Julia

Continuance

I did not intend a wholesale condemnation of moussaka, per se. Truth be told I do not care for lamb but I like eggplant and goat cheese, while Steve loves goat cheese and hates eggplant. Patrick might have been prevailed upon to eat the lamb under more auspicious circumstances but I can think of about a thousand other things he would have preferred. I hate to stereotype, but All Children are wary of Unknown Foods. When you insist that you enjoyed moussaka, caponata and ratatouille regularly in your Lunch Bunch lunch box and offering these dishes to a little kid is not remotely odd it does not move me to alter this thesis, it merely leads me to conclude that you grew up on an eggplant ranch. Should you then insist that you would have eaten boiled sheep's testicle at that age, too, I will just smile politely.

I think the serving of the moussaka, possessing as it does that triple whammy of unfamiliar, strongly flavored, and all smooshed together en casserole, can be correctly interpreted as indifference to whether Patrick would eat it or not. And I do not think that failing to plan her menus around the more limited palate of her grandson is necessarily wrong. Yes, it would have been nice if they had a loaf of bread, or some less robust cheese, or a jar of peanut butter or a lousy package of pasta or SOMETHING in the house so that I did not have to spend four days trying to sell Patrick on the merits of oyster frittata (go on. I dare you. somebody tell me that their four year old likes oyster frittata) but no biggie. It's not like he was going to starve to death or anything. Fortunately, Patrick likes spinach salad and she had bushels of spinach salad and all was well.   

I am teasing her in these posts (can it be called teasing if it is done behind someone's back, or would I be more honest to just call it sniping?) but I do like my mother-in-law. She is very bright and interesting and she is politically and theologically sound and she has never ever presumed to tell me what to do. But she came into the family when Steve and his sisters were teenagers and she quite literally has never spent time with kids. Ever. This of course does not prevent her from having many theories on children and their rearing but hey who doesn't? It is fun to see her interact with Patrick because she is the only person who finds him a little... wanting. A trifle slow. Sweet, but simple.

Example:

Patrick notices their tidal clock and attempts to figure out what time it is. Much hilarity ensues. Grandma decides that this is an excellent opportunity to teach Patrick all about the phenomenon of the tides. She brings out coastal maps and positions the telescope and launches into a detailed explanation of where the high and low watermarks can be found on their property.

Patrick looks blank.

Grandma looks troubled.

"OK, Patrick," she says with exaggerated patience, "you know the moon?"

"No," says Patrick.

And you could tell that she was deeply, deeply regretting the college fund.

But I digress. In conclusion: the thoughtful hostess will inquire as to the tastes of her guests, particularly when those guests are likely to put personal preference before politeness and underscore their point with a hunger strike.

Or not.

I started the estrogen for my big frozen embryo transfer cycle yesterday and you were right, while it is an intramuscular injection I only have to do it every three days. So no big deal. The finance person from the clinic called today and I really have to say, I am a HUGE fan of the DC clinic. Really I am. I try not to mention them by name because I am sure they would rather not be googled here (I offered myself as their spokes-poster-person but they declined for some reason) but I think everyone either knows who I am talking about or wouldn't recognize it anyway, right? So, DC clinic, big, multiple offices, name reminiscent of a cemetery: they have always treated me extremely well. The nurse gives the impression that she knows who I am and actually cares, and the doctor has never prescribed anything wildly inappropriate. Oh, right, and the finance person called to collect today and mentioned that the good doctor was doing this cycle at a 40% discount. I suppose because the last two PGD'd pregnancies were genetically abnormal or something. Whatever the reason, I do call that kind.

Oh, and yes, in answer to a question from a couple weeks ago, this lone embryo went through PGD so, caveat caveat, it is ostensibly normal. Not that it will survive the thaw, because it won't, and even if it did it will drop dead quickly thereafter, but regardless, it theoretically has its chromosomal ducks in a metaphoric row. So, if I did get pregnant, which I will not, it would be slightly more reasonable than usual to hope while touching wood that I would not miscarry. All of which is to say if your feel your chest starting to heave in righteous indignation over the fact that I (*I*!) am attempting to get pregnant again (albeit at a 40% discount) you may feel free to cool your jets. And yeah I am mainly talking to my brother here who does not read this but who certainly feels these last, uh, six pregnancies or so were ill-advised.

