TTC - Onward

Pincushion  (c) Shutterbug

It is just seven weeks since we lost our baby, and here we are well and truly back on the TTC train. TTC roller coaster.

We trudged back into the Mt. Sinai clinic, dreading our day three scan and the chance of running into our now least-favourite doctor (Dr. Arthur), but we were in the clear. My blood work came back showing my hCG levels were back to normal, so we were free to start another cycle with Clomid.

5 days on 150mg of Clomid, the maximum dose available. Remembering to take it, dealing with the hot flashes and bloating and headaches, coping with the emotional instability that could be attributed to the drug or to the trauma...so goes our path to parenthood.

Counting down the days to Day 11 and the scan that would show us where things were at, it was difficult to focus on much else. By the time my name was called and I hopped up on the ultrasound table, I was nearly sick with anticipation. I had bet on three follicles this month; my wife on two. We waited while Dr. Greenblatt pressed unbearably hard on my ovaries, and announced in her very pronounced lisp that there was one follicle on the right side. My heart sank as I realized she seas not going to add anything else. I felt like the drug was useless and the effort wasted, but at this stage who is to say there would have been anything at all without it.

The blood work is always the real issue. Day 11 it took two technicians three tries to find a vein: both arms, and the back of one hand. Day 12 we were given a pass and got to sleep until a normal hour. Day 13 it took two tries by one clearly inexperienced tech, and Day 14 it took two tries by one obviously irritated tech. Sometimes I want to grab the needle and stab it into their eyes, is that so wrong?

Feeling like a human pincushion and totally fed up with the process yet again, I went in for my IUI on day 15. Nurse Kathy asked for the usual history, and took it all in stride. My eye kept going to the unusually thick binder with my name on it in front of her, and I finally asked to see the ultrasound photos that were taken during my pregnancy. I looked at them with a morbid fascination: despite the difficulty in making sense of them, they were physical proof of what I had, and what we lost.

Kathy proceeded to complete the easiest insemination of our entire history at any clinic. Did the miscarriage change my cervix in some way? Is this what IUIs are like for other women? I was shocked to hear that she seas done, since I had hardly felt a thing. I wanted to hug her.

This sperm sample was not our best; only a 3 million count compared to the previous averages of around 9 million (top count was around 18 million), but we keep telling ourselves it only takes one. One tenacious swimmer. We are not going to complain about the sample quality, even though it falls below the guaranteed count. Complaining just takes too much energy.

It is now 6 days past IUI (6dpiui), and I took a home pregnancy test to get a baseline negative. If it had come out positive then it would mean the hCG trigger shot was still in my system. Since it is negative, that means any positive result from this point forward is due to what's going on in my body, and not any of the drugs. 

It's hard to put into words the strain of this process. The mental, physical, and emotional drain and preoccupation; trying to remain hopeful and positive, yet not get our hopes up too high, and trying not to lose our minds.

I think I lost that battle long ago.

Four Legs, Four Toes

Georgia post-surgery  (c) Shutterbug

I knew it was going to be trouble as soon as my wife spotted it.

Even though I am an experienced pet owner, I have given up trying to trim my dogs' nails. The dogs freak out, I'm unsure of how far back to cut the black toenails, and it's just easier on all of us to leave it to the professionals.

Georgia went in for her usual nail trim recently, which includes a difficult rear dew claw. Two days later my wife found a hard, purple abscess where her freshly trimmed nail appears to have cut into her toe, which has swelled to completely encompass the nail. Back to the vet, where my gorgeous girl's tail never stops wagging. She was placed on antibiotics and given a topical ointment as well, which I felt confident would be useless.

And so it was. More appointments and discussion ensued, and we came to the conclusion the only sensible thing to do was surgically remove the dew claw. No admission was made on the part of the vet techs for having caused this situation, which ticked me off.

Our vet had no surgical time slots for an entire week, which wouldn't work when I could tell my dog was in discomfort. Enter my lovely high school chum Dr. Jennifer Newhouse at the Taunton Road Animal Hospital in Oshawa (if you need an excellent vet in the east, do call her). She is an amazing veterinarian and a wonderful person, and she stepped up to fit us right in.

My wife drove Georgia all the way out to Oshawa in morning rush hour traffic to drop her off for surgery...and came home to discover that some brazen asshole had stolen our beautiful new e-bike from under its tarp on our driveway. We live on a main street, with neighbours on both sides who are home during the day, and I can hardly wrap my head around the balls and effort it took to steal this 400lb vehicle in broad daylight on a busy street. It's unreal.

Maybe this person did us a favour; I was very concerned about my wife being in an accident in downtown traffic. Perhaps an injury was in our future that has now been avoided. But it was ours, we had saved for it, waited for it, and treated it with care. People are just so disappointing. There have been workmen mucking around with a flip project across the street for months who park across our driveway and behave like assholes on a regular basis, so we think it must have been one of them. It really would have taken two people and a large truck to transport this thing away without a key.

We tried hard to keep it in perspective, and my wife fought rush hour traffic again at the end of the day to pick up our beautiful little Georgie, minus one toe. In the eight years I've had her she has cost me next to nothing and brought me boundless joy. I doubt I will ever know another creature like her; she is pure love through and through.

A $2,000 loss of the e-bike and another $1,000+ vet bill made for a very expensive day when we can ill afford it. Surely there is a winning lottery ticket in our future...

Lost

"So...are you still bleeding?"

This was the first question I faced, on my first day back at work, from the first person I saw who knew what had happened.

"Are you going to try again?"

"At least you know you can get pregnant."

"It's nature's way of taking care of problems. It's probably for the best."

"Better for it to happen now rather than later. Imagine going through this when you are further along."

"My sister/cousin/friend/fillintheblank had a miscarriage, and..."

"How are you?"

I don't know how to answer this last one. Are you looking for an honest answer, or a polite "I'm ok"?

I am not okay. I find myself wanting to tell everybody and nobody what has happened. I resent insensitive comments from people who can't know any better.

For the past few weeks my last thought at night and my first thought in the morning were the same: "Wow, I'm pregnant." Filled with awe and excitement and anticipation. Now it is the opposite.

I go about my day. I get up, I let the dogs out, I step into the shower...and am paralyzed by the vision of blood splashing on the white tub between my feet.

