Saturday, February 27, 2021

The Good Fight

When we last left off, I was supposed to have a calm, mature conversation with my husband about his feelings and fears regarding the embryo transfer.

I’ll spare you the suspense: I fucked it up. Despite talking through the strategy with my therapist beforehand, I came at my husband guns a-blazing. Instead of listening to him, I spewed all my anger at him. I spat dark predictions of what would happen to our marriage if we canceled the transfer. I swore. I made him cry. (Though to be fair, he’s a crier. It doesn’t take much.) I didn't comfort him. I didn’t want to force his hand, but when I thought about calling California IVF to cancel the transfer, hot tears pulsed in my eyes.

After expressing his fears (“I’m staring down 50. I don’t want to be ‘old dad.’”), he tried to smooth things over. He hugged me, said he loved me, and reminded me that we were a team. He tried to be cute and asked our daughter if she would be kind to a little sister.

This did not assuage me. Strangely, it made me angrier. I wanted him to want another baby, and it was so obvious he didn’t. The desire was just not there for him. That’s not to say he wouldn’t love another little girl once she’s here – in fact, he said exactly that. But was that enough?

We weren't getting anywhere (surprise, surprise) and it was getting late so I said we should just stop for now. I needed a moment to process. Questions I asked myself: Am I being unreasonable? Do I secretly want to abandon this dream, too, but I'm making him do the dirty work? Is this an “opportunity” for me to be the bigger person and stop pushing in order to keep the peace? Do I have it in me to do that? Or is that just another form of ego? How do I let this dream go and not expect him to "make it up to me"? Could he ever do that? Why am I wrestling so hard with this? How do I "solve" it without blowing everything up?

I tried to meditate and pray my way to clarity, but I couldn't feel God in this situation at all. I felt abandoned and stuck. I Googled “How to discern God’s will with having children” and came across one helpful blog post by a mother of eight(!). She wrote about how people do not choose how many children they have. God does. Even if you try to take control from Him (i.e. use birth control or the rhythm method or have a vasectomy), He finds a way around it if you are really meant to have a child.

This advice resonated with me. We were not deciding whether or not to have a child. We could try our best by going forward with the transfer, but God would determine whether or not it was successful. We could also opt out, and who knows? Maybe we would get pregnant spontaneously. (Is there an infertile couple out there who doesn’t indulge this fantasy? I doubt it.) Or maybe we were not meant to have more children and no matter what we did or didn’t do, there would be no more children.

In that sense, there was really no “right” or “wrong” way to go about this. No matter which path we took, God would decide whether or not another baby would come to us. Reframing the issue this way lightened the load.

In quiet moments, I kept coming back to wanting to try, at least once, because I didn’t want to regret not trying five or ten years down the road, when it would definitely be too late.

After a cooling-off period, I asked my husband if there was room for compromise. Could we agree to try once and then give up if it doesn't work? He seemed amenable to that. But that would put a lot of pressure on the impending transfer. What if it failed and I wanted to try again? Could I just leave those two unused tries on the table? The gambler in me had her doubts.

I huffed and puffed and stewed and silent treatment-ed my husband for a couple of days. Then, I don’t know what changed exactly, other than I became convinced that the transfer was happening and my husband didn’t resist. There wasn’t one conversation where we “decided” to move forward; it was more of a silent acknowledgment that the decision had already been made, maybe months ago, and we were finally just submitting to the decision.

Two days before my departure date, my treatment coordinator called my husband to get his consent for the transfer. “You have it,” is all he said. It wasn’t as effusive or excited as I would have liked, but it was enough.

So that was that. I was going. Now I just needed to get to Sacramento…

Wednesday, February 17, 2021

Indecision City, Population: Two

Embryo transfer date confirmed, backup profile selected, and medication protocol underway, I should have felt settled and satisfied. I felt neither.

A lot had changed since December when we were last approaching an embryo transfer. Our daughter was now mobile and her personality was asserting itself. She was insatiably curious, increasingly stubborn, and needed constant supervision. I’m not complaining (I am nothing if not curious and stubborn myself), but somehow, I’d forgotten that taking care of little babies was actually a breeze compared to burgeoning toddlers.

Our daughter was now sleeping through the night again, but I found myself awake at 1 a.m., staring at the ceiling, wondering if we were being reckless in pursuing the dream of another child.

When my husband and I discussed it, we went 'round and 'round the same concerns about having a sibling for our daughter: Do we have enough money? Can we handle more stress? How will another baby affect our marriage? Will we need to hire help? Can we afford that?

When my husband rattled off all these concerns, any rational person would agree that having another baby was crazy. Ah, but when it comes to babies, I am not a rational person. When I saw siblings out in the world playing together, or I witnessed a sweet moment between my teens, I’d think, “Of course the baby should have a sibling.”

