The benefits of having an infertile pediatrician

I don't think that fertile folks read bitter, infertile women's blogs but maybe??? For those of you that have gone through trying to conceive hell, you know that us infertiles are very aware of our bodies. By bodies, I am specifically referring to our vaginas and more specifically to our cervical mucous. There are entire threads on message boards devoted to women discussing their cervical mucous. So while I don't ovulate regularly and rarely have the coveted "egg white" cervical mucous, I most certainly know what it looks like. (R has even showed me hers as she definitely gets it - I know, that's way more information than you wanted but that's the joy of an anonymous blog, I can share EVERYTHING).

In the past week I had 3 teenage girls coming in to see me with a chief complaint of vaginal discharge. When I see this complaint, I have horrid flashbacks to medical school and doing my gynecology rotation in an inner city hospital with lots of prostitutes - it was so gross it turned me away from going into ob/gyn. But I digress, back to my patients - all three girls were not sexually active so STD's were out of the picture (although you're never supposed to believe a teenager when they says that they're not sexually active and so I still tested all of them for STDs). All the girls were here because of "gross vaginal discharge". None of the girls could actually describe the discharge, other than saying that it changes sometimes. When I finally questioned them (each of these visits were seperate visits), the girls describe the grossest of all discharges as "kind of like snot".

On the inside I was laughing. I mean here these girls are horrified enough to come talk to a doctor about the one kind of discharge that many infertile women could only dream of. The appearance of egg white cervical mucous was definitely confirmed when I examined them. This is where the benefits of having infertilepediatrician as your pediatrician come in. Each of these girls received a thorough lesson in their cervical mucous - from watery, to creamy to egg whites... it was all discussed. I assure you that no other pediatrician is going to tell a 16 year old girl that her mucousy discharge means that she is ovulating and is very fertile right now.

This new found fertility information was followed by another thorough lesson in how NOT to get pregnant. I even carry a condom in my pocket to show girls that despite most guys telling them that it's too tight, I can put both my hands in the condom and spread my fingers as wide as they will go. If I didn't care about messing up my hair, I could probably fit it over my head and I then assure them that no boy is bigger than my head (at which point the girls laugh hysterically - I had one mom in the room with the daughter when I went over this and the mom thanked me profusely).

So having an infertile pediatrician means that you are going to have quite the discussion on fertility (more than you ever wanted to know) and that includes discussing your cervical mucous, even if the girl squirms the entire time.

National Infertility Awareness Week

I have just learned that this is national infertility awareness week. I am so glad that there is a week devoted to what I am painfully aware of already. Who the hell knows about national infertility awareness week other than a bunch of infertile women? I do strongly agree that infertility is something that we need to draw more attention to so that it's not some big secret that people are ashamed of. I openly tell everyone about my infertility problems and miscarriages as I don't give a shit that it makes people squirm a bit. It's my life and if you ask me if I have children, then you're going to get the answer (not the one you were looking for but rather my true story of why I don't have children yet). And I don't tell people for sympathy but rather because they need to hear it. Statistics show that 1 in 8 couples suffer from infertility to some degree and somewhere between 30-50(plus)% of pregnancies end in miscarriage but no one ever talks about it. Well not to worry, I'll tell you all about my infertility struggles and my m/c. I'll be your national infertility awareness week spokeswoman (Brook Shields has nothing on me). There also needs to be more done to force insurance companies to cover infertility. It's sickening that finances dictate who can have a child amongst the infertile. It's not some elective procedure like having bigger boobs so that shirts look better or a face lift so that I don't look so old.

For the few readers that I have out there, I apologize for my inconsistency in blogging. I suck at this blogging thing. I have been so busy at work that I don't have time to blog. I usually spend my lunch hour completing my morning's charts. And at home this past week, our internet service has been down. So in essence, I suck for only blogging once a week.

There was big news this week in our families in that we became aunts and cousins. These were two seperate events - while our roots may lie in the South, we're not that kind of Southerners. My sister in law had her first child. This was actually the first grandchild for my in laws so there's been a lot of excitement. It is somewhat bitter sweet in that we were supposed to have the first grandchild. R is the oldest of her siblings. We started trying in the summer of 2004 and therefore we were supposed to have the first grandchild. At the very least, our child should be almost here. It was during the my 2 week wait that my sister in law announced that she was pregnant (we didn't even know she was dating anyone). So we were thrilled when I too was pregnant. Of course she went on to have a picture perfect pregnancy and my baby promptly died. So again, it's bitter sweet becoming an aunt - although what's done is done and we're very excited! It's also been great for my sister in law and she's really become someone I like during this pregnancy (she really grew up).

The other exciting news is that my cousin adopted a little girl. My cousin and her husband had been trying to conceive for several years. They had one failed IVF and had decided to live child free. My cousin had been very against adoption, although her husband really wanted a child. It was while talking to a doctor about an unrelated health issue that he showed her pictures of his adoptive children and changed her mind. She then had a failed adoption last year which was heart breaking. She was then told that she was going to get a boy and then last week it was changed to a girl. She received custody on Friday, so she is now the mom to a beautiful 17 month old little girl. Having personally experienced all the struggles that she's been through to become a mom, I can only imagine how excited she must be. She sent out an e-mail with the baby's picture that says, "I am finally a mother!". I have read the e-mail several times now and cry each time I do. I can't wait to say those words myself.

