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The Long and Winding Road

I’ve wanted to write about this for a long time—over 3 years or so. But because my husband felt our troubles were a private matter then, I respected his wishes and avoided the topic. Since our daughter Sidney was born in September 2009, we are so grateful for her and the chance to be parents. It only seems fitting now to share our story so that other couples might benefit from our trials and tribulations with fertility. I garnered so much information and comfort from late night searches of confessional personal blogs and medical forums. So now with his blessing and in the spirit of wanting to give back, I reflect on our ordeal of trying to conceive and stay pregnant...

Background

It’s truly amazing that anyone is ever conceived or born. But when it seems like there are so many “accidental” pregnancies and with a noticeable rise in the number of multiples births, you might conclude that you could just “wish” yourself pregnant whenever it’s convenient and away you go. According to WebMD, as many as 15% of all couples are infertile or have reduced ability to conceive. Only 1-2% are completely sterile and cannot bear a child no matter how much medical intervention. They say “half of those couples who seek help can eventually bear a child,” but trying to find the right combination of intervention can be frustrating. Part of it is trying to figure out where the issue is. Generally 1/3 of infertility is female factor, 1/3 is male factor and 1/3 is unexplained.

2006

It didn’t occur to us in the beginning that getting pregnant would be a problem. We planned to wait a few years after we married to have children and enjoy some time together first. We even put off trying for a few more months after that because we were going to Finland in late 2006 and I didn’t want to be in early pregnancy in a place with odd food. But also around that time, a few of our friends had started to have children and a handful told stories about how much effort it was taking and how much medical intervention was involved. As our first few months of all-out trying passed with no results, I couldn’t help but suspect that maybe we too might have a problem.

I certainly felt a little bit of pressure due to my age. This was compounded with the fact that we felt having two children would be the ideal scenario. As 2006 turned over to 2007, I felt the need to step up the effort but was determined to address our lack of results in a “natural way.” I began to explore what else was out there and kept Western medical science at arm’s length.

2007

First and foremost, after several months of resisting, I finally bought & read the book Taking Charge of Your Fertility by Toni Weschler. I wish I hadn’t held out for so long. This was the best tool to begin understanding what my body was doing/not doing in regards to fertility. By the way ladies, what you *think* you know about your body from health class is either wrong or a fraction of what you should know. It was a real eye-opener—such as: women are really only fertile for a 24 hour period each 28-day cycle. (So all that paranoia about getting pregnant before when I didn’t want to…yeah, anyway.) My OB and girlfriends had recommended the book initially and I guess I felt that by getting this book it would “admit” we had a problem. One of the best things about this book is that it teaches you how to chart your daily temperatures (taken orally) and symptoms which help you identify ovulation. To know your cycle length and when you ovulate is crucial to hit “the window of opportunity.” Remember, 24 hours of fertility—that’s it. With charts in hand, I thought we were set.

With no pregnancy in early 2007, I was at least able to show my alternative medical providers some data. I had already been under the care of a local acupuncturist for a few years so I asked that “fertility” to be included in my treatment. The acupuncturist also added Chinese herbs to the mix which I took with some trepidation but would do it if it produced results.

By mid-2007, nothing was happening so I decided to also look into Naturopathy which “focuses on natural remedies and the body's vital ability to heal and maintain itself.” (Wikipedia) The first naturopath I saw specialized in fertility and used homeopathic remedies which are “heavily diluted preparations which are thought to cause effects similar to the symptoms presented.” (Wikipedia) I didn’t feel comfortable running Chinese medicine remedies and homeopathy together so I stopped the Chinese herbs. Unfortunately, I never really gelled with that naturopath provider—I felt there was something personality-wise that didn’t fit so I never completely felt comfortable with her. I stopped going to her after half a year.

By this time, Ken also got to join the medical fun times and have an evaluation by a urologist. The results were nothing alarming but he did benefit from taking multi-vitamins and zinc supplements. We noticed improvements after the additions of these things. Unfortunately, reproductive science focuses and resides in the woman’s body so even if it had been a male-factor issue, things would have been done to me.

