Monday, September 18, 2006

A little bit of backstory

Well, what relevant information ought I to tackle today... Let's start with the PCOS, shall we?

PCOS stands for polycystic ovarian syndrome. I hit puberty and started to look like a cross between the bearded lady and a linebacker. My periods, when I had them, were all over the place. My mother took me to our family physician, who did some blood work and said all my hormonal levels were within the normal range, though unsurprisingly my androgen levels were a little high. Anyway, they told me I was fine and to consider myself lucky that I didn't have to deal with periods very often. Ha, ha, ha. Great. In their defense, PCOS wasn't well-described back then.

Flash forward to college. Fed up with the endless monotony of depilatory creams, tweezers, and creme bleach, I talked my parents into footing the bill for laser hair removal. It worked pretty well on parts of me and not so well on others. I also discovered SCUBA diving. I loved it immediately and spent a couple of years underwater. This, it turns out, is not only great fun but a tremendous amount of exercise, which is what my messed up, insulin resistant body needs to be reasonably fit. I lost 50 pounds and people from my freshman dorm started to not recognize me when we met on campus.

Then graduate school, which is how I wound up living in this city and where I met my husband. I read an article in a weekly news magazine about PCOS and it was one of those lightbulb moments. I have this, I said to myself. I have this. Well, of course I was right. We also discovered I have hypothyriodism on top of the PCOS. Years of symptoms started to make sense. I got on a low-carb diet and things improved even more. I was running for 45 minutes three days a week. I was finally attractive and fit. (And let me tell you, I was neither of those things for a VERY long time, and all claims of fitness were pretty thoroughly obliterated by my pregnancy.) I was terrified I wasn't going to be able to have kids, but we figured that was going to have to wait to be dealt with until after my husband and I finished graduate school. That took up most of our twenties.

At long last, finally we were both done. My husband got a good job and I started teaching a little at the college I teach at now. We decided it was time to try for a baby. In my mind this was going to take years of infertility treatments and thousands of dollars. Don't borrow trouble, says one of my more understanding OB/Gyns. (There were three in the practice back then. We've met Dr. Favorite already; let's meet the rest of them later.) Her advice-- start prenatals and metformin for a month, then quit birth control pills (which I had been taking since my PCOS diagnosis) and have lots of fun with the husband for three monhts. After that, my own hormones would probably kick in and spoil the ovulation party, and at that point we should come back and discuss further options.

So off we went. I was certain there wouldn't be any ovulating going on in MY messed up body. I'd seen those ovaries in an ultrasound. I had pictures of them. Bags of cysts don't make nice eggs and send them off into fallopiantubeville. 14 days into the first cycle-- boom. My temperature rose. And stayed up. For more than 14 days. Hmmm. Peed on a stick (okay, several sticks), and there we were. Pregnant. First time's the charm, right? Not so much. I miscarried at 7 weeks. We hadn't told anyone except my best friend J, so we were spared spreading around that particular bit of news. To this day few members of my family and none of my husband's family know.

To gloss over a very dark period, we grieved. But we had a valuable bit of knowledge. We had conceived once. It would surely happen again. And it did, three cycles later, again just with Metformin. Who knows, maybe I would have conceived without even that. Anyway, this was the one that took. We got to the end of the first trimester, and then we spread the good news around. We were through the dangerous part, right? I breezed right over a lot of descriptions of preterm labor and other complications in my pregnancy books. That won't happen to me, I thought. I've had my trouble. I imagine anyone reading this can see right where we were headed.

Anyway, that's the prologue to my pregnancy story. So, I'm not really infertile, though for years I thought I might be, and I still identify with a lot of what the IF people blog about. I took any and all pregnancies around me as personal attacks, etc. I won't describe my reaction when my brother announced his wife's pregnancy during this period. It's possible that I harbored some uncharitable thoughts when I miscarried during their pregnancy. I own a lot of books on infertility. I still worry that I won't be able to conceive again without the benefit of coming directly off six years of nice, synthetic birth control pill hormones that repressed expression of my unique cocktail of reproductive hormone soup. However, I realize that imagining problems which I might have had to face, or may face in the future, pales in comparison to what a truly infertile couple goes through. So, I guess I fall in a grey area in the middle. Neither infertile nor normal. I suppose I have a somewhat unusual perspective on both.