I do my hair, I make my lunch, and I go downstairs to look after the cat...stopping at the litter box, then remembering it no longer matters that I scoop.

I eat my breakfast, then make a last stop in the bathroom where it happened.

I am mocked by the "What To Expect When You're Expecting" book on my nightstand, by my prescriptions in the bathroom, by my prenatal vitamins on the counter, by the pregnancy tests littered throughout our house, and by a thousand other small reminders of what we have lost.

I try to sleep in the bed I couldn't leave for a week as I suffered, and prayed, and raged, and grieved.

We try to make sense of it, and take turns being strong for one another. And we try to make plans to keep going.

Are you there, God?

(c) Shutterbug

For a non-religious person, I sure have voiced a lot of little prayers over the last four weeks to an entity I don't think I believe in.

My life has changed so dramatically with my new/old job; there is no time throughout the day to contemplate my situation, or obsessively Google the week of my pregnancy, and my every worry. And there is now reason to worry.

We counted down the days to our first ultrasound this week, at exactly 7 weeks. We went to bed thinking about our baby, and woke up thinking about our baby. We watched videos of embryonic development, envisioned what was going on inside of me, and wrote notes to our future baby.

The ultrasound at Mt. Sinai was the typical clusterfuck. It was slated for the morning of Friday, September 23: the date we considered our anniversary prior to our marriage, since it was the night of our first date. We took this as a good omen. I booked a vacation day, and scheduled an additional medical appointment for the afternoon to maximize my time off. Then Mt. Sinai called to reschedule the ultrasound to the day before, requiring juggling, then called twice more to change the actual time of the ultrasound. It was finally set for 8:15 on the 22nd with Dr. Liu.

We arrived to face the usual packed waiting room, which conflicted with the nurse's explanation that my appointment was moved up twice to eliminate large gaps in appointments, seeing as how there "weren't that many". I checked in at the desk, letting the receptionist know I was here for my pregnancy ultrasound with Dr. Liu, and was informed that Dr. Liu was away at a conference. Say what now? Apparently Dr. Rebecca Arthur would be filling in, and we were directed to the same change room/waiting area as is used for cycle monitoring. The half hour wait annoyed me more than usual after the specific direction we'd received to be there earlier. Eventually a staff member moved us to the same old hallway outside the same old ultrasound room. My wife noticed there were spouses attending for the first time, so it became obvious that all of us waiting here were already pregnant, and not just the women having cycle monitoring scans. 

As the first couple went in, then emerged a few minutes later, I turned to my wife and said how inappropriate I thought it was to have the rest of us sitting directly outside the room. To say there was a lack of privacy would be a colossal understatement. What if someone received bad news? As soon as those words were out of my mouth, nurse Maddie came out and asked the couple behind us to return to the other waiting room until she came to get them. When our turn came to be led into the ultrasound room, there was no one else in sight. Our moment of truth had arrived, and my heart was beating out of my chest.

Dr. Arthur was waiting at the foot of the exam table, barely visible in the dim light. She asked if I had had any pregnancy symptoms, and I replied that I had increasing fatigue and heartburn, along with some minor cramping that had come and gone since day one. She prepared me for the test as if reading from a page, saying she would insert the ultrasound wand and then would be silent until she was sure of what she was seeing. I was nervous, scared, excited, and still wanting actual confirmation that I was actually pregnant - in addition to confirmation that there was just a single embryo in there! I wasn't sure what they could tell me this early on.

Dr. Arthur's silence stretched on, and on...and on. She moved the wand, pressed it to one side, pressed it to the other side, moved it some more, pressed some more, and squinted at the screen. My nervousness reached a fever pitch, then grew into a hard knot in my stomach that began to sink as it became clear something was wrong. Nurse Maddie stood up and walked around behind the monitor, looked at the monitor with Dr. Arthur, then they looked at one another, and then Maddie returned to her seat beside my wife, who was beside me. Just as I felt like I was going to scream, Dr. Arthur began to speak.

What she actually said is now a garbled mess in our brains. She used the words "abnormal", "reason to be concerned", and mentioned the proportion and amount of space. She confirmed she could see a "pregnancy sac", at which point my wife asked about the size of the embryo, and Dr. Arthur said it was what she expected. We weren't understanding the problem. The doctor herself admitted she wasn't exactly sure herself what she was seeing, and wanted us to go to the hospital in a week's time for another ultrasound. What?!?! She said it was just too soon to tell what was going on, which made me incredibly angry. Clearly she suspected something, but she wasn't saying.

There was a roar in my ears, and her words just kept repeating in my head, making it hard for me to formulate any questions. I finally asked whether she saw a heartbeat, and she replied that she saw "a flickering". What does that mean? She was giving us nothing to go on, and we were being ushered out of the room. Maddie briefly grabbed the back of my hand and squeezed it as she handed me my progesterone prescription, and told me to continue taking it for now. It was the only sign of compassion in the entire appointment.

We left in shock, and drove home in silence. Eventually we cried, ranted about our ongoing frustration with our medical care, and Googled like fiends at home. But there is no magic website that can tell you about your own unique situation, you can only read about how things turned out for other people. The outcomes range from miscarriages, to women talking about their now-toddlers that doctors had told them didn't exist.

With a day's perspective, our sadness and confusion gave way to rage and frustration. Anger at the slew of doctors with no bedside manner, the lack of individualized care, and lack of information. There was no way I wanted to go back to Mt. Sinai at this point, and no way I thought I could wait an entire week for any further news. I called my GP, who scheduled an ultrasound for me at her hospital, but it is still four days away.  In the meantime, there has been no call from Mt. Sinai to confirm the ultrasound Dr. Arthur apparently ordered there. There has been no offer of care whatsoever. I don't know what I expected, but I feel like a number with no relationship to anyone. 

And as today wears on, there is a dull ache beginning in my midsection. I just feel unwell, and for the first time in seven and a half weeks, a trip to the bathroom showed some spotting. 

I fear the worst, even as I sit here praying for the best.

BFP Sinking In

Another week further  (c) Shutterbug

I had my IUI procedure done on August 17, and on August 19 my job was eliminated. So much for maintaining a stress-free environment full of positive energy.

