Fertility Journey for Posterity

When we finally started trying, I knew enough to know that people rarely get pregnant immediately. I had a few indicators that this might be the case regardless, so when it didn’t happen immediately, or even in the first few months, I wasn’t worried. But I did think that as I worked to resolve those issues that with time and a little luck (because really, when you consider how exquisitely sensitive the timing involved is, it’s kind of a miracle anyone gets pregnant) it would happen. I took my Chinese herbs diligently, tried to fit in acupuncture, waited with bated breath each month to see if this was the lucky month.

But it never was.

As the months passed, three, six, seven, eight – hope and anticipation turned into an absence of expectation, which eventually turned into resignation that our path to parenthood might not be easy.

But this is America and insurance companies are evil, so we had to wait for a year before anything could really happen. So I waited, and January of 2020 marked a year and a formal diagnosis of infertility. Seeing the words was both a relief and a punch in the gut. You’re relatively healthy in all others ways, yet your body can’t do this one thing without help, but the diagnosis also means you can get help. So, diagnosis in hand, we met with a reproductive endocrinologist at the end of January.

The first steps were bloodwork, an ultrasound, and a dye scan, all scheduled for February vacation. Unfortunately, because it was vacation, I couldn’t get the scan done because everyone was out of town. I vividly remember how frustrated and almost in tears I felt, standing in the middle of Old Navy and realizing this would delay everything another month.

Little did I know.

It took my doctor another week to get in touch about the ultrasound – he was glad I hadn’t had the scan, because the ultrasound seemed to indicate that there was an issue with my left fallopian tube, likely fluid, and the dye scan could have triggered an infection. He called while I was out with coworkers at a Mexican restaurant in downtown Boston, and I remember standing in the corner trying desperately to process what he was saying. The end result: a referral for a 3D ultrasound.

After much back and forth, I got a date for the ultrasound on March 9th. It was a beautiful, sunny spring day. I left work early and drove to Brookline for the appointment. There were already warning signs about COVID if you’d traveled to China – I remember the woman next to me at the receptionist’s desk was apologizing profusely for her cold – she was also a teacher, and said that she picked up everything that went through her building. I nodded sympathetically, then sat down to wait, acutely conscious of my very not-pregnant status amidst a room of very visibly pregnant women.

The appointment itself was terrible. The tech did a phenomenal job, but when the radiologist came in, she made a series of cryptic remarks as she looked at the screen, then bluntly told me “oh yeah, no wonder you can’t get pregnant.” It was dehumanizing and hurtful, and as she left, I took a few moments to get over my panic and tears before leaving.

There were times after work where I would go to the McDonald’s in Bedford on my way home to get work done – I can’t focus in Starbucks, but McDonald’s served as my “place.” I was in a panic trying to prepare for Genius Hour when my doctor called again. He shared that the 3D ultrasound had confirmed an issue on my left side, probably fluid inside the tube, and that I would need surgery before we could continue. The surgery was necessary because the fluid can pose a risk to a pregnancy. The most likely cause of the fluid based on my history was endometriosis, something no doctor had ever mentioned to me before.

March 12th was the last normal day of school. Teachers came in on March 13th to plan, and over the next few days, the whole state shut down t try and control our spiraling COVID crisis. The shutdown meant that surgery couldn’t happen, which meant interventions couldn’t happen either. Neither could new cycles, but it still sucked.

And so we waited.

And waited.

And then, out of the blue, just before Memorial Day weekend, it looked lke I might have a surgery date. It didn’t make sense, because elective procedures were still off-limits, but I went with it. Suddenly everything seemed really imminent and scary. I went through a rollercoaster of emotions only to find out that it wasn’t actually going to happen.

But then, as Massachusetts transitioned to stage 1, I got an email offering me the choice of 6/15 or 6/19 as a surgery date. I picked 6/15, sent the email, and then didn’t check my email for the rest of the day.

I woke up the next morning to several frantic voicemails telling me that I needed to come to the hospital ASAP for my pre-op appointment otherwise surgery would have to be pushed back. I freaked out, called back immediately, and headed in a few hours later.

