhaps it's an obstetrical obligation; that if I talk the talk, I'd better walk the walk. Least, I come across as sounding noble, I do have to confess that once upon a time I viewed unveiling the gender at birth as a novelty. I thought people might be impressed with my restraint, given how easy it would be for me to determine. I was bitter when both Myrtle and Co-worker also held out until the end, as I feared I wouldn't be perceived as being original, or could be accused of copying. I've finally learned the lessons that I've preached over the years. It doesn't matter, just as long as he or she is healthy. Whatever that means.

I actually didn't watch most of my ultrasound, for fear of accidentally discovering the gender, but also so I could focus on the technician's face. She was very serious, but I didn't see a wrinkled brow or look of fear in her eyes. Jate's measurements are on target and no abnormalities were found. "Based on the American Institute of Ultrasound Medicine (AIUM) guidelines, this is a normal obstetrical study." my report will read. Of course, it will be followed by the legally mandated statement, "the presence of a normal anatomy survey does not rule out a genetic, structural or chromosomal abnormality," but I'll take it.  I can't smugly proclaim that my baby is healthy. I can only hope.

2015 Challenge Update #1

Unknowingly, we actually started this project before my parents' arrival. While we were cleaning and trying to make it looks as if no one actually lives in our house, we had a good cull. We got rid of all things that we don't actually use, including the stuff that we'll claim we'll use, but really won't. Anticipating that our home will be dominated by all things baby related, if this pregnancy goes the distance, I want to pare down as much as possible. We threw all the discarded items into the garage, as we didn't think my parents would have any reason to go into the garage. One of the best things about our neighbourhood is that various charities will come around to collect old clothing and household items. They'll send a flyer in the mail announcing the next date, you leave your crap by the curb and they'll put your donation receipt for the tax return in your mailbox. Usually, the flyers are like buses; if you miss one, just wait five minutes and another one comes along. Sometimes there will be multiple pick-up opportunities within a week. Yet, over a month went by and nary a flyer was seen. So one obstacle was that we had to work around the clutter. The other challenge was that we had to take down the ceiling lights, so all work was done when natural light was available.

While my dad was still here, he and Husband installed a set of pull down stairs in order to gain access to the new storage space.

Stairs and Materials: $300

Husband's friend Susie came over one day to let us have access to her truck. They brought a truckful of unused construction materials to a recycling centre, where they will be repurposed. While, he had access to a truck, Husband picked up the insullation, framing and flooring materials from Home Dep.ot. Susie stayed to help Husband complete the framing in preparation for the dry wall. 

Insullation and Lumber: $600

Recycling Fees: $50

In order to be able to dry wall the ceiling and create a storage space, we realised that we would have to move some of the wiring in the garage. Husband is pretty adapt at simple electrics, but this was a little out of his reach. Plus, my dad noticed there were a few things with the current wiring that weren't done according to code. The professional electricians moved the wires, corrected the faults, and added several new outlets, including a few outside, so that we no longer have to drag extension cords through the garage when we want to use the leaf blower. They accomplished quite a lot in a single day's work. (During which, Husband failed to offer them a cold beverage...) We also had to purchase some new lights for the ceiling (we had been repurposing the flourescent lights that had been in our kitchen) as well as a new outside flood light (it was broke during my father's visit, but I never heard the story on how it happened...) We also needed to call our Alarm company, as our service was disrupted after the electrians' visit.

Electrician: $825

Lights: $200

Alarm Service Call: $175

Total to Date: $2,150

We started installing the floor in the storage space, but all construction came to a screeching halt as Husband went back to the East Coast and then to England for two and a half weeks. I kept things going by re-organising all our tools and researching storage solutions (don't worry, I'll spare the pictures). In all honesty, I appreciate the distraction from my pregnancy and I somewhat hope it keeps us occupied until we have to start planning and preparing for the baby's arrival. One thing is certain; there is no way we could have started this project with a newborn in the house. It does make me wonder when we'll ever be able to tackle other renovations. Husband went into the crawl space under the house (I'm not quite sure why...) and I was in charge of keeping Tyler away from the opening. I thought I had shut the door completely, but Tyler is clever enough to open any door that is ajar. Just as I went to make sure the door was shut, I saw his fluffy ginger tail disappear into the crawl space. Husband spent almost half an hour crawling around trying to find him and to coax him out. It was one of those moments that made me realise how great a father he will be, and I felt that I was doomed to be a horrible mother if I couldn't even keep my cat out of a dangerous place. I left some food out for Tyler and sure enough within twenty minutes, he was either hungry or bored and made his way to the opening and within my reach. He was fine with the exception of being a little dirty. Crisis was adverted. Still, if it is this difficult to work having a cat around, how will we get anything done with a small child? 

