abc family

Paradise is ever elusive

So, not to get all dramatic on you or anything, but remember the spotting that I mentioned in passing when I was telling the How We Found Out I Was Pregnant story? Nearly three weeks after it began, it still hasn’t gone away.

I’ve read enough to know that spotting in early pregnancy is common, that it could be a sign of something bad but could also be something completely harmless. Nevertheless, the morning after that pregnancy test turned up positive (day six of the spotting, in case you were wondering), I was on the phone with my doctor’s office. After I answered some questions, the friendly nurse told me it was probably nothing to worry about, and to call her back if it continued for another week.

Ah, yes, nothing to worry about. You all know how that goes. My conversation with the nurse was on Wednesday (the day I wrote this post) and by Saturday I was a wreck. That was when I really started devoting myself to conquering my fear. And somewhere in there I realized that I would be afraid even if there was no physical reason for it. This whole thing is thrilling but also terrifying and, just like with grief, there is no way around the terror. The only way is to go through it. So through it I started, and by grace fear was forced to loosen its grip on me, and I was doing somewhat better in a few days.

Nevertheless, when Tuesday came around, it occurred to me that perhaps I should call the doctor immediately so there would be plenty of time to go in before we left town on Friday. I called the office, and the receptionist, probably in response to the semi-frantic note in my voice, scheduled me to come in that afternoon. I had an ultrasound, which showed a sac measuring four weeks six days – a week small by the dates, but exactly what I had expected based on what I’d observed during my cycle – and an exam, and everything looked good. The doctor reassured me that she’s had patients spot through their entire first trimesters for no apparent reason – which actually did make me feel better – and sent me off to be bled.

They were looking, of course, for hCG doubling time, which meant I had to go in again on Thursday afternoon. Fortunately, the nurse had told me the best lab to go to (my doctor works with a network of them) and I was in and out in minutes both times, which was a pleasant change from previous experiences. Friday we were at the airport when the doctor called my cell phone to tell me that the hCG “just about doubled” in forty-eight hours, which she considered to be good news. She also told me what I already knew – that until I go in for another scan after we return from our trip, there’s no other reassurance they can give me. We just have to wait and see. 

Meanwhile, I’m reassured because my pregnancy symptoms are increasing. I didn’t have any nausea until this weekend but now I’ve got it in spades, and more each day. (I never thought I’d be happy to feel sick!) But at the same time, the spotting is scary, and I know that we are by no means out of the woods yet.

I’ve been praying hard and constantly these past days, that tiny Pāhoehoe will stay firmly lodged in there. (The name was assigned by my eternally creative younger siblings – my sister’s baby is ‘A‘a, for the other type of lava.) The waiting is not my favorite thing, but what can you do? In the meantime, I’m trying to remember to enjoy this, as I am, after all, very happy to be pregnant. Imagine that.

She went to the doctor... and it took her forever to tell you what happened

Wednesday morning, in the exam room of my new gynecologist’s office, Michael moved restlessly around, now studying the framed print of the Hippocratic oath, now washing his hands thoroughly at the little sink in the corner, now picking up random magazines and staring at them. “Sit down,” I hissed at him, “you’re making me nervous.”

He sat, but it didn’t really help. It wasn’t his fault I was edgy. In fact, I would have been even more so without him there. We talked about the mice in his new office, and tried to figure out if the exam table is heated (it’s plugged into the wall!) and calmed each other with our laughter. Not wholly, though – I was still shaking, still decidedly unsettled, through the whole consultation. Hours later, the dregs of my nervousness still dragged my stomach toward the floor. 

My mother, who has been fighting an anxiety disorder for years, is an accomplished hypochondriac. A few weeks ago my fourteen year-old sister, who is in perfect health, was complaining that her arm hurt, and Mom asked her which arm it was before sighing in relief, “Good, you’re not having a heart attack.” (Yes, she was completely serious, and no, I don’t remember which arm it was. Whichever arm doesn’t signify a heart attack.) When I was sixteen Mom went through the deepest valley of her anxiety and hypochondria, and I remember hoping that I would never be plagued by something so paralyzing. With typical teenage arrogance, I was convinced that I never would be – after all, I wasn’t afraid of dying.

It turns out that my fearlessness was just an accident of my circumstances. As soon as something health-threatening came on the scene, the fear came too. A little over a year ago my blood pressure was elevated when I went in for my yearly pap smear, and since then my blood pressure has been a little worry niggling away at me whenever it crossed my mind. I should have just gone ahead and made an appointment with an internist like the doctor suggested, of course, but I couldn’t. The mere experience of a health problem had paralyzed me. 

