Looking To 2011

I’m loving the quietness of work this week. Most of my team is out, I have my music on, and occasionally work friends pop their head into my area for a refreshing holiday tete-a-tete. We whisper because it’s so quiet.

The holidays were festive and fanciful, but I felt not all there. This sense of sadness and loss (over one measly failed IVF cycle – I know) has left me shaken. One down, one to go. On the verge of tears is my perpetual state and I cannot say enough about Matt. Poor Matt, who is going through this too, and who holds me at night and lets me have my “And you know who I saw on Facebook who is pregnant now too?!” moments, has taken this – all of it – in stride. We are perfectly matched because I am brash and high-strung and can tumble from happiness to tears in .2 seconds and he is, simply, the most even-keeled, pleasant, and optimistic person I know. Nary in a bad mood, his goodness (to me, to others) doesn’t surprise me anymore. He says I color his life…and I suppose that is one way to put it. How very fortunate I am.

So it’s interesting to see this happy-go-lucky guy upset too. When we found out this cycle wasn’t going to work I cried and cried and later exclaimed, “Aren’t you going to cry too? Aren’t you upset?!!” and he informed he did cry – I guess I was too weepy to notice. He still says everything is going to work out, and still talks about us having children, but now adoption references sprinkle these conversations more and more. I say I’m scared because that process if far from easy, and so long, and expensive, and what if we aren’t chosen, and what if it always falls through for us, and …and…and. With resoluteness he holds my hand and says it will happen, and he makes me believe it.

They say this process and all its ugliness (the emotions, the money, the stress, the hormones) deepens the cracks in any marriage, but I have not experienced that. With Crohn’s, I feel wholly alone. Yes, he chides me when I eat something on the “no” list, or asks if I took my medication, but the pains that make me question if I’m leaving this blissful period of “remission” are only felt by me. Heck, it’s nice not to be alone in your misery. We both want children so badly so there is nothing but tenderness when anything baby is mentioned. (And the occasional groan as he submits eyebrow-raising baby names, from the likes of “Willard” to “Samson” – I kid you not. He has since lost his naming rights.)

It’s with this mishmash of emotions I look forward to 2011. I know we have it good (or at least that's what I tell myself every day to ward off the tears), but I’m hoping for resolution. And for greatness.

Letters on 22nd Street

I am officially in the holiday spirit. Last night Matt and I watched Love Actually (the Colin Firth vignette is my favorite) and then I saw this and it really made me smile:

And The Beat Goes On

"The English language lacks the words to mourn an absence. For the loss of a parent, grandparent, spouse, child, or friend, we have all manner of words and phrases, some helpful, some not. Still, we are conditioned to say something, even if it is only "I am sorry for your loss." But for an absence, for someone who was never there at all, we are wordless to capture that particular emptiness. For those who deeply want children and are denied them, those missing babies hover like silent, ephemeral shadows over their lives. Who can describe the feeling of a tiny hand that is never held?"
~Laura Bush


I don’t want to be schmaltzy or melodramatic – and I never thought I’d have a Bush quotation on this blog! – but I thought Laura Bush’s comments in her recent memoir summed up – so accurately – how I feel. And I cry every time I read it.

Matt and I had such high hopes for our IVF cycle. I tried to temper my enthusiasm but didn’t sleep Thursday into Friday – the day of our egg retrieval – and was giddy on the drive to New Jersey. During my ultrasound before the procedure they saw 22 eggs – 14 of them ended up being viable and I jokingly said they better be “big and juicy” and the ultrasound tech and I laughed. Everyone I came into contact (oh, those poor nurses, the embryologist, the two anaesthesiologists) heard me chirping way about how this was my first time, and I had lots of eggs, and everything looks good, right?! And then there I was in the procedure room, in stir-ups, oxygen in my nose, an IV in my hand, and the doctor walks in and says, “I’m concerned about your estrogen levels; they are at 900 and they should be around 1500,” and then I was asleep.