The Invisible Fence

Recently, I ran into one of my patients at Starbucks. I recognised her right away, but I couldn't think of her name. She had a spontaneous conception at the age of 41, who was now the adorable 18 month old boy on her hip. "I'm going to be seeing you soon!" she announced. "I'm pregnant!" She went on to explain that she had recently messaged my colleague about trying for a pregnancy at the age of 43, and lo and behold, she was peeing on a stick a month later. I know cases like this are more of the exception rather than the norm, but why does it seem that I see so many of them? I decided I could be jealous of her ability to get pregnant so quickly, but I also know the risks of miscarriage that are present for her, so I can't be too envious. As I walked back to my car, I had to remind myself, you're pregnant too!  I made a conscious effort not to acknowledge my pregnancy in the early weeks when I was still going through scans with my RE, but even at sixteen weeks, it still is so easy to forget.

Actually, I should clarify that thoughts about my pregnancy only escape my mind during my working day. When I get home each night, Husband's first question is to inquire how Jate and I are doing. Both my parents send me a text message every Thursday, as I reach a new week, and I've been sharing my weekly bumpdate photos with them. The bump has become more apparent at the gym, and more people are taking notice. Myrtle recently described how when she announced her pregnancy and her bump became more prominent, it seemed to invite her co-workers to over share about their experience. She learned about everyone else's hemorrhoids, incontinence episodes, varicose veins, swollen ankles and delivery horror stories. I realised at that moment that I'm especially not ready for my patients to learn of my pregnancy as I don't want it to take any focus away from their visit.

So far, I've still managed to conceal myself at work. It's a great advantage to having a closet full of little black dresses, and best of all, no one really notices that you're repeating the same outfits each week. My clothes still fit, but some reveal the bump more than others. I wish someone would create a line of transitional clothing. 'Transitional Pregnancy Clothes: When you're not big enough for maternity clothes, but you don't want to stretch and ruin your regular clothes...' Sometimes, it's not as easy as just selecting a larger size. I'm reluctant to purchase maternity clothes for a few reasons. Firstly, anticipating that this will be my only pregnancy, I don't want to spend much money on things I will only wear for a few months, possibly less if I need to be delivered pre-term. Secondly, although I'm sure they're super comfortable, jeans with the large expandable panel have to be the unsexiest item ever. I am very grateful for a local blogger who offered some exercise clothes to me.

Nonetheless, I decided to do some research and started looking through a local parenting website to check out recommendations on where to shop. Husband was watching some strange movie on the Sy-Fy channel and I was bored. I typed my search into the google and clicked on the first interesting link. Then Safari suddenly crashed. I felt as if I had been zapped by an invisible fence. Icarus had flown too close to the sun. What are you doing Jane? You haven't even had your anatomy scan yet! You can look at this yet. 

I know it was merely a coincidence. It seems that whenever I install the updates on my iPad, programmes crash more frequently. Yet, I felt it was a reminder that I can't get ahead of myself. I decided to start searching something safer and began looking into garage storage units. "What do you think of this one?" I asked Husband, who could barely turn away from some alien attack. "We don't need to think about the storage unit until the dry wall is done." he replied. Apparently, there is also an order to planning for the garage as well. "This unit is 30% off now." I informed him. "The savings is over four hundred dollars. That's a pram or a car seat."

I smiled to myself. When I first met Husband, he compared the price of anything to how many pints of beer he could by for the same amount of money. When we first renovated our house, we calculated fees according to building materials. Most recently, we measured costs in terms of fertility medications and treatment procedures. This was the first time I was acknowledging a monetary value as it related to items for our baby. My actions may need to be contained within the invisible fence, but my imagination is free to wander.

Do you think he knows there is a baby in there?

