Ten Weeks Pregnant

Current mood . . .

I have been feeling wretched both physically and psychologically/emotionally. Long periods alone have given me ample time to reflect on the past year and wish that it would just end already. This has been the worst year of my life and I'm just over it.

Yes, I'm pregnant, but that could just end again. I'm not out of the woods yet. I still feel very traumatized by the miscarriage that I suffered in June. I was reading a selection of pregnancy books that my sister lent me the other night when I came upon a section on miscarriages. I completely lost it and sobbed inconsolably. It was late at night, the house was still and empty, my husband was on the other side of the country, and I felt alone, desolate, and bleak. And, I felt terrified. I stay up late at night because I'm afraid of the nightmares I have when I go to sleep and there's no one who I can talk to. My cat snuggled up to me as I sobbed and didn't leave my side all night, but I felt low even the next day.

My cat is always by my side.

I keep on thinking that maybe my husband and I should just move away to another country. I'm restless for change and I feel completely unsupported here by family and people who I thought were my friends but who have deserted me through this process. Anyone contemplating going through this process should be ready to be shocked by people's reactions. A few people have been supportive, but generally I have been surrounded by judgmental, fearful, dismissive, or unsupportive behaviour. It's a very lonely road to walk, particularly because almost no one, especially no one who you know, will know what it feels like to not be able to conceive, to have to choose IVF or other fertility treatments to try to get pregnant, to shell out thousands and thousands and thousands of dollars for low odds at actually having a living baby, the fear, the pain, the uncertainty, the physical, mental, and emotional pain and anguish, and never feeling like the same person ever again.

As Christmas approaches, my urge to flee has been rising. I've never liked this time of the year and this year in particular, I don't want to celebrate at all. I just want to go far, far away and be alone. I feel like a wounded wolverine. Hearing cheery Christmas carols in all the shops makes me want to throw myself off of a bridge. Unfortunately, I'm too good of a swimmer.

Physically this week, I've been very nauseous and suffering from continued constant headaches. I would say I'm somewhat less dizzy than I was on the prescription hormones (and I've managed to go for short walks several days this week), but I'm still suffering from dizzy spells and seeing stars often from low blood pressure (especially going from sitting to standing, showering, or changing positions too suddenly). I'm very tense and sore in my neck (right up into my right jaw), shoulders, and back and my pelvis gives some shooting pains that seem to indicate that something is happening down there as far as expanding uterus, moving pelvic bones. I went back to my chiropractor for the first time since before I started IVF on Monday and had an adjustment. It sounded as if everything was out in my back and neck but I still feel very tense. It's probably going to take a while for things to settle down (not that pregnancy is a comfortable time for backs from what I've heard). I also went for a massage therapy session this week again. Even after both of these treatments I feel very sore and tense and I'm sure my mental state isn't helping either. The anxiety that I'm feeling is no doubt manifesting in my body. I feel exhausted every day, but have trouble sleeping at night. I'm plagued by nightmares and vivid active dreams. I never feel rested. Further, the sore throat that has plagued me on and off for the past three and half weeks came back early this week and has made life truly miserable (all I can do is gargle with salt and baking soda in warm water and take the occasional Tylenol).

This is one of the most beautiful places in the world to walk.

At ten weeks pregnant, apparently the fetus is the size of a green olive and about 3.1 cm long or 1.2 inches. Pretty much nothing fits me anymore, but I'm afraid to go out and buy any new clothing in case I lose the pregnancy. It's a horrible feeling living in fear, dreading what could happen next instead of hoping for the future. I can't imagine what pregnant women who are excited to buy baby clothes, decorate a nursery, or don't think twice about buying maternity clothes feel like. I certainly don't think I'll feel like that anytime soon.

It does feel good to be able to get out a walk a bit again, but at the end of this walk I barely made it home and then spent the next hour almost throwing up.

I'm ten weeks pregnant today, but it will be a long time before I feel safe to celebrate.

And he's definitely not going to celebrate if we have a baby since he's used to being the only baby.

The Seven Week Ultrasound

I didn't sleep much last night. I kept catastrophizing, thinking about what I would say in this blog post if the doctor only found an empty sac or something else that would indicate that I wasn't pregnant or wasn't pregnant anymore or something was really wrong with the fetus in the ultrasound today.

This morning I felt hot, nauseous, and exhausted as my husband and I drove to the Victoria Fertility Centre. Despite going pee twice before the ultrasound at the office, by the time I was on the table, I felt like I had to go again. Literature says that around this time, the uterus doubles in size or so and that puts pressure on everything in its vicinity including the bladder, hence having to the go to the washroom all the time.

In the waiting room at the Victoria Fertility Centre anxiously awaiting my seven week ultrasound.

We were both really nervous.

On the examination table waiting for the ultrasound.

Dr. Hudson performed an internal ultrasound on me this morning. He let me take pictures for the blog as usual. I was focussed on zooming in and getting the phone camera focussed on the ultrasound screen. When he said "this is your baby," I couldn't believe it. Did I hear that wrong? Then he pointed out the top image in the uterus (the dark shape in the middle of the greyish white on the ultrasound image), a small white shape and said that that was the baby. The small whitish mass under that is the yolk sac (this is the first aspect of the gestational sac that is seen in humans. It conveys blood and nutrients to the fetus, later the placenta develops more and takes over this function).

The black mass is my uterus.

In the dark mass that is my uterus there is the top mass which is the fetus and the bottom mass which is the yolk sac.

Closer up view of fetus and yolk sac. This is very magnified. The fetus is about the size of a raspberry right now.

The measurement top to bottom of the fetus is at the bottom, as you can see, it's very very small right now.

He kept moving the ultrasound wand around and then he said "this is your baby's heartbeat." Suddenly, we could hear its heartbeat and I burst into tears. He said the heartbeat of the baby is 150 beats per minute. He said that everything looks "perfect."

I couldn't believe it. I then completely lost it and sobbed uncontrollably. It took me a few minutes to collect myself before we met Dr. Hudson down the hall in his office. He gave us some information on tests we could have performed in the second trimester (like amniocentesis) and told us that he would meet us once more in 3-4 weeks and then I would be discharged from the Victoria Fertility Centre. He said that in the mean time I should call and get an appointment with a doctor who specializes in pregnancy and he gave me a referral letter to give to that doctor.

I bought more prescription hormones from the dispensary at the office to last me for the next week that I have to take them (I can send the receipt to the insurance company but I doubt I'll see a cent unless I fight them since they are still refusing to cover our fertility drugs).

As we left the office, I was in complete shock. Reality has still not sunk in and I still feel so emotional thinking about hearing that heartbeat for the first time and seeing the tiny baby that only measures 14.45 mm (or 1/2 an inch for you imperial users) "head to foot" right now. Week seven the baby is about the size of a blueberry and week eight about the size of a raspberry or about 1.5 cm or 15.00 mm. I am seven weeks and six days pregnant today, so it seems that the fetus is right on track and as he says perfect.

Naturally though, there is still the risk of miscarriage. We won't be out of the first trimester for another four weeks and one day. Since we have heard a heartbeat though, the risk of miscarriage has dropped considerably. But having been through a miscarriage already this year, I remain mindful of the fact that I may not have that baby that I've always wanted and that I must still be cautious. After all, people even have miscarriages in their second trimester and onward.