I love anesthesia. Perhaps that’s an odd thing to say, but I love the peace of it. I’m never nauseous or groggy afterwards - just rested. I always try to pinpoint exactly when I go under – on Friday I said with verve, “I can still hear you!” and they responded “Not for long!” and that was the last thing I remembered. I woke up and they were helping me into a wheelchair, and then into the recovery bed, telling me they extracted 14 eggs and I was happy - even with low estrogen (which affects fertilization) I thought some of those had to fertilize and heck, let’s go get some lunch, which we did.

On Saturday they called to tell me eight of the eggs had successfully fertilized and they were freezing four. On Sunday they called and of the four remaining, three were still viable at the two-cell stage. It was then I started getting nervous: why haven’t they divided any further? But our ET was scheduled at 9:30 the following morning, and we left at 7:30 to beat the traffic through the city and I joked about how I was going to run Matt ragged while I was on bed rest and how – if this all worked – we wouldn’t tell our child they came from a stork, but a petri dish (we find this endlessly funny), and with that we crossed the Betsy Ross Bridge into Jersey.

I received a call when were five minutes away: our eggs have not split since yesterday, and they were still only two cells, and they were not likely to ever split again. Our transfer was canceled. On the phone with the embryologist I was almost chipper – or at least pleasant. I motioned for Matt to turn the car around, hung up, and then cried. I’m not going to say I have it awful, because I don’t. I’m not going to say how horrible my situation is, because I know it isn’t. But I will say I sobbed – big, loud snot-filled sobs full of anger and frustration and worry, and didn’t stop until we were ten minutes from home. At first we said we’d go to work to take our mind off it, but as I started crying – staring in my closet at work ensembles –we decided we’d spend the day at home, exchange our Christmas presents, and just be.

And we didn’t lay in bed and wallow: we went out to lunch, mocked Oprah during her “Favorite Things” episode (we were particularly aghast one of her favorite things was a $120 can of popcorn and then $200 leggings – really?!), and made dinner. Work today has been harder: I could not smile or make chitchat through a holiday lunch. My head is heavy and I am exhausted. With one cycle in the bucket, we know we only have one left. We don’t know what this all means: will this always happen? How common is this? Can we change the protocol to combat this? What happened to my estrogen levels on that last day? Statistically, how viable are those four frozen eggs because it costs a hell of a lot of money to thaw them? I have so many questions but our appointment isn’t until January 7th. We are going to take the next month off. We first wanted to plow through – to be done with this whole process by early spring – but I’m tired and defeated. This process is dehumanizing: every other day I’m at the office, in line for an ultrasound, in line for blood work, legs spread, arm extended. My menstrual cycle has dictated our last six months. Every other afternoon I wait for the call with my blood results and next steps. Every other morning I drive the hour to the office. Every night and morning I take my oral medications, my shots. Hell, I’m beat.

Matt keeps saying we have each other, and I know that is so true, but that doesn’t stop me from every day wanting so much more.

Here Goes

It’s been a whirlwind week of doctor visits and medications, phone calls and directions. Tomorrow I will be going in for our egg retrieval / beginning of fertilization process. We have 15 viable follicles, which is excellent – given my age I responded well to the medication. For once, my body totally kicked ass!

I’m honestly much more anxious for this than my re-sectioning surgery last spring. Once that decision was made, I was at peace. We have so many hopes and “what if’s” this time around coupled with finite chances. I’m trying to temper my optimism because what if I wake up tomorrow and I learn my eggs are duds? Or many of my follicle sacks were empty? Or things aren’t fertilizing well? It’s hard to make yourself have low expectations – frankly, I think it’s a bit futile because I was eyeing cribs at Target this week and dreaming up nursery layouts, all in a hazy baby bubble in aisle 14.

What will be, will be. I know we’ll make it through it, whatever the outcome. It’s actually nice to go through this during the holiday season: High spirits? Hope and joy? Sounds just about right.