About a week or so after Angus's death, I announced that I was going to start interviewing potential candidates to fulfil the cat vacancy that had opened up at our house. Like hiring an employee, it was essential that we select the cat that would best fit within our family. Tyler's sweet face invited me to view his profile, which read "his resume boasts of lap-sitting, non-stop purring and looking supercute". It was a little eerie that the word 'resume' was used, as it fit just to perfectly with my interviewing approach. I had the feeling he was the one, and naturally, Tyler aced his call back.

Of course, I had to go through my own interview process to be approved for his adoption. His application form asked many details questions about our home life, including if we had any children in the house. Fortunately, this agency didn't ask is we had plans for children. When my friends Sam and Diane suffered a miscarriage, they decided to adopt a cat while they were waiting to try again. Hitting on a sensitive nerve, the shelter director asked if they were planning to have kids any time soon. When Diane admitted that they were, the director put her pen down and informed the couple they were considered unsuitable for adoption. "I've seen your type before." she explained "Once the baby comes along, you'll neglect the cat." Sam and Diane went to another shelter, this time they were prepared to lie if they were asked the same invasive question. Diane also employed a different tactic, she expressed interest in an older, hard to place cat. The rejection that she experience from the first shelter made her sympathetic to the cat that no one wants to adopt. Diane would go on to become pregnant with twins on their first attempt after her miscarriage, but the cat was actually a good fit for their soon to be expanding family. She actually prefers to be left alone, but she gets fed in the morning, finds sunny spots for her naps and sleeps on the foot of Sam and Diane's bed each night. For her, it's a great life.

It did give me pause to consider that not only was Tyler going to have to adjust to a new home and new family, he was going to have to learn his supportive role to an infertile couple. I once asked Husband if he thought Angus was aware of what we were going through with our fertility treatments and miscarriages. "I think he sensed the tension" Husband speculated. He sure did. He just seemed to know when I was down and in need of some kitty therapy. I just had to hope that Tyler was going to be a quick study. He had only been with us for about two months by the time I did my fourth transfer, and I don't think he was too aware of what was going on, although he did sit on my lower legs while I was resting. Two months later, when we did our final FET, I think he had a better understanding. Post transfer, he snuggled right on my lower pelvis as if he were acting as an incubator for my uterus.

"Do you think he knows there's a baby in there?" Husband asked as Tyler was once again lying on my lap. This photo was taken when I was nine weeks along. Could he sense baby Jate's heartbeat? Cats have a powerful sense of smell and are specially responsive to pheromones. My Vet mentioned that her cats seemed to know that she was pregnant before she did with both her pregnancies. A few years ago, an article was published in the New England Journal of Medicine about a cat who lives in a Nursing Home and would sense when residents were about to die. Dogs can be trained to recognised hypogylcaemic episodes or to detect seizure activity. Is it too much of a reach to think that a cat could detect life?

I like to think that he can. He still sits on my lap, but in a more protective manner. Dare I say even proud.

The 2015 Challenge

Prior to making our announcement to my parents, Husband speculated that they might offer us money or make some other grand gesture after learning that we needed to do IVF. The discussion made me uncomfortable, as it brought me back to my conversation with Myrtle, where she thought I was entitled to ask my parents to fund a night nurse because we had spent so much to give them a grandchild. I instructed Husband that he was only to discuss the financial aspects if specifically asked, and that he should reply with vague answers. It didn't take much prompting. After one question, Husband sung like a canary and divulged the full amount. Although we had agreed that we would only give each other one gift less than fifty dollars as Christmas presents, my parents announced that they would get us new garage doors. (As you read this, remember to pronounce the word gar-ege rather than gah-raghe.) Ours are wooden and they're pretty ratty.

The prior home owners removed the automatic operators, so they need to be opened manually and propped up...

Nonetheless, neither car has seen the inside of our garage since we moved in almost five years ago. The garage has served as a workshop during our renovation products as well as a location to store all things random crap. Finishing the garage has been on our grand to-do list, but relatively low on the priority ranking. In addition to the pregnancy and infertility announcements, the weather may have encouraged my parents' offer. It was pouring rain and unseasonably cold on the night they arrived. Getting wet and cold while lifting suitcases out of the boot yielded concerns about getting a baby in and out of the car seat. I was tempted to voice that the cold and rainy days are rather few, but Co-worker convinced me how useful a functional garage can be. "Your kids fall asleep while you're driving, and you just pull into the garage, put the baby monitor in the car, let them sleep while you go in the house and get shit done." So, we thanked my parents for their very generous present. However, this gift has become a little like one of those If You Give a Mouse a Cookie books...

