Sunday, January 28, 2007

Potty talk

In a comment on my last post, Marie-Baguette asked me to share a bit more about life in Korea. Meanwhile, the most commonly asked question among many of my friends is "What does Mystery Man do all day, since he's not allowed to work?" So, in the spirit of multi-tasking, I've decided that to address these two topics at once.

We rent a lovely little apartment in Seoul. It's not large, but it's very well-designed and comfortable. My favorite feature is the traditional Korean heating system, which involves heating the floor and letting the heat rise. There's nothing lovelier than a warm floor on a cold day.

The one thing about our apartment that we really don't like is the bathroom. It has a number of design flaws, including a sink so big that it takes up 2/3 of the room, a toilet with an attitude, no bathtub, and a shower that's far too small for co-bathing, one of my favorite hobbies. The bathroom is designed around a concept that seems to be fairly widespread in Asia--the one central drain theory. Rather than having the shower separated from the rest of the bathroom by a barrier, the shower door stops about 10 cm short of the floor. There is also no drain in the shower. Rather, there is a trough-like drain under the shower door. The theory is apparently that the water will drain out as it rushes to escape into the rest of the bathroom. The reality is that the bathroom floor is pretty much always wet.

Yesterday, I was in the shower and heard a funny rattling sound. I looked down to see that the sound was being produced by water bouncing off of the beautiful new skirt that was now covering the gap under the shower door, preventing the regularly scheduled flood. It fits the door perfectly, and is clear, with bright green border. It adds just the touch of color that the bathroom was crying out for. I marveled at the fact that somehow, without speaking Korean, my beloved had managed to acquire such a thing.

When I asked him, he told me that he made it himself out of plastic bags and duct tape.

Saturday, January 27, 2007

Korea is beautiful too

Mystery took this photo last November. Sometimes I forget how beautiful this country is.

Hawaii is beautiful

I finally downloaded my vacation pics. Now I know I wasn't just dreaming.

Thursday, January 25, 2007

Confessions of a lurker

I was lurking over at Julie's the other day, and her sad post got me to thinking about why infertility can be so emotionally damaging, and why it can be so hard to get out of the sad place. I think that it's not really the denial of something that we want that makes it so hard. Most even marginally well-adjusted people cope with not getting what we want all of the time. I've always wanted to have smaller hips and fewer freckles, for example, and yet somehow I've managed to go on for 37 years bearing the awful burden of a J-Lo ass. I never seem to win the lottery (could that be because I never play?) I don't think that I'll ever write a great novel, and I certainly won't have time to read all of the great novels out there. I don't even think that I'll ever achieve my childhood dream of becoming Indiana Jones. I don't let these things bother me. I like to think that I'm pretty good at accepting most realities. Infertility, though, is different.

Why is it different? I think that there are a number of reasons, including the isolation, the sense of alienation from one's body, the lack of acceptance of infertility in society, and the mental image of a great long line of ancestors tracing back 3 billion years to the primordial ooze suddenly being snuffed out due to one's own reproductive incompetence. However, bodies can fail us in all kinds of ways, we all cope with being unique or special in some way or another, and most of us weren't really THAT fond of our one-celled ancestors anyway, so there's got to be more to it.

I think that the way that infertility often unfolds is the beginning of the problem for many of us. It's not like a "normal" disease where you have some symptoms, you go to the doctor, you run some tests, you get a diagnosis, and the doctor recommends a course of treatment. Many infertile couples feel fine. We don't have any obvious symptoms that should lead us to believe that there's a problem at first. So, the first real clue isn't something that happens, it's something that doesn't happen. And not happening takes a lot longer than happening. For me, this symptom started as a vague sense of worry, morphing slowly from confusion to fear to panic, which led me to the doctor. A series of tests followed, all of which indicated that there was nothing wrong. But there WAS something wrong. I thought. I couldn't be sure. Maybe we were just taking a bit longer? Maybe it would happen next month? Surely this couldn't really be happening, could it? To me? Really? Oh dear...

I realize that some couples (and singles) have a very different infertility trajectory. I don't know what it's like to quickly receive a devastating diagnosis when seeking infertility treatment, or to receive the diagnosis before even starting to try. That must be a very different kind of pain. I can't say that I envy them the pain, but I do envy them the fact that they got the news quickly, like pulling off a band-aid, rather than having it delivered to them slowly but inexorably hair by painful hair.