Sunday, September 17, 2006

Current state of affairs

I suppose I ought to summarize our current yet tentative plan for sibling creation. I always had this vague idea that any children I had would be about 2 years apart. I have a sister who is 2 years older than I am as well as a brother who is a little over 2 years younger. I suspect this might have had something to do with my vague intentions regarding spacing any children I had during my life. Now, of course, I'm looking at this with an entirely new perspective. I'm 30. Five years or so before I'd like to be done having kids. So my age is somewhat of a factor, if by some miracle we decide to have three kids. I would like to go back to work full time (right now I only work a little bit) once any and all kids are in pre-school or kindergarden, and the longer we space them the longer it will be before I go back to work. We sure could use the money. California is a freakishly expensive place to live (I'm not originally from here, as you might guess). Shortly after our daughter was born, we moved to Development Land. Not really a suburb; more of an exurb. We're way out here. It's the only place we could afford a single family home on a street with lots of other little kids. And I'm using the term "afford" rather losely here. Anyway, so there are some good reasons to have another one sooner rather than later.

But what if I land in hospital prison again? My daughter would be two. She won't understand why her mommy had to go away. Lots of the other inmates, er... I mean patients, that I met in the hospital last time had kids at home already and I heard terrible stories about how they felt as their children became increasingly attached to their substitute caregivers. Would it be easier if my daughter were older? I have no idea. The sum total of my experience with children is with my daughter. The older ages mysitfy me. I have no idea what to expect and when. On the plus side, I seem to have lucked out and ended up with a freakishly good-natured and easygoing baby. I'm sure any separation would be much harder on me than on her, especially since my granny-lust-ridden mother has offered to fly down here and live in our house and look after my daughter if anything goes wrong. She loves her two granddaughters to death (my brother has a little girl, too) and would like many, many more! She's been amazingly helpful over the last year and a half.

Anyway, I'm definitely srarting to think about it. My husband is considerably less ready to even turn his thoughts in that direction. That's another post for another day. I have my annual exam/pap coming up in October with the OB/Gyn who delivered my daughter and, incidentally, was the one who confirmed my drastically shortening and funneling cervix last time and was on the phone with a perinatologist within about 20 seconds. But that's also a story for another day. Anyway, my OB (let's just call her Dr. Favorite.) and I discussed "any future children" when my last pregnancy went south and she said when we were ready to think about trying, she'd refer us to a high-risk group to go and discuss the options. I'm assuming we're talking about a cerclage and obsessive monitoring of my cervical length, with bedrest and tocolytics at any sign of trouble. Anyway, I intend to get that referral in motion when I see her next month. Now... How to nonchalantly introduce this plan to my husband? He still suffers from what I term post-pregnancy stress disorder, and rightfully so.

We shall see.

Friday, September 15, 2006

Sibling creation

Well, here we go. I have been following several blogs on this site written by pregnant women on bedrest due to a number of different pregnancy complications. I'm interested in their stories since my last pregnancy, which resulted in my beautiful baby daughter, did not go as smoothly as it might have. I spent all of the summer of 2005 in the hospital, drugged to the eyeballs, hooked up to a fetal monitor three times a day, wondering each time if this was going to be the hour where they wheeled me back down to labor and delivery. Fortunately for all of us, our story ended well and our little girl was only born about a month early instead of at 24 weeks. She's just fine these days. She's perfect. She's about to turn one.

Which brings me to the point. Those of you with children will recognize the dilemma. There comes a day when you look at your baby and realize that they're not really a baby anymore. Somehow, when you weren't paying attention, they transformed into a toddler. And your comfortable idea that you don't even need to think about having another child until the first one is no longer a baby suddenly becomes all-consuming. Should we try again? When? How bad is it to have an only child? Will she grow up self-centered and bossy? And, more particular to our situation, will my uterus be able to do its job properly this time? Will I spend months in bed at home, or even back in the hospital? How will we survive without my income (again)? Will I not be able to see my daughter every day for all those months? Or, even worse, will we have the same problem again but with the opposite outcome? What if we lose the baby? What if they're able to save her (him?), but then the new baby has some or all of the health problems associated with prematurity that were so terrifyingly explained to us the last time we tried to get my uterus to hold a baby?

I have no idea what the answers to any of these questions might be. I guess we're going to find out.