I was luckier than most of the other people who received similar news that day, because at least the company wanted to find a place for me: back in a job I'd held fifteen years earlier. It was an incredibly traumatic and emotional day as I waited for hours to hear if I was among the coming layoffs, found out that I was, then heard there was an opportunity to stay, but it would be as simply a team member in a department where I had, a lifetime ago, once been the manager. A tough situation, but I knew I had to make the best of it with everything we were going through.

We got our "BFP" (big, fat positive pregnancy test) on August 28, and I started my new job the very next day. The news changed everything. I felt like I was floating, walking around with this wonderful new perspective and an entirely different future opening up in front of me. Work stresses suddenly seem so insignificant in the face of our life-altering news. In one instant I felt like a different person. It's been similar to the experience of getting engaged and married; suddenly knowing how that portion of my life story would play out. And now I get the chance at another role.

The road has been so long already that we've been afraid to get our hopes up: it's not like we don't know how many hurdles there are still to pass. I've taken a silly number of home pregnancy tests to convince myself this is happening, because there is so little tangible proof this is even real. My first beta blood test (to test the hCG level) was done two days early due to a clerical error, and came back at 90: a high enough number to make us think both eggs could be on the go. OMG. It is completely bizarre to walk around for weeks thinking first that there might be nothing, then knowing there is something, but still wondering if it is one baby in there or two. Beta two was 150, but it was beta three that was the most important. All we have to go on are these phantom numbers that hint at what's going on inside my body. It's surreal.

I had the blood test on Thursday, and my wife and I were hoping for the results yesterday. I sat at my desk waiting for the nurse to call, jumping at every ring, wondering how I would have a personal call with so many people around me. What if it were bad news? I was distracted the entire day, and finally left a message on the clinic voice mail asking for our results, but a call never came. Excruciating.

We were on pins and needles today, as each hour ticked past and we still didn't know if we were ok. One phone call. One number. The range of acceptable numbers is ridiculously broad, because it would not only indicate whether a pregnancy was on track, but could give an idea of how many embryos were growing. It was our understanding that anything over 500 was a "good" number. A high number of a few thousand would mean there was more than one baby. As the day wore on and still no call came we became convinced the delay was due to bad news. We kept ourselves busy and tried so hard to keep calm but the mind is a crazy place. 

The waiting ended in the mid-afternoon. Beta three is 774. It is perfect for one baby. We are on our way. There will be no more news now at all until our first ultrasound, scheduled at seven weeks.

My wife has spent time on several different online forums as we navigated this process; now that we've had success she moved to a baby bump group instead of an infertility support group. They create a time line for your pregnancy where each growth stage is represented by different seeds or fruits for the embryo's size. Last week our baby was a poppy seed; this week he/she is an apple seed. Next week a sweet pea. Sounds like a photo project waiting to happen. 

In the meantime we've started a journal to write notes to this baby we've so desperately wanted. I know we are not supposed to get our hopes up, but I want to remember everything. 

I've plugged all our dates into a couple of online calculators, and they say my due date will be May 10, 2012. Mother's Day is May 13 - whether the baby has actually arrived or not, we will be celebrating for the first time. I will be a first-time mother at 42. Not what I'd planned for myself, but sometimes the universe has other plans.

And I thought I was crazy before.

Four positive home pregnancy tests in the last 48 hours. Still doubting, and worrying that the Ovidrel shot is the culprit.

Have never wanted anything so much in my entire life.

Waiting for the doctor to call to confirm blood test.

Always waiting.

Stress and Perspective

This week I had my (our) 10th IUI procedure, coupled with a consultation with a nurse to discuss our next steps should this month be another disappointment.

I can't change the facts with positive thinking, or lifestyle adjustments: I have a roughly 15% chance of success if we go the IVF route. Spending around $12,000 on those odds seems not only irrational, but irresponsible. Yet how do I give up? This isn't working, and we don't have the luxury of more time at my age, nor the money, nor the mental fortitude to continue on this quest much longer. We came to the tentative decision that if this procedure fails as well, we will start the ball rolling to bring in my wife as the pinch hitter.

The universe, however, was not done taunting me this week. As I was being told to reduce the stress in my life (the doctor laughing a little at her own advice, commiserating at how impossible that is for anyone undergoing fertility treatments) and think positively, my job was "eliminated" at my company after sixteen years. Unlike many of my less fortunate coworkers, I was offered a lateral move within the company to a completely different position, which means I can still choose to have a paycheque. The choice was obvious given our hopes of continuing with treatments for either myself or my wife, so I'm grateful on a few levels. I escaped four previous rounds of layoffs unscathed, and have come out of the fifth better than most. To say that yesterday was stressful does not begin to describe the emotion of thinking I might be out of a job, then adjusting to the mindset of starting a totally different job, and then guiltily watching long-time friends exit the building for the last time.

I just can't wrap my head around the fact that I don't have any control over so many major aspects of my life. I can't control my infertility, and therefore can't control what the future definition of our family will be. I can't appear to control my body, which has betrayed me by steadily gaining weight over the last year of fertility drugs, depression and stress. And now I don't have control over what my job will be next week. I suppose you could argue these points, since I guess I have the option of choosing not to have children and to turn down the job offer, but I feel trapped.

This is not where I thought I would be at the age of 41. I'm trying to focus on what is important and good in my life, and maintain perspective on what is not, but that is harder than you might think.

My wife remains my saving grace, my support system, my family, my best friend, and the love of my life. I know that having this relationship makes me one of the luckiest people on the planet, since many will never know the joy of finding their "person". I just wish love could pay the clinic bills.

TTC - Tomorrow, Tomorrow

Another ungodly early day on Sunday showed two perfect follicles (whew), but one dangerously thin uterine lining. It was 0.55mm where in the past it had always been 0.83mm or more. 0.6mm is apparently the cutoff for continuing with an IUI cycle - another measurement to learn and obsess about. Another side effect of the drug that was supposed to be helping me to conceive.

That afternoon my wife and I drank champagne and ate far too many delicious, sugary carbs at a friend's bridal shower. Enjoy it while I can, I figured. The next morning, for the first time ever, I forgot to set the alarm. I was slow to wake, but when I poked my wife in the arm she bolted awake and asked what time it was. Seven o'clock, I said, at which point she gasped that we had to be at Mt. Sinai in fifteen minutes. I don't think either of us have ever moved so fast.