Scrambled Eggs

Last Monday night, when I got the go-ahead to begin my new round of meds I loaded my pen like I was told, attached a syringe, and plunged the thing into my belly.  Just like an insulin pen, you determine how much medication you want to dose out, dial the pen to that number, and then push.  Like the dutiful student I did this, but nothing moved.  "This thing isn't working!" I hollered at Matt.  You need to turn it, he said. Starting over, I removed the syringe and inserted it again.  Still didn't budge.  Then again two more times sticking it into a different part of my stomach flesh.  I don't think you're suppose to constantly remove a syringe and then re-insert it, but hell, I was tired and frustrated and a little more dimpling on my abdomen wasn't going to hurt a thing.  Finally Matt grabbed the pen out of my hands, inserted it, and well, turned and pushed down.  "Like this, K," he said, irritated (which says a lot because this boy does not get irritated).  Oh.  Okay.

And so we have begun our IVF medications.  Because of my questionable mental capacity, Matt now gives me my shots every morning and night.  "Get up, get up, get up, it's shot time!" I say as I nudge his back, already on my feet and dressed. I think Matt finds this particularly annoying as I get up a good hour before his alarm crows but I tell him, "This is how you become involved in the process!"  "Umf," he says.  He then scurries downstairs to the refrigerator for the meds and hands me an alcohol wipe as he attaches a syringe.  His eyes are still closed for most of this.

Every ultrasound tech I have says some variation of the same thing: "I don't know how they're gonna get to that right ovary!"  Apparently, the thing is practically ensconced in bowel and I'm known as the "Crohn's girl" at the office.  Actually, it's more like this: they stick the ultrasound wand in and then say, "Ohhh...you're the Crohn's girl aren't you?" as they fumble around to find the things and then say I'm "gassy" for the fifth consecutive time.  I relayed this to the doctor who told me to relax, the ovaries drop when they are full with follicles and anyway, they can sort of move things around in there when I'm on the table.  If worse comes to worse, they can go through your abdomen for the retrieval (they usually go through the vaginal wall which I think is just as unsavory).

I have 12 eggs that are or will be a viable size and several more that are too small (but I am hoping they catch up between now and the egg retrieval).  That's a good number but, of course, I wanted to push the envelope and get closer to 20.  Of the eggs extracted there is no way to tell at this point which ones will be - for the lack of a better term - grade A and actually fertilize. 

I return tomorrow for monitoring (blood work and an ultrasound) to see how those suckers are growing, but right now my egg retrieval (ER) may very well be this Friday or Saturday. My embryo transfer (ET) could be anytime from 2 - 5 days later, with two days of bed rest following.  By then it will almost be Christmas, and I'm thankful for the hoopla and distraction.  And, frankly, I'm sick of this baby-making business!  (As I'm sure you are too!)  Here goes! 

Drop It Like It's Hot!

I don't go for artistic subtlety in my clip art.

Yesterday I got Matt to say we can have another dog if we can’t have a child. True – I was crying and I think he wanted me to shut-up before the Eagles game – but I’ll take what I can get. (And I don’t think I’ll want another dog, but I like to threaten him with it, as in, “All you do is code! All day and all night! Well, if you want to code all day long then I can adopt another dog!”) True, one thing has nothing to do with the other, but I don’t work like that.

Our last IUI result was negative, which of course was expected but I still secretly hope nonetheless. I protect myself by making jokes, brushing off the possibility of pregnancy, but every ting down below makes me stop. And hope. Usually I don’t change my habits after an IUI – if I want to lift a heavy bag I lift it. If I want to drag my bajunk-a-junk on a short jog, I do it. This time I didn’t do any motions that straining my mid-section but, alas, it didn’t work. The upside? At least Matt carried my laundry downstairs.