All of us, though, are in the same boat when it comes to part II of the infertility journey--the decisions about treatments or alternative family-building methods. I really think that this is the part that makes grown women keep crying for months or even years. On the one hand, I am SO grateful to be living in a day and age, a society, and an economic situation where fertility treatment is available and at least somewhat affordable. I am hesitant to comment negatively about the abundance of available choices for today's infertiles. Clearly it's a great gift, for which I am grateful. However, I have also noticed that I am particularly stressed and unhappy when agonizing over treatment decisions. Unfortunately, every option comes with a series of drawbacks. Today's infertile has to negotiate a bewildering series of risks and obstacles, including:

Health risks (including cancer, OHSS, ovarian torsion, higher-order-multiples, ectopic pregnancy, physical pain from injections, egg retrieval, and surgeries, miscarriage, premature delivery, death)

Emotional risks (What if the treatment fails? What if it succeeds too well? If I use donor eggs/sperm/embryos will I miss the genetic connection? Will the child? If I use my own eggs/sperm is the child at risk of genetic diseases? If I adopt, will the child grow up to resent being adopted? What about the birth family? What about the extended family?)

Financial risks (What if I spend all of my money on fertility treatments and don't have enough left for other family-building options? Is it better to spend less on a treatment with a lower probability of success, or should I pay to pull out the big guns? Will making major financial sacrifices to pursue ART make a negative outcome even harder to take? Can we afford multiples?)

Administrative issues (What clinic/agency should I use? What does insurance cover? How do I arrange a home visit? A semen analysis? IVF?)

The fact is that little in life can prepare you to have to make such potentially life-changing decisions, often with so little information, and with so little social support. Furthermore, while infertility feels like a crisis, the fact is that we usually have enough time to torture ourselves by mulling over every possible aspect of the decision, second-guessing ourselves time and time again. The fact that we're often jacked up on hormones while making these decisions doesn't help either. So, it's not really surprising that most of us feel like we're lurching from crisis to crisis.

Then, once you make the decision, you wait. And wait. And wait. And then you get the decision. Is it thumbs up, or thumbs down?

If the news is good, well, it's still not THAT good. All kinds of things can still go wrong. Ectopic pregnancy, miscarriage, fetal defects, complications, higher order multiples, stillbirth. Sadly, your average infertile has plenty of time to learn all about all of the things that can go wrong during pregnancy. So, rather than being a time of joy, for many infertiles, pregnancy is a time of white-knuckled fear.

If the news is bad, then go back to step II. Only the stakes feel even higher, your emotional reserves are lower, and your wallet is generally substantially thinner. Yippee.

I think that's the problem. With many other kinds of loss, the loss happens as an event. With infertility, it's not an event, it's a process that can go on for years. The outcome is not clear. The only way to know if a decision was good was with 20/20 hindsight. So, it's hard to know when to laugh, when to cry, when to mourn, when to pick yourself up and try again, and when to move on.

I think that's why it's so hard.

Sunday, January 21, 2007

A good day

Last Friday, I had my first really good day in Korea since the IVF. I've had several OK days, but hadn't felt any real joie de vivre in a long time (not counting Hawaii, since you'd have to be a pretty hard case not to manage a bit of happiness when on holiday in Hawaii). Friday was different. I woke up feeling great. Part of it was just biological (I had finally recovered from jet lag), and part had to do with the fact that rather than running off to work, I had taken the day off to go to the US embassy to get a new passport that morning.

Now I know that this makes me a total freak, but I love all business relating to passports. I love getting a new passport, I love getting visas. I love reading travel warnings, planning immunizations, etc. I know. Wierd. I also have this fun game of nerves that I play with myself whenever I have to renew my passport. I never get the passport photos before the day of the application. I always have to be in a hurry, and then to stop into a little passport photo shop and accept the first photos that they make. This is in part to keep me from obsessing about getting a decent photo (having no control over the selection process, or time to remedy errors), and partly to ensure that each photo is a candid shot of how I really was on that day.