We were just ten minutes late, and the blood tech hit my vein on the first try. Dr. Arthur laughed when she took my measurements during the u/s. "What did you do in the last 24 hours?" she asked. "This is an incredible difference for one day, your lining is now 0.78mm. I'm not just saying this, it looks beautiful." We beamed, and the details of this cycle began to sink in. I had two perfect follicles of equal size and maturity, one on each side. This meant there would be no losing half the sperm as they swam up the "wrong" tube, because we had a ticket for both routes. The lining would support implantation, my levels were all where they should be, and this will surely be our best chance yet.

Make that our last best chance. I don't feel that I can continue to put my body, my brain, and my relationship through this process any longer. I also can't keep flying in a holding pattern at my job at a floundering company, feeling as though I can't search for something new when my hope is to be pregnant any day.

I can hardly focus on anything else aside from this process, and my emotions are all over the place. My wife called me over to the sofa where she sat last night, and cautiously expressed her excitement and intense desire for this cycle to work out. We held onto each other and talked about our dreams.

I was the last of my friends to marry, and I will (hopefully) be the last to become a parent. I have seen friends, coworkers, and some strangers in the news who should honestly have never been allowed to procreate, pop out babies like it was the most natural thing in the world. I have had to be supportive and excited while hiding my own jealousy as woman after woman I know announced her pregnancy. I am filled with fears, and doubts, and longing.

Tomorrow is the big day. I am setting myself up for the biggest heartbreak imaginable, but I must believe this is my time. Our turn. The beginning of the next chapter in our life together. I want my child to come into being in an environment filled with love, and happiness, and hope. And so I will treat this once again as a done deal, and believe that tomorrow we are making our baby.

Come on, little one, just get here. We're waiting for you.

TTC - The Final Countdown

"Aunt Flo" arrived right on time this month, just as she has every other month for as long as I can remember. Trying to keep one's expectations low means less opportunity for crushing disappointment at this news, but results in more of a constant, low-grade depression.

Last month was not the first time I told myself it would be the last time I would suffer the pain, inconvenience, and indignity of all the requisite fertility procedures. I said I needed a break and I meant it, but when my seemingly inevitable day 1 arrived, I had to make the choice of whether to call it into the clinic or not. Suddenly I began to feel anxiety at the thought of taking a break instead of relief, envisioning one of my poor little eggs making its journey with nothing there to meet it. This is the reality of being in a same-sex relationship: there will be no happy accidents. It would be another lost opportunity; the slimmest of chances that this will be the month. And so I called it into Mt. Sinai, as I have so many times over the last year and a half.

My day 3 ultrasound fell on a Saturday, as so many of my procedures do, and the Mt. Sinai clinic was packed. My appointment was strangely late, at 9:00, and we could barely find seats in the waiting room. We were uncomfortably close to those around us; two couples who had each shown up with needy toddlers. A woman across from us recognized an older gentleman sitting nearby and proceeded to have totally inappropriate, top-volumme conversation with him about what he and his partner were going through. He took pains to be polite, giving ever-shorter answers to her barrage of questions ("So, are you in the middle of IVF?"), but soon appeared to be completely absorbed in his child's video game as a means of avoiding the interrogation. Some people have zero ability to read others, and zero filters.

A very tall, large, and intimidating black woman appeared in the doorway, swinging her long braids and demanding to know who was still waiting for blood work. She then began pointing at people, stabbing the air and grunting, occasionally demanding to know their names. "YOU!" she would yell. "BLOOD?" she demanded, scowling. When she came to me and heard I needed bloodworm, she grunted and pointed at the hallway, which I had to assume meant I should follow her. She didn't smile, and didn't talk other than to point at the computer screen and say, "That you?". Bracing for the test, I was unsurprised when her painful jab missed my vein. While pulling the needle in and out of my arm, changing the angle of entry to spear the uncooperative vein, she finally asked, "Does that hurt?". I was practically in tears, but had to laugh as I responded with What do you think? Once I was done, my wife and I proceeded to watch as she repeated this exchange with other people. How did this woman ever get her job? Surely you still have to interview and be chosen in the medical field, just like with any corporate job? Or as a nurse are you simply given assignments? Does no one care whether you have the shittiest job performance imaginable? There doesn't appear to be any accountability at Mt. Sinai. How could there possibly be so many incompetent people, month after month, doing a bad job with an even worse attitude? It crossed my mind that it was a teaching hospital, but these people were far too old to be students, and there was certainly no instruction going on that I could see.

This ultrasound was our first introduction to Dr. Rebecca Arthur, who we'd been told would be taking over our case during Dr. Liu's mat leave. She seemed nice enough, and spoke with confidence. When I asked about the follicle count, she told me not to worry about it from month to month, as it would probably not vary much given my age and test results (FSH/AMH levels). I think she said there were four this time. I asked about alternative drugs, since I was feeling like the Clomid wasn't having much effect, and she said injectables were an option for about $1,500 - but would likely not have that different a result. What?! I couldn't really process that news. Wasn't that the next step for an actual IVF procedure? Wouldn't those be the "big guns"? She offered to up my Clomid dose to the maximum 150mg to see if that helped, and we agreed to go with that.

This time the side effects included the usual fatigue, increasing mood swings and bloating, but also threw in some new insomnia, daily headaches, and daily nosebleeds. All this, and yet know that it's important to maintain a positive, stress-free environment for yourself to maximize the chances of conception. 

As I go about my daily life, I can't help but wonder whether anyone has used fertility treatments as a reason for actions of temporary insanity in court.

TTC - One

I have never had to wait so often, for so long, for so many things, in all my 41 years.

There was an interminable wait for our day 3 ultrasound to find out how many "potential" follicles" I had for my second attempt at a medicated IUI cycle, we were thrilled to hear the number six. In fact, that might turn out to be too many for an IUI procedure - but we had come to terms with the very real potential of a multiple pregnancy by this time. I obsessed each night as I swallowed my 100mg Clomid pill, wondering what was going on inside my body. If last month had begun with 4 follicles and resulted in 2 eggs, then surely I could count on that as a minimum this time around. But what if there were three? Four? The madness of the roller coaster continued. And we waited. And the side effects grew in intensity, as we learned was to be expected with successive cycles on this medication.