It was terrifying. We had barely begun doing the occasional distanced visit, but other than that, I hadn’t been in contact with anyone. I only went to school, the grocery store, and the odd trip to CVS. My heart rate was through the roof – well over 100 when they took my BP. The nurse asked if I was ok and I said yes, but this is a lot to take in. Three hours ago, I didn’t even know I had an appointment. We agreed to take my blood pressure again at the end of the appointment. I met the surgeon who was lovely even though the list of “maybes” on the surgery consent form was a little scary to contemplate.

72 hours before surgery, we drove to the hospital for my required COVID test. I promptly made a fool of myself as the nurse stuck the swab up my nose – a glamorous combination of coughing, crying and swatting with my hands as my head attempted to move out of the way. But I still didn’t trust surgery was happening until Sunday night arrived with no call telling me otherwise.

On Monday morning, Adam dropped me off at an absurdly early hour – COVID restrictions meant he couldn’t accompany me – but the team who cared for me was wonderful – caring and respectful and making me feel empowered at every step of the way. The last thing I remembered before the anesthesia kicked in was being wheeled into surgery – bright lights, people getting instruments laid out, and cold air conditioning.

When I drifted back into consciousness in the PACU, my first thought was “my throat hurts.” I faded out again fairly quickly, but the next time I woke up, I was slightly more alert. I dimly remember a nurse saying my throat would hurt because I’d been intubated. At some point, the surgeon and the doctor assisting her came to visit and gave me a rundown of what had happened: my tube had been left intact because it wasn’t blocked, but they had discovered endometriosis scarring, which they had broken up. I wasn’t quite sure what to make of my surgeon scrunching up her face and saying everything was “kind of stuck together,” but I didn’t have it in me to ask for details. Over the next few hours, I moved around, ate delicious Saltines, and finally, it was time to go home. I was in pain, but it felt more like someone had whammied me in the abdomen than intense pain. I got home, hobbled up the stairs, and got into bed, grateful for the miracles of pain medication.

It’s a humbling experience, recovering from surgery. Suddenly, even routine tasks like picking up your phone charger become impossible to do. You’re reliant on someone for every small detail of your daily existence, and it is hard. It’s even harder in a pandemic when nobody can come over to watch you and help out if your partner needs to leave the house, which Adam needed to do for graduation at his school. It was a nerve-wracking several hours, but I survived, and luckily, recovery was pretty fast. By the end of the two weeks, I was back to normal (minus some fatigue).

Getting the surgery report was…surreal. Reading about things that had been done to me while I was unconscious felt like a very dissociative experience. The surgeon hadn’t been exaggerating when she said everything had been stuck together. The scarring was extensive and severe – the entire left ovary and fallopian tube had been covered in scar tissue and also adhered to a ligament. The right ovary was also stuck to places it shouldn’t have been stuck to, one ureter was “tented,” and part of my colon was adhered to the back of my uterus. In addition to confirming endometriosis, the report also noted that, based on the external appearance of the uterus, that I likely also had adenomyosis, where the endometrium invades the uterine wall. But because women’s health gets short shrift, despite a lifetime of heavy periods and intense clotting, nobody had ever raised the prospect that this was anything but normal. It’s a little scary to think what other damage the scar tissue could have done if left unchecked.

Crucially though, the report did not detail what level of endometriosis I had (from 1-4), and this impacted our treatment plan when we finally had a follow-up with the RE. So we made plans to schedule a second meeting with him on 7/3 after I met with the surgeon so that we knew what our treatment plan would be. If the endometriosis was severe enough (stage 4), then we would be able to bypass the requisite three cycles of IUI, but could proceed straight to IVF. Not only did the surgeon confirm stage 4 endometriosis, she also showed me pictures of the scarring, which was simultaneously fascinating and terrifying. The entire left ovary/fallopian tube was completely encased.

So on July 3rd, we established a plan with the RE to begin IVF pending approval from insurance, lots of consent forms, and $4000 to cover the cost of genetic testing and freezing embryos. Insurance approved the plan, and as my next cycle approached, I contacted the nursing staff to let them know that I was getting close. The nurse wrote back saying she had requested my medication, but then a day later I got a phone call from the pharmacy saying that the medications needed prior authorization from insurance (again, insurance is evil) and I didn’t have that. This was a Thursday afternoon, so by the time the preauthorization got submitted (a process that takes 5 days to approve), it was Friday. My period arrived on Sunday, marking yet another missed cycle.

