Pregnancy at Work

I have been lucky.  The last person who got pregnant and gave birth was my Dear Colleague, one of my best friends at work.  And it was two and a half years ago.  That was when we just started trying to conceive.  Since we’re such good friends, her pregnancy was an okay event.  Ever since then, no one at work has ever gotten pregnant.  Our office is filled with singles, married people who are done with kids, or married people who seem like they don’t want kids.  I have enjoyed a very safe period of time during this whole roller coaster ride of TTC and IVF journey.

About eight months ago, I mentioned about a coworker who got engaged after a long term dating relationship.  My very first thought was that she would start trying right after her wedding and would get pregnant immediately.  I called myself silly at the time for having that as my first thought.  Then I consoled myself and thought, well, it’s okay for her to get pregnant since she works for another department and historically I don’t get to see her much if I don’t walk over to her side of the hall or have lunch in the lunch room.  I thought to myself that I can survive having an “instapreg” (coined by my dear friend M) at work if I don’t have regular contact with her.

What a naive thought.  My immediate boss, the clinical director for all professional services, quit her job about a month ago and left in the beginning of this month.  And guess who took over her role?  Yup.  My engaged coworker.  We have departmental meeting every other week.  So it means that I will see my new boss regularly.  So then… I consoled myself again and thought, hey maybe she won’t be trying to get pregnant right away because she just got promoted and would want to focus some of her effort in this new role.  My Dear Colleague has a way of getting information from anybody that she gets to talk with.  So she got the scoop on this new boss’ intention and confirmed that New Boss will start trying to have a baby right after her wedding in late October.

Great.  If she gets pregnant in the next few months, then I’ll have to endure a growing belly in the next year or so.  Maybe I can handle it… but the anticipation is sort of killing me.  I have just enjoyed so much to be free of sights of pregnant coworkers.  I mean, I did and still do have a few clients’ moms who are pregnant.  But… I got over these pregnancies fast.  And I don’t really personally know them much so it’s okay to see them weekly.

My Dear Colleague also told me that another coworker of ours who got married a couple of years ago started trying to conceive about six months ago.  She hasn’t been successful yet.  I have been dreading her news.  Suddenly she announced that she was quitting her job here and would move onto building a private practice.  Her last day was today.  We had a potluck for her yesterday.  I breathed a sigh of relief that I wouldn’t have to bear waiting for her pregnancy news.  My Dear Colleague, the one who knows everything about everyone, broke news to me that another coworker is 16 weeks pregnancy.  What???  I thought I was safe.  This is a new coworker who joined us a few months ago.  I don’t recall her being married.  She is apparently having a baby with her boyfriend.  Dear Colleague also broke the news to me that this coworker is deciding between two girl names.  One of the girl names is the exact name that I will give to my boy in the future.  WTH???  First of all, this is a boy name.  BOY NAME.  Why in the world would anyone give a boy name to a girl?  And second, give me a break.  This is NOT a common name.  Out of so many names in the whole wide world, she wants to name her GIRL the one BOY NAME I have chosen for my baby boy.  My lovely Dear Colleague was trying to steer her away from giving that name to the baby and kept on praising the other choice.  I hope her tactic works.  But even if she does give the baby MY NAME, I would still name my boy the same name.  I don’t care.  And the good thing is I don’t see this coworker much so I can avoid seeing a growing bump if I want to.

I think I have a problem.  Maybe this is something I ought to bring up with my therapist.  *sigh*

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Name It, Own It, and Move On

I thought I didn’t have to go back to my therapist.  Well I guess I didn’t HAVE to.  But the first thing that came to my mind after my cyst incident was to tell my therapist about my thoughts and feelings around it.  As much as I thought that I was done talking to her (because I can take care of myself, right??), my reaction told me otherwise.  I emailed her and got an appointment this past Wednesday.

Right before I went, I still thought that I would just talk about my disappointment surrounding the canceled cycle, then I would run out of things to say.  What a naive thought.  Well, I basically talked the rest of the session without a gap.  I did have a lot to say.