Day 11 finally arrived after another night of broken sleep. My wife and I laid bets on how many eggs there would be this month. We both felt there would be three. Off we went to the clinic for the scan to hear...one. One. The same number I would have had with no medication. One may be all it takes, but after this many failed cycles it feels like a losing ticket. I acknowledged the change in my outlook, the mind games of going from desperately not wanting multiples, to feeling as though it was hardly worth the effort with only one egg.

Day 12 blood work came (after the usual black comedy of attempts to find my vein), and o surge.

Day 13 blood work came (after a morning spent plotting the murder of the blood techs), and there it was. Day 14 would be our big day, and of course it would be the only day that my beloved wife had unbreakable, long-standing plans. Time to call in reinforcements.

On day 14 I woke and soon found myself doubled over with abdominal cramps, and thinking I would have to cancel the procedure. I was panicked about whether there was time to stop the thawing of our $700 sample, and then decided I just don't have a month to waste. Suck it up. My close friend accompanied me as the IUI was performed by a nurse practitioner named Eileen, who happened to be 7 months pregnant. I joked that I really needed to start drinking the water at Mt. Sinai, at which point she looked at my sympathetically and apologized for her condition and said, "I can only imagine how hard this must be." I just hoped she would bring me some good luck.

As I suffered through the experience that I now realized would be the norm for me, Eileen tried to keep me distracted by asking a variety of questions, and my friend tried to support me with solid squeezing of my hand. Eileen was surprised by the difficulties as she admitted what was usually a 2-minute procedure for most women was 15 minutes of sheer torture for me. 

I made it through. And now we wait.

TTC - BFN

BFN  © Shutterbug

If I were smart (and if I actually had any available cash left after my myriad of treatments), I would be investing in one of the companies that makes these magical little sticks.

Judging from the number of comments on various forums and blogs, I am not the only woman who begins obsessing about these tests on the day of her IUI, and proceeds to make and break bargains with herself every day thereafter on when she will begin taking them. I've come full circle in the last year of madness: I began the process full of excitement and enthusiasm, testing far too early, then as pessimism loomed I tested later and later (because as long as you don't see a negative result, a positive one is still possible), and finally I am back to testing the moment a reliable result seems plausible. This time around I took 4 tests, which brings my running total up to…a zillion. Probably the financial equivalent of a really successful trip to the LCBO for some really excellent wine.

We tried to think positively and truly believe that this was the month, how could it not be with two lovely little eggs on their way? Each time we try we do our best to remain calm, be optimistic, create a soothing environment for nature to take its course, and balance all that with not getting our hopes up too high. I failed miserably at that part this time around.

I fear I am becoming one of "those women", the ones who see pregnant women at every turn and feel a combined rush of jealousy and irritation. The ones whose eyes pick out every news headline about abused children and shitty parents who think, "Really? THEY were able to pop out kids, but I can't?" I vacillate between wanting to talk about this process all the time, because it is on our minds all the time, and wanting to scream if someone asks me about it when I don't feel like sharing. 

My lovely wife and I can't help but examine our feelings every now and then, and both of us have to admit that our life together is already pretty full. Our time is our own, our money is our own (aside from this process), we can be spontaneous, we are madly in love, and we aren't anxious for any of those things to change. I worry that there is a reason this isn't working for me, that perhaps this isn't the path I'm supposed to take. I worry that I am too old, too tired, too impatient, too set in my ways to be the kind of parent I would want to be, and that the stress of parenting could damage our marriage. But when our neighbour's little boy threw his arms around my legs and called out my name, tears sprung to my eyes…and I have to believe that is also an indication of what is missing in my life. Children's clothing and book stores are like a magnet for my wife, where she can get lost for hours shopping for our future child.

So I guess we press on until the decision is much clearer. Clomid, round two.

My day 3 u/s this time showed a minimum of six follicles, in which I took irrational pride.

There are still so many hurdles to clear, even if we finally get a BFP. I can't believe we can't even seem to get to that stage of the game.

Please let this be the month.

TTC - Hurry Up And Wait

IVF injection training at Mt. Sinai  © Shutterbug

And so it begins again, the 2ww (two-week wait) that all of us on this journey dread, and dream of, and suffer through, and bargain with. It's been five months since I've stood in these shoes. I'm certainly older, definitely wiser, and struggling with both regret and doubt.

We crawled back to Mt. Sinai in March with our tails between our legs after our negative experiences at Create, and met with Dr. Liu again. It was shocking to discover she was nearly nine months pregnant and about to go on leave any day. There is something just unfair about going to a pregnant doctor for fertility treatments. She and an assistant (which was awkward) kindly spent a long time discussing our options with my wife and I. If we wanted to proceed with an IVF cycle, she stressed the importance of us attending an IVF "class", held bi-weekly, before going that route, and we resigned ourselves to more time away from work, and more feelings of isolation as likely the only lesbians in the room. 

We arrived just before the class started, on a weekday in late March. We could hardly believe it when the rest of the attendees continued to trickle in every few minutes until the class was actually half over. It was disruptive, and disrespectful to the doctor leading the class. It was, by the way, Dr. Ellen Greenblatt, who is the head of the entire program. Much of the information was common sense or we already knew from doing our own research, but there were a few surprises.

I was under the impression that the whole reason for taking fertility drugs, which I had purposely avoided up until now, was to increase the number of follicles I produced each month. This is not the case: they are designed to increase the number of mature eggs the follicles produce, but that number is still limited to the number of follicles I start with (called the "antral follicle count"). They cannot change that. If my body at my age is only producing 4 follicles, then the maximum number of eggs you can hope to grow, even with drug intervention, is 4. OMG. The antral follicle count can change each month, however it's unlikely to vary by much.

The other important things I learned were about the IVF process itself - how eggs are retrieved, scary statistics on fertilization or lack thereof, how the embryos are grown (could be 3 days in a petri dish, or could be 5), grading embryo quality and fragmentation (!), futuristic procedures like helping the embryo to "hatch" (do you know what a zona pellucida is? I didn't.)…the whole thing seemed surreal and clinical and cerebral to discuss growing your future child in a lab.