Anyway, the passport application took me to a new (to me) part of Seoul, and I also love wandering around new places. I found a little photo shop, sat for my photo, and then was told that I had to wait 20 minutes. I took this opportunity to pop into a café, have a lovely latté, and read the newspaper. It was a sunny day, which made having 20 minutes to myself on a work day particularly nice. Then I picked up the photos (not too bad! my hair is a big disorderly, but I look like neither a heroin addict nor a convict, so I'll call it a good passport photo), and headed off to the embassy.

I don't know if this is common knowledge, but US embassies are scary looking places. Some of the old embassies are in quite lovely buildings, but the Seoul embassy is a horrible place that looks like it was designed by the same architectural geniuses that made the Cabrini Green housing project in Chicago. That doesn't actually matter, though, because since the embassy bombings of 1998, every US embassy has had extra security placed around the building, including big fences with razor wire, security checkpoints that make you feel like you're crossing the Berlin wall (before the fall), and general all-around scary business. It's gotten even worse since 2001. Once you come anywhere near the US embassy here, you are greeted with hordes of policemen, TANKS, and lots of guns. It's quite intimidating. When you go through security, the nonsmiling agents confiscate your cell phone, make you go through a metal detector, and use every ounce of their willpower to resist showing you any signs of human compassion during the process. Once inside, everyone ignores you completely. Warm and fuzzy, it is not.

So, I was processed, and then stumbled into the "American Citizen Services" office to apply for my new passport (I couldn't just do it by mail, since I need to hang on to my old passport in case my dad has a crisis while I'm waiting for the new one) feeling a bit stressed. I took a number, sat down, and prepared myself for a good long wait.

After only a few minutes, I found myself eavesdropping shamelessly on a man who was explaining that he was there to get US passports for his three children. The agent asked if they were US citizens, and he said "no, they are Ethiopian citizens. We just adopted them, and are working on getting them US citizenship."

I was entranced. He was told to go away and fill out some form. My eyes followed him across the room. I had already heard him say that his wife was with the kids getting passport photos, so he was the whole show at this point. He looked a bit harried (natural, given the context), but kind. I wanted desperately to talk to him, but balked at the thought of approaching a complete stranger and accosting them about their family-building process.

After a few minutes (which was surprisingly quick), my number was called. I got my business sorted out easily, and was about to go when his wife came in with three gorgeous kids. They were about 5, 7, and 9 or so, and were obviously siblings. All of my resistance dissolved, and I knew that I HAD to speak to the parents. So, I went up to the dad, apologized for the intrusion, and asked him whether he and his wife had arranged the adoption from Korea. A little background--I spent three months in Ethiopia several years ago, and fell completely in love with the country. If we do end up adopting, Ethiopia is at the top of our list of preferred countries. I had actually been thinking about adopting an Ethiopian child since before IF, after seeing how many orphans there are there. However, I had never imagined that an adoption of any child was possible to arrange as an American living in Korea.

The dad immediately started gushing about how happy they are with the kids, and what a great experience they'd had with the adoption. He gave me all kinds of info about the agency they used, how they arranged the home study (that was my big question, I had never imagined that a home study could be completed in Korea), and the details of adopting in Ethiopia. It turns out that his wife is even allowed to do home studies for other couples! So, in one morning, I'd gone from thinking that adoption was totally impossible until we move back to the US to realizing that it is a real option for us now. The best parts were that they completed the adoption in less than a year (!), and were able to adopt three siblings for only about $1000 more than adopting a single child.

I left the embassy feeling like I'd been struck by the thunderbolt (of Godfather fame, if the reference is obscure). We're not ready to make a decision about adoption yet, but the idea that if we decide to do so, we can have a child (or children) within a year is thrilling to me. Realistically, we will not be making a decision that quickly, since I want to give IVF a good shot, and don't think that I am emotionally capable of handling the stresses of IVF and adoption at the same time. Still, it was such a nice reminder that there are other options out there for us.

Wednesday, January 17, 2007

The Ass Files

These statistics summarize the state of my butt as it recovers from two weeks of progesterone-in-oil (PIO) injections:

Days until bruises fade to invisible - 8
Days until lumps become undetectable by feel - 13
Days until the injection sites stop hurting when I touch them - still waiting.

A reasonable person might ask why I keep poking at my sore spots to see if they hurt. Silly silly reasonable person. It's easier to prod my butt than my heart.