I thought it was very productive.  We talked about quite a few things.  She was empathetic about the cancelation because I had been so ready for it since the momentum for the new cycles had been built for quite some time.  Ever since I started seeing her, I began to give more thoughts to my feelings.  I feel like giving them a name.  (Not a real person’s name like Ursula for the cyst.)  I used to feel some vague unpleasant feelings and I might not have pinpointed what they were.  When the cyst was discovered, the word “disappointed” kept popping in my head.  I wasn’t frustrated per se.  Just disappointed.  My therapist commented on how good it is for me to name my feeling, own it, and move on.

I went on to talk about my feelings for pregnant ladies and new moms.  This all stemmed from my friend Anna who is about to give birth.  While I waited to feel ready for a new cycle, Anna’s belly grew bigger and bigger.  She is finally due and the baby is going to come at any moment.  I shared with my therapist about how I found out about Anna’s pregnancy, how I sometimes feel guilty for being jealous of those pregnant friends who had tried as long as we have if not even longer, how I feel that I should not be jealous, and how I feel I should work towards feeling happy for them.  I feel a sense of losing the camaraderie between myself and these friends, the sense of someone fighting a battle with you side by side, and the sense of being left behind.

My therapist’s point on this is that, I am only human.  It’s natural to have envy or jealousy.  It’s natural to feel being left behind.  It’s very much okay to have these feelings.  The more important thing is how we deal with our feelings.  It’s much better to acknowledge our feelings, own them, and move on, than to avoid those feelings or get stuck on them.  It’s normal to be jealous of those who have crossed to the other side, even if they have struggled like we do.  However, if I say that I feel guilty for being jealous and I should be happy for them, then I am putting judgment on myself.  There is no should’ves, would’ves, or could’ves.  And don’t focus on the what-ifs.  We cannot change the past or predict the future.  These thoughts are not useful.  Instead, we strive to live in the presence and experience our current situation, thoughts, and feelings.  That’s a lot healthier than regretting the past or being fearful of the future.  And it’s a lot healthier to name the feeling and move on.

My therapists said that people who experience fertility challenges are often hard on themselves.  I myself included.  If a friend came to me and told me her feelings, I’d most likely comfort her and let her know that it’s okay to feel a certain way because we’re just human beings.  However, we don’t say that to ourselves because we’re often hard on ourselves.  So she said, be kind to myself and sometimes talk to myself like I’d talk to my own friends.

What if I get stuck on a feeling and can’t move on?  She said, if I get stuck with a feeling after acknowledging it, I should get up and move around.  Our frontal cortex is great but it’s difficult for human beings to shut off our feelings.  When we do something different, such as moving around, walking outside, or changing our posture, we help change our feelings and we won’t feel as stuck.

Finally, I told her about the flowers that were sent to work by my husband, how I was pleasantly surprised by them because of our prior fight and talk about saving up every single penny for IVF.  Bob has an extreme focus on saving up money for IVF and more importantly, donor egg cycles.  He sometimes views spending money on something else as deviating from our goal.  However, I feel that we should sometimes stop and smell the roses.  I feel that we should not focus every single moment on IVF but to live life.  This has been a source of tension even when I am actually not a big spender.  My therapist said that money is the number cause of fights for couples who struggle with infertility.  She pointed out that as a partner who is not doing the physical part of IVF, such as the injections, the retrieval, or the transfer, he would want some control in this process.  One thing that a partner feels like he has control over is the money aspect.  It’s very common.  She told me to put myself in his shoes and think about what he’s going through. Then I’ll have more empathy and will be able to step back from a fight if I take his perspective.  The fact that Bob surprised me with flowers on his own shortly after our big fight shows that he is very open to this dialogue of coming to a mutual ground with our finances.  He is trying and he did it out of his heart.

I had never thought about the control part and I found it very true.  It sheds some new light on Bob’s thoughts and feelings and I am very appreciated of this new insight.  However, my therapist said that she agrees with me that living life is very important too.  So Bob and I should sit down and talk about how we want to spend a little bit of money on date nights or entertainment so that we don’t feel that we’re dragged down financially, emotionally, and mentally by this process.  During a fight, she suggested that I (we) can get up and move around.  That should help us be unstuck and feel less angry.  She said I could tell him that the therapist said it’s okay to live life.  She senses that we have a very strong bond and are really on the same page trying to work towards our goal.  We could bring Bob into the therapy session as a guest to talk for a couple of sessions about our feelings surrounding finances, IVF, and infertility.  We could also pursue couples counseling with another therapist that my current therapist highly recommends.