Despite the scary financial number-crunching (most insurance plans, mine included, have zero coverage for fertility drugs), we decided it was time to bring out the big guns and attempt a round of IVF in May. Likely the only attempt, given that the total cost for treatment including the donor sample, drugs, and various procedures could run close to $15,000. We were already closing in on that figure with what we'd spent on our 7 IUI procedures in the last year.

I nervously counted down the days to cycle day 3, when I would go in for the usual b/w and ultrasound, and would begin drug injections. Time seemed to move in slow motion as we tried to evaluate all of the possibilities in advance. This is what the IVF class makes you realize as well; you have to prepare for making absolutely critical decisions, so that if and when the time comes, there is no hemming and hawing. For instance, we even have to sign forms to designate what should be done with our embryos should something happen to me in the middle of the process. Happy thoughts.

The u/s news was not good. I had three follicles in my left ovary, and one follicle plus a cyst in my right ovary. A cyst?! Yet another thing I was unprepared to hear and hadn't researched. My mother had required surgery for an ovarian cyst at a very young age, so this panicked me. A helpful nurse named Donna asked us to wait for my blood results, explaining that my estrogen levels would indicate whether this cycle could be salvaged. We had decided that IVF would be off the table for this month now, since 4 follicles were not enough (4 follicles would likely mean a max of 3 good eggs, of which only one or two might fertilize - a lot of money to gamble on such a low number), but hoped to proceed with another IUI and not waste the cycle. Donna explained that sometimes an ovarian cyst can trick your body into thinking it's a mature follicle, you to ovulate too early and release immature eggs. A level of around 200 might mean a usable cycle, but anything higher and we would have to cancel. And so we waited in one of the exam rooms we knew so well.

The sympathetic look on Donna's face when she returned said it all, even before she announced "640". We were so dejected, and so tired of the process being out of our hands, and now were worrying about the cyst. Donna, bless her, spent half an hour counselling us and said my body would likely reabsorb it. After some discussion, we came to the conclusion that we may have jumped the gun with going to IVF at this point. If I had been afraid of taking fertility drugs because of the chance of multiple births (and side effects), yet I was only producing four follicles and willing to subject my body to IVF now, then perhaps it was worth trying a medicated IUI cycle for the first time instead. The (oral) drug they would put me on is Clomid, and if I did happen to produce too many eggs for an IUI (not likely), we could choose to abandon the cycle and try again another month. Nothing to do but wait for my next day 1.

My very regular cycle, however, became uncooperative. Day 30 came and went. Then day 35. I called the clinic, concerned this was related to the cyst, and was told to come in on a Sunday, my period now nearly two weeks late. We had a very unfriendly doctor we'd had once before, who was quick and businesslike. She said everything looked normal. I explained I had never been this late before in my life, and asked what could cause a period to be two weeks late. She looked me in the eye and said sarcastically, "Uh, pregnancy?" What a bitch. Thanks for that, after all the disappointment and emotions we'd been through, all the procedures we'd endured; thanks for calming our fears and helping us to understand the current situation a little better. It was three weeks of debilitating PMS symptoms before my period arrived on day 45.

Cycle day 3 we were back at the clinic for b/w and u/s, and again I felt rushed through the process. The doctor simply confirmed there was no cyst and everything looked normal, then said I should begin taking the 100mg Clomid pills that evening for 5 days and come back in on day 12. She did not tell me my antral follicle count, so I didn't know if the Clomid would produce 2 eggs or 10.

I took the 5 days' worth of pills, then suffered through another four days of waiting before we went back in to hear what the effect had been. The side effects were bloating and headaches that Tylenol couldn't touch, but everything was bearable because this time we felt in control. We were finally doing something to affect the outcome of this cycle.

Silly me, I am 41 years old. There were never going to be 10 eggs. The answer was 2. 2 follicles measuring 2.05mm and 2.15mm, perfect for a Clomid cycle (larger than normal). Uterine lining perfect. You will learn all of the numbers, all of the abbreviations, all of their meanings, all of their odds. The doctor doing the u/s was the same bitchy one from last cycle with the "uh, pregnancy" comment, but she was in a better mood. She reassured me this cycle was good to go, and I only needed to do b/w the next day.

The b/w technician was none too swift. She asked me my name, I gave her my health card, she asked me to confirm my name, and then she pointed to the computer screen and asked me a third time if that was me. Overkill! I sat down, rolled up my left sleeve and held out my arm, and she sat across from me and asked which arm I wanted to use. Seriously? As usual, when she saw the absence of veins she didn't believe this was the arm they would normally use, and I explained the right arm was worse. She asked, "Have you ever used the other arm?". I feel like I'm on Candid Camera.

As fate would have it, our IUI day fell smack into the middle of a long-planned cottage weekend with friends. We had no choice but to drive the 5-hour round trip back to the city and leave our friends to fend for themselves for the day. It was bizarre, terrifying, and exciting to know that this time there would be two eggs coming down the pipes. After months and months of emphatically stating, "I don't want twins", the thought of never getting pregnant now seemed a much worse fate. Suddenly, the very real possibility of ending up with twins felt like it could be a blessing as much as I'd thought it could be a curse. 

There is no way not to obsess, not to have all of this invade your every waking and sleeping thought. It is hard to focus at work, hard to have banal conversation with friends and family, and hard to not get your hopes up. We just resign ourselves to the process, sing a little Que Sera Sera, and hope for the best. Tiny nurse Bernadette did the IUI this time, and it was just as difficult and excruciatingly painful as always. Poor Bernadette apologized profusely for hurting me and for struggling for so long, and I apologized for my crooked cervix, and my wife apologized for me having to go through all this.

It is now 4dpo (days past ovulation), or 4 dpiui. I have obsessively checked the Internet for stories of early pregnancy symptoms, for percentages of twin pregnancies with Clomid, and for statistics of women over 40 with fertility treatment. It is not productive, and if I had one piece of advice for other women starting this process, it would be step away from Google. Step away from the forums, too. Although they can be a great source of support, there will always be someone with a good outcome, someone with a bad outcome, someone with an outcome you didn't even consider. It's not going to tell you how your story will end. You will spend precious hours looking for answers you can't actually find there, and in the end what you read will probably compound your stress levels. It certainly won't help you sleep better. 

