Tuesday, May 20, 2014

How to Get Pregnant When You're 39

I'm feeling the need to testify.  In grad school, my friends and I would go to the local baseball games and be endlessly amused by the guy hawking drinks, hot dogs, and peanuts.  After you bought something from him (I think his name was William?), he would tell you to "testify" that his drinks were the coldest and his hot dogs were the hottest.  He was awesome.  I need to testify now about an entirely different matter, but it's hard not to bring up William any time any testifying happens.

This testifying is how I got pregnant (and stayed pregnant) at age 39 without any spectacular means. 

There's a lot of talk about fertility among the older set these days, and by older, I mean late thirties/early forties - in other words, 39-year-olds like me.

In the last few years, pop superstar awesomeness Gwen Stefani delivered her third child at age 43 and Halle Berry delivered her second child at age 47, but since we recognize this is as somewhat unusual, we might question just how they got their aging uteruses to work so youthfully.  There's the possibility of the intervention of science, but there's also the possibility that they are genetically blessed people whose female parts are defying the laws of nature which tells us that women become less fertile as they approach age 39.

There's that number.  39.  My number.  Last year, the Atlantic published a fabulous article on the myth of infertility at age 35.  I highly recommend reading it.  But even that article which gives hope to ages 30 through 38, recognizes that a real decrease in fertility begins at age 39.  Again, my age.

So here's how I got pregnant at age 39 without IVF, without Clomid, and without breaking the bank.

After our second miscarriage last year, my husband and I sat in an OB/GYN'S office while the doctor ruthlessly and carelessly discussed our loss.  He came in to the office after making us wait an hour after our appointment, didn't bother introducing himself to my husband, and then looked down at my chart for about five silent minutes.  "Yes, the tests confirm a miscarriage," he announced as if I didn't already have ample evidence.  (Miscarriages are not quiet events.  One knows when one has had one).  Then this doctor went on to explain that given my age, I would have difficult getting pregnant because my eggs were essentially not good anymore.  He recommended a fertility specialist.

We left the office feeling worse than when we came in.  Some doctors have that special gift of making a difficult experience even worse.  This doctor was so gifted.

In the next week, I called and made an appointment with the fertility specialist and received a form in the mail that we were to fill out and return before our appointment.  But as I went over the form which asked all sorts of questions about what we were willing to pursue in order to grow our family, I realized I wasn't comfortable with any of the options set out for us.  As a Catholic in my late 30s, I cannot flaunt a perfect record in the department of sexual activity, but I do have this going for me -- I have never been on the Pill.  Again, my particular road to where I am now is spotted with missteps and self-administered blinders, but after all my sins, I have always tried to figure out how to return to and lead a healthy, Godly sexual life.  Admittedly, that's a lot easier when you're married.

So as a married, Catholic woman who tries to let God run the show, I knew I couldn't pursue the fertility specialist.  I just wasn't comfortable with it.  God wouldn't let me get comfortable with it.  And what's more, the more we thought about it, the more unreasonable the OB sounded.  After all, I didn't have a problem with fertility.  I conceive almost immediately upon trying.  It's the carrying the baby to full term I couldn't seem to make happen.

I hit the Internet and searched high and low for information on natural fertility.  I read everything I could find on diet and supplements and stress and exercise and all the other things that probably do help to make a more livable environment for a baby.  I went on a gluten-free diet, I tried cocktails of vitamins and supplements.  But nothing really changed until I found a site about Catholic fertility which introduced us to the Creighton Model.

The Creighton Model is a natural reproduction approach that gives women (and their partners) information on how their particular cycle is working (or not working).  After finding an new OB/GYN in Fort Wayne who practices the Creighton Model, my husband and I were on our way.

My first meeting with Dr. Christopher Stroud, our new OB/GYN, was intensely cathartic.  He reviewed my chart, listened to me talk about the previous doctor, and told me, "I wish all woman came in here with your 'problems.'  All due respect to (unnamed other doctor), but he's wrong.  I deliver babies all the time to women in their forties."

There's a common phrase in Catholic conversation I should introduce here: "Contraceptive Culture," which means we live in a culture that treats fertility as a problem that needs to be fixed.  That's hard to argue as I've treated it that way for a goodly portion of my life as well.  But here's Dr. Stroud telling me that he delivers babies to women in what is supposed to be their post-fertility years all the time while my previous doctor says he sees infertility and miscarriage all the time in the same set of women.  The difference?  As a doctor who advertises his Catholicism, Dr. Stroud sees a lot of Catholic women who have never treated their fertility as a problem.  Fort Wayne, Indiana is a really Catholic town.  There are a whole lot of huge Catholic families here and Dr. Stroud's delivered a whole lot of those babies.  It's no wonder his experience varies so widely from other doctors.

So my husband and I started the Creighton Model classes which taught us how to chart my cycle.  Over the next three months, what the particular biomarkers would reveal is the why behind "infertility, repetitive miscarriage, abnormal bleeding, recurrent ovarian cysts, pelvic pain, premenstrual syndrome, etc …"

Once we determined my particular problem, in the words of my doctor, "profoundly low progesterone," and since we knew exactly when that occurred in my cycle because of my observed biomarkers, we were able to move forward with conceiving with confidence which we did immediately and which resulted in an already sort of huge four-months-pregnant me.

