Country Roads

Aaron & I are driving to West Virginia, almost heaven, to visit his family over the holiday weekend. I'll try to post some pictures from this trip and our trip to Canada when we get back next week!

Diagnosis & Treatment

Or, how I acquired a new vocabulary.

Here's the synopsis (if you haven't already heard, or if you want a review).

I've been diagnosed with a luteal phase defect (LPD). This means that my post-ovulatory progesterone levels are too low, and my luteal phase is generally too short. Progesterone is the hormone that a woman's body produces after ovulation to sustain any pregnancy that might occur. The luteal phase is the part of a woman's cycle between ovulation and menstruation. Since my progesterone levels are too low, my luteal phase does not last long enough for a fertilized egg to implant in my uterus. Therefore, no pregnancies.

The fertility specialist - let's call her Dr. Peppy - wants to try treating my LPD with Clomid. Clomid is a medication that is taken orally and that stimulates hormone production by acting as an estrogen receptor blocker. Crash course: In the first half of her cycle, a woman produces higher levels of estrogen and follicle stimulating hormone (FSH) that gear the body up for ovulation. Follicles around the eggs start growing, and whichever one gets biggest fastest wins the prize of releasing the egg at ovulation time. After releasing the egg, the follicle turns into the corpus luteum, attaching to the fallopian tubes and telling the body to start progesterone at higher levels. Got it? (Isn't the intricacy of God's creation of the human body amazing?!) The theory behind treating LPD with Clomid is that, even though my estrogen and FSH levels check out fine, something is going wrong with my follicle/corpus luteum that is in turn producing insufficient progesterone. In my case, Clomid should have a kind of domino effect: Clomid boosts estrogen & FSH production, follicles grow bigger, ovulation is stronger, corpus luteum functions better, progesterone levels increase, luteal phase lengthens, and conception & implantation can actually occur. (We hope!)

So, now that preliminary testing and that throw-us-for-a-loop Rubella vaccine are complete, I am eagerly awaiting my next cycle to start so that I can begin Clomid. Here's the plan, for those of you who want the details:

Day 1
call Dr. Peppy's office to report start of new cycle (probably July 4/5)

Day 3
ultrasound & blood-work done to make sure all systems are go before giving the Clomid prescription

Days 3-7
take Clomid pills

Day 11/12
ultrasound to see if ovulation is about to occur (could have repeat ultrasounds a couple days later if ovulation is not impending); endometrial biopsy to make sure Clomid is not thinning my uterine lining

Day 21
progesterone blood-work, to see if Clomid has indeed boosted those levels

Please join with Aaron & me in praying for this cycle. Pray specifically that I will not experience some of the nastier side effects of Clomid, and pray that we will conceive! Pray also that my trust and hope will be in the Lord, and not in a doctor or a medication. I want to be optimistic that Clomid will help, but I also want to be realistic that we still may not get pregnant right away. I am so grateful for your prayers, and for how you share in our trials and hopes!

"May the Lord answer you in the day of trouble! May the name of the God of Jacob protect you! ... May he grant you your heart's desire and fulfill all your plans! May we should for joy over your salvation, and in the name of our God set up our banners! May the Lord fulfill all your petitions! ... Some trust in chariots and some in horses, but we trust in the name of the Lord our God."
Psalm 20:1-2, 4-5, 7

Fruit of the Spirit, If Not of the Womb

As I come to describing my experience of infertility in the current year, it gets harder to be concise. In an attempt to focus, I'll approach this topically rather than chronologically.

Physical/Medical Aspects
In January, I had more preliminary blood-work done by my OB-GYN, to check my progesterone levels. I was concerned those would be low, based on personal observations of my cycles, but I was told the results were normal. At that point, Aaron & I decided to wait before pursuing further medical options, as tests started to get more invasive and we did not feel ready to take those steps yet. At an annual check-up in March, I discovered that my progesterone levels, although technically within the generic normal range by one-tenth of the measurement unit, were significantly low for post-ovulatory testing. My OB-GYN referred us to a fertility specialist, and we had our first consultation there in May. Some details of tests & treatments since then are already on this blog; more are forthcoming (including a summary of my diagnosis and our medical plan).