I’ve been doing well with everything until this week. This week it all hit me: the cost, all the injectables, and what I’m putting my body through. I learned that getting $1,000 worth of meds free was getting three days of meds for free. I need a 10 day supply. Things like that make you suck in your gut and never exhale.

I spent two hours on Wednesday on infertility forums looking for cheap meds sold by women who got pregnant, or who stopped trying. The price differential is staggering, but I didn’t feel comfortable buying who-knows-what and taking that risk. I’m sure that will change a couple months down the road and this becomes old hat. Although, of course, I hope it never does.

An inordinate amount of stress and pain in infertility derives from the cost of it. It’s with this in mind that I want to disclose the money factor – the crux of this insurmountable mountain – that has taken my breath away (oh, and I WISH in the good way!).

My infertility practice has “affordable” rates. The cost of full-stimulation IVF (sans meds and all the extras, and there can be a lot of extras) is $6,500. The practices down the street from me are $10,000. That is why I drive. Anesthesia is separate and comes to $550. The medications are anywhere from $3,000 to $4,000 per stimulation cycle (the cycle when they extract your follicles, or, eggs). So, one cycle of IVF, for me, is a cool 10K. That doesn’t include if they find out the sperm cannot penetrate the egg and they have to perform ICSI, which is the intracytoplasmic sperm injection of eggs, at a cost of about $1,100. If I am fortunate and have frozen fertilized eggs, each subsequent cycle with those eggs will be about $3,000 for the medical procedure. At the end of this year my insurance will no longer cover my myriad of monitoring ultrasounds and blood work, and I will have to buy a “package” of 16 services for $1,300. This will hopefully be stretched to last two cycles.

So, you can see, even oodles of money will only get you so far. We refuse to go into debt so we will spend what we have and then – it’s over. We then start saving for adoption. And I type that so easily: “we refuse to go into debt” but how tempting will it be – if it doesn’t work – to say, just one more cycle? One more try because this could be it? And that’s what terrifies me. The emotional tug and pull. I can only hope – if we are not successful – that I am so tired of the poking and prodding, the needles, the driving, that I am at peace with saying, “No more.”

We are not spendthrifts, but when I look at all of this I wonder why we didn’t further alter our spending habits this past year – how can you not? If we didn’t go on our two mini-vacays and I stopped buying that stupid aged Parmesan, and I didn’t go to the gym, and banned Target, could we have saved almost another $5,000? $10,000? Matt reminds me that’s no way to live, which is why we’re starting our budget after the holidays. So come January 1 if you see me buying those heirloom tomatoes or the organic coffee, or good god just heading into Target, give me a good strong slapping so I'll come to my senses. I'll thank you for it.

Gobble Gobble

"Give me some turkey, human."

I hope everyone had a fabulous Thanksgiving and you enjoyed your stuffing, or filling, or dressing, or whatever they call it in your neck of the woods.  Since we hosted our very first Thanksgiving, there was much preparation underway.  Here's a pictorial of the build-up to the feast:

Matt declared that no one shall be cold at our holiday get-together.  And I think he just really likes blowing insulation.  Here he is looking like an alien (I like that in a man).

While he was busy insulating our house I prepared by eating these pumpkin cheesecake bars.  I took my job very seriously.

OK: now we're getting down to business.  Matt just unwrapped our turkey and is fondling it.

He looks confused as to what to do next.  It took him like 10 minutes to find with bag with the gizzards and such.  (Turkeys are a new thing for us.)

Then the turkey had to get a bath.  We decided on Alton Brown's (recipe below) turkey recipe and brined that sucker overnight.  Here it is sitting in it's bath of ginger, allspice, veggie broth, and other yummies. 

While Matt's bathing beauty was soaking, I made some spiced pecans in the microwave.  Super quick and super delicious (recipe below).

Cue the Hallelujah chorus!  The turkey is magnificent!

"Yeah; I made that."

Action shot of Matt trying to figure out how to cut a turkey.  My mom finally had to intercede.

Time to eat!