So here we are. I began shots two nights ago, and begin more intensive monitoring on Monday. After that, we do the egg retrieval and fertilization, then wait some more for the genetic testing results to come back. Hopefully, finally, at last, the first time will be the charm.

Joy

Today we held a car parade.

When I decided to become a teacher, I never imagined a scenario in which the physical school would abruptly shut down and our entire society would undertake a mass migration into a weird hybrid mix of living our lives online, but not in some kind of virtual realm, but rather through video conferences. Over the past seven weeks, we’ve gone from seeing kids and colleagues face to face to seeing them in a slightly disorienting grid of faces, the occasional flicker of a changed background, the awkward experience of scrolling back and forth to make sure you didn’t miss anyone as we all sit in front of our camera, muted to avoid unnecessary background noise. It’s both a welcome burst of connection out of our little self-insulated pods and a devastating reminder of what is missing, not to mention the exhaustion that comes from our brains apparently trying to play catch-up with interpreting the jerky movements, the sometimes stilted voices.

And today, we held a car parade at school, where 78 cars filled with teachers, children, spouses, and pets, festooned with posters, balloons, leis, window paint, one inflatable sculpture of “The Scream,” one Husky Mascot and one skunk spent two hours processing through the streets of Carlisle. The scene in the parking lot before we got going was something magical. Here were people! Actual people! Talking and laughing and bubbling over with excitement (at appropriately safe distances) at being able to see each other and be gathered together for the first time since March 13th. And then the parade started. And it was amazing. Kids and parents standing with signs, waving, yelling excitedly as they recognized teachers, cars honking. My arms got tired from waving, my voice hoarse from yelling kids’ names out, but it was so worth it.

I had worried before today that this parade would make everything worse by heightening all the sadness around what has been lost and what is missing from this strange new reality, but in truth, I could not have been more wrong.

What I felt today was joy. Pure, unadulterated joy at the relief of seeing dear faces in real time. Waving and shouting and being gloriously real.

My soul needed this more than I knew, and I am so thankful for the gift that was today.

Pandemic Blog #2

I keep hearing that it’s a good idea to journal, to write down and record somewhere the experiences of this strange time we find ourselves living in. I’m acutely aware of the fact that we are living through history, but I find that the urge to chronicle this moment isn’t strong because it makes me feel profoundly sad. Sad for how distant a reality six weeks ago feels, sad for the fact that it all feels like a beautifully weird dream, and sad for the fact that as we struggle to regain some sense of normalcy, we don’t know yet what that will look like or how long it will take us to collectively heal from this trauma. Even when things start to open back up, I don’t know how to reconcile my desire to get a haircut, or get a massage, or any of the countless small “extras” in life without feeling scared or exposed. Even something as simple as dinner with friends, or going to a movie. There’s so much we’re assuming and hoping right now about how this virus works, but the stark truth is we don’t know yet. There are some things that seem to be evident by logic, like a degree of immunity post-infection, but they haven’t been demonstrably proven yet. So how do we know? How do we resume normalcy?

I think back to Mel’s birthday party, the last social gathering I attended before everything fell apart. We crammed into Ben and Callie’s kitchen, waiting for Mel and Charles to arrive. We hugged, we laughed, we painted, shared food. It seems unthinkable now.

We don’t live in a war zone, or a failed state, and yet circumstances mean that now there are lines to get into the stores, and each excursion is like a tactical strike – go in, find and grab whatever you can, whatever you can find, whatever you think you might need for the next 10-14 days, and then get out as soon as possible, both because it’s a stressful experience and because you’re trying to be considerate and allow the people in line outside a chance to get in sooner rather than later. There’s no guarantees you’ll be able to find what you need or want, either. Items that have been unavailable at various points in time: canned soups, jam, honey, broth concentrate, flour, yeast, hand sanitizer, disinfecting wipes (I don’t anticipate seeing those for months to come), all chicken except wings, bone-in chicken thighs. I can’t menu plan ahead of time anymore, electing instead to add what I need as I go along, buy what I can, and then figure out what to make with the items I have. Coming home means a decontamination process – strip down, clothes into the wash, hop in the shower.

