Hardly Different

Today I visited the offices of Dr. Owlish for a lesson in injections, in preparation for the upcoming IUI cycle. If I had know that I would be watching the same instructional video that I saw back in November of '06 (thanks, handy timeline!), I would have brought popcorn to lessen the boredom a bit. Film-making doesn't really qualify as one of the strengths of the fertility pharmaceutical industry. When I met with the nurse afterwards, I declined her offer to go over all the Follistim instructions again. After three IUIs and two IVFs with the stuff, I think I'm familiar enough with the process. What is new for this IUI is that I will be mixing up my own HCG injection. At my previous clinic, the trigger shot prescribed came in the form of a pre-filled syringe. The prescription sent from Dr. Owlish's office includes two vials - one of powdered drug, one of fancy medical-grade water - and two needles - one to mix the contents of the two vials and draw up the combined HCG concoction, and one to administer the injection. This is definitely the next step in my career as a professional self-shooter-upper. Another interesting difference in protocol between the old clinic and the new is that a few days after the IUI, I'll have an ultrasound to check my ovary size. If the ovaries don't measure up, I'll take an HCG booster shot (half the dose of the trigger) in order to notch progesterone production up. Who knew that there is a direct correlation between ovary size and progesterone levels? Other than that, IUI #5 shouldn't vary too much from IUIs #1-4 - except, very hopefully, in the end result. Right now, I'm just waiting for my next cycle to start, so we can start trying again for the first time in a while.

Upon Review, I Should Have Found a Synonym for Confident that Begins with the Letter "D"

Anti-climactic. Brief. Confusing. Confident. All those words describe Wednesday's post-op appointment with Dr. Owlish.

Anti-climactic because I had already received a call from the pharmacy last week about filling my prescriptions for an IUI with injectable meds. Follistim - check! Novarel - check! An astonishing 63 progesterone suppositories - check! Since the progesterone supplementation will only be required for either the two weeks between IUI and beta (quantitative pregnancy test via bloodwork, for all you fertile laypeople out there) OR for approximately the first trimester of a pregnancy, I can only conclude that Dr. Owlish is supremely optimistic or that I will be using an uncomfortable quantity of suppositories for the two-week-wait. Anyway, the premature pharmacy call told me pretty much all I need to know about the treatment plan now to follow the laparoscopy.

Brief because I waited about an hour for about a 10-15 minute meeting with Dr. Owlish. He must have had a crazy day, evidenced by an untidily askew tie and a demeanor almost opposite of his usual leisurely, let-me-thoughtfully-and-sympathetically-answer-all-your-questions manner. In other words, he seemed rushed and we didn't talk for very long.

Confusing because he blithely brushed past the matter of my bent fallopian tube ("It was clear. HSGs can be faulty.") and instead dwelled on the biopsy of my bellybutton mole (of all things!) ("Not cancerous.") and of the pelvic tissue ("Stage I endometriosis. We got it all out."). There I sat, prepared with all kinds of now moot questions about my tube. The few questions I scrambled up about the endometriosis diagnosis met with limited answers. "It was in my pelvis?" (As in, that's a rather unspecified location, doc; what organs was it on?) "Yeah, your pelvis." "Oh. Okay." Now that I've had three different (and two faulty) diagnoses for our infertility, I feel a bit uncertain and wary.

Confident - that adjective belongs to Dr. Owlish. I continued probing about the endometriosis. "Will it come back?" "Yes, but not for a year, and we're going to get you pregnant before then." Dr. Owlish is supremely certain that I will be pregnant very soon. Which is kind of reassuring, but kind of makes me want to mitigate his assurance by abandoning any optimism I have for an opposing, negative realism. But all in all, I'm glad Dr. Owlish is so determined on our behalf.

I do still have hope that we will conceive soon. If that hope is a full balloon, this appointment let a bit of air out, but the balloon is still inflated and floating. I'm praying for good things and seeking to keep my confidence in the Lord.

I'm Too Tired to Think of a Title, Too (But Look! Alliteration!)

Guess what I did last night? I'll give you a hint. It has to do with #2 on this list. I did have a nice salad for dinner, so by using the process of elimination you'll understand why I am taking myself directly to bed (without a book!) and postponing the update I want to write about my post-op appointment.

P.S. If you're looking for some reading material to while away the wee hours of the morning, I recommend Dorothy Dunnett.

