Valley of the Shadow of Death

Confession time: I'm scared to die. Not particularly the after part, I mean sure I have questions like: "will I wake up in Heaven, or will there be 'down time?'", but I feel pretty confident that I know what the after is all about. It's the act of dying that scares me. I often feel really guilty about this. Christians are supposed to be confident, right? Have the attitude of "If I die today, I'll meet Jesus, so I'm okay with that." I don't feel that way at all. I want a nice, loooooong life and then to unknowingly go in my sleep.

I remember telling a friend that I plan on living to 100, his reaction was so adverse to the idea. I was shocked and then felt guilty. He basically told me that there is nothing here on earth that would make him want to stay so bad as to suffer in later years; he's rather go Home. I want to go to Heaven too, don't get me wrong, I just want to skip the dying part.

I haaaaate when other people die too. Since I was a very little girl, death has profoundly affected me. I don't like for anything to die… not people, not animals, not plants, yes I said plants. I always feel guilty about digging something up if I don't intend to replant it. Who am I to say what lives and dies? My mom was also planning to live to 100, but then I realized that if we both live to be 100, I'd be 29 years without her. I'm not okay with that. So I've decided (for her) that she must live to be 129 years, 5 days old; we'll go together. Sam can go at 99 years, 361 days.

In my 27 year life, I've been very fortunate. Very few loved ones have passed. Instead of being thankful, I'm just frustrated that anyone had to go at all. My great-grandfather died when I was 8 years old. When I was 13, a friend in my grade died from complications with pneumonia. This was the first time that it really hit me, I might not live to 100 (or 94 like Grandaddy). When I was 16, my grandmother passed away. This one really affected me. I'm still so scarred by the final days of her life. She was terrified to die. They say she made her peace at the very end, but I wasn't there to witness it. She was one of my favorite people in the world (and I hers), and to see her so scared, but literally unable to give her peace or will her to live; it was awful. When I was 23 my cat Soo Ming died. I'd had her since I was 8 years old. I was literally tormented. I cried every day for over a month. I will still cry today if I think about her. When I was 24, just days before our wedding, Sam's cousin's son died at 19. It was horrible, and shocking, and heartbreaking. And now, at 27 Sam's aunt has passed from stage 4 breast cancer at 45.

Last night was the visitation for Kelly. I did pretty well, but I managed to only hug like two people (hugs=tears). I feel so guilty. Here is her husband telling everyone that he talks to (which was hundreds of people) that he's at peace, that he's happy for her, and if I hug him, I know I'll lose it. I'm not at peace, not at all. I get the argument that she's not in pain anymore, and that is wonderful, truly. But she was 45, she's not supposed to die. She's not supposed to be diagnosed with stage 4 breast cancer that has metastasized to her lymph nodes and spread throughout her body at 40. She beat this once, and was "cancer free". It's not supposed to come back and kill her. That's what doctors are there for.  To find it first and beat it back before it takes a grip again. But that's not how it happened. Kelly passed away less than two weeks after starting chemo again. I'm not at peace, I'm angry.

This death is particularly painful to me as Kelly and I shared a lot in common. Kelly married into Sam's family the same as I. Family dynamics can always be interesting with the "other" side. When Kelly was diagnosed with breast cancer in 2008, I walked the Breast Cancer 3-Day in support of her that year. I don't think I ever saw her, her husband, or her mom that they didn't thank me. I always thought I would do it again one day, when she was strong enough to walk 60 miles herself. Maybe I'll go with her husband one day. But more recently, Kelly and I have shared even more. Kelly and Mark battled infertility. In fact they were unexplained, the same as us, and tried the exact same course of action. They made it all the way to IVF, hoping for a few frozen cycles because they decided that one round was it. Sadly, IVF failed and there were no successful frozen embryos. Heartbreaking. They spent all of their money on IVF, and felt that they could not adopt after that. They lived childless.