And yet, we'd finally scraped together some balance in our days. In addition to working and parenting, I had time to exercise and meditate and pray every day. I had my body back – no, even better: I was 15 pounds thinner than I was pre-pregnancy. Life was pretty good. Why mess with it?

But then I thought about how every milestone our daughter hit – standing up and clapping are her latest adorable achievements – were the last of these kinds of milestones I would see if there would be no more babies, and that made me sad.

When I rattled off the pros and cons of having another baby in my head, it was clear there was only one pro: that the baby would have a sibling. On the flip side, there were so many cons: health risks, financial strain, marital stress, energy depletion. But I couldn’t bring myself to cancel the transfer – and my husband seemed stuck in a state of resigned inaction.

“I wish there was a professional decision-maker we could go to,” I told my husband after we rent ‘round and ‘round again discussing all this. “We’d give them all the information we have and then they’d decide for us.”

“You want a stranger to make this decision?” he said.

“At least that way, if it was the wrong decision, we could blame the misstep on them.”

My husband thought this idea was ridiculous.

“Well, I would throw ridiculous amounts of money at someone to make decisions for me right now,” I replied.

I mentally toyed with the idea of abandoning the dream of another child and just focusing on our daughter. On easy days, I would dote on our daughter and feel my heart swell with how much I loved her. I would think, “She’s enough – more than enough. Why do I need anyone else?” And on hard days, I would think, “I don’t have the desire or the energy to do all this again from day one.”

One early morning, my husband made this announcement: “I don’t think I can be a good parent to any more children.”

I’ll admit: I’d had similar thoughts. I knew another baby would not get as much affection and attention that our daughter does. There just aren’t enough arms and energy. I also didn’t want my children to grow up in a household with unhappily married parents – though I suppose we were at risk of being unhappy regardless of how many children we had.

But my fears hadn’t outweighed my hope. Not yet. Especially not after my lining check ultrasound, which revealed an incredible 17mm of cushion in my baby house! (For reference, 8mm is the minimal endometrial lining thickness required for a transfer.) Mine was so impressive, the sonographer said, “You go, girl!” 

My husband was not wowed by my super-womb. He was a dark, toxic cloud that loomed over what should have been a time of delightful anticipation. This was why I hadn’t wanted to cancel the transfer in December – I knew that given too much time to contemplate, one or both of us might change our minds.

“Are you saying you want to cancel the transfer?” I asked my husband after he dropped the aforementioned truth bomb.

My husband started to cry, which confused me because I thought canceling would make him happy, right? Didn’t he want to be relieved of the pressure?

“Do you think it’s easy for me to tell you this?” he asked.

It seemed easy enough. He said it, didn’t he? Or did he? What was he saying?

“If you’ve decided we can’t go forward, then you call West Coast IVF and cancel,” I said. “You explain to them that you’ve had a change of heart – if that’s what this even is. I’m not going to be the bad guy.”

Of course, my husband didn’t want to do that. Or maybe he wanted to, but he was afraid of my reaction. So our discussion fizzled out, only to be reignited every few days when something would set us off.

Would canceling the transfer be a relief? Or would it welcome in a new wave of grief? It was easy to pretend I would be calm and regret-free post-cancellation when I still had the transfer scheduled. It’s like fantasizing about breaking up with someone you’re still sleeping with at night and drinking coffee across from every morning. You don’t know how devastating it will be until you actually end it and have to confront the gaping chasm of emptiness where their presence once was.

Also: this wasn’t just a decision about a transfer, or even about a baby – it was about the end of an era. What would it feel like to close the door on my fertility, forever? I wouldn’t know until I got there.

I took to Google, seeking answers. I researched outcomes of only children (because, while I have two teens, the age gap between them and our daughter is 16 and 17 ½ years; our daughter would basically be growing up as an only child). All the studies said that only children fared just fine; they are no more likely to experience loneliness or depression than people with siblings (though they are more likely to be obese, interestingly). Only children are, however, more likely to be successful as adults.

So, there was that – the rational, scientific take on whether or not to have another child. But what about the emotional value of siblings? On this, the internet seemed divided. There are many only children who say they desperately wanted a sibling growing up and/or wish they had one now, as adults, to lean on. There are also many people with siblings who point out that growing up together doesn’t guarantee any kind of bond. Sometimes siblings are close, but they aren’t always. I could certainly think of examples of both scenarios in my family and social circles.

As for the infertility community, I didn’t even bother asking their opinion. Women who have experienced infertility are all incredibly supportive when someone is undergoing treatment, but don’t you dare drop even a hint of ambivalence on their social media spaces. It’s as if the first rule of Infertility Club is: Never, ever give up! No. Matter. What.

“Are you still hellbent on doing this thing on Friday?” my husband asked me one morning.

“It’s on Monday, not Friday,” I replied, frustrated that he couldn’t even remember the timeline of when I was supposed to fly across the country to get pregnant. “And I’m withholding any decision-making until I speak with my therapist.”

