Professor Bunny ina HOOOOOUSE!

Like many of you, I am addicted to reading material in the domain of infertility. And like many of you with online access to journals via a university, I head right for the primary source material. I loves me some Fertility & Sterility, the Official Journal of the American Society for Reproductive Medicine! I get the alerts when a new issue is coming out and everything, so I can make sure to read papers such as Estrogen and progesterone receptors in smooth muscle component of deep infiltrating endometriosis. (Um, yeah, not so much on that one.) But despite my desire to avoid unreliable information, and even with all my training as a social scientist, I find that I am still susceptible to a basic flaw in human cognition: we tend to look for evidence that will confirm whatever it is we want to believe. Psychologists have labeled this the confirmation bias, and suggest it's part of a family of principles in human thinking. These principles are adaptive in the sense that they allow us to reason quickly, and don't lead us to be eaten by tigers all that often. I mean, if you encounter a tiger, it's better to believe that all tigers will eat you than to believe that every tiger you've encountered thus far will eat you, but perhaps this next one won't, and you should really test your hypothesis in a way that might allow you to falsify it. So while these principles may not lead to accurate reasoning, um, humans don't reason accurately. And yet we do pretty well for ourselves.

So lately the confirmation bias has manifested itself in a somewhat...selective...approach to reading on my upcoming surgery. Basically, I'm looking for things that will convince me my fertility will be radically improved. That I'll instantly have a hundred fat, happy babies. There are plenty of papers with small numbers of patients that present encouraging figures (e.g., in the year following the surgery, 40-70% of women conceive, with age being the major factor that improves your prognosis). Buuuut...there almost no studies where the entire participant population consists of infertile women or women with recurrent loss. So there's no causal link between the surgery and improved fertility. (Because women who conceive after the surgery might have conceived anyway--they weren't infertile.) In addition, there are several review papers on the surgery that present a more discouraging picture. These are papers that summarize and evaluate lots of other papers, rather than presenting new research. And they are much more cautious, pointing out that many of the encouraging studies are, to use the scientific term, crap. Anways, guess which ones I like to read? I repeatedly find myself looking at abstracts that end with an encouraging conclusion--those papers I download and read. But the abstracts that end with a discouraging conclusion--those I pass by. 'Cause I don't want to learn. I don't want to know the truth. I want data that will confirm what I want to believe.

Fortunately, in my case it doesn't matter whether the surgery helps or not: I can't have IVF without it.

And at least today I found a paper with COLOR PHOTOS of the procedure! Really cool! It shows the different sutures used for different layers of the uterus and everything! Perfect lunchtime reading.

Frocks and mocks

Frocks. I bought a new spring frock last week in one of those pathetic efforts to feel good about myself. HA! It's super cute, as I'm sure you'll agree, but it did make me wonder: How much longer can I get away with wearing girlish dresses? (Let's just assume for the sake of argument that I currently still CAN.) And, more important, How will I know when my time is up? I like to think I have a pretty good mutton-dressed-as-lamb-o-meter, but presumably all those scary fifty year olds wearing low rise jeans think the same thing. My husband is no help. He's never yet told me that something looks terrible on me (though many things do!), so I'm left trying to discern some gradation in the level of enthusiasm with which he says, You look nice! Nor does it help that I spend my time surrounded by undergraduates, thus have a distorted sense of the age/fashion relationship. Maybe this is one of those things that's mysterious until it happens to you. Like one day I'll wake up and just know in my heart it's time to start buying elastic waist pants.

Mocks. I was searching the interweb for myomectomy success stories (as one does), and stumbled across the following:

hi i had a myo in [year] and now im pregnat wid my 3rd child unexpectedly so it is possible.
Okay. Guess what. You don't deserve to be pregnat wid anything. Sorry to be so judgmental, but seriously, you suck, total stranger who I'm sure is a good and lovely person. You already have kids! Plus, you are capable of becoming unexpectedly pregnant! And most important, you can spell unexpectedly, but not WITH. Or PREGNANT! (This from someone who finds at least one typo in every post the moment after she hits publish, but let's not focus on that.)