This past summer, my hypochondria hit a peak. During the day, any random information I saw about high blood pressure would make my chest tighten and my pulse soar, so I would have to distract myself just to get back to normal. I became a wreck after dark, when I had nothing to distract me. I would lie in bed at night and worry for hours, trying relaxation exercises to bring my shallow breathing back to normal. In the darkest of those hours I was really convinced that I was going to die, that the reason we weren’t conceiving a child was that I would never live to raise him.

For me, just as for my mother, the struggle was a spiritual as well as an emotional one. Even as I tossed and turned, I knew that. I struggled to have faith in the face of the truths I realized plainly: that I will eventually die, that fear is useless, and that God’s will, whatever it may be, is always the best plan. This struggle went on for weeks until one day on the way home from work, when I decided to stop by our parish’s Perpetual Adoration chapel. In the hour I spent there, I finally received the gift I had been seeking, a gift of grace that helped me to shake off my paralyzing hypochondria and sleep easily again. 

I must not give the impression that hypochondria is something I have conquered forever. My episode this summer taught me that, in defiance of my sixteen-year-old self, I am more like my mother than I had hoped to be. (In terms of hypochondria, that is. In other ways, I wish to be much more like her than I am.) The tendency toward anxiety is in me, and I fight against it every day, stretching my jaw when I realize I am clenching it and breathing deeply when my heart starts racing. I am still afraid, only in this particular battle I have conquered the fear for now – it is wounded and I am conditionally victorious.

Life never goes smoothly for long, though, and only a few weeks after my hypochondria fell on the battlefield, I was stopped short by the fear of infertility, which is in many ways even harder to bear. I don’t need to tell you more; I have written of it extensively here. It was that fear that stopped me from making any kind of doctor’s appointment through all the months of autumn and early winter. Rationally I know that I could have gotten the high blood pressure investigated without having to face the physical reality of infertility, but irrationally all my fears merge into one. Somehow, it is all connected for me: the fear of dying, the fear of being childless, lab coats, stethoscopes, blood pressure cuffs, and the cold metal corners of exam tables. Those months of anxiety have turned me into someone who hyperventilates in waiting rooms, where time moves so surreally that I hardly recognize my own name when the nurse calls it. 

That is why I was so nervous on Wednesday morning. Sure, we were getting the results of my Day 21 blood test, but I knew that my estradiol and progesterone levels would either be good or they wouldn’t, and we would move ahead either way. I wasn’t concerned about that. My anxiety was the symptom of a much bigger problem. I am fundamentally anxious, fundamentally just plain scared. I have a nagging conviction that things do not go right for more than twenty-one years, and that my relatively wonderful life up to this point means that I am now fated to face not only infertility but also terminal (or at least chronic) illness. It’s all downhill from here.

But I know that is wrong. And I pray every day for the strength to fight my tendency toward those thoughts. Meanwhile, we made it painlessly through Wednesday’s appointment. I am seeing an internist next week to get the high blood pressure checked out, and the next few months will bring the expected barrage of infertility tests. Most likely, anyway – more about that when I have time. Holding my breath and jumping in, conquering the causes of my fear as I continue to struggle also against the fear itself, is the only way I will conquer this. I can feel it happening, slowly, and I hope that in a year I will be able to walk into a doctor’s office without feeling nervous at all.

By the way, I am so mean for making you read this whole thing for the news. The clever among you probably just scrolled down. My hormone levels were fine. The doctor actually called them “beautiful” and said that she is almost completely sure that our infertility is not caused by ovulatory problems. I guess that’s good news.

Patience? Who am I kidding?

I'm the kind of person who likes to pretend to practice patience.  In reality I have no patience, especially with other people, but I like to pretend.  For example, if I have a really yummy piece of pie sitting on a plate waiting for me, I'll ignore it.  I'll load the dishwasher, make myself a cup of tea.  It's my way of feigning indifference.  Since I'm not jumping on the pie, I must not really care whether I have it.  (Completely untrue - I love pie.)

It's the same way with pregnancy tests.  I know that many women who are trying to conceive start using home pregnancy tests the minute they could expect hCG in their bloodstreams.  But I don't.  I just wait, in pretend patience, for my period to start.  It's a kind of denial for me.  I'm not testing, therefore I don't care.  (Ha. Ha ha.)

This cycle is torturing me by being so long, though, and so last night I broke down and bought a test.  Actually, two, because I know that if it's early enough, you can get false negatives.  I did one last night and, sure enough, negative.  My heart tightened and my eyes teared up momentarily, and then I watched a movie with Michael and laughed very hard. 

Later, when I was reading in bed waiting for Michael to come to bed, he went into my bathroom (adjacent to the bedroom) to use the toothpaste, and I heard him rustling.  I asked him what he was doing and he peeked his head out.  "I was just putting the other pregnancy test under the sink."

"Why?  Are you afraid someone will see it?"

"No, of course not!  Who cares if anyone sees it?  I just didn't want you to see it, and get sad."