I must take Endometrin (progesterone) and Estrace (estradiol) for another week (until the end of eight weeks gestation). Starting week nine, next Friday, I will no longer be shovelling down Estrace three times a day and inserting Endometrin twice a day. I suspect that the deletion of these prescription hormones from my life may make me feel less awful, but who knows.

I tried calling the doctor who my sister used for her pregnancy, but he was already gone for the weekend, and their voicemail doesn't take messages, so I suppose I'll be calling on Monday to try to get my first appointment with a pregnancy doctor. Dr. Hudson says that I should see one before my next appointment with him, as soon as I can.

My husband told one of the nurses at the Victoria Fertility Centre, as he held up the three printed pictures of our baby from the ultrasound that this was the best birthday gift that he could ever remember. I agree.

One of the printouts from the ultrasound today. The fetus' heartbeat can be seen at the bottom.

What NOT to Say to Someone Suffering From Infertility or Someone Without Children (You Never Know, They May Be Suffering from Fertility Problems) Part 3

And while we wait for me to take the pregnancy test next Monday (October 17th) to determine if our embryo implanted, after the embryo transfer on October 5th, I continue my list of unhelpful advice, platitudes, statements and restatements of fact, strange pseudoscience, and psychobabble, etc. that people suffering from infertility (or people without children who might be suffering from infertility) don't want to hear. These are all things that have been said to me when I'm alone or to my husband and me when we're together. I have put them into categories for ease of reference. Many items may fit under more than one category, but have only been placed under one.

I've split this post into three parts, as there are so many different things that I have not appreciated hearing from people during this agonizing, stressful, and drawn out process of trying to have a baby with the uncomforting and confusing diagnosis of unexplained infertility. This is the last of the three parts.

I've put brief observations on how each comment has impacted me, but many, if not most should be (but aren't always) self-evident. The thing about infertility is that it's a hyper-emotional topic that makes people irrational (not just the people experiencing infertility, but those around them as well). I wish that a lot of these things had never been said to me or to my husband and me, but I hope that by putting them out there, I can help other people to know that they're not alone in having experienced this kind of insensitivity towards their infertility or fertility struggles. I also hope to help others who know someone with infertility to not be so insensitive towards them. But this is not an exhaustive list of what not to say. I've read some even worse comments, made to people suffering from infertility, on the internet.


Diminishment of the Feelings and Self Worth of Someone with Infertility

31. Well, you can always JUST adopt.
This comment is horrible on more than one level. It diminishes the feelings and dreams of the person who is trying to have a baby of their own and it makes children who are up for adoption sound like they are just pathetic consolation prizes or a backup plan (which they most certainly are not). And in any event, if someone is in the middle of getting IVF or some other kind of fertility treatment, they don't need to be contemplating what they'll do if the treatment fails (or fails repeatedly). They just need to stay focused on the task at hand, the present moment, not the distant and potentially scary future. No doubt adoption works well for some people who can't have children of their own, but it's none of your business to raise it (or to offer the opinion that you'd adopt when you have children of your own already, this is comparing apples to oranges- it's my life, not yours).

32. Well, at least you can afford to get IVF.
I've touched on this above in the comment that getting IVF costs way less than raising a child. Making someone feel like they SHOULD feel grateful for being able to afford IVF just diminishes their suffering. Yes, they are fortunate in some ways, but they are very unfortunate in other ways. Most people will never know what it's like to pay for IVF ($10,000-$15,000 or more per cycle, more than one cycle may be needed, hence financial strain for a lot of people) and then suffer through the physical and emotional strain (learning to inject yourself, being on multiple hormones and drugs for months on end, worrying that it won't work, the potential for it not to work, the real and high potential for a miscarriage after everything if you're "lucky" enough to get pregnant, the waiting, the uncertainty, helplessness watching your partner suffer through the process, hearing asshole comments from insensitive family members and friends while you're in the process, etc.). Undergoing IVF has been one of the most unpleasant and difficult processes I have ever been through in my life (and I've had over a dozen surgeries and more than one stay in a psychiatric facility). And the worst part is that it's not even over yet. So far I've paid $14,000 for this privilege. I know there are others out there who can't afford to pay for IVF or other fertility treatments (and these treatments are not covered in Canada under our "great" public health system), but I just don't need the stress of considering how many other people out there are suffering through this heartbreaking condition of infertility and how they might not be able to afford to do anything (as a statistic, 70% of people in the US who get IVF go into debt to afford it). This will only increase my suffering (and it's a pointless guilt trip), not make me feel better.

33. You're lucky to be able to get IVF.
This is basically the same as above. Yeah, I'm glad I can afford it (but if it fails repeatedly and I have to go through several cycles of IVF, maybe I won't be able to afford it anymore and then I won't be so "lucky" anymore), but I'm not lucky. First of all, luck doesn't exist and has no scientific basis. Secondly, I do not feel "lucky" to be sticking needles in my abdomen loaded with hormones, prodding my body into a most unnatural and tortured stated, and paying $14,000 and counting for a small chance of getting pregnant (28% of a live birth at my age). Others are "lucky" that they didn't have to go through IVF or other fertility treatments. Don't diminish my feelings of fear, grief, and longing for a baby with comments (and a stupid guilt trip) like this.

34. You're lucky that IVF was invented.
As above, yes, we live in an exciting time where science has allowed millions to become parents who would otherwise either have had to adopt or never have children of their own. But IVF is not a process that makes one feel like they've won the lottery (it's more equivalent to feeling like you've been hit by lightning twice, which is still more likely than winning the lottery). Most people will never understand what it's like to go through IVF or other fertility treatments. It's not easy, glamorous, cheap, fast, or certain. It takes an incredible toll on the body, the mind, the couple (if it is a couple doing it, I can't imagine how it would be to go through this alone, but there are women who do), and their bank account. And luck is such a dumb thing to tack onto any comment. Luck is a myth. IVF is science. Unless you've been through IVF or some other complex and agonizing fertility treatment, you have no business making this comment. You're lucky that you didn't have to go through IVF, so there.

35. Well, maybe having children is just not a part of your life's plan and future/ you can do other things like charity work or travelling the world.
This type of a comment really makes me want to tell the person saying it to take a long walk on a short pier. I'll decide what my life is going to be and you just get to witness it, not tell me what it's going to be. That's what being an adult is about. You're not a doctor or a therapist, so just stay out of it. Yeah, travelling around the world aimlessly like a broken Carmen Sandiego or holding charity benefits for kittens is really going to fill that hole left in me if I never have the children that I always wanted to have. If you're going to make comments like this, just keep your mouth shut. It will only make the person suffering from infertility feel worse. And they don't need to consider the (potentially bleak) future while they're trying to concentrate on the present, going through difficult, agonizing, and physically exhausting and uncomfortable fertility treatments. Just let the person be safe in the present moment and be mindful of what they are currently experiencing. The present is overwhelming for someone suffering from infertility, considering the future will just drive them towards the edge of the cliff that they already feel like jumping over.