Hi, I had the myo in [year]. I am 34 and now a full week late for my period. I hope I'm pregnant, but wanted to know if anyone had any similar experience.
Let me chime in here. No, thus far I have not had the experience of being 34, though I expect to soon. I have also not had the experience of being a full week late, but...TOP TIP: pregnancy test. I have most definitely had the experience of hoping that I'm pregnant. Hope that helps!

I'm so lucky to have found a community of people with not only a mastery of English but also an understanding of how to resolve the question of whether or not they are pregnant. I clasp you to my overly-youthfully-dressed bosom!

Feeling like shit is AWESOME

As a number of you reminded me, surgery is a positive step forward. (We assume. If I end up with a hysterectomy, perhaps we'll change our tune.) After all, lots of you don't ever get to do anything, or have to do the same thing over and over, with decreasing faith that it will lead to a cooing, gurgling baby. So instead of dreading, I'm trying to look forward to the surgery. I'm trying to appreciate the fact that there is an action I can take.

Unfortunately, being appreciative has never been my strong suit. Somehow, the line of thinking that goes I'm so fortunate. I've got my husband, my career, my house etc. just makes me feel like I'm being denied my right to bitch and moan. I think it's lovely when I read about other people having moments where they feel gratitude, or where they can resolve not to let IF take over their lives. I can appreciate those feelings on a logical level. The same is true when it comes to appreciating my fairly good prognosis. I am, at this point, still in the Fairly Lucky IF pool. But instead of being hopeful, I just fixate on the fact that lots of women with my basic profile never cross over to the baby side. Many never know why. It would be hubristic to assume it's just a question of time for me. So taking a positive attitude is very...difficult and uncomfortable.

Also uncomfortable is my ENTIRE BODY. I feel like absolute crap. Of course I know it gets way worse that this if you have endometriosis or are doing an IVF cycle. So I'm going to whine about complaints that are, yes, fine, trivial. (Also, I'm covering BFB's class tonight, which meets in the superfine 5:30-8:15 slot. Great for pregnant women / new mothers who need flexible schedules, not so appealing for people who want to crawl into bed at 7:30. This is making me extra crabby.)

I've gained five pounds since Friday. This does at least explain why my abdomen is so attractively DISTENDED. Sexy. I'm brain dead because of interrupted sleep. I can't tell if it's the hot flashes waking me up, or if I'm just waking up and then by body figures, hey, let's squeeze in one of those hot flashes she likes so much! I've had back pain pretty much my entire adult life, but it's extra bad these days, and I even had a massage on Saturday. (Which was lovely, but won't stop me from complaining.) There's a throbbing pain in my left side that makes me imagine horrible things happening to my ovary. And now my knee hurts. How totally unromantic is that?

In short, these are my reasons for not quite being able to hop on the happy train. (It's hard to hop on a train with a bum knee.) But I am trying! Surgery! YAY! Can't wait! If nothing else, it should put an end to the hot flashes.

Cooooooold

Yesterday spring was poised to spring. Daffodils were budding, ready to release their blooms. The few remaining Canadian geese on the lagoon outside my office were looking at each other sheepishly. I don't know guys...should we head out? There seem to be a lot of DUCKS around all of a sudden... All this, in combination with my hot flashes, made it seem like I'd be ditching the winter coat any day. But last night it snowed. Today, walking to work, I felt like my face was going to freeze right off. And, gloriously, my day began with an ice pack to the ass, followed by my second Lupron shot. It feels kinda burny, this time. But maybe that's just my ass thawing. Like the frozen earth. Preparing to bring forth new life. Not like my ass. I hope. That would be bad.