I see Kelly, see Kelly's incredible legacy, the hundreds of people who loved her, who were touched by her, ministered to by her, inspired by her, led to salvation by her, and I know I should think, "if only I could be like her". But if I'm honest, I'm terrified of my story turning out like Kelly's. It's literally my worst nightmares all rolled into one. To fail at childbearing, to get cancer, to die while suffering, to die too young, to leave my husband all alone, Literally nightmares.

Today, Kelly's family and friends will lay her to rest. And 99% percent of them will be at peace, simply thankful for the life she lived. I will be bitter asking God why, why she couldn't have just one little child to love on, why she had to suffer from such a terrible disease, why she had to go so young. I think God would say that Kelly lived her life in such a way, that she fulfilled parts of His plan. People came to know Him because of her testimony, and to Kelly that was enough. And here I am saying, "write me another part". Guilty. May I come to want to be a part of His plan so much, that I would willing walk through the valley of the shadow of death.

An Apple a Day...

I love apples. Honeycrisp are my absolute favorite. I could literally eat them everyday. But they're supposed to keep the doctor away, right? Then why am I fully booked for the next few months with doctors?

Appointment rounds 2 and 3 occurred today. Round 2 was with a low cost IVF clinic in Atlanta. I know what you're thinking... sketchville, right? Well there are some definite shortcuts, and I'm not sure yet how they might affect quality of care. The doctors rent hospital space to perform the IVF procedures. That's apparently the biggest cost savings. Other things I noticed: there is no full time receptionist. Most of the time, it appears you leave a message and someone calls back. Second point of interest was the ultrasound machine. It's portable. Huh? The monitor part basically looks like a laptop. Sam assured me it was legit.

I bring up the ultrasound machine only because there was some frustrating information gleaned from it. The doctor immediately sees something and exclaims, "how interesting". I'm so sick of people all up in my space exclaiming over interesting things about my who-haa. Anyway, I digress. Apparently I have a "large uterus". Does this mean I can fit more than one baby more easily than most? Because multiples is starting to sound better and better. (Don't tell Sam) Even more crazy was that I have a fibroid! What?!?!?? I've had about a million ultrasounds in the last 3 months and NO ONE has said ANYTHING.

So now I'm in a dilemma. Do I believe this old guy, who well, is old, but also crazy experienced and has a resume a mile long with his ultrasound machine/tough book? Or do I believe all of the other doctors? Believe that they would have said something if it was there?

New doctor, the old guy, he's precious by the way, wants to do a saline infusion sonogram. He wants to see exactly where the fibroid is attached. If its a problem with implantation, then I get to have a laparoscopy to have it removed. Yay?

As you can imagine, I'm confused. Where did this come from? Why is this the first I'm hearing of it? Is it really there? Is this "the answer"? Was it this simple all along? I won't jump there, I'll let my mom run down that rabbit hole. But wow! Talk about shocking news.

Before I call my RE at my current clinic, ACRM, and freak out, I'm going to wait for next Monday. I have another appointment (3rd IVF consult). It's a new doctor and they said to expect a physical exam. I'll make sure to ask, "do you see any polyps, fibroids, cysts? Anything I should know about?" Depending on what he says, I'll have to make some decisions.

Ultimately, today was confusing. About half of what my current RE has said, this guy disagreed with. He wouldn't put me on progesterone; he thinks my numbers are fine. He doesn't think the tests recommended to us are worth the money. He's not in a rush to move on to IVF. He was very concerned that I might have a missed PCOS diagnosis (here we go again). I asked why and he said my AMH was high, really high. 5.4 is apparently either a gift straight from God or an indication I have PCOS. He was going to refer me for some insulin test, but then during the exam, he did a good once over my face, INCLUDING a chin rub! Geez old man! I apparently passed his PCOS test because he dropped it after finding the fibroid.

It's becoming more and more clear that infertility has some murky waters to wade through. The doctors don't see it as black and white, and that's frustrating. Especially when it seems like it will probably take exact science, exact proportions, exact combinations to yield a baby. I sure would like to get a miracle and not need them anymore. They are all so frustrating!

