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Wednesday, August 18, 2010

A VEIL OF CALM: Part 1

I am finally calm…..er. A couple of things have happened this week that seem to be the cause of this uncharacteristic serenity. I’ll split this into 2 parts because you all have lives and didn’t sit down to read a book. :)

PART I: The Decision (insert medival trumpet announcement)

Jason and I have agreed that we will try one more time, but that this will be the last time. It took us a long time to get past the paralyzing fear and emotional mudslinging to hammer out the details – although truthfully, the mudslinging was part and parcel of communicating which parts of this were non-negotiable for either party. I don’t suppose ours was a textbook example of “how to communicate with your spouse to make important decisions,” but it was our messy, human version of grappling with life’s cruel bag of tricks.

Frankly, I didn’t know how we’d come to a mutually agreeable decision, even wondering if our relationship would survive the decision at all. But I guess between my insistence on talking, his insistence that we’d make it through this, the specialists, the therapist, the tears, the books, the blogs, supportive friends, my lovingly prostheletyzing mother (who insists prayer will deliver miracles, which begs the question, what did her prayers produce the last three times? – but I digress), my computer scientist father (who delivered a comforting statistical analysis via email*) and lots of chemical crutches – we stumbled through the fog of disappointment and grief and detailed the following plan:


1. Au Natural:
We will just go the natural route since none of the physical or genetic assessments warrant other measures. More specifically, we ruled out IVF for a combination of reasons – mostly financial and emotional. We decided we could not endure the process without absolute assurance that the result would be positive. I mean, I’d rather have my entire back tattooed than go through even one IVF cycle and come out the same way I went in – less $30,000.

I just don’t have it in me … though I did have to consider long and hard whether IVF was a test of how badly I wanted a child. But I don’t think it matters, nor is it even possible to determine, how BADLY I want to be a mother – how the fuck do you measure that? Probably some sort of machine called a guiltometer. Fuck that. What I really needed to consider was what I thought I could endure. Because that is where everyone must draw the line at some point if they continue to fail to conceive. What can one realistically endure before there is significant or even irreparable damage? I am of the opinion that it is all too possible to fail to draw the line, and the costs can be astronomical – physical damage, emotional breakdown, failed relationships, financial distress, damaged career, etc. etc. I knew, even after my first miscarriage, that having a child was not an “at all costs” proposition for me; but deciding where to draw the line has still been a bitch of a decision. I am actually rather thankful that my husband is less inclined than I am to keep trying ad infinitum because I might have pushed myself beyond reasonable limits out of sheer anger. Though initially painful to embrace, I can actually now look forward to the end of this heartwrenching journey either way – with child or without.

Our recourse will be pre-natal vitamins, magical baby aspirin, and a sensible diet.

2. What Constitutes a Pregnancy? 

You may wonder why this is even a debatable issue. You’re pregnant when you’re pregnant, right? Well, not in my mind. In my mind, there are soooooo many shades of grey.

Are you pregnant as soon as the sperm hits the egg? If there was a diagnostic test for that, would fertilization constitute a pregnancy even if the fertilized egg never made it out the tunnel of love (fallopial tube)? Is it when the embryo implants? Or rather, are we “in play” when you see a heartbeat?

I realize that technically, every one of these scenarios constitutes a pregnancy. But back in the day, all of these states of pregnancy would have been completely unverifiable-a mere inkling. I don’t even think I know how you definitively diagnosed a pregnancy before HCG measurements, though I think in the 60’s it might have involved rabbits.

This issue came up because I thought that perhaps I’d feel cheated if this go round, I turned up with a chemical pregnancy or something and miscarried so early that it would almost seem like a late period. But there are just too many crazy scenarios to anticipate, and the whole thing was becoming an exercise in mental masturbation. Better to aim for clarity. So pee stick calls the shots; when the pee stick/s (unlimited number allowed) indicates we are pregnant, that constitutes the fourth pregnancy. Whether the pregnancy is determined to be a chemical pregnancy, a missed miscarriage, or another blighted ovum, there will be no more tries. Final match, final set, final point. 


3. Statistics are NOT our friends:

Finally, we have decided that we will skip the screening blood panels and jump straight to CVS, the earliest diagnostic test available to determine the chromosomal health of the fetus. This is important, I think, in our case since our last fetus was lost as a result of a chromosomal abnormality and I suspect that the first 2 were lost for the same reason. Plus, I don’t trust the HUGE margins of statistical error on those screening tests. With our triploidy fetus, the screening indicated that there was a 98% chance that the fetus was healthy. If we’d decided NOT to do the amnio based on those numbers, the pregnancy could have been much more complicated and emotionally draining. Luckily, the decision was taken out of our hands naturally before the amnio was even conducted.

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As you MUST have gathered by now, I am not a creature that likes to leave any rock unturned. I am vigilant, obsessive, cautious and detailed. A true Capricorn if I actually believed that stuff. My husband is a different beast, he floats through life and is happy about 75% of the time to let life just happen to him … or so it seems to me. I have yet to figure out HOW he made the decision to try once more; it certainly wasn’t by reading or blogging or googling. Maybe his brain worked on it while he was bolting together the jeep he’s rebuilding or maybe he thought about being a father as he planted his vegetable garden -a passion he shares with his deceased father.

I don’t mean to sell him short. When he really wants something, he has the wherewithal to make it happen. A dive course, rebuilding a car, taking dance classes to win me over (he had me convinced he LOVED ballroom dancing, insisting we get together and “practice.” I am so naive). As it seems to function, ours are two mutually unintelligible, but complementary approaches to life. In the most clichéd way, I think we balance each other out. I am sure our decision regarding children reflects the best of both worlds. Despite his inattention to his toenails and his 2 taxidermied ducks-on-a-wall, I am lucky to have him. ;)

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* Email from my dad:

"Suppose you decide to try 4 more times, in future (Hope you are willing to look that far ahead).

What's the probability of success in at least one of those 4 times?
Probability of first failure = 0.35
Probability of first and second tries failing = 0.35 x 0.35 = 0.1225
Probability of 3 failed attempts = 0.35 x 0.35 x 0.35 = 0.042875
Probability of 4 failed attempts = 0.35 x 0.35 x 0.35 x 0.35 = 0.01500625
The probability of at least one success in those 4 attempts = 1 - 0.01500625 = 0.985

Hope Jason likes these odds :-) "


2 comments:

Misfits said...

I heart your dad, that needs saying. I am very glad you have this in your sights as the final go. I have also just succumbed to doing the DHEA route for our next attempt. All snake oil and mirrors, but it gives me hope.

I would have stopped long ago if I'd known where we would be now. But here we are and I don't regret it. I know that I will regret not giving it a bit more time. You are in a good place and I like your husbands approach. I want this to be the one for you both and agree with all of your reasoning here.

Melanie said...

Yeah -
He's a good dad. I definitely align with him in my approach to life vs my mothers approach. Thanks for the support. Since we seem to be in fairly similar situations, I find it comforting that you understand my decisions.
PS. - so do these responses reach you? How are you alerted that I have responded? Or are you alerted at all?

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