So journaling and reflecting on this situation isn’t the cheeriest exercise. I’ll make an attempt every now and again just to get my thoughts out, but it’s draining and sad.

COVID-Quarantine Day 14

Two weeks ago, the world turned upside down, so what better moment to decide to start writing again?

We went to school two Thursdays ago and everything felt normal even though there was tension in the air. Somehow, even without any official word and reassurances to the contrary, the rumors began to swirl that we would likely be shutting down. Sometime in the middle of the day, a second meeting of the school committee was announced (coming 24 hours after the regularly scheduled one), and by 7:30 p.m, the decision was made – we would close for two weeks and then re-evaluate. And then, because pandemics are unpredictable things, everything began to change with startling rapidity. First school was closed through today. On Wednesday, it was announced that school will be closed until May 4th, and I’m certain that before we reach that date, we will find out that the school year effectively ended on March 12th.

The abruptness of it is so startling and painful. When we reach the end of the year, we’re tired, we’re ready for summer, and we have a chance to say goodbye. We didn’t have that, and so every time I go into the school building, I’m struck by how eerie it all is – instead of a building ready for the summer – classrooms emptied and lockers cleaned out, projects sent home – things are suspended in time. Everything is as it was on that Thursday afternoon.

The digital connection helps, somewhat. There are moments when seeing videos or reading comments from my students makes me cry, others where it buoys my spirits and brings cheer to my days. It’s nice to “see” people I usually struggle to find time for, but at a terrible cost.

Going to the grocery store is now a strange experience as well. People have been panic-buying (though I think it’s leveling off a bit as movement has become more restricted and people stay away), and it’s a startling and psychologically unsettling thing to see rows and rows of empty shelves in a country where the shelves are usually overflowing with an overabundance of choices. So we shop as little as possible, use up everything we purchase in a more mindful manner, and being flexible – whatever I can find, I will work with to cook.

Which brings me to Passover. I usually take Passover as a time to be more mindful about what I’m eating – I observe a much more liberal version of most people’s Passovers since I follow Sephardic norms in terms of eating kitniyot (I can survive without bread for 8 days, but take away my rice on top of that, and I will struggle), but it still makes you think more carefully about what and how you eat. And this year, the mindfulness has been forced upon me. I cannot count on what I will be able to find at the store, so planning recipes seems like a futile exercise until I get home. I cannot duck into any old place to get food because either they’re closed or they’ve switched to delivery/take-out only, so decisions have to be made ahead of time. I don’t know if I will wind up observing a strict Passover – I plan to try and get a box of matzah to have on hand for our virtual Seder, but the meal will be whatever I can make of it. It’s a weird feeling – I didn’t observe it last year because we were traveling in Croatia, but that was circumstance rather than necessity.

So that’s where we are on day 14.

#BlogElul 1: Prepare

You work, you run yourself down, you rest, then, you prepare. There’s an abundance of preparation in my life right now.

Preparing for the start of school.

Preparing for my kids to come back.

Preparing activities and lessons and materials.

Preparing my house to be clean and calm.

Preparing my desk to be more organized.

Preparing to turn 30.

Preparing to mentally get in the right space for the High Holy Days.

Preparing for another year’s fast.

Preparing for thinking about forgiveness.

#BlogElul2013: See

I’m excerpting this from an essay I published elsewhere on the internet – just a small paragraph, but it sums up my last moments as a non-Jew beautifully.

I head to the preparation room to ready myself for my immersion, trying to stay calm as I look into the mirror before picking up the phone to call Leah, my mikveh attendant, to let her know I am ready. These are my last moments as a non-Jew, I think to myself. I take one last look at myself in the mirror, a smile of anticipation lighting up my face. Taking a deep breath, I call Leah, then head into the mikveh.

That moment, where I looked at myself in the mirror, truly saw myself, and smiled was incredibly powerful. I saw myself as a woman on the verge of a profound, yet invisible transition – from non-Jew to Jew, the fulfillment of a dream long held and long denied.

