wedding

wedding

Sunday, January 26, 2014

Preparing My Body

Remember when I wrote about my conversion to Judaism and how there was something lovely and holy about preparing myself for the mikvah? I really cherished it and got a lot out of the process that is difficult even to explain. Well, that only took a week (and not for the entire week) and was for something that would be less than ten minutes long. Preparing my body for pregnancy gives me a similar feeling, but I have to be aware of it and consciously act on it multiple times every day, and it is for a process that begins now and will go on for about another year. Intense.

1. The biggest part of this preparation is making healthier nutritional choices. I took it to heart when my PCP signed off on the surgery with my slightly elevated blood pressure and said, "This surgery is low-risk and I'm not worried about it. But you need to be focusing on the bigger picture and get yourself into better shape so you have a healthy pregnancy." She said what I knew but made it real and immediate.

That appointment was on Monday December 23, and I started weighing myself every Wednesday, beginning December 25, and just making better choices - smaller portions, less snacking, only choosing "fun" foods that are really worth it and will be thoroughly enjoyed. I'm not disciplined enough to cut anything out completely so I don't think that would set me up for success. I've also struggled with counting points on Weight Watchers, though I know that when I do, it's a program that is very successful for me. As of this past Wednesday, January 22, I had lost exactly nine pounds. Not too shabby considering all I'm doing is trying to eat more consciously and make choices that are slightly better than what I impulsively want to do.

All too timely, Rabbi gave a sermon a couple weeks ago about the importance of not being enslaved by our impulses, by recognizing and naming the impulse, pausing, and then taking back control over our passions and drives. I remind myself of that when I just want ALL THE ICE CREAM.

We've all heard that people who struggle with weight and eating choices struggle with that their entire lives, no matter how long they may have been practicing better habits. This will never be easy for me. But I need my body to be in good shape so that both my baby and myself can be as healthy as possible...and then I need to stay healthy so I can be in my family's life as long as possible. It's that important.


2. My next preparatory act was beginning prenatal vitamins. They finally arrived yesterday from my insurance company's mail-order pharmacy, and I started them that day. They are crazy looking - one big white pill, and one dark brown capsule. I've heard of people having bad reactions to prenatal vitamins so I'm the slightest bit nervous, but so far so good. I particularly remember my cousin getting so nauseous and sick every day that she had to stop them.


3. I asked my fertility doctor on Friday whether I should be coming off any of my prescription medications as we get closer to insemination. She said that in general it's better to be on fewer, but that she can't make that recommendation and I should consult with my PCP who knows my medical history and prescribes for me. So I made an appointment for the Sunday of President's Day weekend. My PCP is on the Upper West Side, and I haven't changed because every living situation until now was temporary. Now I haven't changed because I just love and trust them so much (I have a favorite, but love EVERY physician I have seen in that practice) and it's still more convenient to go there from work in the Bronx rather than try to get to something in Long Island on a weekday.

My doctor is engaging, easygoing, gentle but frank, and natural-minded. I trust him to help me figure out what medications are safe and weigh the benefits and risks of remaining on them, going off of them, or finding an alternative. I made the appointment for a Sunday because I want my wife to be part of this conversation. I also want my doctor to meet her since he has known me longer than I've known Nicole, and he always asks "how's the wife?" Street parking in Manhattan is free on Sundays and I figured we could make a day of it!

I started doing some preliminary research as soon as I made the appointment. While I take everything on the Internet with a grain of salt and ultimately will be following my doctor's recommendations, I don't want to come in with no knowledge. It was helpful to see what other pregnant women's doctor's have told them, and what the research on certain drugs says.

My medications are for asthma and allergies. I learned that Advair (daily inhalant to prevent asthma attacks), Albuterol (emergency asthma inhaler for during an attack), and Flonase (decongestant) are class C drugs, meaning they have shown birth defects in mice but they obviously can't do this kind of research on humans so it's not known for sure whether it would impact humans the same way. Basically I should come off of them if I safely can, but if my asthma is bad enough (and it will be exacerbated by pregnancy), then it's better to take that tiny risk than to take the bigger risk of not giving my baby enough oxygen while I wheeze and struggle to breathe. However, many pregnant women were prescribed an alternative to Advair, which while maybe not quite as great, does the same job without the ingredient that is the problem. I'm glad I know this so I can ask about that specific medication if my doctor doesn't suggest it himself.

Zyrtec, which I take for everything except congestion (primarily sneezing and itchy, watery eyes), is safe, but Zyrtec-D (decongestant) is not. It appears that there may be no safe decongestant because of whatever the active ingredient is. But that's okay. I don't mind having a stuffy nose for ten months or more (if I can't take it while breastfeeding either) as long as I can breathe!