By the fall of 2007, still nothing had happened so I signed up for a class/group offered at PNW Fertility called Mind and Body Fertility Program. This is a program developed by folks who have studied infertility and recognize how stress impacts the success of conception. It focused on empowering women and their partners undergoing treatment for infertility by teaching relaxation methods, providing a forum to talk about concerns/issues and educating couples on all options leading to parenthood.

By this time, we had begun doing IUIs (Intra Uterine Insemination) through my OBGYN’s practice. Ken provided a sample, it goes into the centrifuge, they get the best swimmers and suspend them in a viscous medium and upon ovulation day for me, it’s injected directly into my uterus, by-passing the often hostile and acidic environment leading up to it.

Many of the women in the group had done IVF (in-vitro fertilization) cycles, suffered miscarriages and had been trying for--not months--years. The hormone supplements, medication, pain, poking, prodding, lifestyle restriction, “medicalization” of reproduction and expense, coupled with doubt, fear and feeling like your body has betrayed you, all take a major toll. I admired these ladies’ perseverance and commitment because of all the emotional, physical and financial demands. I was definitely the “freshman” of the group in terms of what little I’d been through but I knew this was a group that would teach me a lot.

And the hardest lesson of all: just because you spend thousands of dollars on a cycle and take all the meds and do everything right does not guarantee you a viable pregnancy.

Looking around that room each week and thinking about how badly these women wanted to have a child—knowing how much I wanted a child—made “accidental” pregnancies that kept happening all around us during that time excruciating. To that trend, Ken said, “Fertility is inversely proportional to preparedness.” (None of us in the group got pregnant while we were active in the 10-week program but I am happy to report that in the two years since, four out of the seven of us did eventually have healthy babies and one of the remaining three adopted.)

In late 2007, I tried one last alternative method before turning to Western Medicine. It was called Mayan Abdominal Massage. This method of massage was a little strange when compared to the standard practices. It does feel a little odd to have your organs pressed on. It is “a non-invasive massage technique where the abdominal area is massaged to reposition internal organs correctly. This improves the reproductive and digestive functions and can help with infertility problems.” (eHow.com)

During all of 2007, I wanted to try natural approaches because I believed if I found the right “thing” or combo of things, everything would fall into place. If nothing else, all of these methods in 2007 possibly helped get my body ready for the Western Medicine approach. The most important thing for me was to know I had really tried it my way and now I was ready to try something else. So in December, my OB gave me Clomid to take in addition to doing an IUI. This was my 6th IUI, but the first one with drugs. And, it worked…

2008

In January 2008, I discovered I was pregnant--all the while we were in the midst of our kitchen remodel and Ken was training for the Portland Marathon in October. We were so excited and couldn’t manage to contain the secret before the 3-month verification ultrasound. Friends & family had been rooting for us and my birthday was just prior to that ultrasound so I told everyone who attended my birthday party in early March since I wouldn’t be drinking. People began congratulating us.

In late March, we went in for our 3-month ultrasound. (The one that assures you with a decent amount of certainty that the pregnancy is going well.) I had looked at pictures of ultrasounds at 3 months on the Internet so I knew what a normal one looked like. The minute the tech put the wand on my tummy and the image flickered on the screen I knew.

There should have been an image that closely resembled a head and a body of a baby but instead there was just a tiny mass at the bottom of the screen. The tech looked at it for a few seconds, pulled the wand off my belly, then excused herself. Immediately the radiologist came in and confirmed what I was dreading. Apparently the pregnancy had been viable at 4 weeks prior when we saw it on the ultrasound at the OB’s office but based on the measurement, she concluded the pregnancy terminated a week after that.

Devastated, numb and reeling, we made the blurry-eyed walk from the ultrasound clinic to my OB/GYN’s office. Mercifully, this happened during their lunch break so the waiting room was empty instead of being crammed full of swollen-bellied pregnant ladies—a club I had just lost my membership to.

Despite the fact the pregnancy had not been viable for over 3 weeks, my body wasn’t expelling it. The Dr. said I could (a) wait to see what the body would do, (b) take some pills and go home to pass it with a great deal of cramping and mess or (c) have an outpatient surgical procedure called a “D&C” which would remove all tissue of the miscarriage. It required heavy sedation and therefore if they we were to do the procedure that day (which I desperately wanted), I could not eat. All the choices were terrible but I chose the last one because I couldn’t bear to “see it” and I wanted this ordeal over as fast as possible.