The Fear Factor

So I just read Emily's blog: she's facing a second miscarriage. Trisha is dealing with her fourth loss. A friend from high school emailed me this week: she's recovering from her third miscarriage. As I read other blogs, hear other stories, I'm realizing something, something awful. You know that statistic that doctors quote at you after a miscarriage, the 20% of all pregnancies end in miscarriage stat? Well, I'm beginning to realize that infertile couples carry the brunt of that load. I know this shouldn't be a revolutionary idea, no lightbulb moment involved. But I'll be honest, it never dawned on me until I started talking to other infertiles, hearing other stories of heartbreak that I might experience the loss again. I guess the odds seemed with me somehow, and a second loss seemed to cruel. Spread the wealth, right?

As I realize that my chances for miscarriage are even greater simply because we are an infertile couple, simply because we have experienced a loss before, I am gripped with fear. Am I strong enough to survive that kind of heart ripping, soul shredding loss again? I was a real mess for a while after that dreaded phone call. And I was in a MUCH better place emotionally, physically, spiritually then, after only 3 months of trying, than I am now, 16 months later. So many women are recovering from their fourth, fifth, or even 6th miscarriage. They are all so strong. I don't know if I am that strong.

I guess I'm willing to risk it. I'm not on birth control, we aren't using condoms, and we are discussing IVF. And I guess, yes, I am willing to risk it. I'd walk through fire to bring a baby home. But what kind of woman will I be on the other side? Will I be refined by the flame or scorched and scarred?

Flustered, Frustrated, Furious

Well, IVF appointment round 1 was a DISASTER! Ughhhhh! What an afternoon/evening! I told Sam on the way to the appointment that I felt out of sync. The time since finding out about the failed IUI has just allowed my brain to become mush. Instead of feeling engaged and active, I felt benched and out of the loop. I had made an extensive list of questions as always, but still not very confident.

And then the insanity ensued. We were concerned about Atlanta traffic at 5:30, so we left pretty early. Traffic was actually great, so we got there with 45 minutes to spare. Sam wanted to get a coffee. I was hesitant, but figured we could go 3 miles and back in that time even in traffic. We grabbed some Starbucks, but when we tried to leave, the car wouldn't shift from park. Ahhhhhh! This has happened before, for brief moments, but it always works after a few tries. Alas, not this time. We were stuck for 25 minutes trying to switch gears and reading what to do online. Nightmare! To make matters worse, my appointment was technically after hours, so I couldn't call and explain. We did actually make it to the office (10 minutes late), but needless to say, I was flustered.

The appointment started off horribly. She began with "I think we should take a break." Huh? She said she figured we weren't financially prepared to do IVF (true) and that was that. End of consultation. I think that was the entirety of what she had prepared. Obviously, I got my questions out, and she graciously answered, but I felt like she was half answering and dodging questions the whole time. It almost seemed like she thought the consult was a waste of time since we aren't financially ready to move on.

Basically, we concluded that IVF costs $12,500 per cycle or $25,000 for 2 fresh and 2 frozen (no refund if it fails, no refund if you get lucky round 1) or $30,000ish for 3 fresh and 3 frozen with 70% refunded if you don't take home a baby, but NO refund if you get pregnant round 1 (or 2). Well thank you for the bargain! Cue the frustration!

I get that this is expensive stuff! I really do. But I feel like I'm being taken advantage of. The more we talked (and the more I read after) the more I got the feeling that this is a well oiled money making machine. If your cycle gets cancelled after your baseline, but before you start monitoring, you will be refunded 90%. Sounds great, right? Until you realize that your baseline ultrasound and blood work costs $1200! WHAT!!!!! My baseline has been $485 and that's one of the most expensive I've heard of.

I read somewhere online that Atlanta is one of the most expensive cities in the country (if not THE most expensive) for IVF procedures. I'm starting to believe it. Keep in mind that the $12,500 does not include meds or additional procedures like ICSI or assisted hatching. Ahhhhhh!