4. We are slowly switching to decaf coffee. This is what I've been dreading the most, more so than saying no to tempting treats or coming off my reliable meds. I loooooove coffee. I LOVE COFFEE. I love espresso-based beverages as a treat, and I'm a bit of a snob about what I brew at home (always set to "strong" on my bean-grinder) and what I'll drink at other people's houses or at restaurants. It's one of my favorite simple pleasures that I relish every single day. And as much as I delight in the taste, it really doesn't feel so worth it without caffeine. I imagine even people who absolutely love the taste of wine would still balk at the same wine having no alcohol. It's just not right and affects your pleasure on a psychological level!

I've been putting this off for quite a while. I worked with a teen once who wanted to get pregnant but wouldn't stop smoking cigarettes, but swore she could and would as soon as she got pregnant. I didn't get it. Now I do. Addiction is real, people, and this is my first real encounter with it for myself. It didn't occur to me that I was in its throes to this extent until I realized how many mind games I was playing on myself in order to not give it up. "I'll wait til the cycle where I'm trying to get pregnant. Then I'll be so excited I'll be able to stop." "I only have to give it up for that first few months, but then I can have it again. I know plenty of people who had just one cup a day later in their pregnancy and were fine."

Once I realized that all this justification made me an addict, I finally agreed to go along with my wife's suggestion that we start mixing caf and decaf with increasing proportions of decaf until we've switched over completely. Even if at that point I just say "it's not worth it anymore" and stop drinking coffee altogether. I knew if I wasn't going to go cold turkey, then we needed to start that now, and so we have. We just started this Friday, so far so good. We'll see how Monday morning goes.



Watching every single thing that goes into my mouth - food, vitamins, prescription medication, and caffeine - is pretty intense for me. As a somewhat natural-minded person, I've had a mild awareness of my body and what I give to it, but nothing compared to this. I'm going to be really real (and intend to throughout my blogging of this process), without shame and guilt, and say that it is not only about making sure I have a safe environment for my baby-to-be, but also about not doing anything stupid that sabotages us and sends us back to the drawing board of a very expensive process. Of course having that coffee isn't worth even the smallest risk of losing a life that I'm already attached to before it's even there - but it also isn't worth another $3000.

The reality is that I'm not just trying to get healthier because it might be easier to conceive with the idea that I could always change something if we have difficulty. We have to pay every single time we try, and I need to ensure optimal conditions from the outset. With anything that costs that much money, I would hope I would be as careful and protective as I can be, and this is no exception. Obviously I would be dealing with the emotional ramifications of miscarriage or difficulty conceiving, but I would also be dealing with continuing a process that is exorbitantly expensive, a process we can only afford to try so many times, and that's where my mind is right now.

Saturday, January 18, 2014

Privacy or Isolation?

I've been thinking a lot lately about how open I've been with those close to me about our fertility journey. If we were a straight couple starting the "traditional" way, I probably wouldn't be sharing so much. I can't imagine that I'd say, "Okay, here goes - we're going to start trying this month!" Not to anybody, probably, or maybe just to two or three of my closest (mom, sister, best friend). And because that's the more conventional path to parenthood, and people requiring fertility intervention often don't talk about it much because they're stressed, frustrated, and anxious by that point, the "norm" is silence. "Privacy." "Self-protection."

But for us, this involves so much, and so much that by necessity invites in other people we barely know. Once you have your feet up in stirrups four times in two months for three different people (family GYN, fertility doctor, and radiologist), once you've had to consult others in similar situations to get advice, you've already kind of thrown modesty to the wind. And then you have to decide whether you want to go through such an intense and time-consuming process with only the support of these near-strangers, or whether you want to take the emotional risk of bringing in people who matter to you.

I've chosen to share this with people close to me. It's quite simple - I need support. I value having some friends and family who are ridiculously excited for us and cheering us on, waiting happily for good news. If all goes well, we'll have been able to celebrate our baby since before it was even an embryo. How beautiful is that? And if we end up on a long, frustrating, disappointing journey, these friends and family will be the same ones there for me. And if we experience the euphoria of a successful conception with a tragic ending, there will be shoulders for me to cry on. That's a risk I'm willing to take.