Infertility Timeline

I've added an infertility timeline in the left sidebar, below the blogroll. I thought it would be helpful for any newer visitors to my site who want a quick snapshot of my history of diagnosis and treatment. At the bottom of the timeline, I've noted what and when my next step will be. I get that question a lot, so I thought that would make a helpful reference. I'll try to keep it updated regularly.

When putting the timeline together, I discovered that I had completely forgotten about one of our IUIs! I had been thinking (and telling people) that we did three, two with Clomid and one with a combination of Clomid and Follistim. But we actually did a fourth with Follistim alone. I think I forgot about it because we were already gearing up for our first IVF at that point, doing tons of research and having lots of conversations about whether that was a step we wanted to take or not. Still, how strange to have almost no memory of an entire course of our infertility treatment! If nothing else, at least documenting the timeline restored that part of our story to my mind.

Now, I need your opinion. Do you like the placement of the timeline, or would you rather have it above the blogroll? And do you like it ordered from oldest to most recent events, or would you prefer the order reversed so the next step is at the top of the list?

The Icing on the (1)__________

One (2)________ February evening, Aaron and Andrea headed out to get together with friends for a (3)____________. Andrea had baked a (4)____________ Bundt cake to bring. When removed from the baking pan, the top of the cake (5)______ a little bit, so Andrea decided to whip up a (6)_________________ to smear over it and cover up the cracks. She (7)_______ carried her fresh, frosted cake on a (8)_____ as they left the apartment. When they reached the steps outside the front door, Aaron exclaimed, "(9)___________! The steps are icy." Too late. Andrea, wearing very cute (10)_____________-polka-dotted ballet flats with absolutely no traction, slipped dramatically. Her (11)____ flew out from under her, her (12)_______ hit the stairs, while her (13)______ still tightly gripped the plate. The cake soared into the air, (14)_________ and landing on the (15)________ at about the same time as Andrea did. She had frosting on her nose, chin, (16)_____, ____, and _______. Unsure whether to (17)______ or cry, she sat on the ground while her husband (18)________ in astonished sympathy. They (19)________ what they could of the cake and left the rest for the rabbits and squirrels. They returned to the apartment, tracking buttercream through the (20)____, so that Andrea could clean up and change. When she saw herself in the mirror, she almost asked her husband to take a (21)________. He had a similar thought, but couldn't find the (22)_______. They both agreed that this event would make excellent fodder for the (23)_____! Once they finally made it to the party, the cake, though very (24)________, turned out to (25)_____ none the worse for its adventures.

(See my comment for the correct words to fill in each blank. See your own comments on the previous post for Mad Lib fun!)

Mad Lib

I've crafted a Mad Lib out of something that happened to me last month. If you'd like to play along, leave your answers in the comments section before noon (CST) on Friday. (Or leave your answers whenever you like, just don't read Friday's post first!)

1. noun ____________________
2. adjective ____________________
3. event ____________________
4. flavor ____________________
5. verb (past tense) ____________________
6. food ____________________
7. adverb ____________________
8. noun ____________________
9. exclamation ____________________
10. 2 colors ____________________
11. body part ____________________
12. body part ____________________
13. body part ____________________
14. verb ending in -ing ____________________
15. noun ____________________
16. 3 items of clothing ____________________
17. verb ____________________
18. verb (past tense) ____________________
19. verb (past tense) ____________________
20. place ____________________
21. noun ____________________
22. noun ____________________
23. something you read ____________________
24. adverb ____________________
25. verb ____________________

Clothing Giveaway

If you're interested, there's a contest over at Life More Abundantly to win a $50 gift certificate to online clothing retailer Christa-Taylor (who has also been featured on GirlTalk). Just leave a comment on this post to be entered to win. (Or don't, so I have less competition!)

Infertility and Hospitality

An extension of my love for cooking is a joy in offering hospitality. There is a feast of pleasure in showing care to others by welcoming them into our home and nourishing them with food made by my hands. Gathering in a place of comfort, enjoying the gifts of flavor and sustenance, and sharing conversation, laughter and fellowship around a table together - these are gifts of grace.