When Sam and I left, we were both bummed. It wasn't a very informative or helpful consultation. The more we talked the more furious I became. My doctor talked about people going into life-long debt, taking out home equity loans, medical loans, credit card loans, like it was nothing. It was so cold, so clinical. So matter of fact. Now I get that she has to make money. Believe me, the husband and I understand college loans, particularly the med school variety. She'll probably be paying for her student loans forever, but really, have a heart.

I remember being little and my dad (a dentist) would be soooo upset over his patient's financial conditions. He would do "favors" and work for free all the time. All the time. And my dad isn't even all that nice. But he earnestly cared about his patients and couldn't handle the idea that a patient would want treatment, but couldn't have it, based on finances. I'm not looking for a freebie, but lets be reasonable. I'm not here to personally finance your monthly mortgage, car, and student loan payments.

The real FURIOUS part came as we discussed all the times we've spent hours fighting for refunds from them. Currently, we are fighting a $120 bill (that my insurance already paid) and for a $500 refund for bills that my insurance covered after the fact. I feel like I have to suit up for war to deal with their finance people. Zero customer service available. Shouldn't they be groveling at my feet to win the chance to perform IVF on me. If you want $12,500+ from me, at least graciously handle my small potatoes (to you) refunds.

Hopefully, the other appointments will go better. We go to a "low-cost" clinic on Monday. I have no idea how that will turn out, but we felt like it was certainly worth an hour of our time to learn about all our options. And at the very least, kudos to those doctors for giving a darn.

Choose Hope

When Life meets Reality:

Choose Hope

You may remember in a previous post that I talked about how my emotional status seems to be cloudy with a forecast for more cloudiness. This chain of thought was brought to fruition because of a series my church was doing called Climate Change. Well don't you know, three weeks later, the last message was just for me. I'd really encourage you to listen to the message. I think it speaks to EVERYONE, but it really, really speaks to most infertiles. And the good news is you don't have to be religious, or know where you stand on the Bible: it's just a great message about what to do and how to handle life when your expectations aren't met.

The message discusses a kind of chain of events. Let me diagram this for you:

Expectations

I

I

V

Suffering

I

I

V

Perseverance

I

I

V

Character

I

I

V

Hope

The idea here is that no matter how happy or optimistic, no matter how bubbly your personality is, there will be seasons of your life where your expectations are not met as to how your life should go, and in those seasons, our natural inclination is for our emotional climate to look like a bunch of storm clouds. I don't know about you, but I'm in a season of unmet expectations right not. The way I thought my storybook life would unfold is just not reading quite right. We seem to be stuck on page six, and I want to get to "and they lived happily ever after". As I said before, my emotional state is pretty much cloudy all the time. Sure the sun breaks through, but in the quiet of the day, I'm not radiant, I'm not filled with hope, I'm sad, I'm wishing for more. 

Jeff, the speaker, says that when life happens, and expectations aren't met, the storm clouds roll in over your heart and push hope out. Our heart gets sick, an unhealthy emotional climate is created, and we become Debbie Downer. I don't know about you, but I'm often Debbie Downer. I think it's partially just my nature, partially that I'm just sad, and partially that I'm in a place in my live where good things aren't happening. I'm in a place where my millions of prayers aren't being answered. I'm in a place where I feel like it's probably better if I don't pray for others, because they are more likely to be healed, fixed, forgiven if I don't add my two cents. Debbie Downer, right?

So what's the solution? What do we do when our expectations aren't met? When life knocks us down? Apparently, it's several steps, but in the midst of our suffering, we persevere. I think infertiles have MASTERED this step. I don't know if I've ever met another group of people who get knocked down as often or as frequently, and yet CD1, while a crushing blow, is also another chance, and we pull ourselves up, haul ourselves to the pharmacy, or doctor, or acupuncturist, and start all over again… that's perseverance. 

I'm currently under the "suffering" category. An incredibly interesting point that Jeff brought up is that we don't like to think God is forcing us to walk though suffering because we don't see suffering as a blessing. Ohhhhh, this is so me. I keep asking God to get me out of here and I don't want to think that maybe it's God who is making me walk this journey. But maybe, just maybe, He's trying to build His character in me, and give me hope. Maybe He's asking me to trust His ways and walk through the suffering to the other side. 