36. At least you've got a niece(s)/ nephew(s)/ being an aunt/uncle is the best job ever, it's way better than being a parent.
This is a really asshole comment to make to someone who has always wanted to have children of their own. Being an aunt or uncle is not the same as being a  parent. If someone has always wanted to have children of their own, it in fact can be very painful being around a sibling's child or children, knowing that you may never have any of your own (and after you've wanted children for so long, this pain is acute). Your sibling's children will look at least somewhat like your children would look like (you are 25% genetically related after all). Seeing this window into a future that might never happen can make your throat close up and hot tears sting your eyes (and you have to pretend to be okay for your sibling and your parents who will see you as churlish for being jealous of your sibling for having a child/children). Being an aunt or uncle will not fill the hole left by infertility for a lot of people, so don't make it seem like it will.

37. Well, you were only six weeks pregnant, so that makes it easier (that you just had a miscarriage of the only baby you've ever managed to get pregnant with).
Unbelievably, I actually has this comment made to me after I had my miscarriage this June. This was my first pregnancy ever and though I had tried to not get my hopes up too much when I found out that I was pregnant, of course I couldn't help but feel excited and overjoyed that I might finally be a mother (and without IVF). When I miscarried when I was six weeks pregnant (and only a while after finding out that I was pregnant and the IVF cycle that I had scheduled was cancelled because of the miraculous pregnancy) I was beyond devastated. I am still devastated. I can't even describe the pain of this death. It's the worst death I've ever experienced in my life. The length of the pregnancy doesn't make it any easier to miscarry, so don't ever make this comment to anyone. Most especially, this comment is going anger and sadden someone who has suffered from a miscarriage after years of struggling with infertility (don't make any comment at all about miscarriages except to give your love and compassion especially if you have never suffered from a miscarriage and infertility.) Even then if you have suffered from both infertility and a miscarriage, don't make any comment like this, not just because it's an awful thing to say, but because this might have been the persons' one and only pregnancy and they might never have the children that they have always wanted (and you if managed to go on to have children after your miscarriage, you're going to look cold for diminishing their feelings of grief). A kind ear and lots of love and also space for the person who is grieving (because they might not want to be around anyone or talk to anyone for a long time) is what is best in my experience.

38. A miscarriage is just nature's way of wiping out a mistake/ it's better that you had a miscarriage than an unhealthy baby/ we all get many chances in life, this won't be your last/ well that's too bad, want do go out to lunch today (as in the day I started miscarrying)?
All of these comments were said to me during or after my miscarriage. They don't help, even if some of them might be technically true or hopefully true (in the case of getting more than one chance). You don't want to hear any of this when you've just lost the only baby that you've ever been pregnant with. I bled for a week solid when I was miscarrying. Out of all of the surgeries I've ever had, I've never lost this much blood in my life. I thought that I was going to die not just from physical toll that the miscarriage took, but from the excruciating emotional pain that I couldn't make go away. The pain, the physical strain, the mental anguish, the despair, the complete absence of any hope for the future almost killed me. These comments just made the pain of the miscarriage hurt all the more. I eventually went from hiding at home and dodging these insensitive phone calls to running away to my parents in law across the province and then away to Europe, trying to flee from the worst pain that I have ever experienced in my life. As I sit here writing about this comment, I am sobbing inconsolably. I don't think that the pain will ever fully leave me. It was incredible to me how much people could try to diminish my pain and act like it was no big deal. I would say that it's better to just send flowers or call the person and tell them that you're there to listen when and if they want to talk about it (but they may still be too devastated to talk about it, so don't force them.) Trying to paint a silver lining onto a miscarriage is an asshole move.

39. You should be grateful for your health/ the life that you have even if you can't have children, etc..
This comment doesn't help. It's a guilt trip. It's pointless. Leave it unsaid. I don't need to be lectured about what I SHOULD feel grateful for. I feel devastated that I don't have any children, that my only pregnancy ever ended in a miscarriage, that I have to watch everyone around me having children effortlessly and then listen to them whining about it. You shouldn't try to diminish those feelings of grief and hopelessness in me. Why not just lend a compassionate ear or if you can't do that, then just shut the fuck up.

40. I know EXACTLY how you feel.
Unless you've been through the same type of infertility struggle, in similar circumstances, with similar treatments, and a similar diagnosis and prognosis and outcome, you have no idea what it feels like. Saying that you do diminishes the feelings and suffering of the person with infertility. You can have compassion and sympathy, but very few people will be able to know exactly how the person feels or have true empathy, because even though infertility problems seem to be more widespread than we ever thought (at least 15% of the population), variations in those disorders and the treatments chosen and the outcome achieved create an endless variety of feelings in the people suffering from the various conditions (especially because we're all different and we all react differently to adversity, triumph, defeat, etc.).

41. Well at least you're not diabetic and don't have to inject yourself for the rest of your life.
I received this comment more than once, when I had to inject myself 2-4 times a day with hormones for a few weeks leading up to my egg retrieval in my first cycle of IVF. It's technically true, but stating this fact doesn't make the person feel better. Why not just say they've been brave or courageous for giving themselves injections for weeks when they had never touched a needle in their life before that? Leave it at that. Diminishing someone's suffering just makes them feel worse (and makes them resent you too).


Failures of Fertility Logic

42. Wow, I got pregnant the first month I tried/ I can't believe you've been trying that long and you're not even pregnant yet.
This is just going to make the person suffering from infertility feel worse. It doesn't help. And just because it takes one person only one month to get pregnant, that doesn't mean that other people will be so lucky (or unlucky if they didn't want children, I suppose). One size does not fit all. We're all different. Our bodies are all different and no one who's already "failing" to get pregnant wants to be made to feel like an even bigger underachiever.

43.  I never had trouble getting pregnant with any of my children/ you shouldn't have any trouble getting pregnant (you're young, healthy, etc.)/ I wonder why you're having trouble?
You're not a doctor, everyone is different, and your comments are not helping someone who is suffering from infertility. Comparisons rarely make people feel better, nor are they particularly helpful. Why not just lend a compassionate ear. Sometimes even a doctor can't explain why someone can't get pregnant, as in our case, unexplained infertility. Infertility just is.


Smug Advice From People Who Are Already Parents or Pregnant and Like to Whine About It

44. You're having trouble sleeping on the drugs for IVF? Wait until you have children!
This kind of smug comment make me want to scream. If you've never been on the drugs prescribed for IVF and have never gone through the process of IVF, you have no reasonable grounds for making a comment like this. The drugs make you feel absolutely awful, they ruin your sleep or make you sleep all the time, they make you feel nothing like yourself (unless you're in the lucky minority who feel okay or better than usual on the hormones and drugs), and it will be a challenge just to make it through each day, let alone one cycle of IVF (or potentially several cycles of IVF). Don't compare it to having children. This is especially insensitive considering that the IVF may not work and the person may still never have children. Just hold your tongue or perhaps offer them words of compassion or sympathy for their insomnia (and don't try to compete by saying that yours with your baby or children is worse- it's not a competition and this won't help them).

45. You should be exercising, etc. more/ when I was pregnant I went to the gym all the time, you're just on hormones for IVF/ you're not even pregnant, so you should be totally working out.
IVF is not pregnancy and pregnancy is not IVF. You can't compare them, so just don't. Some days when you're in the process of IVF, it's an achievement just to get out of bed, brush your teeth, and wash your face. IVF is grueling, taxing, stressful, and it's a miracle that the body can survive it. Today, every time I've stood up, I've been so faint, I've been barely able to move. I keep seeing stars and falling into things all floppy and unstable. My body feels shattered after six weeks of hormones and I'm not even done one cycle yet. Plus at this point in the process, I'm not allowed to exercise. There are a lot prohibitions on exercising or types of exercise or how much weight you can pick up in the various stages of IVF. IVF is not pregnancy, so don't try to guilt someone who's going through IVF into behaving as you did when you were naturally pregnant. And by the way you're not a doctor. If you've never had IVF and taken the drugs required for a full cycle of IVF, then don't comment on what it feels like, because you have absolutely no idea. Even if you have been through IVF before, everyone reacts differently to the hormones and drugs and various procedures throughout the process, so lecturing someone about how they SHOULD feel or what they SHOULD be doing is useless and tasteless and won't help the person who is undergoing IVF.