Quick, before I go, I have a question. We are throwing a cocktail and dessert party for neighbors on Saturday. I put the invitations in the mail the Tuesday before Thanksgiving, asking about 50 people. It is now a week later, four days before the party and we have gotten: 23 acceptances, 3 regrets, 4 maybes (maybe? I, um... ok) and 20 people have not responded at all. Sorry for the word problem, but how many people should I make/buy dessert for do you think? Also, once we figure out that head count, how many bite-sized desserts should I plan per person? The party is for eight o'clock, well after the dinner hour here. And, finally, I am phrasing this as a question but I am really looking for reassurance, is it ok to just have 7-8 different desserts plus a cheese board with bread and crackers plus some little nibbly nut/savory crunchy things/olives in bowls all over the place? With lots of alcohol (and non-alcoholic drinks, naturally)? Lemme know.               

So You Want To Go To Atlanta

Sometimes holiday travel proceeds so smoothly you wish you could fly to see your in-laws every day of the year.

Sometimes, however, you get a Thanksgiving 2006.

Over 60 minutes into our two-hour flight to DC (Dulles, actually, as we were going to head directly down to Steve's parents' house-on-the-water [estuary house?] 100 miles south of Washington) an unspecified mechanical failure forced us to make an emergency landing in Detroit. We then sat on the plane while they determined whether it was fixable or not. Still uncertain after an hour, they released us to the gate area but told us not to go anywhere unless we wanted the plane to take off without us. After another hour of sitting there (why yes! we were traveling with a small child and no, all that sitting around doing nothing was not going particularly well, thank you) a notice went up saying that the plane would depart but not until three pm, giving us four hours or so to kill. We went in search of food with the wistful hope that Patrick might burn off a little excess energy through, I dunno, magic or something.

We had a dismal, bagel-based breakfast/lunch and when we returned to our gate the departure time had been changed to five pm. I told Steve that this was clearly part of a pilot program the goal of which is to relocate people to Detroit through gradual acclimation. First it was an hour, then three... soon we would forget there ever was a time in which we did not live in Michigan and we would wander away from the airport in search of a realtor. As I enlarged upon this theory to a comatose Steve and Patrick made friends with other Minnesota refugee children, the signage concerning our flight mysteriously disappeared from all monitors. Not only were we no longer departing at 5:00, we had apparently ceased entirely to exist (we later learned that this is Northwest Airline's subtle way of letting you know when your flight has been canceled). 

We bumbled around for awhile (alternately worrying about how we would get out of there and wondering why we would ever want to leave when Detroit has so much to offer) until an agent boarding people for a Tampa flight (gosh those Tampa passengers seemed happy) took pity on us and looked up our reservation. This is when we discovered that they had gotten us three shiny new seats on a plane leaving a mere two hours later. Of course, that plane was flying to Atlanta. And Northwest could not get us from Atlanta to Dulles. But they found some spaces on a Delta flight leaving Georgia at 10:00 pm so... so fuck that, we said, gently.   

Gate agents, it turns out, cannot change flight assignments that have been randomly generated by the airline after they accidentally abandon you en route. For that sort of clout you need a ticketing agent, and ticketing agents only dwell outside the security lines. So I had to throw away all the water and apple juice and 5.8 ounce bottles of duty-free perfume I had stockpiled during our wait (have you seen the new TSA regulations? with the baggies?) and we trudged out to stand in line at ticketing.

I spent my 48th birthday waiting for it to be our turn at the ticket counter.

When we finally were helped we discerned a certain... theme. I do not know why Northwest was so desperate to have us visit Atlanta on this trip but my god they were.

"Could they get us into National?" Yes. Well, sort of. Two of us, tomorrow, and the other one could go to Memphis... how about connecting through Atlanta?

