10 January 2017

The Next Journey

I am grateful that our battle with infertility* was over quickly. We are lucky that the fertility doctor we saw was not one who tried to milk money out of us, or give us false hope. It hurt, but hearing that our chances of changing what my body could do were slim allowed us to make decisions quickly.

From the early days of our relationship, J & I talked about having a family. We discussed what our various options would be -- I thought that due to my age, getting pregnant may be a problem -- and one of those options was adoption. While we were at the fertility doc, she also brought up options, though she was leaning towards surrogacy. This isn't something we really considered. I am not 100% sure why, but neither of us were that interested in it.

We went through two rounds of fertility treatments -- for me that meant a few rounds of estrogen. At the same time, we realized that this may not be the best avenue for us, so we started exploring other options, specifically, at this point, adoption.

I guess nothing in life is guaranteed, but with adoption, you are likely to end up with a child. Unlike IVF, or surrogacy, where you can spend a lot of time and money and still be left with a hole in your family. I'd seen many of my friends go through some extreme fertility issues --  I saw the stress to them and their relationships -- and while those that ended up with children said it was all worth it, I wondered about those who ended up still childless.

But still we thought we would see one more specialist. Then, my uncle passed away very suddenly. Very shortly thereafter we found the second round of estrogen hadn't worked at all. And I was tired of fighting what seemed like a very uphill battle where we were unlikely to be successful. And I needed success; I needed a win. J & I discussed and then agreed to stop fertility treatments and focus more seriously on adoption.

And this decision was the best we could have made.

*I still struggle with considering myself infertile, but, by definition, I am. I can conceive, but not get pregnant. 

05 January 2017

Sicily: Not your Godfather's Palermo

J looking out from our balcony
Before we got to Sicily, we heard a lot about driving there. To be careful, that drivers were a bit crazy... but for most of our trip, the driving was pretty sane and the roads mostly country.

Until we got to Palermo.

Palermo is what folks are talking about when they mention the insanity of driving.

We were headed from Cefalu to the Kalsa neighborhood of Palermo. It was a bit harrowing, to say the least. As is often the case when you go to a new big city, we didn't know the rules of the road that locals follow, so we basically just followed what the cars in front of us were doing.

Our AirB&B was a nice one -- a big one bedroom with a lovely balcony that with a view of the nearby church. The weather was nice, so once we arrived and parked, we relaxed. There is always a point on a long trip where I need a day to not be a tourist, not do anything...this was that day. We hung out and watched movies, drank some wine, and eventually got ourselves together to get out of the house.

The first thing you must eat while in Palermo is arancini. These things are huge, and delicious. They are usually filled -- with meats, cheeses, and sometimes both -- and a wonderful snack while walking around. And, in my opinion at least, walking is the best way to see Palermo. This is a big city, and as such, you should take the same precautions you would take in any big city. My understanding is that there has been a concerted effort to rid the city of the mafia, and other than the Godfather souveniers, I didn't see any overt evidence of it. So there is nothing to fear there. But while there, like in other cities, be smart.

Quattro Canti
We walked towards the Quattro Canti, an important corner with beautiful artwork on each side of the street. This was the first but not the last time we visited this area -- you can spend quite a bit of time wandering the streets, following a parade, and checking out the various churches and monuments...you can also pop into a bar when you need a drink or to hear some locals shout about their families.

Eventually we made our way towards the Teatro Massimo, which takes you through the main pedestrian area. These streets are lined with shops, people, and food vendors.

Stop by il Siciliano to have a few drinks. Arrive early enough that to get some seats...then sit and watch the local nightlife unfold around you. The drinks came with some appetizers -- enough to hold us over for quite some time.  Eventually stumble out and over to get some proper Sicilian food -- it'll be filling and delicious and just what you need before you go pass out!

We spent our last night in this neighborhood, surprised how busy the restaurants were on a Sunday night. We found ourselves at Ciccio Passami l'Olio. The bar here was particularly great -- and had several local, Sicilian beers; I'd highly recommend.

Palermo is ideal for wandering around, eating until you burst, and drinking granitas. I also loved that I didn't feel like I was running into too many other tourists, especially in the neighborhood where we were staying (that was what you would describe as "up and coming").

il Siciliano
Via Orologio, 37

Ciccio Passami l'Olio
via 90133, Via Castrofilippo, 4

31 December 2016

Hello 2017!

2016...a year I am looking forward to putting in the history books.

For me it is marked by loss -- very personal loss.

The world is not completely cruel -- along with the loss I had some gains...I was lucky enough to gain two beautiful new nephews. I am loving watching them grow.

But I do hope 2017 brings more gains than losses. I am entering 2017 with hope -- and hope you will, too.

But 2016...smell ya later!

Wishing you all a very happy and safe New Year.

29 December 2016

The Small Percentage

20% of known pregnancies become non-viable/end in miscarriage.
2% of known pregnancies end in missed miscarriage (the body does not expel the fetus, even after non-viability)
30% of D&Cs from a missed miscarriage lead to Asherman's Syndrome (uterine scarring)
23.5% of women over 35 diagnosed with Asherman's are able to give birth.

What does this all mean?

My doctor was convinced I would get pregnant very quickly once I got my period. Frankly, I thought I would, too! But when that period never came...we started to get concerned. We waited a bit...just in case my body was taking its time getting back on track. When after over two months came and went, it was time to take things into my own hands and push for further diagnosis. (tip: become your own advocate. Push when you think something is wrong.) 