And infertility has partially robbed me of the chance to offer and enjoy those gifts. It is a strange plundering. Who would think that the inability to conceive would result in the lack of opportunities to show hospitality? A minor grievance, to be sure, but I do miss - sometimes with poignant pangs - the simple joy of having friends over for a meal. You see, because we don't have children, we are the mobile, flexible ones. That means that when we have dinner with friends, we go to them. I honestly can't remember the last time we had a married couple or family to our home for a meal. We've invited, but the invitation always ends up getting turned around for reasons of infant sleep habits or babysitting or something along those lines. And I understand; really, I do. I don't mean this as an indictment of any of our friends with children. It truly does make more sense, when we spend time together with other couples, for us to go to their homes and so prevent a lot of hassle. But every time we drive to have dinner with our married friends, I feel a tiny sorrow over yet one more loss inflicted by infertility.

Hospitality is service. I don't want to have people come to our home so that I can impress or entertain them; that's stressful, not fun. The joy of hospitality comes in using skills and gifts to serve our friends. What serves our friends most now is not to have them in our home, but for us to go to them with the flexibility that we didn't choose but nevertheless have in our childless state. The best way, it seems, for me to exercise hospitality currently is to get out of the house.

Mix & Match Quiche

This simple quiche recipe allows me to make a quick dinner with whatever ingredients I have on hand. I usually pair it with a simple salad, or fruit, or cooked broccoli or carrots.

Basic Ingredients
3 large eggs
1/2 cup heavy cream*
1 prepared pie crust
approx. 1/2 cup cheese, crumbled or grated
1/4 cup diced onion (white, red, or green)
1/4-1/2 cup meat, cooked & cut into small pieces
salt, pepper, and other seasonings to taste

Preheat oven to 375F. Place pie crust in a 9" pie pan. Whisk eggs with cream; season to taste. Place cheese, onions, and meat in pie shell. Pour egg mixture over top. Fold and pinch edges of pie crust. Bake 25-30 minutes, or until quiche is firm and golden and crust is lightly browned. Slice and serve.

I pretty much always cook and crumble bacon for the meat, but diced ham or sausage or even torn deli meats would work well. You could also add veggies like diced bell pepper, broccoli, or spinach. Two of my favorite combinations are (1) blue cheese, bacon, and green onion; and (2) fresh grated cheddar (the sharper the better!), bacon, white onion, a sprinkling of tarragon, and a dash of nutmeg. (If I use a pungent cheese like blue cheese, I only use about 1/4 cup and I don't add any extra seasoning - not even salt or pepper.) Experiment and enjoy!

*Half & half works fine, too. If you want to use regular milk, I would use an extra egg so that the consistency of the egg mixture is thick enough.

Pork Tenderloin with Onions

My brother is visiting for a week, which means I have a sous chef! We both really enjoy cooking, so we're entertaining ourselves by trying out some new recipes together. In light of these activities (and the fact that having company doesn't leave a whole lot of time for creative blogging thought), I'll try to post a few recipes this week. This pork tenderloin recipe is one I've been meaning to post for months; it's a delicious favorite of ours.

Pork Tenderloin with Onions (serves 4-6)

3 tbsp melted butter, divided*
1 tbsp olive oil
3 garlic cloves, minced (or crushed through a garlic press)
1 1/2 tsp dried thyme
salt & pepper
2 small red onions, cut lengthwise into 1/2" slices (2 cups)
2 pork tenderloins (about 1 lb each)
2 tsp flour
1/4 cup light-colored, flavorful liquid (I use anything from chicken broth to white wine, depending on what I have on hand; I've even used Marsala)
3/4 cup water

Preheat oven to 450F. In a small bowl, stir together 1 tbsp butter, oil, garlic, thyme, 1 tsp salt & 1/4 tsp pepper. In a roasting pan, toss onions w/ half the butter mixture; push to sides, place pork in center. Rub remaining butter mixture over pork. Roast 20** minutes. Heat broiler; set rack 4" from heat. Broil 10 minutes, or until pork registers 155F on an instant-read thermometer. Remove pork from pan. Whisk flour & 2 tbsp butter in a small bowl; set aside. Place roasting pan w/ onions on stove over medium-high heat. Add water; bring to a boil, stirring to deglaze the pan. Add broth/wine & flour mixture. Cook sauce, stirring, until slightly thickened, 3-5 minutes. Slice pork, and spoon sauce on top.

*I've substituted olive oil for all of the butter, and that works just fine.
**The original recipe only called for 10 minutes, but I found I needed to double the time for my oven.

Redux: Fighting Self-Pity

Yesterday, I talked with a friend about the temptation to self-pity. After that conversation, I went back to read an old post. Remember how much this had helped me, I thought it would be worthwhile to re-post.