So, now comes the time when I begin to freak out for reals. What if there was some miscommunication and I'm supposed to do another month of Lupron? (Don't tell me I could resolve this fear with a call to the office. I know that. And I just confirmed the plan with the nurse this morning. Yet I continue to worry.) I admit to being quite scared about the surgery itself. What if something goes wrong? What if this decision is something I'll regret all my life? Plus, I'm scared about little things, like the fact that I've never spent a night in a hospital before. What will it be like? And what if the recovery is unbearably painful? Let alone all the fears that will arise once I'm through the worst of it and facing six months timed intercourse and negative tests... And don't tell me I could get pregnant. I don't believe you.

I might be extra distraught and pessimistic because of the couple in the RE's waiting room today. The woman came up to the window and cried out ever so loudly, I HAD TWO POSITIVE TESTS THIS MORNING! The office manager congratulated her...blah blah blah. They plunked down next to me in the empty waiting room and I could feel the excitement pouring out of her, and the happiness...uncontainable. I could feel her efforts to make eye contact, which I refused to indulge, as tears were welling up in my eyes. Every time I go in there, someone is getting a beta blood draw after a positive test. I know that's a good thing. It means my clinic is doing right by its patients. God only knows what this couple had to endure to get to that point. And why should anyone have to be discrete about something so thrilling? Why should anyone have to care about the feelings of others in a moment like that? No one should. But it's still going to be depressing for me.

I appreciate my job, I SWEAR.

Hot flashes seem to be triggered by actual thoughts. Do any of you find that to be the case? Several times I've thought about something embarrassing or upsetting, and HOOOOOOOOT! This morning I was thinking about the way I represent my attitude towards my job in this here online journal. It may seem that I don't value my job, and when I thought about the fact that a few people who drop in regularly are also academics, it occurred to me that this might be the occupational equivalent of those fertile women who complain about pregnancy while rubbing their enormous bellies. HOOOOOOT!

I've got some complex feelings about my job. I've mentioned really not caring about my career anymore, and that's kind of true. But it's also a major source of pride. This weekend my husband and I were spring cleaning the filing cabinet and encountered the file that contains my academic documents. There's my high school transcript, which sports a strange combination of As and Fs. My terrible SAT scores. My crappy-state-university transcripts wherein I show that yes, I can get all As, my transfer to a really wonderful institution of higher learning, my letters of acceptance to graduate schools, my offer letter from Mediocre Institution... And while my job is very hard on me--it involves public speaking and I'm socially phobic, it involves constant criticism, and I'm a delicate flower--I did love it until infertility struck. Then, weirdly, a couple of people said things that resulted in me somehow linking the two. I might have done so anyway, but these offhand remarks really sealed the deal.

1. My father (who then rudely died before I could make him take it back) said: Some people don't get to have everything, and you have a career. Implication: if you didn't have a career, you'd get to have a baby.
2. BFB, when she told me she was going to start trying, and I revealed I was infertile, said: I should get pregnant first because you have a tenure track job. (BFB has been on the job marked multiple times, with no offers.) Implication: her getting pregnant and my getting pregnant are dependent on each other.

As I sit here, writing this instead of combing the NSF website for some source of external funding that will allow me to get tenure, I begin to wonder. Does part of me believe, really believe, that if I abandon all ambition, I'll get pregnant? Is all this apathy I feel actually me sabotaging my career in the hopes that I'll get that baby? Should I quit my job so we can find out?

My it's warm! And I ain't talkin' 'bout the weather.

First, I wanted to thank you all for articulating your thoughts on my last post. There was an awful lot of very beautiful and moving stuff in there and I found it comforting ('cause I'm the one who needs to be comforted, don't you know) and touching. (Twangy's news has since been posted on LFCA--I'm not sure why I felt delicate about outing her yesterday--I mean, how offensive can offers of sympathy really be? Hopefully not too offensive.)

But now I'll try to distract you with some assorted...stuff.

Until today, Lupron had resulted in no menopause-like side effects. Perhaps because the side effects it causes are highly likely to go unnoticed. I mean, mood swings? Like I would even recognize one--my mood has been swinging for at least a year. I suppose if Lupron made me really cheerful I'd notice, but...it hasn't. Anyways, today: hot flashes. I AM SO HOT. Oh...no...I'm actually fine. HOT. Fine. HOT. Just like when on Clomid, they started in the dead of night and woke me up so I could enjoy being drenched in sweat. Mmmmm...feels so good.