The message explains that the leap from perseverance to character is a "then God" moment. These are the places that God shows up. I love the idea that through this I might gain more of His character, that I might look more like Him on the other side. But man oh man, am I far, far away from having any character in this, let alone His. I pray I learn fast because otherwise, I might be here for awhile. And having hope, real true hope, even in the darkest moments? Yea, I'm a long way from that.

I mentioned before that I'm wishing one of the many doctors I will be seeing starting this week can give me some hope. And I still feel that way. After three failed IUI's, I've become disillusioned with the medical world and their ability to solve our problems. My doctor never gave us odds for the success of the IUI procedure, but I felt like my OBGYN in Augusta and the RE in Atlanta felt like that would work for us. They have always talked like our infertility was minimal, like our problem was so small. It made me feel that despite reading hundreds of blogs and thousands of message boards where IUI failed, despite only knowing one success story when we started, I felt like it would work for us. We would be the lucky ones. Never once has my RE voiced any reason to suspect that there might be more going on, that we might not be "easy", that IUI might not work. My first appointment in this marathon of appointments is with my RE this Thursday. I'm 99% sure that I know what she'll say: there is no explanation for why IUI didn't work for us, but she would recommend moving onto IVF. But I want answers. I need more than "standard procedures". I want someone, whether it be my doctor or one of the other two we are seeing to offer some hope to make me believe that they have a plan, and a reason for that plan. 

But after listening to this message (for the third time), I'm thinking that maybe it's not the doctor's words that will give me hope, maybe it's walking through this wilderness, spending my forty days out here, maybe it's the journey that leads to real hope. I think the scariest part is knowing that my hope isn't supposed to be placed in eventually having a baby, but instead my hope is in the One who loves me and cares for me, whether that brings me a child or not. 

Heavy Heart for the Holidays

Not too much to report on the baby making front… We're au naturel for this cycle (and the next several), so not too much hope right not. But we are doing our part and carrying on as if BBT's and OPK's really do help make babies. Strangely, I got a positive OPK waaayyyyy early this cycle. The earliest I've ever gotten a positive OPK before during a non-medicated cycle was CD 16. Normal is CD 19. This month, I was dragging my butt and didn't start testing until Monday, CD13… and don't' you know, it was positive. I didn't get a shift on CD14, so I tested again… still positive. Hmmmm…. No clue what any of that means. I'd like to say that three months in a row of medication taught my body the appropriate time to ovulate, but I didn't get a shift today, CD15, either. So maybe it's the opposite, my body doesn't know how to do anything now without meds… lovely.

I am excited about the slew of appointments we have coming up! As you can see from my timeline, I have three appointments at different clinics to get second opinions, discuss IVF, and find the place I'm the most comfortable before moving on. We also have an appointment with a urologist, just to get a specialist to give us the all clear and thumbs up for Sam before we move on. I know that no one will have the magic key, it's called unexplained for a reason, they don't have a clue what's wrong, but I'm hoping that someone can restore some of my hope in the medical world. I want to really believe in the process if we are going to sink a down payment on a home into these procedures.

In the mean time, I'm going to try to enjoy Thanksgiving. I've read on several infertile ladies' blogs that they are skipping family time this year as it is just too tough… I wish. There's no escaping for us: Thanksgiving is being held at my mom's, which is where we currently live. There will be two precious new faces at Thanksgiving this year, my niece Alexis, and my cousin's little girl. But there should be three new little faces. Alexis is 8 months old, my cousin's baby is 7 months, and my little one would have been 6 months. Needless to say, I feel like the failure. Here's my grandmother wanting to hold and love on all her great-grandkids, and I failed to provide. Here's my mom cleaning the nursery that she converted a guest room into incase her granddaughter spends the night. She thought it would get tons of use from my niece and all of the babies I'd be bringing into the world. The crib has yet to be used. Poor mom.

My family will more than likely not even mention my failures at motherhood. And that is certainly not how any of them would put it. They are good people, and I love them all. But I will feel the underlying tension, hear the unspoken questions, even if it's all in my head. While every one oooo's and ahhhh's over the new little one's in the family, my heart will be breaking, I want someone to oooo and ahhhh over mine, but she's not here.