I walked out of the session more empowered.  Talking to her really helps to straighten out my thoughts and feelings.  Bob is still trying to decide if he wants to come to a session with me.  It’d be interesting to see how the dynamics change.

As for our current cycle, today is cycle day twelve.  I went for my acupuncture appointment on Tuesday and Maya abdominal massage appointment yesterday.  I am also doing self care massages at home and taking herbs to try to clear up the cyst.  We’ll see if Ursula is as agreeable as my first two cysts.  Bob and I are trying naturally as usual.  We continue to hope for the best that we’ll find ourselves pregnant in a couple of weeks and we’ll get the refund from UCSF for the mini cycle that we have paid for already.  Let’s hope, pray, and believe together?

Surprises – The Pixley and Dr. No Nonsense

“The Pixley” is the name of the bouquet that my wonderful husband sent to my work.  I was so surprised!  Remember our big fight on the eve of my birthday this year?  I would never have guessed that he’d be so thoughtful so soon after we had that fight.  Yesterday I went down to greet my 11am client.  I was signing the intake sheet when one of my front desk staff pointed at this bouquet of flowers right next to me.  I still didn’t understand what she meant.  She said, “This is for you.”  Since the note was clipped on the bouquet, I couldn’t see the name of the sender.  My coworkers who gathered around me at that point said that it must have been from your hubby.  I was still doubtful and said, “I don’t think so”, simply because of the fight and the subsequent talk that we had about saving money for more IVF.  I took off the clip, turned the note over, and read it.  I immediately started tearing up.  This is what it said:

To: Isabelle

From: Bob

Note: I know it’s been a tough week for you and us.  Hang in there.  Love you!

the pixley

This is the biggest surprise of the year.  The packaging, the flowers, the presentation.  Everything was perfect.  I didn’t even want to take the flowers out of the burlap because of how perfect it looked.  I am very grateful that Bob was there with me during the baseline appointment when we found out about Ursula the cyst.  He saw how disappointed I was and how much I wanted to cry but couldn’t.  He witnessed everything and thought that some flowers would cheer me up.  They definitely did cheer up although I cried like a mess in front of others who had no clue why this week has been difficult for me and us.  Fortunately, my 11am client’s mom is the one who is pregnant with her miracle baby after losing her other baby.  I wrote about her in this very long post.  I am so glad that she was the one who was there to see me being a mess.  I showed her the flowers in the waiting room and told her what happened this week.  She started tearing up and we hugged each other.  We were both a mess!  This is the sweetest and most perfect gift.  My husband rocks!  I think I’ll keep him.  😉  (Too bad he doesn’t read this blog anymore so he doesn’t know my praises for him here.)

*****

Another surprise is Dr. No Nonsense’s phone call to me on Thursday.  After I was told by the doctor who did the ultrasound that the cycle would be canceled, I didn’t think that anyone other than the nurse would contact me.  After all, this is a big university clinic with many many patients.  I didn’t expect any more personal phone call from the doctor himself like the care that I’d get from Dr. E at her tiny little clinic.  I was actually writing his nurse an email when the phone rang.  I picked it up and was so surprised to hear Dr. No Nonsense’s voice.  He asked me how I was doing.  I told him that I was a bit disappointed.  We went on to chat about my history of having cysts and how they were the cause of two canceled cycles.  He said that this cyst is pretty big. He asked me how I would feel about putting me on estrogen after ovulation.  I asked him what that would do.  He said that it would help suppress my FSH so that my body does not start recruiting follicles prematurely.  So that’s the plan.  I will take estrogen a week after ovulation and we’ll see how things go.  I like that Dr. No Nonsense is proactive.  I feel that he cares and I feel cared for.  The sting of the canceled cycle has slowly subsided.  I am starting to feel at peace again.  I will continue with acupuncture and Maya abdominal massage next week to hopefully make Ursula go away.

*****

Finally, I have blocked infertile no longer pregnant friend on gchat.  She will not see me online anymore… at least until I unblock her.  It has actually been a relief.  I still feel a little guilty at times for blocking her but I enjoy the peace and quiet and being free of unsolicited advice.