"What about Richmond?" Sure! They could connect us to Richmond, on Friday, through Atlanta.

We finally settled on a direct flight to Baltimore and I am glad I did not notice until after we had gone back through security that she had not given us seats, just boarding passes (as the flight was seriously overbooked). Because if I had realized at the time that she had committed us to flying standby, with a little kid and no juice, to a city four and half hours north of our ultimate destination, I might have murdered her. I am not saying I would have, just that I might have.

Eventually we did make it to Baltimore. As we were landing Patrick threw up on himself and me (THIRD time EVER in the history of EVERYTHING that Patrick has vomited. impeccable timing), causing a wardrobe shift that left me in a camisole and him in a sweater down to his knees. Do I need to tell you that we went to Baltimore but our luggage was sent back to Minneapolis? Of course I don't. And that it did not find us down in the hollows of Virginia for THREE DAYS? No. You can imagine that for yourselves.

I was so smug about this trip, too. I gaily packed our small carry-on backpack and chortled over the lack of diapers, wipes, and tiny loud toys. I threw in a pair of underpants for Patrick more as a token for the gods than anything. I had numerous conversations with people about how very easy it is to travel with Patrick now that he is partially civilized. And it is true. He read books and looked out the window and played Hangman with me like a champ. However, the ten extra hours of unexpected travel were a strain. When we finally limped into Steve's parents' house well after bedtime and hours past dinner Patrick was feeling a little fragile.

Steve's stepmother sat us down as we got there and handed Patrick a plate of lukewarm...

"What," Patrick asked, "is that?"

"Moussaka," my mother-in-law said brightly.

"What is moussaka?"

"Eggplant and spiced lamb and goat cheese."

Patrick looked at me. He looked at Steve. He looked at Grandma.

"That is not funny," he said. And he got out of his chair and went to bed (still wearing my sweater) without another word.

"I didn't realize he was such a picky eater," my mother-in-law said, in that tone that mothers-in-law reserve for remarks like that.

Freezing in my camisole, smelling like vomit, exhausted, dying for a drink, blistered, being stared down by a congealing eggplant, and my mother-in-law hits one out of the park like that... ah. Classic. I treasure these moments of absurdity, I really do.

So how was your holiday (holiday for Americans and, I suppose, holiday for everyone else who did not have America calling to bug them every five minutes, thus they were finally able to get the coat closet cleaned out)?

PS You know serving moussaka to a non-Mediterranean preschooler is... bizarre, right? Just checking.

Knitting The Ravelled Sleeve

Patrick did not sleep through the night for the first thirteen months of his life. I remember that number, thirteen, because I scratched it repeatedly into the back of my hand during the sleep-deprived delirium I suffered from the moment of his birth until, roughly, July of 2003. In the very beginning he would wake up six or seven times a night. After a few months the every hour thing  gradually eased up, such that when nice people at Target and the gas station would ask if Baby was sleeping well I was able to reply  "Why yes! Yesterday he only woke me up at 11:00 and 1:00 and 3:00 and 4:30 and 5:30 before getting up for good a little after 6:00." Then I would ask them if they would please remove some of the live birds that were nesting in my hair.

That first year was a little rough, sleep-wise.

It gets better. You think it never, ever will and that you will remain hollow and brittle from exhaustion for the rest of your grievously shortened life, but it gets better. Now when Patrick wakes up in the middle of the night it is always because he is sick and so, apart from the difficulties of administering liquid Tylenol in total darkness to an irascible child, it is an infrequent and easily managed occurrence.

I suppose I should say it is usually because he is sick.

Last night I opened a bottle of red wine after reading that, in addition to all its other health benefits, researchers have just discovered that red wine helps fight diabetes. Steve's last physical indicated his glucose levels are on the high side of normal so I decided it was in his best interests to drink a few ounces. Then, because the bottle looked rather sloppy just sitting there with only half a glass missing, I finished the rest of it.