Even though I was there under the worst of circumstances, everyone at the hospital day surgery center was very nice, things went very smoothly and when the anesthesiologist asked me how sedated I wanted to be, I told him, “Whatever gets me to food the fastest.” At least I still had my priorities. That was one of the worst days of my life naturally but I got to see the mettle my husband was made of and he was amazing throughout. He also made those terrible calls to our families and close friends to tell them what had happened. I could not bear to do any of it, so he did it all.

The doctor later explained the fetus probably had a genetic abnormality so we would not have wanted it to come to fruition. I logically knew that and was grateful, but the event fundamentally rocked me to my core. Naturally, I was eager to try getting pregnant again. ‘Get back up on the horse’ so to speak. Even as early as the day after the D&C procedure, I got my charts back out again and I was looking ahead to the next IUI cycle. I tried to stuff my grief by gearing up for our next try. After all, we had been able to get pregnant so it was possible. All we had to do was replicate what worked for us. And all I needed was for my cycles to restart. But weeks went by and nothing.

Prior to my own experience when I had heard about people having miscarriages in the news or through acquaintances, I couldn’t understand why they were so worked up. It wasn’t even a fully formed baby yet…Just get pregnant again… Yeah, well there’s a lot more to it, I realize now. The loss spawned a rampage of introspection and the hormones shredded my composure, causing moments of laughing then crying in the days and months that followed. I was kidding myself when I thought quickly conceiving again would fix the pain. With months in limbo to ponder, I faced disappointment on that scale I’d never known.

But by August (5 months after the miscarriage), my cycles finally returned and we resumed what had worked: doing IUI + Clomid cycles through my OBGYN. But after 3 more unsuccessful attempts and the end of 2008 nearing, I decided 3 things for 2009:

1. We would seek help from the fertility experts at Pacific NW Fertility
2. I would go to Acupuncture NW, a clinic known for supporting fertility success.
3. Ken was going to get re-evaluated (this never happened though)

2009

OBs are great at taking care of pregnant women and delivering babies but in terms of fertility, it’s not so much the focus of their work. The slightest nuance can make the difference between a pregnancy and not. Luckily I had finally found the right team, treatments and support I needed around me. Here was the winning strategy:

• My primary care physician caught a slight thyroid deficiency and supplemented me with a low dose thyroid medication.
• In the first Clomid + IUI round with the fertility clinic running the show, they moved up the timing of both the Clomid intake and the egg release shot. They recommended it based on my age and previous experiences.
• The folks at Acupuncture NW made a comprehensive fertility support plan that transitioned into a pregnancy support plan.
• I read a book right before we discovered we were pregnant called The Mind-Body Fertility Connection and it really affected me in a positive way. While it hearkened me back to the work we did in the Mind and Body group, it helped bridge the gap of attitude, outlook and working through emotional baggage that could have been blocking conception on some psychological level. I felt that coming to terms with a few things really helped lift a weight off my mind and it opened the door for a positive outcome.

So it was in late January 2009 on vacation in the San Juans Islands, we found out we were pregnant. It was our first try with Pacific NW Fertility (who we highly recommend). The pregnancy progressed as it should and we truly waited until that 3 month ultrasound and reasonable assurance from the doctors until we told anybody.

Nine months later, Sidney was born.

I notice many more couples needing fertility support to have babies these days. I certainly remember how lost and clueless I initially felt about what to do when things weren't working. From our experience, there was a lot of trial and error but the main thing to remember is that there are many resources available for infertility treatment and support. Don’t ever feel that you have to wait until years have passed or you are at your wits end to consult with someone. And don’t be afraid to make a change if the provider you’re working with (despite their well-meaning) isn’t giving you the help you need.

New Olympic Sport

Not more than 1 hour prior to this were we talking with the Testas about how uncanny it is that babies love to aim for anything but the burp cloth. Our girl did us proud.