46. I didn't even swell up like that till my third trimester and you haven't even had the embryo transfer done yet!
Yeah, well guess what, it's also not normal for the human body to be injected with and ingesting tons of hormones for months on end (or years on end if you go through several cycles of IVF) as it does through a cycle of IVF. IVF is not pregnancy and pregnancy is not IVF. You can't compare them, so just don't. I feel grotesque and I don't need to be made to feel like even more of freak than I already feel. Many people undergoing IVF already feel like failures or broken women, they don't need to be made to feel even less appealing, attractive, or whole by someone who has managed to have children the "old fashioned way."

47. Well, we didn't really plan on having children, but oh well, we'll just make the best of it.
No one who's suffering from infertility wants to hear you complain about the timing or fact of your pregnancy. When someone has tried to get pregnant for so long and hasn't been able to, they are devastated every time they find out that someone else has become pregnant (especially if it is effortless or unplanned or unwanted and even if they like the person). Just leave out that fact and spare their feelings. Just hearing about anyone's pregnancy (regardless of the circumstances) will likely make the person suffering from infertility feel at least some sadness, hopelessness, and desolation. The world is a totally unfair place and this doesn't need to be pointed out even more to anyone suffering from infertility.

48. You should be enjoying this time that you have together without children/ you won't have any time together, money to do what you want, won't be able to travel, etc., when you have children.
We've wanted to have children for over six years and we still don't have any. We always planned on having children. The night that my husband and I met, we discussed names for our future children (strange perhaps, but that goal of having children was very important to both of us when we met and we weren't into wasting time with the wrong people anymore, we just clicked). That was ten years ago this New Year's Eve. And we still don't have any children that we can give the names that we discussed that night. It's hard to enjoy anything right now with the stress that we're under dealing with unexplained infertility, having had a miscarriage earlier this year, and undergoing our first (very costly) cycle of IVF. Other than my acupuncturist, I know no one who has ever been through the process of IVF, so no one should be making these stupid flippant comments to me. Besides, that $14,000 that we could have used to take another trip to French Polynesia to relive our honeymoon, we just spent on IVF (and we may be shelling out more soon). So, I guess we're just grounded here in our reality for now (and in any event, we don't want to act like everything is fine and dandy when we feel sad- realistic is better than flakily positive).


Well, that's about all I can think of for stupid comments that have been said to me (and my husband and me) over the course of this infertility nightmare (I'm sure there are others that I've blissfully forgotten). I wish that I could forget about a lot of these comments (if not all of them- some still anger and upset me a lot) or that I had never heard them to begin with. These comments were not helpful and just stressed me out or angered me or made me more sad than I was already feeling. Sometimes the best thing to do for someone who is suffering is just to be there if they want to talk (but they may not want to talk and that's okay too) and just let kind silence and compassion be your gift. No one wants your lectures, so just save them for your dog or cat (who can ignore them with a witheringly contemptuous look).

Failure of Care: Perinatal Psychiatry in Victoria, BC

As I mentioned in a previous post, I went to see a perinatal psychiatrist for a consultation in Victoria, BC, three years ago, to ensure that the psychotropic drug that I was on at the time, lithium carbonate, was safe for pregnancy (long story short, she told me that there is a small cardiac risk to the fetus, but this risk has been overstated in past literature and it is more risky for the mother to be taken off lithium carbonate and then to suffer from a manic or mixed episode or depression).

In psychiatry, as in other branches of medicine, there are various branches and levels of specialty. While a GP might treat depression or anxiety or even bipolar disorder, many patients with psychiatric disorders will either have a consult with a psychiatrist or be treated by one regularly. This ensures that the patient has someone monitoring their condition and the medications that they are on, their blood serum levels of certain medications, and checking to see if there are any negative things happening to the kidney and liver, etc. from the medications.

If the patient gets pregnant, they are shifted from their psychiatrist (if they have one) to a perinatal psychiatrist, because most psychiatrists are uncomfortable treating a woman while pregnant, so a new layer of specialist is required for the duration of the pregnancy and often for a year or two postpartum (a fragile time when things like postpartum depression can occur and while the woman might be breast feeding and calls need to be made over whether or not she can on certain medications). Unfortunately, in most areas of Canada, specialists are in short supply and "special" specialists are in even shorter supply, leading to long wait times and difficulties for a patient to get an appointment or consult with a "special" specialist like a perinatal psychiatrist.

In early May of this year, my psychiatrist told me that he would not treat me while I was undergoing IVF. He said that he lacked familiarity with the hormones used in the process and their potential impact on my bipolar disorder/anxiety disorder to feel comfortable treating me. He said that I would have to be treated by a perinatal psychiatrist. I asked him to refer me to one (in Victoria the office is out at Victoria General Hospital and has a couple of perinatal psychiatrists). His office told me that he would not refer me when I called, so I went to my GP and asked him to refer me. My GP gladly did this (it turned out that my psychiatrist also sent a referral letter and that his office had somehow failed to communicate this to me).

Then I waited. I started to get concerned and called the perinatal psychiatry office. I was told that there were no appointments available until late summer at the earliest (I was calling in early May). They booked me an appointment in the late summer.

Then I got pregnant before my first cycle of IVF was set to commence. I called up the perinatal psychiatry office right away (as instructed by my psychiatrist and the Victoria Fertility Clinic) and asked if there was any way that I could get in earlier to see the perinatal psychiatrist who I had been referred to, since I was pregnant and my dose of lithium would have to be adjusted with my growing weight and blood volume (I did not want to deregulate, have an episode, and put the baby at risk or worse yet, be on a level of lithium carbonate that would be toxic to the growing baby). The perinatal psychiatrist's office  told me the perinatal psychiatrist was absolutely swamped. I asked what I was supposed to do if I my psychiatrist couldn't or wouldn't treat me and the perinatal psychiatrist couldn't fit me it? Ie. who would provide me with the required medical care (someone has to order blood tests, interpret them, and then give me prescriptions for my medication)? The office eventually said that I could come into the office in June. I was concerned that I'd still have to wait several weeks, but relieved that at least it wouldn't be the end of the summer. You shouldn't have to beg for basic medical care and I was disgusted with how much I had had to push to get even that appointment (what if I was less proactive or less able because I wasn't stable?).

Then they cancelled this June appointment.

I miscarried June 15, 2016. I didn't tell the perinatal psychiatrist's office that I miscarried though, because I knew that I'd be booking an IVF cycle again and my psychiatrist wouldn't treat me during it, so I'd need the perinatal psychiatrist very soon. I hoped that I would get in to see the perinatal psychiatrist before my first IVF cycle, so that she might warn me what to look out for with the IVF hormones, my condition, and the medication that I'm currently on.

