Day 3 blood work

On a lark (and at Will's request), we did Day 3 blood work after our most recent one day work up in Denver.

I got the results today, and was surprised at the levels.

E2 = 58 (slightly elevated but not monstrously so, I think)

FSH = 6.8 (seriously? I know the E2 suppresses FSH, but this number still seems shockingly good)

LH = 6.4 (after years of fertility treatments, I still don't know what this number means)

AMH = 0.4 (OK, decidedly low, but my sister's AMH was 0.19 and she's six months pregnant, so it could be much worse). Nurse said this predicts how many eggs would be retrived (versus FSH is a proxy for quality)

My antral follicle count was five total (guess that explains the low AMH).

Will had had the idea that maybe we'd do one last fresh IVF cycle (ha ha!). So in my mind, these tests were basically to confirm that at age 43.5, the fresh cycle days are over. And well, hmm...now I don't know what to think.

I wonder what Will will make of these results and whether he'd want to endure the time and expense of cycling again with a fresh IVF.

Fellow amateur fertility specialists, what do you make of these numbers?

Mo

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When the sky is falling

Yesterday there was a tragedy in my neighborhood. A two-year-old little girl was sitting with her grandmother in front of a building when some bricks came loose from the building's window ledge and fell onto them. The grandmother was injured. The little girl suffered massive head injuries and died today.

The sidewalks around this corner building were closed off on both sides yesterday and my neighborhood was filled with news vans and police cars all day. New York is such a strange place because we are all packed in so tightly, traveling, walking, living together. Many of the buildings are old. Most of them are tall. When a brick falls here, it will likely hit someone.

This tragedy hits very close to home, because, it is close to home. This girl is two, and so is my girl. We walk by that spot as a family frequently. We walked by that spot one hour prior to this event happening yesterday.

I hugged Magpie extra tight last night and sang to her in the rocking chair longer than I usually do, "You are my sunshine, my only sunshine," at her request. She seemed to sense my slightly raw mood and turned my face with her little hands to look directly into hers, "I love you, Mama."

And I think she knows that she is deeply, deeply loved in return. I just wish I could be sure she was always protected. That nothing terrible could happen. And yet, of course it can. Random, terrible things sometimes happen, a part of life that has to be accepted. You do what you can and you let the rest go. I know this, and yet, ugh.

I've spent the past day sending all of my thoughts to that mom and dad, and that grandmother, who was injured and will survive but was unable to save her granddaughter. I just can't even imagine.

Mo

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Two and a half

Magpie is now two and a half. Wow. How did that happen?

She is more and more a little girl, with fewer glimpses of the baby she once was. She is so definitively herself. Ardent, enthusiastic. joyful. Dare I say it? intense.

She loves to be read to. She loves to go through a review of her day with me at bedtime. "Mommy, tell me my day please?" And I walk her through her day, starting with awakening and ending in the present moment. To which she then says, "Tell me my day again?"

Her lovey is a lamb who has become a close friend now and often plays the role of baby, or the student in a ballet class (guess who else is in ballet class?), or the child who goes to school "all by herself!"(an upcoming event that Magpie is very excited about)

Slightly more controversially, Magpie wraps the lamb in a swaddle and says it is the Baby Jesus and she is Maria (her caregiver is Spanish-speaking and very observant Catholic). She also sometimes puts a towel on her head and says, "I'm the Baby Jesus!" (Will and I usually give each other a behind the scenes wide-eyed look when this happens. I think it strikes us both as almost sacrilegious, although she means it in the most innocent way). I'm not sure how this Baby Jesus role play will be received once she officially starts school next fall (I'm thinking it will need to stop), but Magpie seems drawn to it for now, and it doesn't bother me personally. As long as any God the caregiver introduces is benevolent and loving, it's fine by me.

Magpie is very chatty and speaks full sentences almost all of the time now. Many of these are directives, like "Mommy, I would like warm milk in the sapo (frog) sippy." Or "Daddy, no cut my meat. I do it myself!" My girl is often emphatic and has a very specific vision of how she wants things. We are working on developing patience and flexibility.

More and more Magpie seems like she is learning to handle her "harder" emotions, which makes me happy because she's a pretty intense kid. Last night, I was responding to a work email and Magpie wanted my attention and wasn't getting it fast enough. She started singing a tune from Daniel Tiger, "When you feel so mad that you want to roar....take a deep breath...and count to four. 1.....2.....3....4!" I very much liked her using a cognitive and behavioral skill in the moment to cope with her frustration. Go Magpie!

Magpie is usually correct in her use of English but has a few adorable mashups that I love. A few recent ones:
"Daddy, are you going on the climber?" (stepladder)
"Let's play hide and peek!" (hide and seek, although her version does involve a lot of peeking)
"I'm going to sneak Daddy!" (sneak up on)
"Tell me my born" (the story of when we first saw her and she first saw us after she was born, a significantly sanitized version)

Not a mashup but a new word last night that got a lot of air time (and made me think I must be using it a lot): "And then the Daddy came back, eventually." We will brush our teeth, eventually." 