God's Word
In January, a guest speaker at our church gave a message on God's word. As he spoke, I realized with gratitude how precious the truths of the Bible have become to me through this trial. It could have been just the opposite; suffering could have turned me away from God's word, but instead it has drawn me further into it. I read Psalm 119 around this time, and I was astonished to realize that this long psalm is not just about God's word, but about how God's word applies and comforts and sustains His people in the midst of affliction and trouble. People's words will be imperfect and inadequate at time, but God's word will never fail me.

Jealousy & Self-Pity
These have definitely been my two besetting sins during this season. By God's grace, I have finally started to see some fruit born in the fight against these sins over recent months. I was greatly helped at a women's retreat with Carolyn Mahaney, through her messages (which can be downloaded here, here, here, and here) and through the time she kindly took to speak with me and a friend personally about the struggles of infertility. She encouraged me to pray for those of whom I am tempted to feel jealous, and she also suggested reading materials on the topic of suffering (through which I am gradually working my way). A couple posts on envy from the GirlTalk blog also helped me to gain conviction and equipped me for the battle against sin. I still sin in jealousy and self-pity frequently, but through God I am seeing my sin as more serious than my suffering, putting those sins to death, and putting on love and kindness in their place.

Desire for Children
The Lord has definitely refined my desire for children over the past two-and-a-half years. My initial yearnings for children were probably more characterized by selfishness: wishing to have a cute baby to cuddle, to share the experience of pregnancy with friends, to have a share in the conversation with other mothers, to have funny kid stories to share, to prove what good parents Aaron & I would be. Those wishes still crop up occasionally, but mostly they have been replaced by the desire to see God's faithfulness shown to the next generation, the hope of raising children to know Him, to be transformed by the gospel, and to bring glory to the Savior. I have also come to see this time of waiting for the blessing of children as an opportunity for prayer and to see the Lord work. My eyes have been opened to see how God delights to work through barrenness; look to scripture's record of how many great servants of God were born to barren women! Isaac, Jacob, Joseph, Samson, Samuel, John the Baptist... This is not to say these men were perfect, and it certainly does not mean that children who are easily conceived are less special or less likely to bring glory to God. But infertility does mean I have time to invest a lot more prayer into my unborn children than I would if we conceived right away. And I think infertility also leads me to realize more fully that any children we conceive belong to the Lord, and not to us.

I still have plenty of thoughts buzzing around, but I think I'll end my summary of the road into the valley of infertility here. I've brought things up to date, reminded myself of what God has done and is doing through this trial, and now I feel ready to just keep sharing what I am currently experiencing and learning. I'll give an update on medical plans soon, since the Rubella vaccine should be out of my system and we're gearing up to start the first round of treatment.

Overwhelmed to Entrusted

Medically, our first consultation with my OB-GYN got the ball was rolling toward a diagnosis of infertility. I had some initial bloodwork done; Aaron had a semen analysis. So far the results looked fine, so we were still unsure what was keeping us from conceiving.

Spiritually and emotionally, late fall 2005 found me sinking into a pit. Those months were especially trying, and December found me overwhelmed with sorrow and sin. That month brought the death of dreams. We were not going to celebrate Christmas with a baby; we weren’t even pregnant! Our first year of trying to conceive had yielded nothing. Friends that I expected to be pregnant with gave birth to their newborns. Other friends announced their pregnancies. I don’t even remember everything that happened that month, but I remember feeling like I was being dealt blow after blow to my hope for having children. I was grieving.

A turning point came as a result of a Christmas party in mid-December. Leaders of the church gathered together to celebrate. I was expecting to enjoy the time with some of our closest friends. But then one pregnant woman after another arrived at the party. I knew those ladies would be attending, but I hadn’t computed how many would be in one room with me! I think about half the group was expecting, and all I wanted to do was run and hide. It was a miserable evening. I took a huge nose-dive into self-pity and stayed there. After dinner, we went around the table sharing something we were encouraged about from the past year; every other couple mentioned the gift of the baby on the way. When it was my turn to share, I said something about our care group, but internally I was thinking, “I have nothing to be encouraged about! God is not blessing me! He has forgotten about me!”

On the way home from the party, Aaron asked how I was doing and I told him truthfully. I was completely overwhelmed. I knew I was sinning in a thousand ways – pride, unbelief, jealousy, self-pity, impatience, lack of contentment, etc. – but I felt absolutely stuck. I felt like the pain of not being able to conceive was leaving me no other options. There was too much pressure, too many temptations, and I didn’t know where to begin to fight against it all. I was ready to throw my hands up in despair.