The perinatal psychiatrist's office booked me in for an appointment near to the end of June this time. Then they called and cancelled again.

They then rebooked me for September. Then on the day of my appointment, they called to cancel again. They told me that the perinatal psychiatrist was off on leave and that when she was back (in 2 weeks) I would be at the top of the list to see her. They would call me to book me in in two weeks.
Well, it's now October and no one from the perinatal psychiatrist's office has called me. If I was actually still pregnant (and they don't know that I miscarried in mid June, so for their purposes I am), I would be five months pregnant and still would not have had an appointment with a perinatal psychiatrist (so, more than halfway through a pregnancy without ever having been treated by the specialist who is supposed to treat you for the duration of your pregnancy).

I find this level of failure of care in our medical system abhorrent. Is it because I have a mental disorder that it's acceptable that I'm not provided with a basic level of required medical care, that no one will treat me at all? Or is this just our medical system in general? One only has to look at a newspaper, online, or listen to people's stories to know that medical care in Canada leaves something to be desired. In Canada, about 50 cents on every tax dollar goes towards our medical system (and in BC we pay MSP fees every month on top of this too), yet our medical system is piss poor.

When I questioned the perinatal psychiatrist's office earlier in the year about what I was supposed to do (in the mean time) since my psychiatrist said he couldn't/wouldn't treat me and the perinatal psychiatrist couldn't fit me in, the medical office assistant suggested that until I was able to get in (which seems to be never in Victoria), my GP or my psychiatrist would just have to be instructed by letters from the perinatal psychiatrist over what my dose of psychotropic drugs should be, etc. Really!? If you told a cancer patient that they couldn't see an oncologist and that their GP would just be tinkering around with the radiation and drugs and doing their best to try to treat their cancer (when they had never been trained in oncology and had only read bits and pieces about it), it would not fly (and like cancer, mental disorders and illnesses have very high rates of death, including from suicide in the case of disorders like bipolar disorder).

I have a feeling that a lot of this intolerable situation with regard to treatment of mental disorders stems from the fact that it is still not acceptable to have a mental disorder or illness in our society (or at least not to admit that you have a mental disorder and seek help). It is shameful, the system is underfunded, these disorders are feared, shunned, seen as weak or immoral, and they are not treated with the level of care that other illnesses are (one only need look at the psychiatric emergency triage in Victoria- PES- where most patients are not given a bed while they wait half a week to two weeks to get into the hospital, but instead are expected to sleep sitting up in armchairs. That would never happen to a cancer patient or someone with a broken arm).

I asked my psychiatrist in June what I was supposed to do to get care if things started to go wrong. He said that I could always just go to the hospital if I suffered from a relapse. Oh great, so I could go to PES and sleep sitting up in an armchair for half a week to two weeks before getting into the actual mood disorders unit of the hospital? And I could be around psychotic strangers who could lash out and injure me or my baby (and I've been hospitalized there more than once, so I can tell you that people do have psychotic meltdowns from time to time where they must be restrained by security and the nurses, drugged, and dragged off to a restraint room- it  is not a relaxing or healing environment to be in for anyone). He told me that he could always get me on the waiting list for the actual hospital. For those who don't know, this can take up to half a year in Victoria, although he told me it might only take a few weeks (great, so if I'm suicidal, I can just wait around three weeks for treatment?).

Yes, I could call the perinatal psychiatrist's office yet again, but I'm so overwhelmed and overwrought with the IVF process, that I just can't do it right now. Maybe I'll do it tomorrow, just to check that they didn't make me an appointment and then forget to call me to tell me that I have an appointment (wouldn't surprise me given that they cancel appointments at the last minute). But maybe I won't call. Why bother, when I know that they won't have an appointment for me and if they do, they'll just cancel the appointment at the last minute again.

I've been waiting five months now for an appointment with a perinatal psychiatrist and it seems I'll be waiting a lot longer. It appears that in this medical system, it's every person for themselves and only a very few get an acceptable level of care (especially given the amount we all pay for this medical system). It's only the squeaky wheel that gets the grease and I can't imagine how many people are falling through the cracks.

P.S. I called the perinatal psychiatry office to check if I had somehow missed being told about an appointment (I didn't want to miss it and then have to wait several more months). The assistant said that the psychiatrist was back now and then she asked if I had a referral (so I guess that if I hadn't called I would not have been given an appointment like I had previously been promised at the beginning of September when my last appointment was cancelled). I told her that my referral was sent in five months ago and that I had been waiting to see the psychiatrist ever since. She put me on hold and went searching for my referral, which she found. She said that she could get me in next week for an appointment. She apologized for the long wait, but said that they've been short of doctors for months (don't they have locums?). I only hope that this fourth appointment time will not be cancelled like the other three have been so far.

Facing my Fears to Avoid a Lifetime of Regret

I was not in a good mood, as I weighed myself ahead of my appointment with my endocrinologist this morning (I had my blood tests done yesterday). Yes, I just had a miscarriage a couple of months ago after taking hormones to prepare for IVF, yes I just returned from three weeks in delicious food capital of the world, Europe, yes I've been depressed and living with a broken thyroid for who knows how long (though medicated with varying degrees of success for about six years now), and yes, I'm on a psychotropic drug known for its weigh gain side effect. But still, I thought that I just shouldn't weigh as much as I weigh.

I suffered from an eating disorder as a teenager (but before that at age 11 I went on my first diet- self-imposed). My eating disorder was not severe enough to attract the notice or at least concern of my family and eventually I worked it out myself, but it has cyclically plagued me ever since. And when I'm not mentally optimal, my eating disorder gets louder in my head. It ferociously growled in my ear as I walked towards the kitchen.

I proceeded to angrily consume my vegetable heavy homemade protein shake for breakfast, slopping part of it down the front of my white patterned Brooks Brothers pajamas. This further worsened my mood.

I went to my endocrinologist, expecting to be further tormented as he weighed me and tut tutted about how overweight I am (this has happened in the past many times). Instead, my endocrinologist gave his condolences for my miscarriage and did not comment really on my weight at all. He asked me if my husband and I were going to try again soon. I told him that I was scared and having trouble getting over the miscarriage. He told me that it is not an easy thing to get over, but then reminded me that it happens to a lot of pregnancies and that it is usually because there was not viable fetus and that it is better to proceed with a healthy pregnancy than one that is barely viable.

He told me that he didn't want to make me feel worse, but just the day before he had had three women in a row my age, one trying get pregnant for the first time, one with a three month old baby, and one who was pregnant for the sixth time after five miscarriages and had made it past crucial week 18 finally (she had been referred to him only after miscarriage #5 and he had found a slight thyroid disorder and had medicated it and this had made all the difference- I was mind boggled that our medical system would leave it this long to refer her to specialists who could save her the pain of repeated miscarriages, but that's our medical system.) All of them have thyroid disorders.

He asked if I would schedule for IVF again soon. He told me that he thought that I should. I was interested to know his opinion, since he's the only doctor who's managed to get my thyroid into a stable range (and there have been several who have tried over the past six years). He told me that my thyroid levels are currently perfect, the best they've been in a long time, and if that was what was worrying me with regard to proceeding with IVF, I need have no fear.