I enjoy watching her creative language constructions to get her ideas across.

With Will and me, Magpie speaks all English, with some Spanish vocabulary thrown in: servieta (napkin), sapo (frog), basura (trash). With her caregiver E, she understands everything in Spanish and she will reply in Spanish sometimes and English sometimes. I'd like to push her to only speak Spanish with E, but it's difficult because she knows that E speaks English too. When she stayed with E and her husband while we were in Denver recently, she spoke mostly Spanish with them for the day and a half we were gone, so I know she can. I'd like to emphasize that more for her, because I know it's a use it or lose it. She's able to translate back and forth between English and Spanish and seems to really understand what words belong in which language, which surprises me a bit.

We talk a lot about feelings. Trying to identify what a character in a book is feeling and then identifying why we are making that guess, pretending to express different feelings (happy, sad, surprised, scared). I see this as hopefully building the beginnings of emotional literacy for Magpie. I work with adults who sometimes can't identify their feelings in words, can't observe the physical manifestations, thoughts, and behavioral urges associated with various emotions to figure out how they are feeling or why they act the way they do, which I think makes life much harder. I figure the more Magpie can know her own emotions and become a skilled observer in noticing those of others, the better off she will be. And it seems like she's getting it. She often points out characters now and talks about their feelings. And the other day, she looked at me and said, "Mommy, are you sad or mad?" Taking me completely by surprise. I was rushing to accomplish something in the evening and realized I had a furrowed brow. Funny to have my little girl now be able to let me know she's noticing my emotional state (and help me then to correct it in the moment!).

She is able to count to 11 in English (then skips to 40 for some reason) and to 20 in Spanish, but if she's counting objects or pictures she's only able to get to four or five before getting confused. She still seems to not know ANY colors, but she knows enough to name a color (confidently). So if you ask her to what color something is, she will (confidently) tell you a color name that isn't even close. Not sure when that will sort itself out, but I'm sure we'll get there before she reaches adulthood.

She is very independent and wants to try to dress herself, undress herself, and generally navigate her way in the world  herself. Magpie remains super active, always always always on the go. She doesn't like to sit in the stroller. Or really to walk for that matter. "I run!" she tends to say, exuberantly.And even when sitting she is often tapping her foot or playing with her fingers. I can catch her for a quick hug and then she's off again to the next thing. If only I had her energy.

She's eating most everything but the volume is not as much as I would like. Partially because she gets full fast, and partially I think because it is hard for her to sit still. So she is still a small little one, weighing I think between 24 and 25 pounds. She loves all kinds of fruits, especially berries and loves all kinds of nuts. She loves many vegetables: peas, green beans, broccoli, carrots, corn, tomatoes, avocado (I know some are technically fruits, but I'll take it). She loves beans of all kinds: pinto, edamame, black beans, lentils. She likes cheese and fish and chicken and beef. She loves tortillas. We try to offer a number of different flavors and ethnic foods (sushi, Mexican, Indian, Chinese, Thai) and she's usually game to try everything. Sometimes she spits it out, but I love that she will try. Especially when we are eating something spicy for dinner, I'll be sure to have a toned down version available if the spices are too much for her after she tries it.

Magpie starts school in the Fall and she is already very excited about it, "I will go to school by myself!" The several month long application process for New York preschools....I will just say, Oh My God. Another one that should be its own post. I feel fortunate that we can send her to be honest, but the process was outrageous (lotteries to get applications, multiple essays - and how much can you say about a kid who was 1 at the time of the applications?, interviews for Will and me, interviews for Magpie, open houses, tours, just WOW).

Magpie has become an expert at her routine. Last night we were walking Moxie and on the way back home, I reviewed with Magpie what we would do once we returned to the apartment (reviewing in advance seems to help reduce resistance when the time comes.)
Me: "What will we do when we get home?"
Magpie: "What will we do?" (Magpie has the habit of repeating your question when she's not sure of the answer).
Me: "We will put on our bathing suits!" (said in a silly way)
Magpie: "Naaah! We will put on pijamas!"
Me: "Oh, yes! pajamas. You're right! And then what will we do?"
Magpie: "We will read!"
Me: "What do we always do before we read?"
Magpie: "Brush our teeth!!"
Me: "Let's do it!"
Magpie: "Yay!"

Having tooth brushing (which used to be a big battle) now occur as a precursor to reading (a favorite activity) has basically eliminated all tooth brushing resistance. That was Will's idea, and it was a brilliant one.

I will try to do a whole post on potty training but for now I will just say we are in the midst of it. She's doing really well and proudly wears Dora and Hello Kitty underwear when we are at home. She's usually good at noticing when she has the urge to use the potty. I've learned to drop everything and help her get there because there have been a few occasions of not making it in time, which is very upsetting to her. She is mostly self-motivated about wanting to use the potty and yesterday apparently wore panties all day with E, even out of the house (I've been putting diapers on her for outside the house outings beyond just a walk for the dog around the block, but maybe I need to advance to the next step).

Overall, Magpie is doing really well. It's a joy to watch her grow and develop.