My wonderful husband suggested that I just pick one area of temptation to focus on; he even helped me pick which area (yes, I was that paralyzed by my struggles). He suggested that I specifically focus on the jealousy I felt around pregnant women, that I find one Scripture verse to call to mind in those moments. “One bit of truth for one bit of life,” as we had been taught at a conference in the fall. My dear husband went even further; he spent his devotional time the next morning looking for Scriptures for me. He pointed me to 1 Peter 3, which I read and then kept reading through chapter 4. Verse 19 stood off the page: “Therefore let those who suffer according to God’s will entrust their souls to a faithful Creator while doing good.”

O, what sweet help and consolation came to me through those words! Was I suffering? YES! I didn’t have to ignore that fact or try to cover it up. But my suffering was according to God’s will. For reasons that I didn’t (and still don’t) understand, His loving plan required that I endure this trial. And this God who willed my suffering is a faithful Creator. A God who saved me. A God I could trust not to forsake me as I waited for the creation of a new life. So what do I do in the face of temptation to jealousy of other pregnant women? I don’t run away, I don’t try to escape, but I entrust my soul to the Lord. He is my refuge and shelter in which I can hide, even as I remain in a difficult situation and fight temptation. But it doesn’t stop there. He also calls me to do good, even while I suffer. I need to pursue kindness and love towards those that tempt me to envy. 1 Peter 4:19 has become a bedrock verse for me throughout this trial. (By the way, that’s where I got my blog title.)

A trip to visit family and friends in Texas for the holidays brought a very welcome respite to the onslaught of temptation, and I returned home for the new year hopeful for what God would do in 2006.

Hope Deferred

So we come to September 2005. How I longed to give Aaron the birthday gift of a pregnancy announcement! Instead, I got the gift of finding out two close friends were pregnant within two weeks of each other. Friends who got married after us. Friends who started trying to conceive after us. I was genuinely happy for them, but I was devastated for myself. I sobbed uncontrollably after both announcements. (I used to not be much of a crier. Now the waterworks can flow on an almost unlimited basis.) My desire for a child physically hurt, and I was convinced that something was very, very wrong. Why was God choosing to bless everyone but me?

In my desperation, I found the cross of Jesus becoming sweeter to me. I was suffering; my Savior knew what it was like to suffer much more horrifically that I will ever know. I felt abandoned by God; on the cross, Christ truly was abandoned by His Father so that I would never have to be. I was in emotional turmoil; Jesus bore punishment in order to bring me peace. I was in the midst of a crisis; the salvation purchased for me on the cross solved the greatest crisis of my sin against a holy, perfect God.

Around this time, I was given a copy of the CD WorshipGod Live. I listened to it for the first time in the car, and when I reached track 3 I almost couldn’t see the road through my tears. (Thankfully I was only 3 blocks away from my destination, the post office!) The song “Count It All Joy” met me right in the midst of my pain, the truthful antidote to my distressed feelings:

Lord, I'll count it all joy when my troubles close me in on every side
Lord, I'll count it all joy when this road of faith runs through the darkest night
For I know You're at work in me
Yes, I know You'll provide all the grace I need

You have always been my Rock
I will trust You forever, forever
You have never failed me, God
I will trust You forever, forever

Lord, I'll count it all joy when the weight of sorrow drives me to my knees
Every heartache and pain in Your mighty hands is forming Christ in me
And I know that Your word is true
Yes, I know every trial will only prove

You have always been my Rock...

(Can you tell I like music? 4 of my last 6 posts have mentioned songs, I think. I often feel like I am best able to pray and listen to God through singing.)

In October, Aaron & I decided it was time to call my OB-GYN to schedule a consultation and see if we could start running some tests. The hope of pregnancy had been deferred long enough to pursue medical intervention...

The Next Nine Months

In January 2005, we decided to officially start trying to conceive. I was so excited! I told all kinds of people that I expected to be pregnant soon. Some friends from church had just announced their pregnancy, and we talked about how we would probably be pregnant together. I started counting down the months until I would be at home with a baby. My patience had finally paid off, and now I would soon be pregnant.

Or so I thought.

We started out by “not not trying,” as Aaron put it. In other words, we weren’t preventing conception anymore, but neither were we changing our lifestyle specifically for the goal of conceiving. In my proud assumption that I would now be getting what I wanted, I figured we would be expecting by the end of three months, tops. More friends announced pregnancies; I daydreamed about joining them soon and going through it all together. February passed by – no worries. March – I was impatient, but not anxious. April – wait a minute, why isn’t anything happening?