I then shared that I was afraid that I wouldn't be a good parent. He seemed genuinely surprised. He told me that "being a parent is easy. You have to:
1. Set a good example; and
2. Have the child's best interests in mind.
That is it." I was amazed that he had distilled an entire lifetime occupation down to two principles. However they didn't seem bad. "You don't think that you can do that?" he asked as I sat there silently. I told him that I didn't know if I could. He told me that he thought that I could as if I was crazy to doubt it.

I am terrified of being a bad parent and screwing up another person's life (and everyone who they then come into contact with), but I suppose having this fear is better than blundering into it without a thought or having the narcissistic belief that you're perfect and will be the "perfect parent."
But it's not just that that I fear. I fear:
1. Taking hormones to prepare for IVF and the impact that they'll have on my body (horror stories all over internet) and mind (I have bipolar disorder, so I have to be careful that I stay stable);
2. Having to use hypodermic syringes to inject myself full of hormones every day leading up to the egg extraction to prepare for IVF (I hate needles so much);
3. Not having any eggs that can be extracted/used;
4. The egg extraction, which is done with a needle through the wall of the vagina (it sounds so horrific- I know they give you some drugs, but still!);
5. Not having any viable embryos to implant and/or freeze; and
6. Going through all of that pain, bloating, weird body manipulation,  and stress and then:
(a) getting a negative result on a pregnancy test and having to decide whether or not to put out another several thousand dollars and try again, going through all of the above, or to give up on the dream of ever being a parent; or
(b) getting a positive result on a pregnancy test and then worrying every day until a baby is born whether or not the fetus will die (I don't think I could handle another miscarriage) or be healthy and live and whether or not my body and mind will survive pregnancy.

All the same, what would it be like to live with regret every day for the rest of my life (however long that is), knowing that I could have done something more to try to become a parent, but I let fear win and I didn't and now I'm stuck with the consequences forever? I don't think that that would feel good either. And going through the thing that you fear is a shorter amount of pain than a lifetime of regret. I've been through many scary things in life including being bullied, dysfunctional family dynamics, car accidents, surgeries (over a dozen), being in abusive relationships, being diagnosed with incurable disorders including hypothyroidism and bipolar disorder, being hospitalized in a psychiatric facility twice, having to give up the professional career I trained for due to my health, and most recently, a miscarriage after years of trying to become pregnant and on the eve of undergoing IVF which I very much feared.

So, I'm not about to let this fear beat me. I called the Victoria Fertility Centre this morning after I arrived home from my appointment with my endocrinologist and I booked in to start IVF on my next cycle (should be around mid September). I know that it's not going to be pleasant (I start the first of the hormones, Estrace, again on the 18th day of this cycle- I'm currently on day 4- so, September 1st), but all I can hope is that in the end it will be worth it. And if it's not, at least I won't have to live with the regret that there was something more that I could have done that I didn't do, because I was too scared.

R.I.P. fears.(This cross is in  Ross Bay Cemetery, Victoria, B.C.).

Where Do We Go From Here?

At the beginning of my next cycle, after my trip, I was supposed to call the Victoria Fertility Centre to tell them, so that they could book me in for IVF in my next cycle (ie. about a month from now). I was seriously overdue for my period (6.5 days) this morning, so I finally took a pregnancy test . It said "not pregnant." I was confounded and went back to bed angrily and proceeded to sleep away the morning, filled with nausea and stomach pains.

My cat, Lamont, gladly kept me company.

Around noon, I awoke and found that I had the first signs of my period. Great, so I just threw away about $16 on something my body would have confirmed for free had I held out just a few hours longer. Why did I go through all of that emotional drama leading up to the pregnancy test? Why did my period have to be that late? Or is this an early miscarriage? The thought crossed my mind only because of all the research I did on miscarriages a couple of months ago when I was going through mine. Apparently late periods are sometimes early miscarriages and women just never realize they are because they never took a pregnancy test earlier, before the fetus aborted.

Either way, I was thoroughly pissed off, but naturally, also disappointed. This whole monthly cycle of hoping, waiting, and then writhing with heart crushing disappointment (almost inevitable, except for that one month, which actually turned out to be a more heartbreaking disappointment when I miscarried).

I had thought that I would be ready to proceed with IVF (for real this time, because I didn't anticipate getting pregnant on the eve of having IVF last time) when I returned from vacation. But now I feel even more conflicted, if that's possible. With each passing month and disappointment, I feel more and more doubtful that I could ever be a competent parent, let alone a good one. I grow more and more scared of if my body can actually carry a baby to term (didn't work out last time), if my brain can withstand the hormonal changes brought on IVF hormones and then pregnancy if it happens, if my brain can withstand the sleep deprivation and further hormonal changes with having a baby if I ever get there, and how I'll manage being a parent for the rest of my life. I'm overwhelmed with fears and doubts that have only multiplied with each year that I have not had a child. I've been on prenatal vitamins for six years. I've watched almost everyone in my life, who is plus or minus 10 years of my age have children (some willing, some reluctant, and some surprised into parenthood) and I have remained childless, feel increasingly socially shunned and isolated, and more and more doubtful that I can ever fit into this clique.

Maybe it's a sign and I'm not meant to be a parent. Maybe the curtain it falling on my childbearing years to allow me to explore something else in the next stage of my life. Maybe my genes are just bad. They say that it's darkest before the light, but I feel like it's been dark for so long that I would be permanently blinded if the light ever found me again. Perhaps this shadow world is my permanent home and my life is just not going to include children. But how could I live a life without children when they've factored so deeply into my plans for my future life and my future identity? I've defined myself always as a future parents and the future just isn't arriving, so who am I? Who am I becoming? What will I do with all of those years that might be left in my life? Am I going to have to become a kitten rescuer or something?

My husband has been devastated by this journey as well and tells me not to decide right away, but I know that he just desperately wants to proceed with IVF as soon as possible before it's too late and we're forever barred from becoming parents (except by adoption or divine intervention perhaps). He has always defined himself as a future parent and sees it as crucial to his life's plan. What would he ever do if he had no children?

We've already become weird hermits who have an unhealthy obsession with our one cat, Lamont. Our increasing desperation for a baby, has led to increased babying of the cat (not that he minds it most of the time). 

You can very clearly see Lamont thinking 'not again!'

Most of our friends have drifted away to other cities or into the parenthood club that we are not a part of and may never be. I think that people think that our life looks pretty charmed, but many are not aware of the unexplained infertility struggle/nightmare that we've been living the past many, many years. They see us doing things that they would like to do, but can't because they have children and say that they're jealous. We look at them, snuggled at home with their bundles of joy and feel hot tears sting our eyes and our throats tighten with emotion that we can't share with most of them, because it's just not socially acceptable or would be seen as oversharing.

Should we go through with IVF this next cycle or should we wait? We were already warned we shouldn't wait long, because of our advanced ages (the miscarriage rate keeps going up every year by a lot). But it's hard to get excited about spending thousands and thousands and thousands of dollars and injecting myself with countless hormones, undergoing further tests, having my eggs extracted out of my vagina with a needle, etc. all for the roll of the dice odds of getting pregnant (minus the 20-25% chance of miscarriage). I had talked myself into it and hyped myself up last time, only at the last minute to find out that I was pregnant naturally and "didn't need" IVF. Well, I do again, and I feel like I've lost my nerve again. Great.