*****

Cycle day five.  Time is moving very slowly…..

“Ursula”

So… Our cycle is cancelled.

I have maintained a very positive attitude in the last couple of days.  My dear coworker asked me what I would like the outcome to be for today’s baseline appointment.  I said, I don’t care how many follicles we have; I’ll be happy as long as we don’t have a cyst.

Well, guess what?  A big one was found on the the left side.

I should’ve known.  That seems to be my pattern.  Whenever I spot for a long period of time in the beginning of a cycle, there is always a cyst the following cycle.  It happened last month.  I spotted for ten days and ovulation was late.

UCSF is very different from Dr. E’s boutique clinic.  You don’t get to see the same person every time. You don’t get to see your own doctor.  We arrived and paid for our cycle.  Then we waited for 35 minutes before we got called back.  I was anxious about the time because I needed to get back to my work to see my last client of the day.  The nurse did not introduce herself.  She called my name.  I got up.  She then said, Let’s go.  I don’t know.  She wasn’t rude.  But she wasn’t the friendliest.  In the exam room, she told me to undress from the waist down and left.  I was thinking… what if this is my first ever cycle?  It would have been the most impersonal experience ever.  After a couple of minutes, this doctor came in.  She said her name so fast that I didn’t catch it.  I figure I probably won’t see much of her, so it’s okay.   She measured my lining, which was 5.6.  Then she asked, Did you know that you have a fibroid?  She measured that too.  She proceeded to the right ovary.  It had two follicles.  Then the left ovary.  She discovered this big cyst.  She asked if this is something that I’ve always had.  I explained that I have it once in a while.  At that point, my heart sank and I knew that we’d cancel this cycle.  Every single time there was a cyst, my cycle got cancelled.  It happened twice already.  I mean… it always gets resolved so I am not worried about it not going away.

Nevertheless, I am very disappointed.  I have had great momentum going into this cycle.  I was really ready to move on.  And now… the cycle came to a screeching halt.  The doctor saw another small follicle on the left and couldn’t proceed with the scan because of the view being blocked by the evil cyst.

I actually almost cried there.  But I held my tear back.  The doctor went to talk to the doctor of the week (instead of my own RE) and said that if it’s not a persistent cyst, then we’ll cancel the cycle.  I wasn’t surprised… but it was still disappointing to hear.  She then said that she’ll confirm with Dr. No Nonsense and give me a call.

I went back to work disappointed.  But I had to put on my game face because I still had a client.  Bob was sweet.  He was saying all the right things when we walked back to my work.  But I still felt like crying.  At 5pm, the doctor who did the scan called and confirmed with Dr. No Nonsense of the cycle cancellation.  No surprise there.

Elisha is such a sweet heart.  This is what she wrote to me when she found out:

“I know how disappointed and discouraged you must feel because I have had several cycles cancelled in the past.  But the one thing I have learned since that time is to verbally say, ‘I don’t understand, but I trust you God.’  Just keep affirming your trust in Him and those thoughts of fear, doubt, worry, and discouragement will slowly fade away as you are reminding yourself that He is in control and can see the bigger picture. ”

Thanks girl!

And what does it all have to do with Ursula?  Well, the brilliant Jane Allen asked what I was going to name my cyst this time… since every time I named my cyst, it seemed to go away.  She suggested Ursula because it’s a dreadful name.  I think it’s very fitting!  Whatever her name is, I just want her to go away and not ever come back…

Instead of telling myself not to be disappointed, I am going to experience it and then let it go.  But yeah… we’re going to go back to old fashioned way of making a baby this time.

(Thanks everyone for your well wishes.  We’ll try again next month.)

Am I Ready?

Completing the first acupuncture session in four months?  Check.

Medication inventory?  Check.

Scheduling the baseline appointment for tomorrow?  Check.

Mentally preparing for the baseline appointment?  Check.

Initialing all pages of the IVF and cryopreservation consent forms?  Check.

Putting the consent forms in my purse?  Check.

Sending out an email update to all of my prayer warrior friends and family?  Check.

Scheduling an appointment for Mayan Abdominal Massage?  Check.

