IF-Colored Glasses

A few weeks ago, I bought a belly book--like a baby book, but for documenting the pregnancy.  It's a cute, little spiral-bound book, with questions about your pregnancy, and pages for pictures and notes, week-by-week. 

I left the book sitting on the shelf, with the receipt.  I wanted to start writing in it, but I didn't like the idea of having to deal with it, in the event of the m/c.  So, I kept on giving myself benchmarks--if I make it through this u/s or the next appointment, then I will start writing it.

Each benchmark would come and go, with more great news that Little E was still thriving.  I'd feel relieved, and then I'd say I would start writing in the book, but I never got around to it.  By the time I was thinking about writing in it again, I'd be halfway to a new benchmark, and so I'd tell myself to wait again.  I did this at least three times.

I almost did it again, too.  My NT u/s is next Wednesday.  After it, I'll again receive (I hope) the confirmation that Little E is still alive.  My fatigue continues, and the low grade nausea is definitely ever-present, so I don't have any reasons to question this.  I've had such an easy time--no spotting and no cramping to induce major worries.  Yet I still fear that we'll just go in and Little E will be gone.

On top of the persistent fear that gradually increases after some times has passed from the most recent confirmation of life, I also experienced cramps for the first time this weekend.  These cramps were different from anything I'd experienced before--they were sharp or stabbing, and passed in just a few minutes.  They occurred about once each day over three days, and each time, they were in a different spot--the left side, the right side, the center.  They weren't major, and I have read enough to know that mile cramping is completely normal.  Plus, I didn't have any spotting.

Even knowing that cramping can be normal, I still went and looked it up.  What to Expect identified mild cramping as normal, as I expected.  I also looked up round ligament pain.  The description there sounded exactly like what I was feeling--except that the description was in the fifth month section, and I'm only 11 weeks. 

I'm pretty sure this is what I was feeling--just my uterus growing, and I know that's a good thing.  A quick check on the online message boards also reassured me that many women feel round ligament pain earlier--13 weeks was commonly cited.

I've never had a m/c, and there's no indication that anything might be wrong now.  But my time in the land of IF, as well as on the message boards and blogs, has made this fear an extension of my struggle with IF.  I think I'm pretty average when it comes to infertiles in this too, seeing the world through IF-colored glasses.  Those glasses certainly aren't rosy--they're tinted with the heartache, failures, waiting, and frustration that comes with IF.

Last night, however, I opened up the belly book, and I started writing.  I documented the first 11 weeks, starting with IVF.  My fear won't go away, but I also won't let it rule this pregnancy.  I won't be superstitious, even though I had moments of regret after sharing the news with my coworkers last Thursday, fearing something would go wrong now that I was really "out." 

Beyond fear, however, IF-colored glasses also give me a different perspective on this pregnancy.  I enjoy the symptoms, even though they've been so easy to deal with and minor compared to many women.  I am cautiously optimistic, even though I have this fear.  But more than that, I also don't want people to know about my pregnancy without knowing about my IF. 

When I announced the news to my coworkers, I started with IF: "Many of you know I've been doing IF treatment for the past year, and I have some good news to share.  After my first IVF, I'm pregnant!"  For me, it's important to raise awareness about IF; too many people don't talk about it, and I never liked feeling like it was a dark, dirty secret.  I don't tell people I'm pregnant without telling them I'm IF...and I still consider myself IF...I received successful treatment and am pregnant, but without that intervention, I wouldn't be pregnant.  I know that differs from others' definition of IF, but IF has changed me, and it's become a part of me.

IF still feels like a dark, dirty secret though, because while I was open and out about IF before the pregnancy, I'm even more open and out about it now.  I always thought this would happen, and I don't like it, but it is true.  For some reason, it's easier to talk about IVF or IF when you're already pregnant. 

When I'm writing in the belly book though, it's not a dark, dirty secret.  IF is a part of our journey TTC, and it played a major role leading up to this pregnancy.  I can't write about this pregnancy without writing about IF.  So, I pick up my pen and write; I don't have to put on those IF-colored glasses because they are always already on.