For the next few months, I will close each blog with my proclamation - I will be pregnant in 8 weeks.

Karma

So I feel like a complete asshole for my rant of a post 2 days ago. I've mentioned before that I occasionally work in a small town, covering for all the local pediatricians. As part of my duties, I cover the newborn nursery. Usually that is a source of grief for me because this town has an unusually high rate of meth users. So almost every time that I work here, I have some meth babies that I have to place into foster care because they can't go home with their meth addict mothers. It usually pisses me off that I can't seem to have a baby but every meth addict can have 10 babies. I do think meth is better than clomid or any injectable in terms of a fertility med, but I haven't gone there yet.

Anyway, getting back to why I'm a complete asshole for being upset about a friend's easy pregnancy. So I get called to attend a delivery around midnight on Friday night. It turned out that the baby was known to have multiple lethal anomalies. The family had been aware of this since about 22 weeks gestation but had chosen not to terminate the pregnancy. As long as the baby was inside of mom the baby could live as mom's organs did the work that the child's maldeveloped organs couldn't do. But once the baby was outside the womb, her organs could not sustain life. I was called to be there in case the baby did something. The family had already decided that they did not want any resuscitation measures done.

The mother was under general anesthesia for the c-section so she was knocked out. I was upset with that decision since it meant mom would not get to hold the baby for several hours but apparently it was mom who wanted general anesthesia versus a spinal anesthesia. Dad is squeamish of blood so he didn't want to see mom cut open. So we agreed that I would get the baby cleaned up and then take her to dad to hold in a quiet room. Once I got baby cleaned up, I went out and explained to dad that her heart was still beating but because her lungs didn't develop she couldn't breath and thus was blue. She occasionally had some reflex like gasping effort although no air went in or out of her lungs. I explained to dad that it might be minutes to hours before her heart stopped. I then took dad the baby to hold as she died. I sat with dad for about an hour. We took pictures of dad holding her in his arms. Mom was still in the recovery room but was too drugged to comprehend things or to hold the baby. After about an hour the baby's heart stopped and pronounced her (dead). Mom was able to hold her several hours later once she was more alert. I did speak to mom the next day to assure her that her baby had not suffered and that she had passed while comfortable in her daddy's arms.

While I don't think this was necessarily karma (since hopefully Karma would bring me something good as I've been good to others), I do think this was the fertility gods letting me know that they are in control. I much rather have delivered my 9wk old bean into my hand than to have my full term baby die like this. It makes my friend's positive on her first ever IUI seem so stupid and insignificant - well stupid that I had my panties in a bunch about it. However it happens for us, it will happen. Although I am boldly declaring - I will be pregnant in 10 weeks!

No more help

Life is not fair. I think all of those going through infertility crap know this lesson all to well. I have this thought at least several times a day as I take care of kids whose parents seem very unfit to parent yet they already have 3 plus 1 more on the way. Well today's unfairness rant comes not from a patient but rather from a friend - a fucking fertile friend.

About 2 months ago we received an e-mail from a friend of ours who lives in another state. This is a friend whom we had not heard from in a while so she was catching us up on her life. In her e-mail she boldly proclaimed, "I will be pregnant in 6 weeks". HAHAHA - we laughed so hard and thought how nice it must be to be that stupid and naive. Upon further questioning, it turns out that she and her partner hadn't even set up their account with the cryobank. So we (well mostly R, as this is really her friend), spent countless hours on the phone and via e-mail educating this friend on all things related to trying to conceive. We gave her realistic expectations about her percentages and the such. We held her hand through the whole fucking process. And how are we repaid for our knowledge??? With a text page regarding 4, that's right 4 fucking positive pregnancy tests.

Now don't get me wrong, I don't wish all this infertility crap on anyone else. By no means am I proud of the bitter woman I've become. However I firmly believe no one should get pregnant on their first try. Seeing your menstrual period and experiencing that disappointment once is all that I'm asking for. I think it keeps you humble and lets you know that you don't really have any control in this. Certainly not the level of control that is implied with statements such as "I will be pregnant in 6 weeks".

And really, even though her betas aren't until next week, I'm sure she'll have a perfect pregnancy - all 40 weeks of it. Not 9 weeks, 3 days of it like my first pregnancy. Or not a fist full of positive pregnancy tests only to have the blood work confirm that it's only a chemical pregnancy like my second pregnancy. No, the fertility gods don't work that way. The blissfully ignorant will have a healthy pregnancy. The women who put pregnancy tickers on their message board posts at 3weeks5days will go on to have some 10 lbs. baby. But those of us who study the toilet paper every time we wipe to ensure that we're not spotting during our pregnancy - well we're the ones whose babies will die in our uterus without so much a drop of blood, leaving us walking around carrying a dead baby in our uterus for days to weeks.

So R and I have decided on a new policy. We will no longer serve as your infertility or trying to conceive counselors. We have many friends and acquaintances who call us for this information. Usually we have gladly walked them through the entire process (except for one acquaintance who we don't think will make a good parent, so we kind of blew her off - let her figure it out on her own). I'm tired of people stealing our fertility. Karma is just crap. We've been through too much while still being nice to everyone else. It hasn't come back around yet, so fuck it. Everyone is on their own.