Lining up all my Menopur in case we need it?  Check.

Rescheduling my clients because of the baseline appointment?  Check.

Praying for God’s peace, wisdom, and guidance?  Check.

Ready for IVF #5?  Check.

Acceptance, Toxic Friendship, and a New Beginning

Those were the topics of my second therapy session.

I was paying a lot more attention to my feelings and thoughts after our first session.  I noticed that I didn’t think about the next steps as much as I thought.  One morning I woke up at 5:30 am.  The first thought that came to my head was the amount of money that we may end up spending for this whole process (for my own eggs and then possibly donor eggs).  Thinking about that huge, inconceivable amount, my heart jumped and I was instantly stressed out.  Reminded of the technique that the therapist taught me, I immediately stopped what I was thinking, took a breath, observed my thoughts and my feelings, and told myself to let go at this moment and to revisit it again at night.  Instead of being worried, I fell asleep again until the alarm clock went off.  The technique is useful.

I shared about feeling like I am living a double life at work at times.  This is the place that I spend most of my time outside of my home and the coworkers are the people that I see the most other than my own husband.  I only feel comfortable sharing with two people at work.  One person knows many of the details. The other person knows some.  The rest of the people, my colleagues for the last ten years, I don’t share with.  I go to my appointments and have been in and out of the office during my cycles.  I am glad that no one has tried to pry.  I just don’t feel comfortable sharing the details.  But I do feel like that it’s very weird they don’t know the biggest part and struggle of my life in the last three years.

I also shared about my infertile pregnant friend, who is obviously no longer pregnant because she gave birth already.  I have included the links about her in this post.  Basically she is somebody who had tried to get pregnant for four years and finally did.  She was less than upfront when she wanted to share her pregnancy news with me.  She has been saying all sorts of things to me that are very insensitive, like asking me about details about IVF so that she could do gender selection for a boy for number two, telling me not to give up because as long as I ovulate, there is hope…  I had been keeping a good distance from her since she gave birth.  I saw her and her baby at the baby’s party.  I let my guard down.  One day she asked me where we were in our journey and I opened up and shared about the early pregnancy loss with her.  I really shouldn’t have.  So this is the exchange:

Me:  Back in February, we transferred two embryos. Got pregnant, then lost it.  It has taken me 3 months to start thinking about trying again.

Her:  Just keep trying.  Things will be ok.  Do you move around a lot after you transfer.  Try not to move around too much or do heavy lifting.

Can you see why I would be annoyed with her?  There was no “I am so sorry for your loss”.  What does it mean by “Just keeping trying”?  Is it that easy?  And how does she know that “things will be ok”?  And why blame ME for the loss by asking me if *I* moved around a lot?  Thanks a lot for making me the culprit for the loss.

I was stunned that that was the response I got.  It took me a whole hour to write back with this:

Me: You know, my embryos not sticking had nothing to do with whether or not I moved around or not.  I was being careful with my movements.  It was probably the embryo quality. I did everything to give my embryos a fighting chance.

What I didn’t tell her was, “Back off!  You’re not being a nice friend.”

She wrote me back an email:

” Yes I know. I think you are right. Please do let me know if you have any questions and I can try to get you answers.  Don’t give up. It still looks very hopeful.”

ARRRGHH.  I hate it when she says “Don’t give up”.  Hate it.

She works for the reproductive endocrinology department for some hospital and she thinks that she can get me answers from one of the REs.  I know she’s trying to be helpful, but am I really going to go through her to ask an RE a question?

Most recently she has been offering me tips for saving money, such as a clinical trial offered by her hospital, for which I won’t qualify.  She suggested Attain program, for which I won’t qualify either.  Then she tells me to ask if my new IVF clinic offers clinical trials that include meds so it’ll save me money.

I have had enough with her advice.  I knew about the clinical trial.  I knew about Attain.  I have been doing this for a while.  I really don’t need her to tell me information that I already knew.

So… as a parting comment for that day, she said, “Don’t give up”.  Again??? For the freaking tenth times!

So I wrote, “I don’t think I’ll ever.  And even if I stop, I won’t call it ‘giving up’.”