I laughed a little at the irony.  He doesn't realize that it matters not a whit whether he puts the other pregnancy test under the sink.  There could be no tests within five miles, or the house could be full of them, and I would still think about pregnancy, about babies, about dealing with infertility, every single day. 

I would be lying if I said that I've given up hope on this cycle.  No period yet, after all, and everyone knows that the evening is not the best time to take a pregnancy test.  If I haven't started by Friday, day 32, then I'll test again first thing that morning.  If I have started, believe me, you will hear about it.  This is my place for false hope, but it is also my place for very real grief. 

What the heck?

Since I have almost five pages (out of seven) written of my John Paul II paper, I am taking a break to ask all Internet MDs a question:

I used an OPK this month, and although my peak in LH was about day 12, I have had positive tests of varying strength every time.  I took one yesterday (day 22) thinking it would show up negative, but it was positive.  The line was about the same strength that it was on day 10!  What does this mean?  Does this happen to everyone?  Am I just supposed to look for the peak?  I need help here; there are only a couple weeks before we have to try again.  Please help!

Back Home

There were definitely margaritas, which was great. Also there was ice cream and shrimp scampi and card games and walks in the posh downtown and this little winery (the southernmost winery in Florida!) and Latin Mass and fun rosaries said outside in the beautiful warm night. But then, yesterday, on the way home, there was engine trouble on the plane, so there was lots of waiting in the airport and very tired Michael and Elizabeth getting home in the wee hours of the morning. Today, there is this paper I have to write, comparing Basil's De Spiritu Sancto with Augustine's De Trinitate. It's due by midnight. I also will vote today! Tomorrow, or perhaps Thursday, I will be more profound.

P.S. All you Internet OBs out there - what does it mean if I have spotting, days 14-17, as if it was the last day of my period (i.e. not red, more brownish)?

This week is the worst, every month

Today is Day 21 of my cycle. As my cycles are usually 26-28 days, this means I probably have less than a week before I start my period. A month ago now, I was sure I was not pregnant, and thus the wait was not hard. I was just excited to get to the next cycle so we could try again. Now, though, I'm back to my regular dreading and worrying.

Back when we were trying not to conceive, NFP did not take much effort. I have regular cycles, so all I had to do was count days and take my temperature around the time of ovulation, and we managed to avoid conception every time. (I was a very lazy NFP user, and I prided myself on our ability to avoid pregnancy without having to follow all the strict NFP rules. In retrospect, I laugh at the irony of it, because it seems like we wasted all that abstinence – we probably never would have gotten pregnant anyway!)

When we decided we were ready for a child, we stopped using NFP completely. Even the small amounts of charting I had done were too much effort for someone as effort-averse as I am, so we decided to go all natural. Because I knew that cervical mucus is supposed to peak at ovulation, we have been trying, for the past year, to cover the days in each cycle when it was peaking. Needless to say, no conception.

Well. Last cycle I charted, for the first time in over a year. My cvm peaked, and my temperature did not go up. And did not go up. And did not go up. Finally, an endless five days later, it did. By this time conditions for conception were not ideal.

Since I’m only 22, I had never worried that infertility would be a problem for me. Over the past year I’ve just been shrugging and saying, “Oh well, we’ll try again next month.” So even though I have a basic knowledge of the way human reproduction works, I haven’t collected much information beyond that. When I discovered that I was ovulating five days after ideal cvm conditions, I did what any self-respecting child of a mother-of-six-whose-dream-is-to-be-a-midwife would do: I asked my mom.

I told my mom when Michael and I started trying to conceive, and even though we haven’t talked about it a lot since then, I know she’s been praying for us, and I know she’s aware that there’s no baby yet. She never had problems with infertility herself: I was born a year after my parents got married, and my youngest brother was born, with no complications, just before Mom’s 42nd birthday. Her dream is to be a midwife, though, so she is a fairly endless fount of knowledge on all things pregnancy and birth-related. She’s probably read every book the local library has on the subject, and I know that if (when) I ever get pregnant, she’ll be able to grab a stack of books off her own shelves for me to read.

Despite her cheerful, encouraging attitude regarding our failure to conceive, I know she must have been a little worried, because when I told her what I’d discovered about the discrepancy between my cvm peak and my ovulation, her face lit up. I asked, tentatively, “Do you think this could be causing the problem?” and she answered me with a resounding, “Yes, definitely!” She suggested that, before going on to more complicated treatments, I try just taking guaifenesin because it “makes things runnier.” So I did, this cycle, and I took my temperature to make sure we covered the right days (I’m pretty sure that in the past year we’ve missed ovulation as least as often as we’ve covered it).

So I’m really hoping to be pregnant, but I don’t want to hope too much. It seems like it hurts more if I let myself start dreaming. I’ll just wait the week out and see what happens.