First I had a sonogram -- luckily we had this scheduled because my doc thought she saw a strange blood vessel and wanted to get it checked. That didn't tell us much, but the sonogram doc recommended that I have a sonohysterograph. Sounds intimidating, no? (tip: take a few ibuprofen and be prepared for some cramping. It is uncomfortable but not painful) The doctor became concerned when she could barely get the fluid in. I became concerned when she said that meant there was some scarring...and the call from my ob-gyn further confirmed this and suggested I see a specialist.

Off I went to a specialist in minimally invasive gynecological surgery. Full of hope, I watched as he looked over my results. I listened as he talked about my uterine scarring, also known as Asherman's syndrome, and went over how he would perform the surgery, an operative hysteroscopy, and the risks involved. And a few days later, there I was in the operating room, and shortly thereafter, in the recovery room. The scarring was extensive, he had gotten most of it, but I needed to have one more to finish it off. In the meantime, I would take estrogen to help build my endometrial lining, and progesterone to help get my body to have a period.

Knowing what I know now...not getting that period would have been a sign that something else was wrong. I didn't know that then, though...what I did know was that I had a short window in which to have this surgery before I, once again, had to travel for work. I adjusted my schedule, and on our first anniversary, 9 May 2016, I went in for my second hysteroscopy.

I will not forget the look on my doctor's face when he told me that while he had gotten all the scarring, my endometrial lining was less than optimal; in fact, it was almost non-existent. After a month of estrogen, it should have been nice and thick...and it wasn't. I cried a lot that day. J felt sad that day. To me, that news was harder than hearing our pregnancy was non-viable. It was harder than the D&C procedure that had likely caused the scarring. The following day when my ob-gyn called to tell me to say she'd never seen anything like this, reminded me she had stopped the D&C so she wouldn't go too deep, and that I would need to consider other options, I cried more.

In a weird way...it felt like the first time I had felt something visceral since my dad passed away. The sorrow was deep, my cried more like bellows...I wonder what the person in the hotel next to me thought. I quickly made an appointment with the fertility specialist, but that day, I started grieving. I had lost my ability to carry a child.

We went to the specialist -- tried a few more rounds of estrogen. We tested my eggs -- there were a lot and they were good. My body was absorbing the estrogen well, but still my lining didn't exist. The cruel irony didn't escape me...I thought it would be my age that would hinder our ability to have kids, but no, I am fertile Myrtle but with no place to put 'em! I listened and cried as two different fertility docs told me to consider surrogacy. I grieved that my body couldn't do what it was supposed to.

And I was angry. Angry that my body couldn't do what it was supposed to. That through no fault of my own, my fertility was taken from me. I was angry that my body felt terrible -- bloated and crampy -- and I got no relief. And I was sad that J's chance for a bio child was taken from him, too. That took a long time to get past.

During this time I also suddenly lost my uncle, which, in a weird way, helped make our next step decision a bit easier.

So what does this all mean?

It means I had a lot of bad luck in the fertility department. How I ended up in this small percentage, I don't know. But I did.

This wasn't where I expected life to take us. I allowed myself to grieve and be sad. This was very important. I tried not to be too hard on myself -- which in itself was tough. Once I allowed for all of that...I was able to focus on our next journey.

06 December 2016

When It's Finally Over

When your pregnancy is found to be non-viable, you have a few choices:
1. Wait for it to pass naturally
2. Take medication that causes your body to abort
3. Have a medical procedure
4. Drink (well...that is an adjunct to all of those!)

I had a work trip planned about two weeks after we found out. I didn't have the luxury of time, but also, my body wasn't doing a great job of miscarrying on its own. I decided first to take medication.

This was the only time I slowed down slightly from work. I relaxed, took the medication, and waited for the cramping to come. I waited...and waited...and waited...There was one moment when I thought, yes, this is it. But a small clot passed and a small cramp, and that was it.

This gave me a lot of time to think and get angry.
Why was my body behaving in such a way?!
Could it not do anything right?

This did no good, I could not will my body to pass this mass of tissue that was now tricking my body into thinking it was still pregnant. Until I could let it go, I would remain tired. My boobs would remain swollen. My hormones would remain a bit out of whack.

I remained hopeful throughout the weekend that the medicine would take care of things. Alas, it was not to be. My body -- she is a stubborn one! We had a contingency plan with the doctor should this happen, and that was to get a dilation and curettage (D&C) early in the week. This carried with it some risk, but I was told that it was minor and the best way, at this point, to complete the miscarriage.

I have always been a strong advocate for a woman's right to choose, and for safe access when a woman chooses to end her pregnancy. After going through the procedure myself, this need to safe access resonates even more so. This is not a sophisticated procedure -- you have strong pain medication, and the doctor sticks a suction tube up your lady bits and scrapes around. Without a sterile environment, by a professional who knows what they are doing, there is a huge risk for infection or worse.

At any rate, my doctor and I chit chatted while I tried to stay brave throughout the procedure. I was super grateful for my high pain tolerance...though I did ask them to pump up the drugs at one point. And then, just as quickly as it had all started, it was over.

The procedure. My pregnancy. All officially over.

It was pretty unceremonious, and while they required that someone pick me up, I could have just as easily driven myself home.

Which I should have...because to add insult to injury, I ended up getting a parking ticket after leaving my car parked nearby overnight.