Prior to mounting the garage door openers, we should dry wall the ceiling...

If we'll be dry walling the ceiling, then we finish the walls...

If we're going to be pulling cars into the garage, then we'll need to improve our "organisation" system
   

So, we should create some extra storage space above the rafters...

And we might as well give the floors an epoxy treatment...

Not to sound ungrateful, but this gift of the garage doors is going to involve a bit of money and work on our part, which we weren't quite expecting. My Dad suggested that he and Husband could tackle the project while he and my mother come to visit/help after Jate's arrival. I quickly rejected that suggestion. Firstly, I know how all-consuming renovating can be, and I want Husband to learn his fatherly duties. Specifically, nappy changing. Although, I know it's good to have normal volume in the house, as a fetus is exposed to a lot of sounds in utero, pure quiet can be startling, but I don't think the loud noises from power tools will be particularly soothing. I'm also not a germophobe, but no matter what room you renovate, the dust and dirt invade the entire house. Finally, although we've said that we'll fit baby into our lives, rather than revolving our lives around the baby, after all this time, he or she will have earned their moment in the sun... It later occurred to me that my Dad may not really know how to help care for an infant. Paternity time wasn't a concept in 1976. I was born on a Saturday, came home on Sunday and he probably went back to work on Monday. Scheduling conflicts don't allow my dad to come out before Jate's due date, so it will be up to us to complete the garage before Jate's arrival, which could be earlier than anticipated. Long time readers may recall our 2013 Challenge, when I tried to become pregnant before finishing painting and installing all our kitchen cabinets. Watch this space for updates on our progress.

Bump Denial

After announcing to our family and a few friends from Cross-Fit, it's starting to feel that I may just be, actually pregnant. We haven't quite connected this fact with the possibility that we might really be having a baby. It still seems like an abstract concept. We'll casually speak about a baby coming into our lives, but I think we sound like one of those fertile couples who discuss plans for their future children as they believe they're guaranteed to have kids. (One of my patients is trying to conceive her third baby, her last menstrual period was 22 December, so she's still in her luteal phase, too early to test with a FREPT, but she already scheduled a new OB visit in February. Probably while smoking the post coital cigarette. Just try to imagine that.) We're still working our way past the major hurdles. Although it was a bit perfunctory, we still scored our normal NT scan and negative first trimester results as a victory. Our Panorama testing was negative for the most common microdeltions, including 22q11 deletion syndrome. Also know as DiGeorge Syndrome, most notably portrayed as 'The Bubble Boy' from Seinfeld. The next stop is the Quad marker screening, to be followed by a hopefully normal anatomy scan. If all that goes well, then we focus on reaching viability and holding off pre-eclampsia. I still haven't purchased anything baby related, and other than my cousin's offer of her bassinet, I haven't given any thought to the nursery or the million other items we'll need, but I suspect that is to be expected for anyone at this gestational age, and not just those as wary as us.

I'm still not ready to be public about the pregnancy, but I'm not sure how long I'll be able to keep it secret. I informed my mother that I won't have the fucking textbook perfect pregnancy that Myrtle did and I instructed her not to discuss any specific medical details with Mrs Myrtle. She later complimented me on how I looked, so I offered that she could mention to Mrs Myrtle that I was barely showing and had only gained one pound by 12 weeks. (Myrtle gained an excessive amount of weight during her pregnancy and her mother hounded her about it.) "I don't mind if you compare us in the categories where I'm WINNING!" Yet, I may have spoke too soon as my weight gain doubled by the time I officially hit my second trimester. I can still fit into my regular clothes, although I'm starting to hypothesise that work out clothes can serve as maternity wear. Fortunately, I have a lot of black dresses, so I've been relying on the slimming effects of the dark colours. I've been asking Husband to do a 'bump check' before I leave for work, although I claim that I don't have a bump yet. "Yeah... you do..." Husband counters. I argue that he's anxious for the bump's presence as he's been rubbing the space. As well as talking to it...