Tuesday, January 16, 2007

Back home

My body is now back in Korea. My mind, though, seems to still be in transit. There's a five hour time difference between Seoul and Honolulu, and I am feeling every minute of it. So, I don't promise that this post will be at all coherent.

The trip was for the most part wonderful. About an hour after takeoff, I realized that for the first time in a long time, I was feeling really excited about something other than a fertility treatment. I realize how sad that sounds, but it's actually true. The emotions associated with IVF were so overwhelming for me that I really don't think I'd gone more than five minutes without thinking about it for the past few months. On the plane, though, I was thinking about other things, and it felt great. It wasn't so much excitement about the trip itself that I was feeling, but rather excitement about the future in general. Somehow being on a plane reminded me of all of the great things that life may still have in store for me. It felt great.

Hawaii is a ridiculously beautiful place. It's hard to turn around without seeing something amazing. In a week, I saw a volcano, the most amazing coral reefs, zillions of gorgeous fish, sea turtles, rainbows, incredible sunsets, and my favorite, humpbacked whales! It really did my heart good.

Spending time with my parents was a bit harder than expected, but also good. It was hard because I'm so worried about my dad, and we just don't have a lot of information yet, so it's hard to know how best to support him. He seems not to want to talk about it, but it may just be that he doesn't want to upset me. He's never been one for complaining. I just did my best to let him know that I love him, that I want to hear everything that he's willing to tell me, and that I'll do everything that I can to be there for him. I don't know what else to do. We still don't know when his surgery will be. His doctor should have left a message with last week, but so far he hasn't phoned. I'm hoping that this is a sign that there isn't anything urgent about his condition, rather than that his doctor is incompetent!

My parents and I are also still getting used to communicating about my fertility struggles, which made spending time with them when I'm still recovering from the failed IVF a bit difficult. I just told them that we're having problems last August, so this is all pretty new to them. They still don't really "get" it, and of course I don't want to make a big deal about my own problems when my dad is dealing with cancer. Still, it IS a big deal to me, so it can be hard to put on a happy face all of the time. I ended up having a long chat with my mother about it at one point (after she made one comment too many about my "bad attitude"). It turns out that even though I'd told her that we were seeing doctors and spending a lot of money, she hadn't grasped that this meant that we were actually undergoing painful, emotionally taxing, and expensive treatments. I don't know what she thought I meant, but she was totally shocked when I told her about the IVF. I felt a bit bad afterwards for burdening her with this information when she's already so worried about my dad, but I just couldn't stand being misunderstood any more. I think that my mother wants what's best for me so much that she doesn't like to believe it when I tell her that my life isn't in fact all sunshine and roses. Things went much better after our talk, so I'm going to assume that it was a good thing.

Well, I'm exhausted, so I'm off to bed. Hawaii was great, but it's also good to be home.

Friday, January 5, 2007

The elephant in the room

I can't say that time heals all wounds, but it's amazing how much better I feel today than I did a few days ago. I'm still sad, but it no longer feels like a crisis. It just is what it is. I'm expecting to feel even better tomorrow, because I'm going to Hawaii. We planned this trip several months ago. My parents were going to Hawaii, and said that they wanted to buy us plane tickets to join them as a holiday gift. They didn't have to offer that twice! However, given my dad's health problems, I wasn't sure that the trip was actually going to happen. Well, as it turns out, his doctor said that he'd need at least a week to review the results of my dad's latest tests before his surgery, so he told them to go ahead and go. So, my parents are already there, and we'll be joining them tomorrow. I can't tell you what a godsend this trip feels like right now. Not only will I get some time away from my "normal" life to think happy thoughts, but I'll also get to spend some quality time with my dad before his surgery.

Two unwelcome, but appreciated bonuses of NOT being pregnant: 1) I don't have to try to figure out how to take syringes and bottles of progesterone-in-oil onto the plane (the flight is long enough that I'd need to shoot up in mid-journey), and 2) I'll be able to have a nice fluffy tropical drink when I get there.