Healthy People 2020

In my field (teen pregnancy prevention...yea, I get the irony....haha), everyone knows about Healthy People 2010, and we're all talking about the draft of Healthy People 2020 that was just released. In my world, HP means something other than Harry Potter. ;)

However, when I was at the RESOLVE Advocacy Day in DC in June, I asked if IF was included on the HP objectives, and the ED did not even know what HP2010 was.  This surprised me--we're advocating for the advancement of research and treatment for infertility, and yet we're not looking at the HP objectives, which drive much of the funding for the public health world.  We see so many grants that identify HP objectives as the content; having IF identifying as an HP objective would seem like a concrete step forward. 

For those of you unfamiliar with HP2010, here's the summary, from their website:
Healthy People provides science-based, 10-year national objectives for promoting health and preventing disease. Since 1979, Healthy People has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of our prevention activity. Currently, Healthy People 2010 is leading the way to achieve increased quality and years of healthy life and the elimination of health disparities.

 I know IF isn't the top priority for health disparities, but it is a disparity, and socioeconomic status greatly determines availability of treatment.  If that's not a disparity, I don't know what is.

You can review the proposed objectives for HP2020 here.  You'll note under "Family Planning" that there is a great deal about preventing unintended pregnancies, and this makes sense, but I want to see IF here, too.  We all know that if more IF couples had access to IVF, covered by insurance, there'd be fewer HOMs, thus fewer lower birth weight babies, hence better public health outcomes.  And we've all seen how we infertiles get picked on for raising the HOM rates, unfairly so, given our limited access to appropriate treatment. 

Hence my conclusion that IF should be included in HP2020 objectives.  I've already contacted RESOLVE and asked them to review the HP2020 objectives, but I encourage YOU to contact RESOLVE on this issue, too.  

I haven't submitted comments on the proposed HP2020 objectives, but I will.  It takes a little time because you need to propose an objective, justify it, and provide research, but we all know the reasons and there's plenty of data to support it.  So I'm doing this, and I encourage YOU to make comments on the proposed HP2020 objectives, suggesting the inclusion of IF, too.

There's no deadline listed, just a vague timeline that the HP2020 objectives will be finalized and launched in 2010.  The website does say that comments are solicited in 2009, so best case scenario, you have a month and a half to respond. 

Please do!

Heartbeat

I heard Little E's heartbeat today, going strong around 160bpm!  J. couldn't come to the midwife with me since he had a staff meeting, unfortunately.  He'll be there two-three weeks from now though for our next ultrasound, the NT scan.

So, I'm officially graduated from the RE and a "normal" patient now.  I liked the intensity of the RE, always doing b/w and u/s and hearing back the same day, and I know I'll miss it, but it's definitely a good thing to be here now.  The midwife was really nice, and she sat with me and answered all my questions, so at least I didn't feel rushed.  It took over 45 minutes to get b/w done though, in a lab in the same building.  I definitely loved the efficiency of the RE!  If they can process b/w patients that quickly, why can't all labs?

Back in Town

I was out of town last week, so I'm working to catch up on blogging and commenting.  The pregnancy fatigue has also stepped up a bit--though that may be because I was working 12+ hour days last week.  However, I was diligent about taking a break each day, and I even took a nap Wednesday, Thursday, and Friday!  That's a BIG accomplishment for us to be able to balance staff responsibilities, but most staff took breaks, so it was a good year.

Yesterday, our office was closed to allow staff to recuperate, and I did nothing!  I was quite lazy, watching tv and napping with the puppy.  I don't think I ever slept more than 20 minutes, but I think I must have taken at least 6 or 8 separate naps!  I'm tired today, but I think I'm recovered from the conference last week.

I've also had a cough since Friday 10/16--that's right, I'm on day 11 of the cough!  But it's really just a cough--no congestion, no phlegm, no sore throat, no fever...so I don't think it's H1N1, though we all got a good laugh about me spreading it at the conference.  However, I think I've turned the corner on the cough too, as I've been sleeping better, when I'm not waking up to pee, since Saturday night.

Oh, and thanks for the commentor who clued me in to the big pi.nk rib.bon flashing below the previous post!  I went back and added the handy periods in the middle of key words, to see if that confuses the adware.