I’m sorry.  I know that I should be very loving and forgiving to my friend.  But she annoys me to no end.  She knows what to say to push my button.  The thing is, she does not even know that she is doing this.  She genuinely wants to help and is trying to help.  But I don’t need her help.  When she writes me and asks me about the next step, I just want to close the window and not respond.

She is the most insensitive infertile woman I have ever met.

I told my therapist about her.  My therapist asked.  Why do you want this friendship?  Well, because I may not want to talk to her right now, but I still want to be friends with her.

My therapist then said, It seems like she is a trigger for you.  Whenever you talk to her, she triggers your negative emotions.  So it seems like you want to keep her for later?

Bingo. There you go.  She is a trigger for my negative emotions.

I feel guilty for not wanting to talk to my infertile no longer pregnant friend.  My therapist tells me that I have to feel okay not sharing because it seems like whatever she responds makes me angry.  I don’t need this friendship at this moment.  I have to let go of the feeling of guilt.  And I have to learn to keep a distance so I won’t feel hurt or annoyed every time I talk to her.

I’m so glad that I shared about this so now I know that I don’t have to feel guilty to keep a distance from this friend.

I told the therapist that sometimes I feel like I am not missing my embryos enough…. I see people grieving for the loss of their pregnancies for a long time… and I only sometimes think about the embryos.  She guaranteed me that everyone grieves differently.  I do get sad at times and I acknowledge my feelings.  Then I move on.  She thinks that it’s healthy and there is nothing wrong with not thinking about the embryos all the time.  She said that I am not cold blooded and I am being too hard on myself.

Another take home message for this session is acceptance.  My biggest fear is that I may regret the path that I have chosen for myself.  It seemed like I had already chosen UCSF since I did all of the pre-cycle preparation work.  But in the back of my mind I sometimes wonder and fear if I will regret my decisions.  How do I not regret?  My therapist thinks that I have to work on acceptance.  How do I work on acceptance?  I have to remind myself to live in the present instead of the past or the future.  If I think about the What ifs, the worries are going to take away the energy that I have to put into the present cycle.

With these points in mind, I am working towards acceptance.

*****

Phone follow-up consultation with Dr. No Nonsense went well yesterday.

He answered all of my questions.

Using anesthesia will cost an extra $763 for the retrieval.  I remember that the online friend who has banked her embryos doesn’t use anesthesia and she said that it is tolerable.  Doctor said I should be fine without.  It feels like a needle going through you.  He said I can try one to see.  My pain tolerance is usually pretty good so I’ll try it once.

I asked him the logics behind choosing Femara over Clomid.  He said that it makes no difference.  I have tried Femara twice and both times I made one embryo.  So he said we should try 100mg of Clomid this time.  It won’t affect the lining much and won’t make my FSH jump higher.

Do we freeze on day two?  Day three?  When we thaw, should we transfer on day two or day three?  At first he said we could freeze on day three and thaw/transfer on day three.  I told him that my history shows that my day three embryos are usually four-celled only.  Is that the best for transferring?  He then said we’ll freeze on day two and thaw/transfer on day two because of my history.  For those people who have fewer eggs, it’s better to put back in the uterus for a chance to grow.

Depending on my response each cycle, it’s possible to bank each month instead of taking a break.

We’ll see how I respond in order to know if we need to add injectibles like Menopur/Cetrotide.

Realistically it’s hard to see how many banking cycles we need.  I told him about the worry of running out of resources in preparation for donor egg cycles.  He said we should and will evaluate the situation one cycle at a time.  This is what my therapist told me as well.  I said that I always feel pressured when Bob asks me how many cycles I want the money for so he can save it up once and for all.  I get stressed out having to make that decision right now.  Now both professionals told me that I can’t really do that.  My therapist said that I may decide after one cycle with my own eggs that I have had enough.  I can plan all I want but in reality we just won’t know what will happen.

Dr. No Nonsense guarantees me that although he may not be the one who will be present at every single appointment, he’ll monitor my cycle and progress closely.  So I don’t have to worry about my questions not being answered or my concerns not being addressed.

Today is ten days past ovulation.  My period should come in five days.  I hope to call the pre-cycle coordinator next Monday to have the nurse create a calendar for me.  On cycle day one, I can call the clinic and start the clock.

Friends, we are back in the game.