Concealing the bump at swimming has been easier than expected. As I tend to run a little late, by the time I'm diving in, everyone else is in the pool doing their warm up laps. I also decided to swim in the 6 PM session as it's been so cold in the morning. Thus, I get to avoid Lena and Summer and the other girls in the locker room. Actually, even pre-bump I was tempted to tell my latemates as swimming was such a struggle in the early weeks. Shortness of breath and reduced exercise tolerance are common symptoms and the high oxygen demands making swimming especially arduous. I went from being the lane leader, to barely being able to keep up with the interval. However my absence during our east coast trip and my post transfer recovery supported my claim that I was just really out of shape (kernel of truth). As an extra bonus, the swimmers in the evening session are much slower, so I'm feeling like I'm a rock star.

I don't check my blood pressure at home as often as I should, but I've been really diligent about taking my Labetalol twice a day, as well as my baby aspirin. When I went for my first OB visit, the medical assistant measured my blood pressure with the automated cuff. 166/107. Holy shit. I am going to die during this pregnancy... I asked her to check in manually and it was 130/84. While I am no longer in denial about my hypertension, I will always insist on manual readings. My mother also had a hard time accepting that I have blood pressure issues. She thought it could be attributed to my luteal phase support meds, and I ignored her advice to consider stopping the Labetalol after I went off my progesterone. Of course, this could also be her defense mechanism as I claimed that her genes were to blame. Nonetheless, I explained what is in store during my pregnancy. Frequent ultrasounds to monitor baby Jate's growth. ('Jate' was my mother's creation, as it's a combination of our intended boy name 'Jack' and girl name 'Kate'. More appealing that the other option 'Kack') Twice weekly survaliance testing starting at 32 weeks. Hopefully these aspects along with my lab work will be stable and I won't need an emergency Caesarean delivery. Otherwise, unless I spontaneously go into labour, I'll probably be induced sometime between 38-39 weeks. Yet, my mother asked me if I were planning to have a natural delivery. Twice. Bump denial comes in many forms.

The Prodigal Daughter

A few weeks after the failure of FET #4, I received a call from my mother to discuss visiting over Christmas. My aunt expressed that she really wanted to see my father this year after her ordeal with breast cancer. As my mother works in health care, she isn't able to take extended time off around the holidays. So, she decided to move her retirement up a few months and come out to the West Coast for two weeks. During this time, Husband and I were discussing when to take the plunge with yet another FET. He wanted to defer the transfer until after October, so I wouldn't have to administer meds while visiting my parents in Connecticut, and it would give us a break financially. My RE's vacation in November meant the next opportunity would be in December, which would coincide with my parents' visit. It was interesting that Husband thought it was burdensome to shoot myself up with Lupron at my parents' house, but we could discretely run out for a transfer and then casually breeze through the two week wait while hosting my parents. Obviously, that was not appealing to me. I convinced Husband to proceed with the transfer in October, so that if it didn't work, we could perform the Endometrial Function Assay and prepare for a final transfer in January. Meanwhile, I tried not to think about the fact that if that transfer worked, we would be able to inform my parents when they came to visit for Christmas.

I scanned myself that morning to make sure we were still good to go. Their flight arrived in the early afternoon. Traffic delayed the drive home and my parents had just settled in with a glass of wine when I came home from work. I started opening the Christmas cards we received in the post that day, while on cue, my mother mentioned that she didn't receive one from  us. "Oh, we decided to save the postage"  Husband explained, as I presented them with their Christmas card. Tucked inside the card was a recent ultrasound photo with the announcement "Baby Allen, due July 2015" as well as the blastocyst picture. My mother burst into tears and revealed that for years she has been saying that all she wants for Christmas is an ultrasound photo. "Well, we've been trying for years to give you one..." these words began to explain our experience with infertility and repeat pregnancy loss. As I anticipated, my mother was upset that I didn't confide in her. She brought it up a few times during her visit. I reiterated my reasons multiple times, but I think it still bothers her. My father was much more understanding.