That's it for now, just a quick update.  First visit with the midwife is Thursday, though that won't be so exciting as there won't be an u/s.  I'll miss the RE and the easy access to u/s!

The Power of Ribbons as Symbols

I'm joining the conversation now on ribbons, awareness, and such, started by The Maybe Baby (Babies) and continued by the Stirrup Queen (and here), especially after our little get-together for coffee Sunday afternoon. But first, note the disclaimer at the bottom of this post, acknowledging my liberalness, in case you didn't already know.

I don't wear ribbons, not since I wrote my thesis on the message of fear the pi.nk rib.bon movement uses to scare women into medicalizing their bodies and fearing bre.ast can.cer (above all other diseases and conditions) and places a great deal of responsibility on women to prevent a disease that often isn't preventable.  I know that one sentence isn't enough to explain my thoughts on this issue, and I hope I haven't offended you here, but that's another post.

I believe in bre.ast can.cer awareness and supporting research to find a cure, but The Maybe Baby (Babies) already asked some good questions here, and I want to talk more about ribbons and symbols in general on this post.  Plus, Melissa's already written excellent points on the problems of awareness versus action, with which I whole-heartedly agree.  Suffice it to say that I'm not the only critic of the pi.nk rib.bon--my thesis was triggered by the Barbara Ehrenreich article The Maybe Baby (Babies) quoted--and the "culture of pink kitsch.  Another great article, "Think Before You Pink," by Mary Jane Horton, talks about thinking carefully before you donate because proceeds may not be going to bre.ast can.cer research as you'd hoped.  For those of you looking for a national organization that pointedly does NOT use the pi.nk rib.bon, Bre.ast Can.cer Action is a great resource.  There's a long list of articles on the problems with the pi.nk rib.bon here.

Ok, still with me?

Anyway, part of my thesis examined the ribbon as a symbol.  I won't go all theoretical and academic here, but suffice it to say that symbols are a powerful thing.  And they have a life of their own, that can change. Two examples:

1) Post 9/11, so many Americans--and people from other countries--proudly displayed the American flag to show pride in America (and patriotism), remembrance to those killed on 9/11, and defiance to terrorism.  I'd argue that after the years immediately following 9/11, after Bush lost his greatest support from the American public, the American flag quickly became a symbol of political conservatism and support of the Bush administration.  I don't know if that's why Obama didn't always wear an American flag pin, but it's my reason, and I wouldn't be surprised if it was his.  Two years ago, to me, in a pre-Obama world, it felt like the American flag as a symbol was quickly changing...again though, another post...My point is, the American flag has always been a powerful symbol, and post 9/11, it became an even more powerful symbol as people scrambled for a way to show solidarity and remembrance after our perceptions of the world changed so drastically.  The American flag, already powerful, changed quickly not once, but I'd argue twice over the course of about seven years.

2)  Our country continues to argue about the display of the confederate flag because as a symbol, it is so powerful.  Confederate flag supporters say that it's a symbol of Southern heritage and pride.  Others, however, say that as a symbol, it's too closely tied to the Civil war and support of slavery and racism (though I know that wasn't the reason for the Civil War...) that you can't separate the heritage and pride from the symbol.  I'd certainly agree...I'm sure some of those supporters aren't racist, but I don't think it's a coincidence that you so often see this symbol aligned with the politically conservative, whose ideals very often don't include human and civil rights for all, whether this time, that discrimination is aimed at gay and lesbian people, or whomever...My point here: the confederate flag was such a powerful symbol that despite the wishes of a minority, the meaning of this symbol has not been effectively changed over time, hence the continued debate about its display.

My point is that symbols are powerful, and individuals can try to change their meaning, and maybe, over time, groups of individuals can change their meaning.  With time and history, symbols gain meaning, and regardless of individual intent, symbols mean something.

When I see a yellow ribbon, I feel like I'm hearing "I support our country."  But I also feel like I'm hearing "I support(ed) Bush."  So, could you sport a yellow ribbon and still think Bush was a horrible president?  Many, I believe, would argue no--hence all the bumper stickers about supporting our troops by advocating for peace, or a change of presidential administration and hence a change of war strategy.