At this point, we move from the casual approach to the attack method. I read about fertility. A couple months later, I started charting my cycles, and began suggesting to Aaron that we time intercourse to optimize chances of conception. Now, I thought, we’ll get somewhere. Now I am educated, armed with the knowledge necessary to bring about my desires. I will do this!

At this point, every month turned into a cycle of hope and despair. I would tell myself, “Surely you’re pregnant this time – look at your beautiful chart!” Then another voice would say, “Now, Andrea, don’t get your hopes up. You’ve had perfect charts before, with no pregnancy.” After wrestling back and forth like this, I realized that I just had to stop that internal conversation and say to myself, “You don’t know if you’re pregnant or not. You have no way of knowing. Only God knows if you have conceived, and that knowledge is in good hands.”

Nine months later, I wasn’t welcoming a newborn baby Patterson into the world. I was still fighting for contentment. I read Psalm 16 a lot. I prayed a lot. I sought help through fellowship. But I was impatient. I wanted to be in control of when we conceived, and I clearly wasn’t. I was starting to wonder what was going wrong.

How do you hold on to a good desire without turning it into an idol? I know that God says children are a blessing; my desire for children is a good thing. Yet that desire remained unfulfilled. I didn’t want God to take away my desire, but I knew I needed to be patient while I waited for Him to grant it. A good friend suggested that my desire probably had not morphed into an idol as long as I was not accusing God of withholding blessing from me. That thought helped me a lot at that time.

In September 2004, the heat turned up several degrees. I’ll tell the story of the past nine months in an upcoming post.

(By the way, right now I find it deeply ironic that my chronicle of infertility can be divided up into two nine-month sections. What’s even more “fun” is that there are living reminders of each of those nine month periods, friends’ babies that were conceived and born in those exact time frames.)

We Interrupt Our Programming to Bring You an Important Message from Our Sponsors

Okay, so I don't have sponsors.

But I am going to interrupt my mini-series on the story of trying to conceive. (By the way, that is what TTC stands for in my last post title, for those of you unfamiliar with the acronyms of the infertile population.) I composed two-and-a-half more posts along those lines on my husband's computer last night, but he cannot e-mail them to me today, so my eager audience (all four of you) will have to wait until next week. And I ended the last post with such a cliffhanger!

In the meantime, here is the consolation prize, lyrics from another worship song that has meant a lot to me during this trial, especially during the first half of 2005.

How Good It Is
by Nathan & Louise Fellingham

O God of love, I come to You again
Knowing I'll find mercy
I can't explain all the things I see
But I'll trust in You
In every moment, You are there
Watching over, You hear my prayer
You go before me, You're behind me
Nothing's hidden from You

How good it is to be loved by You
How good it is
How good it is to be loved by You
How good it is

O God of strength, Your hand is on my life
Bringing peace to me
You know my frame, You know how I am made
You planned all my days
Hand of mercy, hand of love
Giving power to overcome
If all beneath me falls away
I know that You are God

Who can stand against us?
In our weakness, You are strong
Your word is everlasting
I will praise You, Faithful One

What He Ordaineth (Pre-TTC)

Not long after Aaron & I got married in November of 2002, I began to look forward to having children. Believing that children are a blessing from the Lord, we wanted our family-planning to glorify God and not stem from any selfishness or foolishness on our part. The desire for children really began to crystallize about a year into our marriage. Aaron & I started talking and praying more about when we would like to have children, and we started seeking input from our parents and from wise friends. I was ready to start trying to conceive right away, blissfully imagining that everything would just fall into place. Aaron was more cautious, and as he sought counsel, we were advised to take time to pay off some debts (school and car loans) and to aim for enough financial independence that I could stop working and we could live on Aaron’s salary alone. I really do want to be able to stay at home with our children, but in my impatience to start a family I had thought I would prefer to work after a baby was born rather than pursue more financial security. So initially I was disappointed at the delay, but recognized the wisdom of the advice. With the help of friends who have much more financial wisdom than we do, we established a plan to pay off school and car loans. It took a lot of self-control to steward our money in that way, but the motivation of having a child and staying at home kept me going.