#BlogElul2013: Hear

Hearing is different than listening. When we listen to another, we take in the sound of their voices, their words. But when we hear them, when we dig deeper than listening, we pick up on the subtle cues that were not present when just listening. When we hear someone, we get the fuller picture: the joys, the fears, the anxieties.  Sometimes I wonder how many of our interpersonal communication issues could be resolved if we took the time to hear, rather than simply listen.  It’s good food for thought.

#BlogElul2013: Believe

I am someone who relishes reading all sorts of material from any corner of the internet, regardless of whether it makes me angry, makes me question, or is simply diametrically opposed to my worldview.  Sometimes this is just a purely intellectual exercise – I enjoy finding out what makes people who are so different from me “tick,” and other times, it is a useful exercise in critical thinking, in finding some semblance of common ground, and I’ve found that my thinking gets shaped by what I read and how I interpret it.

I don’t generally venture into the realm of atheist blogs/communities online, but in the course of pursuing other interests, I’ve come across a sizable number of skeptics, who seem to see it as their life’s mission to decry any form of outdated, superstitious, silly nonsense (or, to use their favorite term, “wooo”). Some of these skeptics are dear friends of mine, but I’ll admit that, as a person of faith, knowing that their skepticism extends into their religious beliefs (or lack thereof), and sometimes, it can be tricky not to take their blanket statements about people who believe a tiny bit personally. Yet, at the same time, I know that they have a point – I have no way to prove that God is real. All I can do is take the proof that has been offered up in my own life and my own experiences as enough, and trust that my belief is sufficient, that it is real and justified. It’s not called a leap of faith for nothing, but I choose to believe that what Judaism teaches about the existence of God is real.  Perhaps paradoxically, I also take comfort in the fact that my faith allows for people who doubt or even do not believe – Humanistic Judaism is not something I ever see myself subscribing to, but I like the fact that just because you don’t believe, you are cut off from the Jewish faith, and that it is open to so many diverse interpretations.

To end, let me shamelessly copy the Ima on the Bima, who posted this song at the end of her own entry on “believe”:

To me, this song says it perfectly.

There can be miracles/when you believe.

#BlogElul2013: Be

How do we train ourselves to be in the moment? To be present in our relationships with other people, to fight the increasing encroachment of our phones, of the urge to grab our phones even when in the presence of other people? When engaged in conversation but our mind starts to wander? When sitting in shul waiting for services to begin, head down instead of up and smiling, trying to build relationships and connections?

It’s something I struggle with a lot, and it’s a habit I not only dislike, but one that I think is detrimental. When we are not being in the moment, when we are not giving someone our undivided attention, our relationship with them suffers. I’ve hurt people and had to seek forgiveness for behaving this way. I’m sure others have in turn hurt those they love with these behaviors. The less we “be” in the moment, the more absorbed in our own internal world we become, observing rather than participating. And that’s sad. It’s one of the main reasons I’m thinking of banning smartphones at our wedding – so that our loved ones are focused on us and our vows instead of being distracted by their phones.

Spiritually, more and more, I find (sensing a recurring theme here) that I’m struggling but very much needing to be in the moment of Shabbat. To disconnect, to engage, to recharge and to be in the moment, in the peace, and the quiet, and the rest that is Shabbat.

I have some teshuva to do in the context of my human relationships, but as far as my relationship with Hashem is concerned, I need to work harder at being mindful and present and just being in the moments, big and small and everything in between.

#BlogElul 2013: Do

Things to be done. Things to do. Doing, doing, doing.

Sometimes, it’s really easy to retreat from the seemingly endless list of things that need to get done, and fall instead into a hopeless puddle of inertia, enabled by the internet.  The “to-do” list seems to grow ever longer, the alerts and notifications creating a buzzing sensation in my brain, all the things that need to be DONE, but aren’t, that I’m not doing, or only partially doing, but are not done.

So, I take a deep breath.

I work on the lists of things to do. I break it up. I do what I can, when I can, which takes more effort some times than others.

And yet, when I do do things that need to be done? I feel great.

It’s not always easy to do the things we need to do, should do, ought to do. But it’s also not helpful to get stuck, or to beat yourself up when you don’t do all the things that need to get done.

Instead, do what you can do. Some days, that’s a lot. Others, not so much. In the end, it all gets done one way or another and if it doesn’t, well hey, it couldn’t have been that important, right? 😉