I know there are success stories (it would increase our odds of conceiving per cycle from 3% or 50%), we've all heard them and read about them, but there are also countless couples who don't find success with IVF either after all of that time, money, and pain. I just never pictured having to do this (not that anyone does) and I'm having a really hard time (again) accepting that this is my path.

Perhaps a few good sleeps will make the future look less bleak and make our decision become more apparent.

Another Pregnancy Test

This morning was Day 36 of my cycle, so I was a full six and half days late. My husband had been encouraging me to take a pregnancy test, so that I would know one way or the other if I was pregnant (I need to inform my specialists immediately if I'm pregnant, so that my medications can be kept at a therapeutic level with the changes that pregnancy brings).

I was really reluctant to take a pregnancy test. They are expensive, annoying (I hate having to hold my urine for as long as I can in the night and limit my fluid intake in order to have "perfect pee" that is not too dilute to test accurately), and have done nothing but disappoint me, or falsely get my hopes up (ie. you find out you're pregnant and then less than a week later start miscarrying).

I knew I wasn't going to screw around with the non digital type of pregnancy test this time though after what happened last time . Of course, digital tests are much more expensive, but with something this life changing, I didn't want to mess around.

Was my period just obnoxiously late from the miscarriage I went through a couple of months ago or traveling or was I actually pregnant for the second time in my life (could lightning really strike me twice?)?

I passed an uncomfortable night last night knowing that if there was no sign of my period, I'd be doing a pregnancy test in the morning (I even bought two yesterday in case I couldn't believe the first one- by the way, two digital pregnancy tests are $30 plus tax in a two pack, yes being a woman is always expensive).

Yep, over 30 cool smackers for a two pack of these. Being a woman is expensive in so many ways.

At quarter to six this morning, I couldn't hold it anymore and went to take the test with my husband holding his breath beside me. Could this explain my moodiness and bloating lately or was that just a late period coming on and jet lag?

We waited the few minutes for the results and number of weeks if applicable to pop up on the very clear Clearblue digital screen.

I had told my husband over and over again in the past almost a week that I was not pregnant. It was too remote of a possibility that I would ever get pregnant without assistance again and especially so close to miraculously having done it a few months ago. But secretly, inside, I wondered and hoped if lightning could have indeed struck a second time in this roller coaster of a year. Was I pregnant? Could I carry the baby to term this time and finally become a mother? Or would this test just lead to further disappointment, anger, and disillusionment with my life and this world?

In truth, as much as I have wanted to be a mother my whole life, I was terrified that the test would say "pregnant" because I was so afraid of going through another miscarriage. I doubted that I had the psychological or emotional reserves left to survive another one of these horrors (and it's still too fresh in my memory, I'm still having flashbacks all the time).

Then I felt guilty for not wanting to see a positive result and thought about what my counselor had said about making a good environment for a baby to come into, including psychologically and emotionally. If I was fighting becoming pregnant, would I ever become pregnant and how would my husband who had always wanted children feel if I never became pregnant?

I was absolutely swirling with emotions, as we sat there together in the tiny cramped bathroom, waiting for a result that could either change our lives or further increase our feelings of hopelessness and despair.

And by the way, we didn't tell anyone that we were taking a pregnancy test this time, because we didn't want to disappoint our emotionally ravaged families anymore. Plus, I feel I have no one really left to talk to (except my husband) . How many people know what it's like to fear, loathe, and despise the inanimate object which is a pregnancy test (I've found some of these wonderful folks on the internet, but they're not sitting in my living room, with a cup of tea, able to stare into my eyes, and try to comfort me).

With regard to pregnancy tests, I think that most women fall into the following groups:
1. Oh, shit! I think I'm pregnant and I didn't mean to get pregnant. Guess I better take a test;
2. My partner and I just started trying to get pregnant and we think we are (we haven't been trying long enough to be worried or jaded). Let's take a test;
3. It's been taking a long time to get pregnant, but I think I'm pregnant. Oh my God, I am. (Nine months later or thereabouts) . . . look at my beautiful child;
4. I can't get pregnant and I've never seen a positive test and I never will; or
5. It took me forever, I can't actually be pregnant. Oh my God, I am. No, that can't be true. Oh my God, lab tests confirmed it, I can't believe my luck. I'm going to actually be a mother when I had given up all hope and had started to try to adjust my expectations of what my future life would be like. Oh, wait, I'm miscarrying. I actually might never be a parent, but I don't know and the uncertainty is pushing me further and further towards the edge of that cliff, ever though my life looks perfect from the outside, because it's not socially acceptable to discuss infertility or the pain that it brings, so I must try to look perfect and happy and okay with the fact that I have no children and respond coyly to the questions that everyone is asking me such as if I have children and if not when I will have them or why I don't have them.

Other than my mother, I don't know of anyone else in camp #5. My mother went on to have two children and regularly dismisses my feelings of hopelessness, despair, and disillusionment, telling me that I'm definitely going to have children and that I need to stop worrying and being ridiculous or fatalistic (it's not just her, I have other family members and friends who are in this Pollyanna/denial group). I don't want my feelings dismissed. It's far from certain that I'll ever be a mother. And if I do become a mother, it's most likely that it will be because I undergo expensive and protracted IVF (and remember it's only a 50/50 chance of even conceiving each cycle and I have a 20-25% chance of miscarrying each time due to my age) treatment(s). My mother was able to conceive naturally and gave birth at 32.5 and 36.5 years old; I've only ever become pregnant this once and then I lost the baby and now at almost 36 and half years old, my time is running out, so I doubt that that dream is going to happen for me.

This is the worst thing I've ever had to go through in my life (I would go through all of those over a dozen surgeries that I've had in my life again, just to avoid ever having to go through unexplained infertility and the terrifying and heartbreaking roller coaster ride that it entails. Emotional and psychological pain is way worse than physical pain, but I've had my share of that too on this infertility journey with all of these tests, the hormones, and the miscarriage).

I'm sick of being in this stressful limbo and not talking about it (except on this blog and with a very few friends and family members). I'm a perfectionist from a dysfunctional family, who puts up a perfect looking facade to fool outsiders into believing that my life is rosy and that the birds sing me out of bed every morning, because that's what I got used to doing as a child. Plus, as mentioned above, it's not okay to talk about infertility or how awful it is to be going through it in our society. The dialogue is starting to happen a bit more, but it's still the exception not the rule. Most people don't understand infertility and many don't want to hear about it or understand it. People are incredibly insensitive and ask the most personal questions without considering how the other person might feel. Consider the time that I was at my family reunion two years ago and my aunt wandered up to the table that I was sitting at with some of my cousins and one of my aunts in the huge hall packed with assorted relatives and practically shouted "why don't you have any children yet?" Well, I'm done giving polite, coy, and/or misleading answers that make it seem like I'm okay with what's going with my uterus, like "well, we're working on it" or "we'll see." Next time someone asks about whether or not I have children and then asks why I don't or when I'll have them, I'll be sure to give them an honest answer. I'll tell them about how it took me years to get pregnant for the first time and then how I lost the baby and I don't think I'll get pregnant naturally again, so I'll be paying $10,000s just for the roll of the dice odds of ever getting pregnant and then the waiting to see if I lose yet another baby, bleeding profusely for days and days and days, reminded constantly of what I don't have and may never have. I doubt they'll ever be that insensitive to another woman ever again. If they are, they're a complete sociopath.