The "Stay At Home Mom" conundrum

You'd think that being a mother in modern times would be a easier. Our generation of women proved we could be anything we wanted to be and many things simultaneously. When we started having babies, it was supposed to be the best educated and best prepared group for motherhood. Yet the guilt, anxiety and exhaustion of trying to fulfill this prophecy made some of our ranks competitive, doubtful and judgy. Lots of discussion started about the "Mommy Wars," pitting women who remain in the workforce against those who stay home. All this rhetoric makes everyone feel defensive and that whatever situation you've got isn't quite good enough.

I'll admit making this decision was not easy for me. For all of my adult life, I worked hard to earn respect and credibility as a highly competent digital media professional. Then all of a sudden, I was on the doorstep of another role I had always aspired to (being a mom). But I had no idea of how being a stay-at-home-mom (or as I like to say "domestic project manager") would fit me or how to reconcile my professional self with being the kind of mom I wanted to be. So I knew I had to get back to basics. While mulling it over, I realized there were just 5 fundamental questions I needed to ask myself.

1. What can we afford financially?
I created a budget in 2007 when we started thinking about a baby and figured out that we could meet our financial responsibilities with one income. Not everyone can do that, I understand. Sometimes it's a matter of living within one's means but for others it takes both salaries to make the mortgage. In this economy most people on the bubble are not eager to jettison the second income. I definitely needed assurance we could do this before I committed to giving up my job. But indeed our life would need to contract and the discretionary spending would have to tighten up considerably. To this day though, I am still feeling my way through our budget and seeing what things really cost. I'll be honest, it's been a challenge to alter the spending behavior of once having had two incomes.

2. What effect will this have on our child?
Before we had Sidney, Ken and I discussed what we liked about our own childhoods and both of us had moms who stayed home in the early years. I vividly remember the comfort I felt when I would be at home with my mom or come home from school & she would be there. Also, she would go on field trips with my classes and would volunteer at the school. I knew that I would want to provide that for our child too.

From everything I have read, the first 3-5 years of a child's life are the most important in setting the stage for confidence, curiosity and a multitude of fledgling skills. Especially since it took great effort to conceive her, I was determined that one of her parents would get the privilege of experiencing these hard-fought milestones.

3. What effect will the decision have on me (my aspirations, my sanity, my desire to be a good mom)?
I wanted a new challenge and I certainly got it. This is the hardest job I've ever done with 10-12 hrs a day including weekends and both physically & mentally demanding. But it has rounded me out as a person. I didn't know I had the compassion, creativity & patience that I do. For me, being a mom at home showed me that.

As for my future in the workforce, I am linked to many of my former colleagues via Facebook, Linked In and keep in touch directly too. While I am most comfortable with high tech, I have also been interested in project management and non-profit work. I look forward to working for a company I believe in when I start again and it could be in any sector as far as I'm concerned. So it's a big question mark what will happen to my career next.

I do miss the constant, daily adult interaction and am amazed at how "small" my world has become. Being interested in technology, things change very fast so I skim a few technical blogs so Ken and I can chat when he gets home about the industry. But I've heard stories about how women who leave the workforce are looked down upon. In terms of my own professional identity, I worked very hard my whole life in school and in the working world to earn the respect of others by delivering results and learning new things. What I hear myself talking about now completely amazes me. Just yesterday I detailed the ingredients of a slow cooker recipe, described Sidney's poop, groused about other mothers at co-op and had a few hours of rambling narrative directed at my daughter about what we were looking at any given moment.

I have joined a few parenting groups, attend foreign language story times and have enrolled us in an infant co-op so that there are things to look forward to & other people to interact with. But most important for Sidney & me, amassing a new community of friends and associates who are focused on raising children.

4. What childcare options do we have?
With the closest immediate family 3 hours away, we would require a non-family member to watch Sidney if I worked. It's very expensive to get good care and naturally competitive with many like-minded parents vying for limited spots. The economy sucks right now but even before, most companies (except some few enlightened ones) really don't accommodate working families. It's short-sighted and forces people to choose job or family.

5. What work options do I have?
It seemed the right timing to ride off into the sunset after my maternity leave. If there was a way to command a completely flexible schedule with minimal part-time hours, I wouldn't mind staying somewhat connected to a workplace but I just don't see it right now. This choice comes across pretty black and white but maybe that's because the American society sees it that way: either you're in the workforce or you're not. Yes, there are people who have situations that are the perfect balance but it's a rare thing.