I get overwhelmed with the number of stories that mention miscarriages, often multiple lost pregnancies, and often late in the game (10 weeks or even further along). At this point I can't even imagine getting a positive pregnancy test, let alone getting used to the idea of expecting a baby and then having the rug pulled out from under us. I know the chance of miscarriage at my age is high, and I know the chance of genetic abnormalities is also high, but it's impossible not to get our hopes up. This has to work.

I want to believe a happy ending is possible.

And so we wait. And we hope that we can add our photo(s?) to the baby board...

Evergreen Brick Works

On a recent Saturday morning, I made my usual trek to the farmers market at the Evergreen Brick Works, but with a different task at hand than obtaining the best lemon feta cheese in the city (truly, you have to taste it). Toronto photographer Edward Pond was hosting his first photography workshop there, free of charge, to anyone interested in hearing his approach to shooting food. The agency I worked for wanted someone to check out his talk, and I was happy to go.

Edward sharing tips © Shutterbug

Edward is a somewhat soft-spoken and unassuming man, rare in the industry to begin with but even more so when you consider the level of success he has achieved. Most of the people in the group appeared to be hobbyists of another generation, and I wondered how many of them actually knew of Edward. He began with a short, obviously unrehearsed presentation outlining his personal philosophies, which included the following useful tips: 1) Don't buy props and set up artificial scenes if you don't have to. Figure out how to shoot what's in front of you in an interesting way; include surroundings to tell more of the story and possibly find some humour. 2) Get in close to your subjects and try to engage them. Always be respectful and don't just "steal" photos of them without permission. Ask. 3) Think about and evaluate the light you're dealing with, move around the subject to see how the light falls from different angles, and try to consciously choose side or back lighting for addd interest. 

Edward even went so far as to fully answer each and every one of the litany of questions regarding his own equipment choices and preferred settings, offering a level of transparency that many professionals simply won't share. It's as if some photographers feel that by sharing their methods they are giving the competition a boost, whereas Edward seems to genuinely want to help people create the best possible photographs they can. Refreshing.

Lilacs on table  © Shutterbug

We made our way through the various stalls and vendors at the market, with Edward pointing out several objects that caught his eye. Sometimes we'd stick together in our small group and jostle for views at the same table, and sometimes we'd scatter to where our individual interests took us. I spotted a beautiful bunch of lilacs sitting on a table, and decided to start with this easy subject. It was a static scene that I could move around and experiment with my framing and exposure until I had what I wanted.











From there, I moved on to a display of the most unusual-looking radishes I've ever seen, with vendors who were more than game to allow us to descend on their merchandise and rearrange it for aesthetic purposes. I went in for a close-up that showed the beauty of the produce, then pulled back to show more of the surroundings, unattractive as they were. A cookbook publisher would only want a beauty shot, but an editorial article on the market or this farmer would want to include some "real" images that didn't appear staged. It was interesting to see how different everyone's take on the same scene turned out to be.

Radishes at Brick Works market  © Shutterbug

At this point I decided to separate from the group, who continued to poke through piles of lovely organic produce, and make my way to some of the stalls I normally frequent. The vegetables are indeed beautiful, but I'm more intrigued by the people who are selling their wares. One of my favourite booths is Ying Ying Soy Food, which sells organic tofu in a variety of flavoured marinades. The gentleman manning the table is quite passionate about his product, and has a small electric grill going with samples he excitedly holds out to people on toothpicks, demanding that they give them a try. He talks about how he created certain flavours, which ones are his daughter's favourites, and how best to enjoy his products. On this day my toothpick held something I hadn't tried before, which he offered as a blind tasting. As soon as I tasted it I exclaimed, "Oh! Tofu bacon!" He shook his head, explaining that he really didn't like the association with bacon, and named this particular product "Deli Slices". Smoked tofu. I got the distinct impression that he must be a vegetarian, and remembered to use the correct name when I went to make a purchase.

Ying Ying Soy Food table  © Shutterbug

At the end of the allotted hour, I thanked Edward for his time and his contagious enthusiasm, and made my way to a large display area at the far end of the market. A man by the name of Bernard runs his company ShelfLife Materials out of a workshop on site, breathing new life into old reclaimed wood. He is committed to sustainable building practices, and offers clients a wide variety of finished products in addition to supplying raw materials to other designers and builders. Today he had quaint little birdhouses, beautiful polished slate chalkboards, a filing cabinet I was already mentally placing in my office, and a stunning bench I could easily see in my garden. I had to hold myself back from just handing over my Visa. I'd love to follow Bernard through the process of creating one of his pieces…perhaps if I ask nicely he'd let me shadow him.

Bernard of ShelfLife Materials  © Shutterbug

Filing cabinet at ShelfLife  © Shutterbug

It was a productive couple of hours, and I'm reminded of why I love this city. You can travel just minutes, blocks, or even feet from where you live and find cool stuff, meet interesting people, and learn something new. And it doesn't have to cost a dime!

Starbucks Redux

The clientele at our local Starbucks are always a source of amusement, frustration, and disbelief (see previous post here).

Yesterday was a rainy Sunday, and I needed a good coffee to sustain me through a photo shoot at a derelict house. Pleased to find just one person ahead of me in line, I figured I'd be in and out in a flash. Such optimism after so many years!

The woman ahead of me had two boys with her, aged 9 and 11 I would guess, and had ordered herself a coffee, and hot chocolate for them. I waited while she fumbled with her money and continued to stand at the register long after her order was complete. Then I waited at the pick-up bar while she multi-tasked, trying to taste her coffee, hold her phone, and talk to her kids. The shaggy-haired boys were as slow-moving as their mother, and took their sweet time leaving the counter area as they licked the whipped cream from their drinks.

By now both myself and another man behind me had our coffees, and had to wait while the boys took up the entire milk station. They were shaking sprinkles onto their drinks, pausing and laughing, and it took a moment for it to register with me what was taking so long. I suddenly noticed their mother standing off to one side, holding up her phone...and I realized she was shooting a video. She could clearly see two people were waiting to get some damn milk for our coffee, and she was shooting a video of her kids putting sprinkles on their hot chocolate. Like the good Canadian I am, I resisted losing my shit on her.