Making myself vulnerable fosters connection. If I end up hurting, I don't want to hurt alone. And if I end up with earth-shattering joy, I don't want to have to hide my happiness. The traditional second-trimester announcement doesn't fit who I am. Of course that will be the case for letting the world know - coworkers, acquaintances, somewhat distant relatives. But for those very important in my life, I need them alongside me in my journey. I'm okay with having a friend ask, "So?? How did that last appointment go?" or "What's the next step?" In fact, the idea of having that emotional accessibility makes me feel safe, loved, and secure. It makes me feel like we will be okay wherever this journey takes us, because we are not in it alone.

Calm Before the Storm

We are seriously planning to start trying to conceive in March, and suddenly, two months or less out, I find myself trying to freeze time. I don't mean feeling immobilized or freaking out and not wanting that time to come. I mean that I am living in and enjoying every moment until then.

I've spent the past couple years agonizing over when we could have a baby. Not every second, of course. We were occupied with house-hunting, moving in and settling in, my conversion to Judaism - a lot of wonderful things have been happening, and we've had a great first couple of years of marriage! But I've also been acutely aware throughout of our financial struggles and goals as well as the complicated and expensive process of family-building for us as a same-sex couple, and that's kept conception always just past the horizon. Now we have a realistic timeframe, and it's right around the corner!

Preparatory surgery and all the appointments leading up to kept us busy and distracted throughout late fall and early winter. Now we're just kind of...waiting. Waiting to get a little more money for this very expensive process so we don't have to dip into savings or charge it or go on a payment plan. Waiting for our upcoming counseling session so we can be approved to order sperm. Waiting for my wife to work up the nerve to get HER bloodwork done.

And in the meantime, I am reveling in the smallest, sweetest details of domestic marital bliss.

Last weekend we spent most of Saturday with our friends A&A and their two boys. We had made a Tot Shabbat date for that morning and did a really sweet Tu B'Shevat workshop with them afterward. It was SO fun to see this side of our rabbi and to get a sneak peek of a different way to experience temple life! We had a great time and they were so eager to talk to us about where we are on our path to pregnancy that they suggested we have lunch together afterwards at an Indian restaurant a few villages away. We spent HOURS there in a booth overlooking the lake, chatting with them and interacting with their young sons (4 and 2).

A&A gave us a lot of helpful advice - but also asked a lot of questions we don't yet have answers to! "Do you know which vaccinations you want to give your child and which you might want to decline?" (Um...I don't even know all of the vaccines that are recommended!) "Are you going to save the baby's cord blood?" "How 'natural' or not are you going to go with labor and delivery?" And more!

I felt embarrassed for a while that our answers were mostly, "Um...we started talking about that a little but haven't gone into depth. We're kind of focusing on the intense getting-pregnant process right now and then we can talk through that stuff more once we're pregnant." It made me feel unprepared But now I realize that people have been (and still are!) getting pregnant without planning it for THOUSANDS OF YEARS, and they manage to start planning this kind of thing during pregnancy. I know this goes against everything our baby-obsessed, mommy-centered "BUY [INTO] THIS NOW if you want to be the perfect mother with the healthiest, most well-adjusted child!!!" culture, but we just aren't thinking about all that yet. And I think it's okay to start having a lot of those conversations when the time comes to actually figure it out. Not only do we not need to know how we feel about every single thing before it's an issue, but actually living it may lead to constant re-evaluation anyway.

We have been on the same page with pretty much everything we HAVE discussed, with the exception of circumcision. But since that's a Jew thing, she'll get her way and it actually helps me go through with it to know it's what she wants. Before my conversion, though, she was actually willing to budge on that because I felt more strongly about it than she did and had put a lot of thought and research into it. But I digress. I'm not worried about how we'll iron all that out. I mean if we disagreed on something now, would we just forego having a child because we can't agree? Of course not. We'd figure it out just like we do everything else in life, by hearing each other out, doing our research, and coming to a consensus, so that's what we'll do as parents-to-be and as parents. With all our pregnancy preparations, we just don't have the brain space available right now to determine every move we'll make in our child's life! (And I don't know that A&A had it all figured out beforehand either - I think they're just curious about our opinions because it's all things they've had to address in the past few years of their life.)

We've kept our baby preparations in general to a minimum out of an unspoken consensus that we want our marriage to be about more than baby excitement. As wonderful as that is, it's going to consume the next 20 or more years of our life. This time before is precious and things will never be the same! I know all too well how I sentimentalize memories of past stages of my life. I know that for the rest of my life I will look back on that first few years of marriage before baby with much wistfulness, and with a wish to be back in that moment and feel it again just for a day. I'm like that with childhood, with college, with being in my own first apartment, everything. I am queen of appreciation of the moment and what's around me while at the same time missing everything that's behind me. I get very attached to people, places, and stages of life and it's always difficult to let go even when I'm happy where I am. I don't want to wish away these last few months out of eagerness for Baby when I know EVERYTHING IS ABOUT TO CHANGE FOREVER.