5-Minute Pumpkin Cheesecake Bars

• 1 (16 ounce) package pound cake mix
• 3 eggs
• 2 tablespoons butter or margarine, melted
• 4 teaspoons pumpkin pie spice, divided
• 1 (8 ounce) package cream cheese, softened
• 1 (14 ounce) can Sweetened Condensed Milk
• 1 (15 ounce) can pumpkin
• 1/2 teaspoon salt
• 1 cup chopped nuts (optional)

Directions

1. Preheat oven to 350 degrees F. In large bowl, on low speed, combine cake mix, 1 egg, butter and 2 teaspoons pumpkin pie spice until crumbly. Press onto bottom of 15x10-inch jellyroll pan.
2. In large mixing bowl, beat cream cheese on low until fluffy. Gradually beat in sweetened condensed milk, then remaining 2 eggs, pumpkin, remaining 2 teaspoons pumpkin pie spice, and salt; mix well.
3. Pour over crust; sprinkle with nuts. Bake 30 to 35 minutes or until set. Cool. Chill; cut into bars. Store covered in refrigerator. 

*********

 Easy Microwaved Spiced Nuts

• 1/4 cup butter
• 1/2 cup brown sugar
• 1/2 teaspoon ground nutmeg
• 1 teaspoon ground cinnamon
• 2 tablespoons water
• 3 cups pecan halves

Directions

1. Melt butter in a 4 quart glass casserole dish in the microwave. Stir in the brown sugar, nutmeg, cinnamon and water. Microwave on high for 1 minute. Stir in the nuts so they are well coated. Microwave for 4 to 5 additional minutes on high, stirring every minute. Spread cooked nuts out onto parchment or waxed paper to cool. 

 **************

 Alton Brown's Terrific Turkey

Ingredients

• 1 (14 to 16 pound) frozen young turkey  

For the brine:

• 1 cup kosher salt
• 1/2 cup light brown sugar
• 1 gallon vegetable stock
• 1 tablespoon black peppercorns
• 1 1/2 teaspoons allspice berries
• 1 1/2 teaspoons chopped candied ginger
• 1 gallon heavily iced water

For the aromatics:

• 1 red apple, sliced
• 1/2 onion, sliced
• 1 cinnamon stick
• 1 cup water
• 4 sprigs rosemary
• 6 leaves sage
• Canola oil

Directions

2 to 3 days before roasting:


Begin thawing the turkey in the refrigerator or in a cooler kept at 38 degrees F.


Combine the vegetable stock, salt, brown sugar, peppercorns, allspice berries, and candied ginger in a large stockpot over medium-high heat. Stir occasionally to dissolve solids and bring to a boil. Then remove the brine from the heat, cool to room temperature, and refrigerate.


Early on the day or the night before you'd like to eat:


Combine the brine, water and ice in the 5-gallon bucket. Place the thawed turkey (with innards removed) breast side down in brine. If necessary, weigh down the bird to ensure it is fully immersed, cover, and refrigerate or set in cool area for 8 to 16 hours, turning the bird once half way through brining.


Preheat the oven to 500 degrees F. Remove the bird from brine and rinse inside and out with cold water. Discard the brine.


Place the bird on roasting rack inside a half sheet pan and pat dry with paper towels.


Combine the apple, onion, cinnamon stick, and 1 cup of water in a microwave safe dish and microwave on high for 5 minutes. Add steeped aromatics to the turkey's cavity along with the rosemary and sage. Tuck the wings underneath the bird and coat the skin liberally with canola oil.


Roast the turkey on lowest level of the oven at 500 degrees F for 30 minutes. Insert a probe thermometer into thickest part of the breast and reduce the oven temperature to 350 degrees F. Set the thermometer alarm (if available) to 161 degrees F. A 14 to 16 pound bird should require a total of 2 to 2 1/2 hours of roasting. Let the turkey rest, loosely covered with foil or a large mixing bowl for 15 minutes before carving.