Tuesday, January 20, 2009

Magical Thinking

(I've been obsessed with designing patterns lately. See more here.)

I'm no longer sick. Thanks goodness.

My naturopath said I don't have PCOS (polycystic ovarian syndrome), just PCO (polycystic ovaries). What is the significance of this distinction? I can't say that I know. I arrived at her office on January 9th with J~ in tow, ready to get the lowdown, but the appointment was railroaded by a misunderstanding.

In a nutshell: Over the phone, while I was sick, she told me to eat only vegetables and broth. I did not understand that she meant this recommendation only until I felt better. She had also mentioned seeing my ultrasound report, and that I had PCOS, which hit me hard. I thought the food guidelines related to this diagnosis. I wanted to ask questions. She assured me we would talk about it at my appointment.

But we never got that far. Instead, after I confessed that I was unsure about what to eat, and feeling hungry and lightheaded, she gave me a brief lecture on how I need to "take responsibility" for my diet, eat every two hours, and have protein at every meal. She then proceeded to write out a food chart for me, right down to the breakast-snack-lunch-snack-dinner-snack detail. Just give me the guidelines, I tried to argue, I don't need a meal plan, but she was convinced this was necessary. In the end, there wasn't time to discuss the ultrasound.

I left that appointment feeling distressed and angry. I've been following a strictly limited diet for half a year now, and it has not been exactly easy. I've been proud of how well I've done. The last thing I want or need is a prescription for every morsel I put into my mouth. Or a doctor-patient relationship that feels like being sent to the principal's office.

I've been in a bit of a tailspin ever since.

It doesn't help that the freezer broke down at my local food co-op and they gave away all the ice cream - just as I arrived at the store.

In her moving memoir, The Year of Magical Thinking Joan Didion tells of how, after her husband's sudden death, she found refuge in the belief that he would one day return — if only she kept the way open for him. She held onto a single pair of his shoes, for instance, not for sentimental reasons, as she allowed others to think, but because he'd need them when he came back.

I can relate.

I've been thinking that if I am a very good girl and do exactly what the doctor tells me to do, if I eat exactly the right foods and get exactly the right amount of rest and exercise, if I do meaningful work and cross a few big projects off my lifetime To Do list, and then, finally, if I am so happy and fulfilled that I stopped trying altogether, I will get to have a baby after all.

I've been thinking this way for five years.

I always assumed, however, that if I still hadn't had a child by age 38, I would throw in the towel. I figured that by then I'd feel sick of all the disappointment, and ready to move on. What a relief it would be to quit wondering half of every month if I might be knocked up. Like right now, for instance - my breasts are uncommonly tender. I keep thinking I might be pregnant, but I need to wait another week before I can know for sure.

I hate the question mark lurking in the back of my mind, and yet I cling to it.

I turn 39 in six weeks.


Anonymous said...

It's pure torture, I am sure. It seems like it would be easier if someone could just say, "no, you will never, ever get pregnant, no matter what you do." Then you could possibly get some closure. Instead you have the possibility looming month after month. I hope you get closure, in the form of a baby.

Just me said...

I wonder if it's easier if one knows for sure they CAN'T get pregnant- there's definitely the opportunity for closure there, but oh, the loss! My neighbor has gone through this and my heart breaks for her.

I've been thinking a lot about hope (specifically around ttc). Is it better to be hopeful and then be disappointed, or better to be doubting but go around in a fairly constant state of negativity and possible despair? I don't know the answer, and I'm in the point of my cycle (just before IUI) where I am trying to decide which attitude to adopt for the next 16 days or so.

this one said...

I have polycystic ovaries but NOT PCOS. My RE is a leading researcher on PCOS and he doesn't think I have PCOS. Apparently a set amount of healthy women wihout PCOS have ovaries that appear polycystic on ultrasound, but they have no ovulatory dysfunction, symptoms and their hormone levels are normal. If you want to google it try searching for PAO or "Polycystic Appearing Ovaries". It's actually a bit confusing because I've found some research that women with PAO but not PCOS have higher rates of miscarriage but they don't know why. But a quick google will help clear up the difference between PAO and PCOS. Hope this helps. Sounds like you don't have PCOS which is a good thing.