I can practically see the clock ticking down to pregnancy. It's so exciting that my insides are jumping and I can't wait to get started!!! But I'm also so very aware that this is (hopefully) our last few months of calm. As soon as I see that plus sign on a pregnancy test, it's lights, camera, ACTION. How we spend our weekends and what we shop for will change. The books I read during my commute to work will change. The content of our conversations will be vastly different. There will be a countdown on how many weekends we have to just relax in bed together, go to any event at temple that we want to without a second thought, travel anywhere with five minutes' notice and not spend a half hour preparing a bag and a baby.

I'm basking in the joy and contentment of the simplest moments right now - every meal together, every cuddle, every peaceful Shabbat afternoon during which Nicole naps while I watch a movie, every intimate just-the-two-of-us glance, conversation, flirty joke.

I hope 2014 ends with a sweet baby in our arms. I hope we are successful in expanding our family in our ideal and most cost-effective way. And anticipating our year ending this way helps me enjoy every second of its vastly different beginning!

Saturday, January 4, 2014

Post-Op and Next Steps

We had a big snowstorm Friday, so the fertility clinic called me Thursday morning to let me know they'd be closed and to reschedule my post-op exam for the following Wednesday, the next time my doctor would be at this location. I panicked and said I have already been out of work for a broken foot since December 9th, am hoping at Monday's appointment to get approval to go back to work Tuesday, and no way could I then take off again Wednesday. The receptionist was very understanding and said she would call the doctor when she gets out of surgery to see if she could fit me in this afternoon, but I'd have to be ready to run there the second she notifies me of any availability. So that's what happened, and I'm so grateful to have it overwith!

Dr. K showed me photos of my uterus and some other random organs and my cyst, but it honestly just looked like a jumble of gross slimy things so I don't know what was what and was too embarrassed to ask more specifics. Then she checked out my incisions and said everything was healing beautifully, and she took out my stitches. She said to stop taking the birth control pill and then wait one full cycle for my next real period and then we could start that next cycle! There are many steps in between, though, so I think we will have to wait another one before we will be fully ready.

I had to meet with a physician assistant there afterward, and she explained all the next steps to me. (I had Nicole on speakerphone so she could hear it too - she had scheduled to take me in Friday but couldn't leave work suddenly to come to this make-up appointment, and was very upset about it.) It was so overwhelming that after a few minutes, I had to interrupt her and ask for a pen and paper because I felt like I had no idea what I was supposed to do next. I needed to write down clear steps. The PA patiently went back over it one by one so that I could get myself organized. What a process! I'm going to write it as a list here so that it helps clarify it for me and just keeps it less muddled descriptively as well.


  1. We both need to get bloodwork done, though Nicole's will not be tested for quite as many things as mine will be. But since we are sexually involved, they need to know if she has HIV, Hepatitis, etc., anything that could jeopardize my health or the developing fetus.
  2. I need "counsel bloodwork" done at the clinic (the other bloodwork has to be done at a lab) to do genetic testing. If anything comes up, that will be cross-referenced with the donor's results to make sure it's a safe match.
  3. We need to make an appointment with a social worker to have a session of counseling around using donor sperm. This is required of anyone using donor gametes for whatever reason, eggs or sperm. They want to make sure we understand the implications and are ready for the responsibility. I get it, especially when a clinic wants to make sure they're covering their ass and you can't accuse them later of not having done such-and-such, but it still feels a little demeaning to have to go to another LCSW (I'm an LCSW) for them to assess me and approve me to become pregnant. I'm accepting it, but I'm struggling with it a little.
  4. Once her assessment is in my file at the clinic, their office will accept sperm to wash and store for me. I need to order four vials of unwashed sperm to be shipped to the Melville office where insemination will take place. It makes sense to go ahead and have four vials on hand, but for some reason we hadn't prepared ourselves that we'd be paying for more than one at a time! We had budgeted for one vial a month until I get pregnant, not figuring it as a lump sum. $470 just quickly went to almost $2000! The clinic wants it unwashed because they don't trust the banks to do as good of a job as they do.
  5. When we're ready to start, no sooner than two periods from now, I need to call the day I get my period and schedule to come in eight days later (Cycle Day 8) because I have shorter than average cycles. They will begin testing me daily for ovulation, and as soon as I test positive, I have to be ready to go right to the Melville office for insemination, and wheeeee here we go!
  6. I need to start prenatal vitamins today. PRENATAL VITAMINS. This just got really real, people.