In my friend Sarah's yearly letter to friends and family, she said this of her pregnancy though I think it could be applied to parenthood in general:
"And your body pulses with a cocktail of new hormones like "relaxin," which while sounding lovely, makes your joints stretch in ways that would impress Gumby. Along with all the physical stretching, though, it's the mind that bends the most. What about my career? My travels? Our ability to feel spontaneous and independent? Pregnancy challenges us to face uncertainty and changes in a life pattern we've come to cherish."

And so my mind is bending to embrace the new priorities as each day passes and Sidney grows up. I feel undeniably fortunate to have this chance to participate and witness it first hand. As Shannon reminded me, though Sidney will not remember much of this time, I will. So I just need to remember that on those rare, tough days when the routine gets a little tedious or the girl is fussy.

Slow Cook(ing)

I will be the first to admit, I don't like cooking and I'm not good at it. I like eating but when it comes to the joy of the preparation, I say "meh". My dad, mother and brother are all good at meal prep. They have "skillz" and seem to revel in their creations. I have mentioned my brother before, the spice master, who is impressive in his expansive cooking repertoire. But I guess I saw cooking as a gender trap. That's kind of a lame reason to not learn but I figured if I ever became good at it, that role would be mine and I'd be stuck in the kitchen forever, The End.

Well here we are in the New World Order and somehow I have become the person who makes 99% of the dinners--mainly because Ken is tending to Sidney in the final hours before bedtime. I don't begrudge him that because it's really the only dedicated time he has with her on weeknights and I finally get a break from the 10-12 hours I've been on duty.

So the meal prep responsibilities fall to me and in light of aforementioned amateur abilities, we have frozen prepared meals at the ready. Not Hungry Man dinners, actual dinners that are awesome but frozen. We've sampled from Designed Dinners, Delicious Planet (Organic but pricey) and our current favorite Savory Moment (who also deliver said meals to the house). And the interesting thing is that they are portioned, seasoned and ready for about the same price as if we were to buy the raw ingredients at the store and prepare it ourselves.

I am also reminded of the old adage: give a person a fish, they will eat for a day or teach a person to fish, they will eat for a lifetime. In my case: give a girl a website and she'll eat for about 2 weeks or give a girl a slow cooker and she might just do something resembling cooking. And that is what happened. Austin gave us a slow cooker cookbook for Christmas and Mom got us an enormous party-size slow cooker in January. We have tried two recipes thus far. A chicken curry noodle dish when Mom was here and a Beef Barley Stew tonight. Ken called it goulash--and technically he is right but it does not sound appetizing. I called my brother just now and asked him if everything in a slow-cooker is supposed to taste "the same"--in that none of the flavors are distinct. He said, "I'm pretty sure if you eat ice cream it will be cold so when you cook something in a slow cooker, yes it's all going to taste the same." Funny guy, my brother.

I realize something else about slow cooking that is surprising--I don't like the smell of the food when it's cooking. We have a tiny house, granted, but maybe it's the volume or the manner of cooking but the smell of the food fills the house. The curry thing smelled okay as it was going but it was pungent and this last one had (among other things) paprika, ketchup, beef broth and beans--uggh it did not smell great. Tasted okay but needed some salt. The problems I have...

Remembrance

In June 1997, my great aunt Susie Sakai gave a talk to students at Skyview High School (Bev's school) in Vancouver, WA about the Japanese-American Internment during World War II. Bev gave me a DVD of the presentation a few years ago but it was only this week that I popped it in and watched it. My aunt spoke for an hour and a half in great detail about what it was like to grow up in the Yakima Valley and then as an American citizen to leave her family home behind and be summarily imprisoned for the crime of being Japanese during a war with Japan. She spoke about her internment camp experience in Heart Mtn, Wyoming and the troubling conditions within its walls. She showed slides of famous images from that time and talked about the lawsuits and the much delayed reparations that were ultimately made for such an unjust act.