When I see a pi.nk rib.bon on a product or used by a corporation, I feel like I'm hearing "I'm good.  I support women," with the sub-text being, "You should buy my product over my competitor because I am this way."  I believe the pi.nk rib.bon, most of all, has been co-opted by corporations and misused.  At this point, what does "bre.ast can.cer awareness" mean?  Many have pointed out the problems with the use of the pi.nk rib.bon on products--the fund raising doesn't always go to research, or if it does, it goes to researching only the genetic causes of can.cer, funded by pharmaceutical giants, rather than researching the environmental (and more likely and predominant) causes of cancer. 

I don't wear ribbons because while the surface message might seem okay--support this cause--bring research to this cause--remember victims of this cause--so often, there seems to be a subtext with which I cannot align myself.  Or the ribbons just don't have quite the right message emphasizing ACTION, as Melissa so aptly explains here.  I've worn the purple ribbon on limited occasions, and then, only as a function of my job at the time, providing crisis intervention to victims of sexual violence.

And I've also got the pomegranate ribbon on my sidebar...which is the REAL reason for this post.  As many of you know, "Infertility's Common Thread" is a form of organized awareness--with strands of pomegranate embroidery thread (#814 from DMC).  It's not a ribbon or a rubber bracelet.  It's just a homemade solution: a simple piece of embroidery thread tied around your wrist.  And it's not about awareness, at least that's not my take on it (though of course, I still believe individual understandings of symbols can't outweigh public understandings of symbols); because it's not well-known, really, it's about letting us infertiles find each other.

I like this idea.  I think it's VERY different from ribbons.  While I'm all about infertility awareness AND action (as in health care coverage for IVF and fertility medicine for all people), if you aren't from the ALI community, you don't know about this thread, and I'm okay with that.  It's a way for us infertiles to recognize each other out in the real world.  In a few months, I may be walking around with a pregnant belly (I hope!), but I'll still be wearing my pomegranate thread.  For the ALI bloggers who may see me, they'll know that pregnant belly wasn't easy or accidental; they'll know I'm one of them. With or without the pregnant belly, maybe I'll be somewhere and meet an acquaintance I've known for years, but we've never shared our IF struggles.  And with the pomegranate thread she or he will know I'm a friend.

I'm very much "out of the closet": with regards to my infertility--I'll tell anyone if/how it comes up in a conversation.  I don't think it should be hidden, but the pomegranate thread is a separate thing.
Although, I've only ever met one other person who also wears the pomegranate thread--the Stirrup Queen, and she's the one who inspired me to wear one--I have hope that I will.  I have hope that over time, the pomegranate thread will become a powerful symbol among the ALI community.  We're not there yet--many people know about it, but so many of us do not wear it, and for good reason too.

Infertility is a private journey, and many of us don't want a public display of it.  I've never yet been asked about the thread (well, except for J...and it took him over a month to realize I was wearing it), so for me, it's still a private symbol, but I understand how it isn't something others would want to wear.  Maybe someone will someday ask me about it, and in that way, yes, it can serve to raise awareness...I just don't believe that will ever be the primary function of the pomegranate thread.

That's why I wear the pomegranate thread: for those of us who are looking for that "Infertile" "scarlet A" of sorts, so we can find each other in the real world, the pomegranate thread exists.  Maybe I'm in a funny place, and maybe it's just because IF is so personal, and thus so important, for me that I'll wear this thread (and I hope it gains traction and power as a symbol among the ALI community), but I won't wear ribbons.  Maybe I'm naive in thinking this thread could thrive without being corrupted as an "awareness" symbol, because of it's "in community" nature.  But maybe I'm not.  For now, I wear the pomegranate thread.


Disclaimer:

*I'm liberal.  I believe all people deserve the same human and civil rights.  I think we should nationalize health care (but only if our fucked up government could actually do it right, like England, France, Canada...or even Cuba...watch  _Sicko_ and you'll know what I mean there...).  I think education is the great equalizer, but I think our fucked up education system doesn't give children equal opportunities, and then we can't expect people to "pull themselves up by their bootstraps."  I heart Obama.  Can I make it more clear where I'm coming from?