In the meantime, I was really struggling to have contentment as we waited. (I also kept hoping for an accidental conception!) I did not want my desire for a child to become an idol, and I did not want to my yearning for the day when we would have children to make me ignore the blessings of that time with my husband. Through fellowship and teaching, I was encouraged to hold fast to the twin truths that God is sovereign and God is good. He was in charge of our finances, He was in charge of my husband’s decisions, He was in charge of my dreams. And He is good; He was not arranging my life in a disappointing way, but He was (and is) lovingly ordaining my circumstances for the best. So I fought for contentment.

During that season, I found great encouragement and comfort in the song, “Praise to the Lord, the Almighty,” especially the following verse:

“Praise to the Lord, who o’er all things so wondrously reigneth,
Shelters thee under His wings, yea, so gently sustaineth.
Has thou not seen how thy desires e’er have been
Granted in what He ordaineth?”

By the end of our second year of marriage, Aaron & I gratefully saw that the Lord had enabled us to pay off a significant amount of debt, and it seemed that we would have enough paid off by the following fall to be able to live on his salary alone. While we still weren’t trying to conceive yet, as we drove to visit family that Christmas, we anticipated how we would be celebrating our next anniversary and the next holiday season with a new baby.

Thus Far

“Through many dangers, toils, and snares, I have already come...”

I want to take a few posts to chronicle the past couple of years of desiring children, trying to conceive, and entering the valley of infertility. This is mostly for my own sake; I don’t want to forget what I’ve already walked through and what God has done up to this point. Hopefully, these next couple of reflections will share my story and give the Lord glory.

“Tis grace that brought me safe thus far,and grace will lead me home.”

"Unanswered" Prayer

Returning from vacation has been somewhat discouraging. I feel like all the fight for faith in the area of infertility has been undone, and all the temptations to jealousy and self-pity are hitting me full force as if they are brand new. To remind myself of what the Lord has been teaching me over the past several months, I read back through my quiet time journal. I rediscovered these two quotes about prayers that seem to go unanswered - encouraging reminders to me as I continue to wrestle with the unfulfilled desire for a child, deferred for one and a half years and counting... (not that I'm keeping track - HA!)

"Give me unwavering faith that supplications are never in vain,
that if I seem not to obtain my petitions
I shall have larger, richer answers,
surpassing all that I ask or think.
Unsought, thou hast given me the greatest gift, the person of thy Son,
and in him thou wilt give me all I need."

from "The Prayer of Love" in The Valley of Vision

"If the ships of prayer do not speedily return, it is because they are heavily loaded with blessings. When prayer is not immediately answered, it will be all the sweeter when the answer arrives. Prayer, like fruit, is ripened by hanging longer on the tree. If you knock with a heavy heart, you will soon sing with the joy of the Spirit. Therefore, do not be discouraged because the door is still closed."

from Beside Still Waters by C. H. Spurgeon

Thankful

Psalm 40:5
You have multiplied, O Lord my God, your wondrous deeds and your thoughts toward us; none can compare with you! I will proclaim and tell of them, yet they are more than can be told.

In a season where I easily lose sight of my blessings in the midst of my yearning for an unreceived gift, it is good to be reminded that God's wondrous deeds and thoughts toward me are more than can be told. Here is an attempt to proclaim a few...

I am thankful for:

1. my Savior, who forgives my iniquities, heals my diseases, redeems my life from the pit, and crowns me with steadfast love and mercy, and satisfies me with good (Psalm 103).
2. my husband, who is "more to [me] than ten sons" (1 Samuel 1:8).
3. our apartment, a cozy home that shelters us and allows us to extend hospitality.
4. my church, a truly outstanding body of believers who worship God, learn together from His word, and pursue rich fellowship.
5. friends who pray for me and have faith for me when I despair of ever having children. (Thank you, specifically, to Katie F., Elisabeth, Jodi, Linnea, Lisa, Beth, Brooke, and Katie R. for all of your encouraging notes.)
6. the word of God, which has become more precious to me during this time of trial. (Psalm 119:50, 71 - This is my comfort in my affliction, that your promise gives me life. It is good for me that I was afflicted, that I might learn your statutes.)
7. my job, which allows me to serve the church in a unique way. I am also so grateful for the flexibility my job provides as we pursue infertility treatments.
8. our health insurance, which will completely cover the cost of infertility treatments, other than the occasional $10 co-pay.
9. the flowers I just planted on our patio.
10. our vacation to Montreal - we leave tomorrow!

I could list many others, but ten seems like a good round number and I need to get ready to head out of town. I'll be back to blogging in about a week and a half!