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In D.A. Carson's commentary on 1 Kings 19 in For the Love of God Vol. 1, he examines some of the ways that Elijah gives into "the despair of unfulfilled expectations." As I read that this week, I found myself really resonating with Carson's description of Elijah. Though I am not particularly tempted at this very moment, self-pity has called like a siren during this extended season of unfulfilled expectations, and I'm sure it will continue to do so. I have adapted some of Carson's thoughts into a plan to fight against self-pity.

1) Be honest about the facts (don't exaggerate). I give into self-pity when I only focus on a momentary trouble and magnify how bad it is, rather than acknowledging that there are blessings in my life as well as trials. For example, when I found out about our need to do IUI or about the cyst, my first reaction was, "Everything that can go wrong does!" While both of those were truly disappointing setbacks, my response exaggerated the problem and overlooked the many positives in our battle against infertility (only facing one hormonal problem, great doctor & nurses, excellent insurance, good response to medication, etc.). Not only that, my response overlooked the big picture of my salvation and sanctification.

2) Don't judge the hearts of others. Self-pity not only affects me, it affects how I view others. I feed my self-pity by thinking, "No one else cares. No one else understands. No one else realizes how hard this is for me." In reality, I am surrounded by people who care, who want to offer comfort, who want to help me escape from sin and trust God through this trial. I do a great disservice to those people when I judge them out of my self-pity.

3) Remember God's promises. In the throes of self-pity, my circumstances and emotions seem so much more real and true than God's word. But I can nip self-pity in the bud by having faith that God's promises (to be faithful, to do good, to sanctify me, to bless me) are true even when I cannot see them or feel them.

4) Remember that God will not always work in the obvious way I want him to. I have great ideas about how God should work - he should end this trial by letting us conceive a healthy baby! I've learned all my lessons, right? He'll get glory by answering my prayers as soon as possible, right? Seems like a good idea to me... But when I think I know best how God should work in my life, I am easily tempted to self-pity when God does not work how I expect. I need to trust that his ways are higher than mine.

5) Find others to carry part of your burden. When I give into self-pity, I tend to isolate myself. Then, it becomes that much easier to exaggerate how bad my circumstances are, to judge others as uncaring, to ignore God's promises, and to complain about God not working how I want. When I am the only human audience for these thoughts, they start to dig in deep. But if I open up to others - my husband first, and then other friends - my sin is exposed and can be addressed and corrected, my despair is lessened as others help me, and I am pointed back to my loving and trustworthy God.

I think if I can even remember one of these things when I am tempted, it would throw a big wrench into the cogs of self-pity. By the Spirit's help, I hope to be able to capture self-pitying thoughts more and more quickly as time goes on. May he "fulfill every resolve for good and every work of faith by his power, so that the name of our Lord Jesus may be glorified" (2 Thessalonians 1:11-12)!

(originally posted on 8.18.2006)

Blueberries for Hope

Many infertile women have a box. Or a drawer. A shelf. A room. A place where they have stored up a collection of items for that longed-for baby. Outfits. Blankets. Books. The collection and the place where it's stored can be a symbol of hope or a painful, tangible reminder of misplaced dreams. I don't have that collection or that place. I think it's partially due to a streak of Dutch practicality - why would I waste money on something that isn't a reality? And I think it's a form of self-protection - there are enough reminders in the world of my childless state, so why willfully inflict additional pain on myself? So I don't own anything* for my future children, and I'm content with that.

That is, I didn't own anything for future children, until yesterday. Yesterday, when my sweet husband came home from a brief business trip with a gift to represent our newfound optimism. He bought me a children's book, Blueberries for Sal, which he said he hopes will be the start of a collection. I hope so, too.

For the record, if I were to make a similar gesture to him, I would give him this. In fact, the only thing that stopped me from ordering it as soon as I saw it is that same Dutch practicality which whispered, "Yes, you're confident you'll be parents someday, somehow, but what if you adopt a two-year-old too big for this to fit?" But I regularly check to make sure the item is still there, on sale, waiting for the right time to purchase it. (Lord, please let it be soon!)

*Unless you count the box in storage that contains gifts that each of our mothers presented on our wedding day: one (1) pair ducky baby booties and the supplies to create one (1) ducky bathroom. I told you they were obsessed with giving us duck stuff. (We love you, moms! We just like joking about the duck stuff!)