Some time later, after arguing politics with the cat, having my way with Steve and successfully negotiating the bathroom floor (who left that tub there? very dangerous), I fell into the deep and peaceful repose of the pious, expecting to be fully restored to health and lucidity after a good eight or maybe ten hours. Imagine my confusion when I was awakened a mere 45 minutes later by the sound of fake crying coming from Patrick's room. I ignored it. He stopped and then started again just as I was about to fall back asleep. Eh-hehn-hehn, eh-hehn-hehn.

I stumbled up to his room.

"Ah, there you are, Mommy," said a pompous little voice in the darkness as I fumbled the door open (he really talks like that for some reason. he says "ah" and "indeed" and he rarely uses contractions. very normal, is our Patrick.)

"I just thought of a story and I wanted to tell it to you."

What?

He's crazy, isn't he? You can tell me. My child is grapetastically insane.

"Patrick," I said, shoving him over in bed and climbing in beside him, since I was FREEZING (stupid Minnesota), "no. Too late. Very late. Dark. No talking. Shhhhh."

"But Mommy, I just thought of a story and I wanted to tell it to you. I did. Indeed I did. I just thought of it and I wanted you to... I wanted to tell it to you."

I shushed him again.

"But mommy mommy mommy mommy mommy mommy mommy mommy mommy mommy... ."

"FINE. Tell me the story QUICKLY and then stop talking and go to SLEEP."

There was a long pause. Had he actually... fallen asleep?

"Mommy."

No, not asleep, offended. His tone was as of one wounded.

"Aren't you going to go get a pen so you can write down what I say?"

Crazy. Like Nero-crazy, I think.

Grifter

Steve and I had to go to the bank yesterday to get our frozen cycle consent forms notarized. When you consider the sanctimonious hectoring I employed to get Steve to take off in the middle of the day and go do this, it is rather unfortunate that I was the one who had left her driver's license at home. However, the banker cheerfully took Steve's information and offered to let me return with my license later in the day. As we left I told Steve that I felt like we were attempting some sort of a con: unkempt couple with loaner preschooler pull notary switcheroo, details at eleven. Steve asked what possible scam did I think could be accomplished in this manner. I told him that wasn't the point, I still felt uncomfortably like I must be lying.

I returned to the bank with that same feeling. The feeling I get when I discover that a police car is driving right behind me. Even though I am dead sober, duly licensed and registered, observing the speed limits and all applicable traffic ordinances, I still feel like I will be lucky to not wind up in jail. I must have a guilty conscience.

So in an effort to act as normal and innocent as I actually am, I wound up being overly effusive and twittery with the banker to the extent that he asked if I was having a hard day.

At which point Patrick stopped fooling around with my wallet and trying to figure out how one would say credit card numbers the long way ("five decillion three... no that's not it. five hundred decillion-million, three octillion...) and leaned over to peer at my license as the guy entered the information from it. Out of nowhere he asked, "Is that REALLY a picture of you, Mommy?" with a heavy and sarcastic emphasis on "REALLY."

I laughed like Wolfie in Amadeus and the notary stopped writing to examine my picture and then look at me more closely.

"Ha ha, Patrick," I shrilled. "Of course it is. Ha ha."

Now, Patrick for some reason is at a stage (so far it has lasted for about two years. I am thrilled) in which he will insist to his dying breath that black is white provided I say it is not. So he did what he always does. He disagreed with me.

"Oh I do not think it is," he said with a roguish sort of oh-ho-ho-caught-you.

And the guy looked at the picture some more.

"You don't have another ID with you, do you?" he asked apologetically.

I handed over six credit cards, my business card (you know I work for Steve, don't you? yep. I've got cards and everything so stick that in your audit and file it, man) with a Target list written on the back, and an appointment reminder from my last haircut in July.

The whole time Patrick was merrily contradicting me. "That is not yours! I do not think that belongs to you either!"

The guy finally realized that Patrick was just being a jerk, size extra small, and stamped my stupid form for me. I left, slick with sweat and trembling, with Patrick still giggling beside me.