I was drawn back into the present moment by my husband's voice. He read the test first, as I was staring off into space, contemplating what this life of mine is supposed to be about and where it is heading. "It says not pregnant," he said gingerly.

I stormed from the bathroom and threw myself back into the still warm bed. It was before six in the morning and the day was already ruined. I felt awful, not just emotionally, but physically. But I knew that the nausea and gastrointestinal upset that I was having were not pregnancy related. That much was certain (or about 99 point something percent certain).

All I could think, as I struggled to get back to sleep, was fuck all this shit. I'm sick of this roller coaster ride. I want to get off. But I can't. And there is nothing worse than the feeling of being trapped, hopeless, and helpless.

Halfway Around the World and I Can't Stop Thinking of You

Whenever something bad happens in my life, my usual instinct is to flee (though other times fight is my reaction). This summer has been filled with vivid and perhaps drastic examples of me trying to run from the pain of my miscarriage after waiting years to become pregnant. 

View from the Nativity Tower of Gaudi's La Sagrada Familia in Barcelona, Spain

Going up to Kamloops to stay with my parents in law gave me a break from being at home in the usual routine of writing, housework, and seeing where the whole miscarriage scene unfolded. I caught up on sleep that I had lost, started exercising again, basked in my parents in law's love, and felt somewhat stronger when I returned home to Victoria.

Coming back from Kamloops I looked better rested than I had on the way up.

I then turned around almost immediately (four days) and left again for three weeks in Europe with my husband. We had been planning to go to Europe this summer or early fall anyways (depending on the IVF schedule/ pregnancy and waiting for the first trimester to be finished) so we seized the opportunity to do it in July before getting onto the next IVF schedule.

The cat was displeased with the reappearance of suitcases which signaled our imminent departure.

I had long dreamed of showing my husband Amsterdam and Barcelona where I had found so much wonder and joy as a teenager. Returning to the former 18 years later and the latter 20 years later was sure to be interesting. What new things would I notice? Would they be significantly different? The world is shrinking, how would that impact two of my favourite European cities? Would this cruise that we had received basically free of charge after our last disastrous cruise with Costa last year be better? I had never been to a couple of the Spanish Islands and Italian cities that we were stopping at on the cruise or Monaco, what would I learn from these places?

Exploring Amsterdam 18 years older than I was last time.

I was also nervous. What if something wasn't right after the miscarriage? After all, I hadn't been examined during or after it and had not had a D&C (it had just happened naturally). What if I discovered a uterine infection while I was away? Or what if the bleeding suddenly started again and became uncontrollable? If the condition was apparently stable before leaving, but hadn't been examined by a doctor and it reappeared, would it be a pre-existing condition, not covered by our travel insurance (yes, a lot of this anxiety is from my past as a litigation lawyer representing clients who were denied travel insurance coverage and other insurance coverage).

Panorama from our room at the W Barcelona.

The break away from home and all of the new sights and familiar sights were good (see my travel blog: www.tworestlesswanderers.blogspot.ca), but no matter where I went I was often preoccupied and sometimes even brought to tears, thinking about the baby that I had just lost. In the old protestant church, Oude Kerk, in Amsterdam, I lost it and started crying, despite the fact that I was in public, as my husband handed me a candle to light for the baby and one for ourselves.  I was halfway around the world, in someone's dream vacation (certainly mine), and unable to escape from this fresh loss in my life.

I was sombre lighting a candle in Oude Kerk in Amsterdam for our dead baby.

It proves that when you're running from yourself and your own grief, there is nowhere far enough that you can go. There is no escape. You have to feel the hot tears stinging your eyes, the tightness in your throat, the crushing feeling in your heart. You just have to feel. It's painful, but there is no escape.

The view from the W Barcelona's infinity pool.

Beauty around me, I scrambled to make sense of this world. I had expected to be taking this trip pregnant, happy in the almost certainty that I would finally have a child and now all I had was the bloated body of someone who had freshly lost a pregnancy. I couldn't help but ruminate. How could I not be able to get pregnant for years and then finally get pregnant on the eve of having IVF done and then lose the baby? Why is it that people who don't want to get pregnant get pregnant and actually carry the baby to term, but I couldn't? I know that life isn't fair and I've struggled with this concept my whole life (especially as a lawyer, sharing the pain of injustice with my clients, don't even get me started on insurance companies). My Myers-Briggs Personality Type, INFJ, makes me a very strong believer in justice, so really I'm just fighting myself. I guess I'll just never feel comfortable with how this world really is. But if you give up the fight, what is there left in life?

One of my favourite paintings from the Rijksmuseum in Amsterdam, Jan Steen's "The Dancing Lesson." Yes, I too loved to make cats dance as a child and I still do (much to Lamont's delight).

It being summer vacation, there were children everywhere. Harried parents, tired from travelling, and probably from their children's antics, didn't look grateful enough to be parents to my child hungry eyes. I know that children are annoying and try your patience and I get that not every day is a great day, but I've been waiting so long for a child, I hope that I'll appreciate every day if I ever become a parent. And it's hard not to doubt that I will ever be a parent, especially after this fresh loss in my life.

The remains of a dead teenager from Pompeii. I found the remains of the dead child too macabre to even photograph.

My husband I celebrated our eighth wedding anniversary on our last full day in Europe. We have grown more in love with each other every year (we've been together 10 years this New Years Eve), but a giant hole has been left in our lives, as we have been unable to have a child or two to grow our family and enhance our lives. We talked about children's names the night we met, having children was an important goal for both of us, and we've still be unable to name a child, hold a child, or move on to a new stage of our lives.

In the Grand Central Hotel Barcelona's rooftop infinity pool on our eighth wedding anniversary.

On the other hand, we've had much more of a chance to be adults without children than most people ever have (except those who never have any children). We've been able to both obtain advanced degrees, try out various and diverse careers, have more leisure time and hobbies, travel the world, and get to know ourselves to an almost unnerving degree. We've skipped across various islands of French Polynesia, wandered north to south through Japan, and strolled through many countries in Europe together (this year and last year) and Morocco (last year). Dreams like returning to Amsterdam and Barcelona, seeing a giant EDM concert with David Guetta in Ibiza, exploring the ruins at Pompeii, or gazing off into the sea in Monaco where Grace Kelly might have stood, might not have ever been possible if we had had children earlier.

Taking in the famous Monaco view.

In Ibiza for David Guetta's "Big" EDM event.

I thought that returning from Europe, my resolve to proceed with IVF would be stronger than when I left, but I'm finding the contrary. Perhaps I'm just exhausted. Also, my period which was supposed to show up a few days ago (so I could inform the Victoria Fertility Centre what my Day 1 is so that they can book me in for an IVF cycle starting with my next cycle) has not shown up. Perhaps my body is still confused after the miscarriage, or by the 9 hour time change, or by traveling, or there is that other remote possibility that I can't risk hoping for anymore (even if I were to be pregnant, which is highly unlikely, what if I miscarry again? I don't think I would survive that mentally).

Lamont has the right idea. Take it easy.

So, now I wait to see where I am mentally and emotionally with regard to when to start IVF and physically for my period which is necessary for me to even tell the clinic when I would be ready to start IVF. Sitting with the unknown is terrifying and highly uncomfortable, but at least I am home with my cat now. Lamont's the best life coach I've ever met.

My guru gazes off into the distance, fake crow disciple awaits the latest life lesson.