Yesterday evening I attended the reception for people nominated for the teaching award I told you about. The university president made a speech that brought tears to my eyes. (Or maybe it was the glass of wine and the fact that I somehow ended up SURROUNDED BY PREGNANT WOMEN. Seriously, they were drawn to me like moons to Jupiter. And stood there, rubbing their bellies with glazed looks on their faces.) She asked us to think back to the person who'd made a difference in our lives, maybe set us on the path to academia. The person who inspired us, encouraged us, led us to believe in ourselves. Now you are that person, she said. Weeeep! I guess those are the moments that help me when things seem so dark. The knowledge that just by showing a little enthusiasm at the right moment, you can genuinely make someone's life better. Of course, I'd rather have a baby than make people's lives better.

Another thing that makes me feel better in times of sorrow is...squirrels. I love squirrels. Below is a photo taken from my office window. As you can see, there's a wonderfully tall tree that stretches all the way up to the sixth floor. And it brings the squirrels to me. After posting yesterday, I looked out my window and watched a squirrel sitting on a branch so far above the bustling world, buffeted by wind, just going about its life. The sight brought me a little peace.

Me and God

I just discovered that a well-loved fellow traveler seems to be on the path to miscarriage. The heartbeat is gone at 10 weeks. Amid all the thoughts, this one kept recurring: I'm glad I don't believe in God. If I did, I'd struggle so mightily with understanding how He could subject a good person to this experience. It would seem like such a complete betrayal. I'd feel that He was so unloving.

I hope so much I don't offend anyone by expressing my thoughts on this subject. I know it's a touchy one. I have great respect for people of faith. In fact, I was not always an atheist.

When I was four, my parents divorced and my mother moved us to a tiny town in northern New Mexico. She decided we should become Catholics. She grew up Catholic, though she had morphed into a sort of pagan by the time we were born, so for her it was partly a return to the fold. But I think her main motivation was not a resurgence of her faith but a desire to avoid complete social ostracism. Everyone else in town was Mexican, Spanish speaking, and Catholic. We were the only non-Mexicans within a good 50 mile radius. (In case you object to my use of Mexican rather than Hispanic, this is how they referred to themselves 'cause they traced their lineage from Mexico, not Hispañola.) To be white and not Catholic would have been too much, I think. So we were baptized. My mother even managed to find me a gay godfather, which is pretty awesome given that the population of the town was about 300.

Church in this town was a remarkable experience. The tiny church was decorated in what asshole academics like myself would refer to as folk art. It was beautiful. Mass was in Spanish. I still remember the prayers and say them to myself sometimes. I particularly love the second half of the Hail Mary: Santa Maria, madre de Dios / Ruega por nosotros, los pecadores / Ahora y en la hora de nuestra muerte, Amen. Pray for us sinners, now and at the hour of our death. Very goth.

I was a dedicated Catholic. I was always searching for Grace. Apparently I was quite a little martyr, too, always wanting to sacrifice things to show my love for God. But my faith disappeared when I was about 10. I don't know why, but I no longer believed. I remember crying because I realized I'd never see my father in heaven--that once he died, it was over. I don't expect my faith to come back. I am also angry at the Catholic church for many of its teachings. It seems to emphasize shame and guilt so much, rather than love and kindness. But my goal is not to criticize the church, simply to say that I've had the experience of faith, and I've had the experience of no faith.

If you do believe, how do you draw strength from God? I know the standard line: you tell yourself that you are not always able to understand His plan, that you just have to give yourself over to Him. But there must be more to it than that. If you are willing to share your experiences, I would find it helpful to hear them. Maybe it's not something that can be put into words.

And if you are not a person of faith, what do you do in your darkest hours to comfort your soul?