As we were clearing the table at Thanksgiving, I talked to my aunt about her chemotherapy treatment, so I could have some suggestions to help my friend who was about to start that process, and I felt badly that she was hosting both Thanksgiving and Christmas. I made what I considered to be a non-offer, and suggested that we could have Christmas at my house. She replied with the anticipated response, "oh, that's sweet! but no thank you, I was planning to have everyone here for Christmas." A few days later she reconsidered, and sent me a text, "Actually having Christmas at yours would be great". I didn't think that (A) my 76 year old aunt was texting and (B) that she would ever accept my offer. I had to break the news to Husband, who of course thought of all the practical considerations that I neglected. "Where are we going to fit 10 people?" and "Do we have enough matching plates and flatware for 10 people?" Fortunately, my parents are expert entertainers and worked this dinner as if they were our catering staff. We put our breakfast table next to the dinning room table and found it would seat 8 adults and 2 kids. I did an alternating plate pattern, which I thought I could pull off as being trendy. The only hitch in the day was that we asked my aunt to bring a chair for my cousin's older son, and we asked my cousin to bring her travel high chair. They both forgot, so we had to use our office chairs, which meant I had to re-arrange my entire table configuration. Grrrr.

We deferred to my Dad to lead a toast before dinner commenced, as he wanted to acknowledge his sister's triumph over her cancer. It was extremely touching to hear him recall his initial fear and anger after learning of her diagnosis to allowing himself to be inspired by her recovery. My father and his sister may only have one common parent, but they are full siblings in every way possible. He described how they made their decision to make the trip to the Bay Area this year, but then he added that they'll be back next year. "Only, I'll have a new title. I'll be called 'Morfar'" My aunt was the only one who recognised the Swedish word for grandfather and shrieked before hugging me and Husband, which clued in everyone else. I was able to disclose to my relatives that I've been pregnant for the past three Thanksgivings, but this was the first time I was still pregnant by Christmas. Husband quickly recapped our infertility stats. "Oh, we know all about going through that" my cousin responded.

There was so much venom that I wanted to spew. I wanted to express that as a fellow infertile I felt betrayed by the way they displayed amnesia toward their own experience. I wanted to express how shocked I was by their lack of sensitivity. I wanted to express my anger at they way they fueled the ignorance by proclaiming their spontaneous conception was the result of 'being so relaxed...' Yet, I knew it wasn't the time nor the place. Especially as my cousin offered to let us use the bassinet used by her sons and my other cousin's children, I retracted my claws. As infertility has made us chavs, we will accept any item offered to us, but I liked the idea that something used by other infants in our family, would be passed along to me. My cousin's husband was quick to say "Well, now you can forget all about that [our infertility experience]" NO WE WON'T. Husband and I responded in unison. He also warned that we might conceive spontaneously on our next trip to Hawaii. "No, I'm familiar with this stuff called birth control" I retorted with a snappy tone.

Trying to contain my parents' excitement was an impossible task. They were able to attend my nuchal translucency ultrasound, but following Husband's lead, they were watching my reaction as well as the screen. I'm not trained in performing NT scans, but I've seen enough images to recognise a normal versus an abnormal scan. Our baby looked textbook. My mother expressed that after knitting sweaters and hats for so many other babies, she was delighted to have the opportunity to work her knitting needles for her own grandchild. She mentioned that she recently donated two knit onesies to a charity event. "Well a knit onesie may be a little warm where we live" I informed her as I noted that we would love any hats, sweaters and blankets. Meanwhile, my father causally mentioned they visited a furniture consignment shop that was owned by an English couple. He later described that they had some nice leather chairs. The next day, my mother showed me a picture from her phone of my dad sitting in one of the chairs. Two days later, my dad described that the arms of the chairs were perfectly positioned for holding a baby in one's arms. Okay, I know they're excited about their future grandchild, but does that mean they get to redecorate our living room? Before I could address that, my mother pulled up a picture of the onesies she donated. They were actually more of a complete pajama with closed feet. I'm not an expert, but I thought you wanted something soft like cotton against baby's delicate skin. It didn't seem too practical. "I still think it might be too hot..." I suggested. "Fine!" my mother snapped as she closed the cover to her mini iPad. "I won't do anything for you!" Sigh. First lesson in parenting: learn to pick your battles with the grandparents.