In other news, I had the most interesting conversation with a friend the other day about my infertility. It was all part of my "being a better friend" program for 2007. I have been kind of upset with one of my best friends because she never asks about how treatments are going, how I'm feeling, or anything relating to my infertility. I get these email messages (she's in New York, so with the time difference phone calls are hard) full of chatter about her baby, work, our friends' news, her family drama, etc., but my infertility has been the elephant in the room that nobody talks about. She never even asked me how my IVF cycle was going. I have usually just tried to ignore things like this, and ended up pulling away from people who don't offer me the support that I need. However, this is a good friend, whom I love, so rather than taking the easy road, I told her how I was feeling. The results were shocking. It turns out that she hadn't been asking because she thought I didn't want to talk about it with her, since she has a child. She said that she has the hardest time knowing what to say when all that she's really thinking about is how I'm doing, and what's going on, but that she had been afraid that it would bother me if she asked, so she was trying to let me take the lead. She even said that she noticed that I talk about it with her less than I did before her daughter was born, and that it hurt her feelings, but that she was trying to be understanding! Meanwhile, I felt like the fact that she never brought it up meant that she didn't care, or found talking about it too unpleasant to be worth it. It honestly had never occurred to me that fertile people might think that it's rude to ask, given that I told them about my situation in the first place. I HATE it when people who don't know (and therefore by definition are NOT among my close friends) ask if I want kids, but I have always figured that by telling people about my struggle, I am also inviting them to share it with me. I had noticed that most of my friends were very supportive before they had their own kids, but that as soon as the kids are born, everything changes, and had attributed that to a combination of survivor's guilt and (understandable) self-absorbedness on their part. It had never occurred to me that they might be trying to be sensitive to my feelings. So now, I'm wondering how many other friends I've misjudged. I also wonder if I'm unusual in that I LIKE it when my friends ask me how things are going. Thoughts about infertility occupy at least 25% of my brain at any given moment (I realize that I need to work on that), so being able to discuss it is SUCH a relief. Now I'm realizing that I really need to tell my friends this. So, I've learned my first major life lesson of 2007. Not bad in only five days.

I don't plan to post from Hawaii, but will be back on January 15th, hopefully with a smile on my face, and a butt free of needle tracks. See you then!

Wednesday, January 3, 2007

It's official

The beta was negative.

I'm actually feeling surprisingly OK about it. I think I pretty much processed my initial (admittedly crushing) grief over the weekend, so the news was not so much an additional blow, as a welcome bit of closure. This cycle is now officially over. Now I can move on and think about the future.

In the future, there will be another cycle. My doctor suggested March, I suggested February, and she said OK. So, there we are. I have one month to collect my thoughts, live a little, and have many nice glasses of wine. I'm planning to start today.

The other bad news is that nothing made it to freeze.

The silver lining is that my doctor emphasized that my response to stims was "great, considering...", and I interjected "my age?". She laughed and said, "yes". She also said that our embryo quality was "excellent". She says that sometimes she discourages couples from trying again, but that in our case, she really thinks we have a good chance of success if we are persistent.

Given that stubbornness is my most basic personality trait, I don't think that persistence is going to be a problem.

Monday, January 1, 2007

Happy New Year

Well, it's now 2007 everywhere in the world, I think, so it's safe to say Happy New Year.

2006 has been a bit rough for me, but also has been full of nice surprises. I moved to Korea, got a new job that I love, my older sister got pregnant with her first child (conceived on IVF #3, so thankfully this was a pregnancy announcement that I welcomed without even the slightest twinge of jealousy or pain). We spent quality time with our family and friends, and did many of the things that we love. All in all, while 2006 didn't bring me the child that I want so badly, it did bring many other blessings that I may not always acknowledge as much as I should.

Now on to 2007. In honor of the new year, I thought I'd share a few of my resolutions.

1. To be a better friend. One of my reactions to infertility has been to pull back from many of my loved ones, especially those that are new parents themselves. I am sometimes frustrated that they aren't a bit more understanding about my situation, but when I think about it, I am also a bit disappointed in myself that I have been unable to be more understanding about theirs. Being a new parent is difficult and stressful, and they deserve my support. I also deserve theirs. In the new year, I hope to find a better balance between protecting myself and being there for them. I think that if I work a bit harder on opening up the lines of communication, it may also help them to be there for me in a more meaningful way.

2. To not forget to enjoy this amazing adventure of living in Korea. We don't plan to stay here forever, and it really is an incredible place. So, I hope that in the New Year, I'll spend less time obsessing about the things that make me sad, and more time enjoying the great life that I have.

3. To try new things. (I'm borrowing this one from my friend Cheryl).

Happy New Year!