All this is to say, never use a four year old as your flim-flam accomplice. They're unreliable.   

That Is To Say - Edited

To clarify, the 16% I cited in the last post came from this Stanford study and refers to the implantation rate not the success rate. The actual clinical pregnancy rate was 36%. However, the implantation rate was more relevant to me because we just have the one embryo.

That is the main reason I am so pessimistic about this frozen cycle, by the way- there is only one so if anything goes wrong at any stage (AND IT WILL)... pffft.

A year ago I wondered about success rates under these circumstances and someone left a comment here that I thought was very clever. She wrote something like, "Well, at this point it either works for you or it does not work for you." And I liked that. Good-bad. Binary. We know we are going to try to transfer the remaining embryo regardless of the poor odds, so there is no sense in my getting too het up about them. I am so conditioned to expect bad reproductive news that a failed FET will not break me and, well, there is always hope, right? Besides I will have 42 hours all alone with my mother and I think it will be lovely.

Of course I am slightly less breezy now that my actual drug protocol just showed up. Am I crazy or isn't estrogen supplementation supposed to be done with some kind of a pill or patch? What is with the intramuscular shots listed here? Who thinks this is a good idea? Plus progesterone in oil, which is another daily IM. And then my OB believes that we have been seeing good results in the past two pregnancies with Lovenox injections (genetically abnormal fetbryos, now with 50% greater in uterine life expectancies!) so she has ordered me to start that again at ovulation. Which I suppose would be transfer in this case. I predict lots of needles in December.

I have not actually decided that we are definitely done after this FET. I am just more comfortable with the idea of being done now than I was a year ago. Or two years ago. I used to worry that I would feel vaguely unhappy forever if I never had another successful pregnancy but I don't think I will. I am a big theoretical fan of Suck-it-up-bravely-and-move-on although I admit that I am eight years along in the acceptance process and I have only gotten as far as not actually crying when I think about all the children I will not have. My goal, provided I live to expectancy, is to be fully at peace with our subfertility by my death-bed. So, that is something to look forward to at least.

The good people in DC called yesterday to let me know that the infectious disease panel that the local place ran in August did not include syphilis so we need to get that done and sent to them within two weeks. What is it with the state of Maryland and syphilis testing, anyway? Aren't you guys the only place that still requires a syphilis checks before issuing a marriage license? Rather 18th C. over there, aren't you?

Since Steve is never a patient of these clinics (just the Partner) he keeps calling his primary care doctor to ask him to write an order for whatever testing is needed. The requests usually go through an admin and just get processed. Yesterday afternoon, however, his doctor called him. Apparently the doctor had approved the order for HIV and Hepatitis screening two years in a row with no questions asked but Steve's request to be separately tested for syphilis three months later alarmed him. He called to say that he would write the order but discreetly asked if Steve would like to discuss any "lifestyle concerns".

I laughed until I choked. Steve the Oozy Pervert, as he must affectionately be known around the water cooler.

Then I got the fax from my OB's office with all of my updated blood work (including syphilis, thank you very much) and saw that the whole staff had signed the fax coversheet like a yearbook: "Good luck in Maryland!" the ultrasound tech has written. "We love you!" from the nurses. All it needed was a "I never really knew you all that well but you seem cool" from the new receptionist.

I cried.

Yep. We've got it all here at the Hippo: booze drugs guns lies blackmail and laughter. And tears. 

I was wondering, why do you suppose they have all these health requirements in place for people seeking infertility treatments that do not exist for people having procreative sex? Simply because they can? It is not against the law for a syphilitic man to impregnate someone (as far as I know) but it is if an RE is involved. I believe. Seems rather... well, I don't know what I think. 

Edited to explain what I meant - Fertile women might be tested for venereal disease after they conceive. Infertile ones are tested before and can then be denied reproductive assistance on the basis of those results.

I cannot do a FET in DC next month if we do not get Steve's syphilis results back in time, despite the fact that the embryo in question was created over a year and a half ago. We were able to do an IUI in Minnesota (or would have been) without syphilis testing for either of us. In California it is illegal for an HIV positive man to attempt an IVF cycle with his consensual partner, despite technologies in place that insure the safety of both the woman and any putative children. New York has no such law.   