El said...

I'm so sorry things went badly with your doctor. That just makes it all so much harder than it needs to be.

I've always (since I was a girl) had "around 50" as my end-date for having a baby because surely by then I'd have the family I always wanted or if not I'd know that I'd tried my hardest for as long as I could. But maybe I'm just putting off the inevitable. I'm 41; I have three living children, and ten who did not make it. I still want the large(r) family that I always wanted. Some dreams are just as hard to live with, as they are to let go of.

Anonymous said...

That's a beautiful post.

Anonymous said...

Sorry if these seems redundant, but I'm thinking out loud.

You still biologically have not been told any reason that you can't have children. So, considering you are not in menopause, then technically, you can get pregnant and perhaps keep a pregnancy. But as you've shown us, something happens between conception and development of a viable embryo or fetus.

Could it be as simple as taking blood thinner, like a baby aspirin a day? I don't know, I'm not an OBGYN, nor am I a reproductive endocrinologist. But if you really want to have a biological child, if this is high on your priorities, then wouldn't anyone in the same situation try to find out?

Sure, there might be no answer. Unexplained infertility exists. But from what little I know, it's rare.

Having said all that, I am in no way telling you what to do. That's up to you. I love the fact that you are honest about your ambiguity and that you aren't rushing to high-stakes solutions (triplets, anyone?) without some careful consideration.

My own situation is this--I had my first at 38, and I just turned 39. I'd love to have another. My beloved husband, not so much. So I'm learning to be zen with it and appreciate what I do have, and as you attest through your writing, it's hard. I appreciate your candidness and thoughtfulness.

Frenchie said...

Hi Amy,
Thanks for stopping by my blog. I understand that place of "magical" thinking. After nearly 5 years of not producing a real live baby despite lots of trying (our one and only pregnancy ended in m/c), you'd think I'd just "let it go". But, somehow, each month, there I am feeling my breasts, looking for any hint of nausea, hmmm...do I feel more tired than usual?, etc., etc.. Always to be reminded that NO! I am pretty much impregnable. You would think I would have listened to the first RE who told us we had less than a 1% chance of getting pregnant on our own. But I for some weird reason keep thinking, "yes, but he didn't say we had NO chance..."

It's torture.

Anonymous said...

My RE, in his very matter-of-fact way, told me it is harder to get someone pregnant than to keep them pregnant.

What I did -- and I by no means mean to suggest this is what you should do -- is give myself over to my RE. Yes, my body was not working right. Yes, I wanted it to "work" so I could have a baby "naturally" without a lot of medical intervention during the pregnancy. Then the second miscarriage happened, and something in me broke. I wanted a baby more than I wanted to negotiate with my body and more than I wanted to have a baby the "right" way. It then became about playing the odds and upping those odds meant blood thinners, baby aspirin, and progesterone shots, in addition to my diet, herbs, and acupuncture.

I don't know what kept causing me to miscarry but I don't for one single second regret all the shots, all the "unnatural" interventions, when I look at my son. He is perfect and wonderful and he completes me in ways I could never have imagined. I don't care how long or by what means it took to get him here. He is the most natural thing I have ever done.

Having a child, I have come to realize, is not about you. It is not about how you want to do it; it is about how it is going to happen. I had to give up control (or the illusion of control) and reconcile with the fact that my body, on its own, could probably eventually carry a pregnancy to term. I was just unwilling, or emotionally unable, to go through any more miscarriages to get there.

Suzanne said...

Amy - I've been reading you for years. I certainly don't want to interfere with your care...but consider a medicated IUI. Obviously this is up to you but...it is not so invasive and will help you ovulate properly. I'm all for natural and holistic methods but at our age going from point a to point b is wise... I'm not a pushy old broad just one with experience on this one (sadly). I'm at www.waytoomuchinformation.wordpress.com

Happy to offer any help, words of encouragement. You are a talented and thoughtful person (like I said, I've been reading your blog every week since you were about to divorce) so I consider you an old friend even though we never met! All the best to you. xoxoxo Suzanne