But there are plenty of wonderful people who are here, great conversations to be had, wonderful food to eat, and a beautiful home to celebrate the holiday in. It's a lot more than most people have. I will try my very best to keep bitterness at bay tomorrow, to love on my family, to serve with a joyful spirit. I am blessed, even while I'm waiting on one particular blessing.

When I Grow Up

When I grow up, I want to be…

Remember when you were little and people asked you "what do you want to be when you grow up?" Like pretty much every other little girl I went through my vet phase and teacher phase. As I grew up though, I realized that I would never EVER be able to put an animal to sleep and I have ZERO patience for kids who don't do their homework. Scratch vet and teacher off the list.

When I got to college I began my freshman year as an undecided. I thought about everything from English to Communication Disorders. I have varied interests. I really felt like I could do lots of things. But what I really wanted to be was a mom. A stay-at-home mom to be exact. I could never find tons of motivation to pick a particular major because I never saw myself as a career woman.

Graphic design was always in the back of my mind. I loved the design experience that I had, but I also LOVED the idea of working part-time or maybe even from home. That was the deciding factor for me. I enrolled in the art program at the end of my freshman year.

Looking back, graphic design might have been a mistake. Don't get me wrong, I LOVED my college career. I had a blast in my program and really felt good about my chances upon graduation. But three and a half years out, my confidence is nil. There are several reasons for this, but bottom line, I don't feel good about putting myself out there. I think like a lot of college graduates, I had an idealized image of what a college degree equals. I felt that even with a super specialized degree, I'd be fine. A college degree from the University of Georgia equals solid employment, right? As I've come to learn, not always. Do I still think I can do design work? Definitely. But with zero post graduation work, my portfolio still consists of school projects. I can't imagine hiring me. I think the only chance of a job in design would be someone that knows me and knows what I can do.

So what's next for me? Good question. I wish I knew. I recently read somewhere that in this age of post-recession, poor job market, finding the best fit isn't always about your degree. It's about finding some happiness whether that be in salary, job security, promotions, or job satisfaction. They recommended thinking not about what you want to do, but about where you've been most happy. Past job experiences in which you were happy may lead in a different direction, but that's okay.

For me, past job pickings are slim. There was a lot of waitressing and that is certainly not my job of choice. Without a doubt, the place I was happiest was working as in intern for my church doing graphic design. Interestingly, the design work was not what made me happy. I enjoyed my work, the day passed quickly, I had an outlet for my creativity; all of that was great. But that's not why I loved my job. I loved the people. I felt like I was a part or something that mattered.

I think that's my take away. It is not in me nature to be a workaholic. I'm a hard worker for sure, but I guess I've always known where my priorities lie, and that's at home with my family. I tend to be frustrated with most of my jobs. I end up grouchy or discouraged, frustrated or apathetic. But working at my church I felt appreciated, valued, engaged; therefore, I loved my job.

Sam loves to work. Really. He could align soup cans all night and love his job. He's rarely frustrated, rarely discouraged. He enjoys a day's work for a day's wages. That's just not me. I can't really imagine how much I'd have to earn to not care what I'm doing, but it would be a lot. The money is just not the motivating factor for me. I need something beyond a paycheck to find satisfaction.

Even now, when the more I make, the faster I can try IVF, I still want something more. I want to work for good people. I want to be a part of an organization that I can respect. I want to feel like I'm doing something, helping someone. I want it to matter.

Part of me wants to hold out, to wait for the perfect job. The selfish part of me wants to find a job that makes me happy. I remember how much I hated my last job and I don't want to be that miserable again. The realistic part of me says money is money and my happiness at work won't be quite so critical once the bank account is full.

My goal is IVF. To meet my goal, I need a job. The faster I get a job, the faster I can attempt to make a baby. For the sake of our family (and my sanity) I need to put myself out there, risk rejection, and start bringing home a paycheck. My future child depends on it.