Different places have chosen to utilize the opportunity that ART affords the state in different ways. You cannot screen all women prior to conception for the myriad conditions that might negatively impact a fetus. You can, if you like, screen all infertile couples seeking help and further you can put strictures in place to prevent conceptions in less than ideal situations. But only if the couple is infertile. Otherwise it would be unduly intrusive.

Like I said, I don't know what I think. I just find it interesting.   

The Other Thing

So what about that frozen embryo, you ask (you didn't really. I am just telling you).

We have one, single, measly, solitary, day-seven blastocyst still stored in DC. I tend to forget about it until I find myself suddenly unpregnant with no babies around anywhere but at the neighbor's house and then it holds an interesting place in our reproductive decision-making process. A sort of repellent magnet, if you will.

The logic following a miscarriage goes something like this: Should we try again? Well, we have that frozen embryo that we can neither destroy (because we do not want to destroy it. why would we?) nor donate (because our two IVF/PGD pregnancies were genetically abnormal and it seems unethical to wish that on someone) so, by process of elimination, yes, we should try again. Do a frozen cycle. And then we sort of go, huh, yeah, well, sure, great. Because success rates for single frozen blast transfers are lousy lousy lousy, the process is time-consuming (month on birth-control, weeks on estrogen), the logistics are involved (some local monitoring, a trip to DC) and the whole thing is not cheap ($3000? $4000?) so it never seems like a great idea in those moments that we need to decide. But by this point we have already emotionally committed ourselves to the concept of trying again. Thus we initiate the process with this idee fixee (must. use. frozen. blastocyst) but we wind up consistently rejecting an actual frozen cycle because it is a hassle and it will not work.

Three failed alternative-to-FET pregnancies later and October found us, yet again, saying, well, we DO have that frozen blast, maybe we should try again. Suckers that we are.

And since a frozen cycle is still so very uninspiring (honestly I think implantation rates are 16% or something equally dismal and that is IF it survives to transfer at all) I began trying on all our other options like so many ugly hats: IVF with PGD back in Washington, IVF with PGD locally, another stab at a superovulatory cycle (my OB oddly but emphatically believes this is our best bet and I do trust her), sex....

I wound up with about fifteen pros and cons for each alternative so I just called everyone and scheduled... everything. Seriously. Local, Washington, frozen, fresh, IUI. We decided we would just do whatever came first, depending upon whether I began a cycle seven weeks, eight or nine weeks after the D&C. Surprisingly, I started a period five-and-a-half weeks after the procedure (all-time speed record for me) and the first appointment on the docket was... a frozen transfer in DC on December 18th.

Voila.

Last week I started the pill, requested my most recent infectious disease blood work, booked couch space in my mom's tiny apartment, bought an airline ticket and I am now all ready to be disappointed but not surprised when the blastocyst comes to room-temperature and promptly dies. To add a little zip to the proceedings it has not escaped my notice that this will be occurring a week before Christmas, a holiday that I am hosting this year. For ten people. For six days.

Fortunately, nothing says welcome and bless the yule like a nice frozen lasagne, synthetic progesterone and forty bottles of wine, right? Right. Fa la la la la la la la la.

All in all I am glad that we are finally dealing with the mobius embryo and, now that it is settled, I am quite looking forward to my mini-jaunt to DC. One of the nicest thing about surviving air travel with a child is subsequent air travel without a child. I think I will even enjoy that final ride across Styx because I won't have to worry about Patrick repeatedly kicking the ferry seat in front of him. I will not say I am excited or optimistic or anything about this cycle, but I am looking forward to the parts that I can.

As time goes on I am more and more comfortable with the fact that unless a meteor hits we are only going to get to raise one child. It is not ideal, it is not what we wanted, it is not what we planned, it is not fair, blah blah blah, but it is reality.

And, really, it will be fine.