Mo

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Mother's Day insensitivies: will people never learn?

This coupon brought to you courtesy of my local grocery store: "If you're a mom, shop on Mother's Day and get 15% off your purchase with this coupon." (I guess if you're not a mom, just stay home and cry, or come in, suck it up, and pay full price).

In Mo's fantasy land: "If you're infertile, shop on Mother's Day and get 50% off and a hug."

Ok, actually I wouldn't have liked that either.

How about a simple, "On Mother's day, come in and get 15% off your purchase with this coupon." All comers. Those who are moms and those who are not. Those who have moms and those who do not. 

I had Magpie with me and it had been a long shopping trip already when I was handed my receipt with this printed boldly at the bottom.

It reminded me of an infertile patient whose church pastor yearly has the mothers stand up on Mother's Day, leaving those who can't have children sitting there painfully.

The receipt bothered me enough that I decided to take the time to officially speak to someone. Politely, but it felt worth mentioning. 

Management's response to my saying this coupon could be painful and left some people out? A genuinely baffled look, followed by a confused, "Oh, yeah, I guess it discriminates against men?" 

Intentions were clearly in the right place, and I knew that, but I also know that this holiday is a painful for many people.

Me: "What about women who want to have children but can't? Or women who lost their pregnancy?"

Awkward....Silence....

I'm sure I'm oversensitive as someone who thought she'd never get to be a mother. Mother's Day is already such a painful day when you want to be a mom and you can't get there. 

Local grocery store, I know you had all the best intentions, but this one missed the mark.

Mo

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Benign

Results on my breast biopsies are back:

Both areas are benign.

Major phew over here.

I had tried and mostly succeeded in not panicking. But I am super relieved, nonetheless.

Both came back as fibroadenomas. I was told I can leave them alone and there's no risk of malignancy, but if they are "bothering me," they can be removed.

The biopsy sites are feeling much less tender than they were, for anyone facing a similar procedure. One is very ugly, having bloomed into generous green and bluish hues, but it doesn't hurt that much so I just had to reassure Magpie last night when she saw "Mommy's owie" that I'm ok.

So big sigh of relief over here. Thank you so much for your thoughts as I waited. It meant a lot. If you could send your well-wishes and support to Mrs. Green Grass who is facing a breast biopsy this week as well, and is unfortunately a BRCA-2 carrier, I'm sure she would appreciate. I am hoping very strongly that she gets the same benign results as me.

Mo

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Biopsy

Not a word I hoped ever to write again as a part of my current experience.

But Friday afternoon I had a biopsy. Actually two. On my right breast.

A week ago I  had my annual mammogram basically just to check it off the list of requirements for the Denver clinic in preparation for our future FET.

They did two mammo scans of the left breast. Two on the right. Then I went to sit in a back waiting room while the doctor looked at the films to be sure they were happy with them. The tech came out. More images were apparently needed on the right side. FIVE more images to be exact. Ugh. More imaging done. Then back to the chairs.

Then the radiologist came out and said that it all looked OK but they wanted to do an ultrasound on the right side anyway, because I'd reported some pain in that breast. So they did the ultrasound. I was actually calm up until that point, and even into the beginning of the scan. But as the sonographer was doing the scan, I could tell she was seeing something. I started to feel scared. I felt like I felt at age 27, when I was about to be diagnosed with lymphoma. I tried to talk myself out of how afraid I felt.

The radiologist came in and said that the ultrasound revealed two masses. "Don't worry," she said. "But these masses weren't there last year when you had your mammo and sonogram. We need to biopsy them just to be sure."

That was eight days ago. I've been trying not to think about it since then. It is what it is; why suffer in advance? If it's bad, I'll have plenty of time to freak out and re-collect myself. An adage I take from having cancer before.

So I successfully held off thinking about it much until today. And today I was busy supervising a trainee dealing with a patient's psychiatric emergency, so that took a lot of my attention. But when it came time for the biopsy, I was scared.

A different radiologist performed two core needle biopsies on my right breast: one mass at 1 o'clock and one at 6:30. Both of them were pretty deep inside the breast. The radiologist took 10 tissue samples in total. The procedures took awhile. It wasn't comfortable but not terrible either. One site bled. They said a hematoma was already forming as I laid there on the table (awesome). Now I just feel bruised and sore (The sites are bandaged so I can't tell anything about how they will look yet).

About halfway through the procedure I started shaking. I told the team I was cold, because I was in fact a little cold. But truly I think the shaking was my nerves. I have laid on too may tables and had too much bad news. Like there's some neural imprint of my past on me. After the biopsy they took three more images to visualize the titanium clips they'd placed in my breasts to mark the sites. Now that I'm at home in bed, my whole breast is achy and I've been wearing ice packs on it to numb it a bit and reduce swelling. The achiness makes it hard not to think about what might happen.

So now I wait. Results are expected back by Tuesday. I hate waiting for results. I hate imagining my tissue culturing in dishes in a lab, potentially yielding up negative information that could throw my life into a tailspin. I hate being afraid. I hate even the slight possibility that this could be cancer again.

Mo

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