Hope Quotes

While preparing my heart for the laparoscopy (from which I really did not expect good results), I listened to a message by Janis Shank entitled "Hope Is a Verb: Biblical Hope" (HT GirlTalk). I highly recommend this outstanding message on the life of Sarah, which offers weapons to battle fear and wisdom to refocus our hope on God's purposes. Janis also littered the message with high-impact quotes. Here are a few favorites:

"To hope means to look forward expectantly for God's future activity. The ground of hope is God's past activity in Jesus Christ, who points the way to God's purposes for his creation." New Dictionary of Theology

"In the case of every child of God, calamity never comes alone; it invariably brings Jesus with it." Octavius Winslow

"Has your wishful hope been converted at the foot of the cross to true hope?" Elisabeth Elliot

My laparoscopy brought Jesus with it. It also brought good news, so that my temptation to fear has been replaced with a temptation to rely on the wishful hope of getting pregnant soon. I want that wish to become reality, but I want to keep my true hope grounded in God's past activity in Jesus Christ.

I Am a Delicate Flower

Recovery has progressed quite well so far. I haven't needed the pain medications at all since the day of the laparoscopy (which seems like such a waste of a powerful prescription!). The shoulder soreness has eased up some, to the point that I hardly needed to apply heat at all yesterday. So I attempted to return to work today. You know, my strenuous job as a church secretary. Which I do from home.

Y'all. (Weakness makes me feel all Southern-belle-like.)

Sitting upright at a desk is taxing stuff.

I worked for a total of three hours, catching up on e-mail and voicemail, and oh, the exhaustion! The achiness! The fresh (though slight and not worrisome) bleeding! I took due notice from my body and returned myself to reclining on the couch. And now I shall take a nap. Work can wait.

The Only Thing Removed from My Body Was a Mole Deep in My Bellybutton

Happy results from the laparoscopy! My tube did not actually have any blockage due to scar tissue or damage or anything like that. It was obstructed because it had actually gotten tucked around my ovary somehow, so it had a kink in it kind of like if you bend a garden hose. So Dr. Owlish (I think I'm going to go with that; it was one vote behind in the poll, but I didn't get to vote, so my vote tips the scales) simply repositioned the tube to its proper place. He said that my uterus and my tubes all look really good, healthy and clear. He took a couple of tissue samples to send to the lab, but he said nothing seemed concerning. In his report to Aaron (which is where all this information comes from), Dr. Owlish said he felt very optimistic for us and thinks a couple of IUIs should "knock this out." We'll get more information at a post-op appointment in a couple weeks, and then we'll know how soon we can begin treatments.

As happy as the final news is, my experience of the day ran along fairly dismal lines, at least to start. I woke up with the beginnings of a bad headache, and I had no defenses against it - no water or anything allowed. It got pretty raging, to the point where it induced nausea (not pleasant when one doesn't have anything at all in one's stomach). All my attention was focused on my body, with little ability left to concentrate on the truth of God's nearness. Once we made it to the hospital and they hooked me up to an IV with liquids, the nausea subsided but the headache (caused by dehydration, I'm sure) remained. It was a tempting way to begin the day of the laparoscopy!

After all the pre-op preparations, I was wheeled back to the operating room. I remember having all sorts of monitors attached to me, having my arms stretched out to my sides, and then... nothing. The next I knew, I heard someone saying my name and telling me to take deep breaths. I think at that point I was being wheeled to the recovery area. My body was shaking uncontrollably; I wasn't cold, but I couldn't stop shivering. The nurse wrapped me with lots of warm blankets and added extra pain medication to my IV. I dozed off some, and the nurse kept checking on me. I think I spent about 30-45 minutes in anesthesia recovery, and then they brought me to a private recovery room where Aaron could join me. That was when I finally got the report on the laparoscopy findings. I felt pretty alert by then, and I was so grateful to hear happy news! My prayers for obviously good results were answered. We are rejoicing and thanking God.

Recovery is going fine so far. The headache was completely gone when I woke up from the anesthesia, so in many ways I felt better after the surgery than before it! My abdomen is a little achy but not bad when I am reclining (and I've got plenty of strong pain medication to take!). My shoulders feel fairly tight and sore, a result of the gas they filled the abdominal cavity with now rising to escape; heat helps, so Aaron is busy running the heat pack back and forth between me and the microwave. The pain medication makes me drowsy, so I'm getting plenty of rest. Most of all, I'm resting in God's favor and hoping for his future blessings.