A Renewed Sense of Calm and Happiness

We had our second u/s today, and everything looked great, again.  "Little E" was measuring at 8 weeks, and the heartbeat was right where it is supposed to be.  It's still a pretty blobby picture; the RE said it looked more like a gummy bear this time, but I don't know about that.  Here's two pictures, one with labels.

It feels like a renewed sense of calm and happiness to have this news. Without evidence to the contrary, I know you just assume you're still pregnant, and that's what we've been doing of course, but I love these checks just to see that yes, I am still pregnant. 

Of course, now I "graduate" to the midwife, so I won't be getting as many checks.  I go to her for the first time in two weeks, but there won't be an u/s that day.  I'll definitely miss the RE and her readiness to use the u/s!  At that point, I'll almost be 10 weeks, but she probably won't be able to hear the h/b on the doppler, so I don't think I'll get any reassurance that Little E is still alive.

I know without major spotting or cramping, I can still assume, for the most part, that all is well, and we definitely are doing our best to do that.  But it scares me to think of the possibility of going in for a regular check-up and being told that for the past two or more weeks, I haven't been pregnant, and I haven't known it.  It would be horrible no matter how it happened, I know, missed miscarriage or not, but I guess since I've been so lucky, knock on wood!, not to have any spotting at all thus far, that's my big fear.  Of course, I'm sure I'd worry just as much with spotting, even if it were routine.

But for now, I'm pregnant!  I keep saying that, but days like these are the best because I know I am pregnant.  And I also know that with each check-up, with appropriate growth and a good h/b, my risk for miscarriage goes down.  That too is reassuring.

It's Just Weird

I feel the need to come clean and just flat out admit that this blog is going to detail my pregnancy.  The title still fits, and I still consider myself an infertile, albeit one who's successfully responded to treatment, and that colors everything about how I see and feel about this pregnancy. 

I know though, that this means I might be losing some of you.  I admit that I'm more likely to comment on TTC bloggers than pregnant bloggers.  Maybe that's been because I haven't felt like I had much to contribute to the conversation of pregnant bloggers, and maybe that will change, but I don't know.  I do know that I've felt a little lost in my blogging space the past few weeks, and thus my overall commenting has dropped off, though I'm still reading you and keeping up with you.

I think part of the reason for this feeling is that I can't quite believe I'm pregnant.  I am, and so I feel like I should be thankful and happy--and I am--but when I'm not particularly feeling that though, I feel like it's kinda wrong for me to worry here, when I know so many others are still working through IF treatments.  So blogging about my worry and disbelief seems out of place.  It also seems out of place for me to complain about my symptoms...and by complain, I think I really mean gloat...because I'm really thrilled with every bit of discomfort I feel.

On the other hand, I am (cautiously) optimistic and happy, but like Murgan said here, there's more to write about when you're struggling in the depths of IF treatment.  How many posts can I write about this tentative happiness?

My resolution, therefore, is to stop being so analytical.  I started this blog for myself, to get all the stuff rolling around in my head out of there, in an attempt to find some peace.  Along the way, I've become involved in the ALI blogging community, but that doesn't change my reasons for blogging, and this is where I'm taking Melissa's advice to blog for me, and let who follows follow.  I really love being part of the ALI community, and I know I'll continue to be a part of it, just as so many other infertiles before me have done. 

It's just that I'm still feeling like it's too much good luck that I get to be here, and that it can all be taken away so quickly (and of course, it can).  It's also very weird to have this knowledge that I'm pregnant, and to be experiencing these symptoms (constipation, heartburn, mild nausea, achy-ness, fatigue), but other than that, to not feel or look any different.  It's hard to conceptualize that that flashing heartbeat is beating inside of me.  It's hard to believe that it's happened to me. 

So that's where I am...assumed to be pregnant still, as there's no evidence to dispute it, enjoying the discomfort of the symptoms, even wishing for more symptoms, and fluctuating between disbelief and cautious optimism.