I eventually drove off on my photo mission, but ran into roadblocks set up for the Good Life marathon. Instead of a ten-minute drive, I had to take several detours and fight traffic for thirty minutes to reach my Riverdale destination. As I gathered the tools of my trade before entering the house, I realized that I had memory cards, a tripod, lenses, a flash, and a spare towel (for kneeling on filthy floors)...but no actual camera. OMG.

At least I had a good cup of coffee to see me through the return trip.

Overheard at Loblaw's

My wife stopped into Loblaw's to pick up a couple of things on a busy Saturday, and saw an elderly lady getting out of her car in the parking lot. The woman dropped a couple of items, including a cane, but before my wife can offer assistance another woman stepped in to help.

Once the senior was back under control, seemingly quite unsteady and frail, the younger woman comments on the bright orange bow that is tied to the older woman's cane. "Oh, is that so it doesn't get mixed up with other people's canes?" she asked. "No," the elderly woman replied, "it's so that I can see it."

Anyone catch that license plate?

Where Are My Keys, I've Lost My Phone

A lyric that Lady GaGa could have written for my lovely, if organizationally-challenged, wife.

We recently had the sort of week that left us shaking our heads, and wondering how there can be so many souls out there seemingly without a conscience.

Hoping to enjoy some fresh air on a clear spring day, I ran home on my lunch hour so that my wife and I could take our two dogs for a walk. We only had about twenty minutes, and just did a short route on the streets around our home. Our conversation covered the many decisions we're trying to make, how strained we feel right now both in terms of time and budget, and what we can do to reduce our stress. Most of it comes down to money, which I think is pretty common for married couples–even those who aren't spending thousands of dollars trying to make a baby, or caring for sick pets.

Shortly after returning from our walk, my wife realized her Blackberry was gone. Panicked, she retraced our steps in full in less than twenty minutes, but there was no sign of it. We did the route again later when I got home from work, and then tore our house apart to be certain her Crackberry wasn't mislaid somewhere indoors. It was gone, and the only explanation that makes sense is that it somehow fell out of her pocket on our walk without us noticing, and someone picked it up. It was fully charged and had plenty of contact names and personal information for anyone who found it to try to contact us, but no one called.

We placed ads on Kijiji and Craigslist offering a $300 reward, even stating that we'd be happy to just get the memory card back. If someone was that desperate for a used phone, they could keep it. One of the first responses my wife received to the ad was from someone who said they'd found a Blackberry in our area, and they would "let her have it back" for $600. We asked what the screen saver photo was to confirm it was hers, but got no response. Charming. We had no choice but to incur the unexpected expense of replacing the phone, but there was no way to replace the information on it that wasn't backed up.

A few days later, I realized that a credit card number was stored in a memo on the lost phone, so I went online to check my statement. Lo and behold there were two charges from a gas station in Scarborough that I'd never been to, dating back two weeks. This had nothing to do with the lost phone, I was able to connect it to visiting my mom in hospital, and using the card at the parking machine (which I noticed was out of order the next few days that I was there). What kind of evil person defrauds people trying to help sick relatives?! More time was lost dealing with the credit card security people, but the charges (including pending ones I didn't yet know about) were reversed relatively easily, and I was issued a new card. I lost a little more faith in people's innate goodness.

As if this weren't enough, we finally decided it was time to spend the last bit of money we'd received for our wedding, which were two $50 bills a friend had folded into origami hearts and stuck inside a picture frame. We carefully unfolded them, tried to use them for a purchase...and discovered they were counterfeit.

It's sad to run into this much dishonesty in the space of just a few days. I struggle with the idea of how I will raise a child to believe the best of people, be savvy enough to recognize when a person is bad, and not let it bring them down when they encounter a deviant. And how to stop my child from ever becoming one of the deviants...

Down By A Taz

Taz  © Shutterbug

The House of Doolittle has shrunk by one.

This was our Taz less than a month before we had to let him go, being the good sport he'd always been for my camera. An ad agency client from work wanted to see photos of a black and white cat licking its lips, so I came home and tried to take some new photos of Taz to send in for the job. He happily ate several treats in my studio, but slowly lost interest in my quest. I ended up giving the client a few older photos I had of him in my archives.

Over the next couple of weeks our boy's respiratory infection grew worse, and he began to lose weight. We were out of options with regard to antibiotics; nothing was working (see previous post here). His breathing was laboured, and he was frequently blowing green snot bubbles from his nose. 

As a last resort we started him on steroids, hoping this would give him just one more remission to enjoy life again. Sadly, this isn't how it turned out. After five days of waking up in the morning to find his nose crusted shut, wheezing and rattling and growing thinner by the day, we knew we'd reached the end of the road. Our vet was the kindest and most devoted caregiver we could have asked for, and he agreed to come into the clinic on his day off to help us say goodbye to Taz.

The same afternoon we made this sad appointment, the advertising client from a couple of weeks earlier called to proceed with purchasing the photo of Taz. The timing was so eerie and emotional – almost as though Taz wanted to help us pay for his final vet bill.

I couldn't sleep that night at all. I sat up reading with Taz on my chest, stroking him and listening to his purr still rumbling away. I counted the hours as they passed, and had a good cry. I took him to the kitchen sink for frequent drinks from the tap now, house rules be damned. The sink where he'd previously gotten into such trouble for kicking dishes to a spectacular crash on the floor was now his domain.

When I went to the bathroom, Taz surprised me by jumping in the tub and proceeding to playfully bat the shower curtain, then stare at me. I wasn't sure whether he was trying to tell me it was okay, or giving me a guilt trip.

Taz in the tub  (c) Shutterbug

Morning came, and although it was cold, it was a beautiful day with bright sun. Taz has always been an indoor cat, but loved to sit at the back door and try to sneak outside with the dogs whenever possible. Sometimes he made it to a safe haven under a bush or the barbecue, seeming quite pleased with himself. This last day we walked him out in our arms to let him enjoy the sunshine.

Then our hearts broke as we said goodbye to this member of our family; my wife's companion of 17 years. He knew things about her that even I will never understand. I am so happy to have known him, because he was truly a wonderful animal filled with personality. He was there for my wife when she had little else, and saw to it that she made it through to a happier place. 

Thanks for being the bridge, Taz. We love you.