This photo really struck me:



A resilient people, the Japanese-Americans. I think about how they basically had all of their assets stripped from them, were imprisoned for 3-4 years then released back into a hostile and racist post-war US of which they were citizens. But despite this, they and their offspring made the most of their situations and moved forward. I have a lot of respect for that. It seems to me that they somehow funneled the anger and betrayal that must have been so painful into bettering themselves and their stations in life. All of my relatives were farmers before the war but remarkably all of the children of my grandfather's generation went to college--even the girls--so when they had to start over, they at least had something to work with.

As great as the content was, I have to be honest that the camera work was distracting and Ken & I started to make fun of it. Sometimes it would zoom in so uncomfortably tight on her face or just lose focus randomly. But the entire time I was watching, I felt that I was seeing it for the first time. At the very end, Bev can be heard thanking everyone, including the video camera operator who was a WSU student and was given some sort of award by their department as student of the year. At that moment my chest seized and I said, "Am I the camera operator?" Not only do I not remember the presentation but I shot it badly! Ken looked at me incredulously and just at that moment the camera panned to the very back of the room where Bev's says 'Susie's family' was sitting. Thankfully (mercifully) I was sitting there next to Austin and my grandmother so I clearly couldn't have been the camera operator. But it is disturbing that I was in the room and 13 years later have no memory of it whatsoever. Wow.

This chapter in history can never be forgotten for the lessons it teaches us about our country and what it means to be an American. Thank you to Bev for putting this in a digital medium so that we'll never forget--even if we're in the room.

Grocery store opening: highlight of the week

I'm not complaining but since becoming a Domestic Project Manager (aka Stay at Home Mom), the caliber of my daily excitement has definitely changed. For today's big outing, Sidney and I went to the newly opened QFC grocery store here in Ballard. I was trying to think of a place that was:

• free
• had parking
• would be interesting to an infant
• sold croutons.

Voilà!

I do all the grocery shopping for the family and while I once loathed it, now it is an outing I look forward to. First it's incredibly stimulating to Sidney and that makes me feel better about her being strapped into her infant seat for that length of time. Second, I get to pick out the food I like since I'm the picky eater and have specific brands of things I prefer. Third, the day I discovered Whole Foods is the day I felt like a young girl in love again. For the record, we seldom buy groceries at Whole Foods but it doesn't stop me from going there and cruising the aisles like a star-struck groupie. If there is a heaven, it looks like Whole Foods. It's probably because everything in that store is either organic, natural, cage-free or was spoken to nicely before it became food.

But today we went to a brand spankin' new QFC. We were there midday so besides parents and young children there were a great number of "retired folks" milling about. Nothing wrong with that except don't get stuck behind them in the aisles or at the sample table. A sample to avoid: the freshly made California roll. They have an amazingly compact sushi station there with Asian-ish looking folks putting stuff together but it just didn't taste fresh. On the plus side, they have an enormous wine section and their bakery is impressive. I also marveled at how energy efficient their frozen food aisle is. Usually you'd want to camp out there on a hot day but when we strolled down, it was roughly the same temperature as the rest of the store. Nicely done.

There were lots of extra employees on hand since I think they just opened a few days ago. (Nope, actually yesterday.) So they were still painting a mural in the parking garage and getting some things figured out. One major drawback is the parking. Though they have it under the store, it's tight. You think the Ballard Trader Joe's lot is small, this is worse. I would not suggest heading into the underground unless it's not very crowded like at midday or late at night. Thankfully they had several of their extra staff members who were extremely friendly and cheerful down there to help direct traffic. One guy (I kid you not) offered to fetch an elderly shopper's car, valet style, as she was coming down into the parking area with groceries. And she took him up on it.

So good for you QFC, I don't know if you can maintain that level of service, but more power to you. But if we're going to compare prices, I was shrewdly eyeing items we constantly buy: formula, diapers, wipes, cereal, yogurt, croutons. And sorry to say QFC's prices are higher for the exact same brands as our current favorite store, Ballard Market. This QFC does have some organic/natural selections but not enough to substantiate markups on everything. The boutique grocery stores have better artisan and organic selections with still better prices--so it looks like despite all the bright and colorful aisles, we'll still be trolling the aisles of our old store.