Total cost of Creighton Model classes?  Around $60.  Compare that to the cost of other fertility treatments which are not always effective, are often more invasive, and which are certainly more costly.

Using the Creighton Model, "76% of couples achieve pregnancy during the first cycle.  For couples with infertility, the overall pregnancy rate runs approximately 20 to 40% during the first six months."

I know the Creighton Model is not the answer for everyone.  I have dear friends who have benefited from other treatments and who have beautiful children as a result and that is nothing more than awesome.  I wouldn't deny them those pursuits for the world.  All I will say is that this is what worked for us and I needed to testify.

Lots of non-religious people are using the Creighton Model now either because they can't afford other treatments or they want to try a different approach.  This is me testifying, which, for the record, is not a very Catholic thing to do.  But still, William, I'm inspired by you.  I just had to testify!






Thursday, May 15, 2014

Once More Into the Fray with Hyperemesis Gravidarum

That I'm insane goes without saying.  Why I would voluntarily choose to risk Hyperemesis Gravidarum yet again in the pursuit of another child can only be chalked up to a mind that is not right.

And the truth is my mind has not been right for many months now.  A brief reminder for those who might be in the dark, Hyperemesis Gravidarum (HG) is severe, out-of-control, life-threatening (if untreated) condition less than 3% of pregnant women suffer from.  The vomiting and debilitating nausea do not stop - not even for an hour - for weeks and weeks and often months and months on end.

Friends, it is a very, very difficult thing to live through.  This is my second time getting to the other side of HG.  The vomiting has stopped, the nausea is almost entirely gone.  Other symptoms persist - ashy-taste of many foods, sensitivity to smells … but all in all, the worst is gone.

And yet, I can't seem to leave it behind.  I find it difficult talking to people whose lives have been normal over the past few months.  I've used the analogy of being a soldier who has returned from the war traumatized while everyone else has continued living their mostly peaceful lives.

I wish I could explain it to people and yet I'm grateful they don't understand.  To you few girlfriends who have suffered through this, sometimes it's hard to think about you because it makes me hurt and vulnerable in places that are still so broken.  I wish none of us understood it, feared its return, were scarred from the dark place it takes us.

The facts this time around:

  • 8 days in hospital
  • 4 weeks and counting of homebound, couch bound care from home health nurses
  • 3-4 weeks of Feeding Tube (Total Parentral Nutrition (TPN)) via a PIC line threaded from my arm to my heart
  • Hydration in arm for longer than TPN
  • Incalculable volume of Zofran, Phenergan, Reglan, Visterol pumped into my system every two hours night and days for months
  • Husband, mother, and mother-in-law exhausted, overburdened, helpless up every two hours to administer meds for months
  • Frightened four-year-old son asking every morning how I'm feeling
  • Trillion-billion = weight in fear pressing down on me that it will return any given second
Friends have asked if this pregnancy was better than my first.  There's no "better" when it comes to HG.  You just try to survive it.  It's like ranking versions of hell.  This hell is taking longer than the last hell to go away, but when you're in hell, time is meaningless so it's difficult to explain.  I can only tell you that I have prayed that God counts this toward purgatory.  That's not a joke.  He must.  Purgatory could not be harder than endless nausea pinning your stomach down in a suffering that makes it impossible to understand how you could survive from one moment to the next.

Being this sick twice has made me more religious even while it has made me question the shape of God.  I will probably never forgive the juxtaposition of suffering and purpose and people who say "God is not doing this to you" and "He is trying to teach you something" in the same breadth.  It's one or the other.  He either is responsible or He's not.  And I can be mad about that, but what I also know more fundamentally than the me who had not suffered that much is that I need Him to be real.  I need the comfort in the darkest moments that even it was Him putting me through that, I was not alone.  And because of that knowledge and need, since Atticus, I have found it more difficult to really engage with friends who don't have God in their lives.

People have said to me that it's all worth it once you hold that baby in your arms.  And implicitly, I must believe that or I wouldn't have done this again, but I still want people to stop saying it.  It exposes a horrible ignorance and insensitivity to the hell of HG.  HG can take more than it gives.  This one might have taken more.  Or I might still be too close to it to have a positive comment.  Probably the latter.  Nothing is worth going through it.  You can only just hope as me and my husband did that it will be different next time.

But I am through it now.  Even as the war rages in my head, I am aware that I am sitting upright at my computer writing and drinking.  I ate breakfast this morning.  I folded laundry.  (Rather, I watched my husband fold laundry because I was out of breadth after carrying the basket to the bedroom.)  Still, life is moving forward.  Tomorrow, the PIC line will be removed from my arm.  No more tubes sticking out me.  No more fridge full of IV meds.  I pray that my body catches up with this decision quickly and that tomorrow the act of folding laundry will be more within my reach.

That there's a baby coming - one we worked really hard to get - isn't joyful just yet.  But I know it will be in time.  And I have Atticus to remind me of the why.  And now when he asks how I'm doing in the morning, I can tell him I'm fine which is more than I could have hoped for weeks ago.  So we have that going for us, which is nice.