I think my husband thought my therapist would talk me out of the transfer. I hoped for the opposite – that she would encourage me onward. Of course, what I got was typical therapist spiel: objectivity and non-answers. Don’t get me wrong; it felt cathartic to talk it all out with Shania. But her conclusion was: “It’s not the decision itself that matters; it’s how you two come to a decision together.”

It reminded me of a column in The Atlantic by therapist Lori Gottlieb (whose perspective I usually love) in which a woman was considering divorce because her husband refused to give her another child. Gottlieb essentially told the woman to coddle her husband’s feelings and accept that she might have to smother her baby dream so that her husband could take more naps. (This is my ruthless interpretation, which is naturally biased given that I’m going through a similar situation; others will probably read it differently.)

I told Shania that my husband and I have talked this thing to death and we just keep having the same conversation. I already know his fears about moving forward (money, stress, relationship quality) and his fears about not moving forward (my anger and resentment). I know why he sticks his head in the sand (he’s afraid of my reactions; as he probably should be). What new information could possibly come from another conversation?

Shania gave me a set of questions to ask my husband and encouraged me to be non-threatening when listening to the answers. She told me to be present in the process and to avoid charging ahead to the outcome. 

But instead of feeling curious and compassionate about what my husband was going through, I was infuriated. Why did it seem like he got to make this decision, not me? How could we make a decision together if we couldn't agree on how to proceed? And when it comes to having a baby with IVF, there really is no such thing as compromise. You either do it or you don’t.

During our session, Shania acknowledged how frustrating it was that I’d spent the last six months filling out paperwork, fighting with West Coast IVF, undergoing procedures, and taking medications, only to have to contemplate canceling the transfer this late in the game. If we were going to shut down the baby factory, what the fuck had I spent the last half-year doing? Was it all for nothing?

“It’s like training for a marathon and not getting to run it,” she said.

Yes…but no. It’s like training for a marathon and being told you will never run again, even though you’re raring to go and your body is perfectly capable.

So here we are, on the cusp of one of the most important decisions of our marriage – if not our lives – and I’m instructed to just sit back and listen (’cause that will go well) while my half-packed suitcase awaits next to the bed...

Sunday, February 7, 2021

Hurry Up And Wait (And Deliberate)

After a hellish month due to my baby’s breathing issues, I finally received a new embryo transfer date, for late February. Though the health drama had been giving me second thoughts about moving forward, once I saw the treatment calendar, I was all in again.

I giddily booked my travel arrangements and scheduled my ultrasounds. I refilled my prescriptions. I calculated the due date and corresponding astrological sign of the potential baby-to-be. I brainstormed new names. I attached to the idea of her. I let myself feel hopeful again. 

Then I received another email from my treatment coordinator. She’d forgotten that I wasn’t on birth control. (Of course I wasn’t…because she told me to stop all medications in December!) The embryo transfer date was null and void. I would have to wait for my next period and reschedule. Again.

I lost it. I went full Karen on the clinic manager. (Again.) I threatened to pull out of the contract, demand my refund, and pursue treatment elsewhere. Of course, I didn’t want to do that, because it wouldn’t get me pregnant any faster.

A nurse called to talk me off the ledge.

“There’s still a chance you could keep the transfer date,” she said. “When was your last period?”

“December 26,” I told her. And that one, as far as I could tell, only happened because I stopped all the fertility meds when my previous transfer was canceled.

“Are your periods regular?”

“They haven’t been,” I said. I explained about my missing period in the fall and the Provera I had to take to get it back. There had been nothing “regular” about my cycles since…oh…2019, before I got on the infertility treatment roller coaster.

“We need to figure out if you’re growing follicles,” she said. “Because if you are, your body might be releasing hormones that could interfere with the medication protocol.”

I didn’t know the details of my follicular count, but I knew that in the past, it had been puny. The nurse reviewed my last baseline ultrasound and my SIS and confirmed there wasn’t much happening in the follicle department – but was that because I had been on birth control? Or because I was old?

“One advantage of being a seasoned woman,” she said (and, yes, that was the term she used), “is that we don’t grow many follicles. So I think we should do an ultrasound, see what’s going on in there, and if it’s not much, then we could potentially go straight to Lupron and stay on track for late February. What do you want to do?”

It was a risk, diverging from the tried-and-true protocol that had worked when I got pregnant with a donor embryo the first time, but at this point, I was feeling desperate. I had re-entered West Coast IVF’s program back in August and I still hadn’t had a transfer. I didn’t want to wait anymore. I wasn’t sure I could.

“Let’s try,” I said.

And so, the following Monday, I trekked to Dr. Baby-Maker’s clinic, where I once again submitted myself to another baseline ultrasound. As the sonographer readied the machine, she asked about my infertility journey so far. I told her all about the tooth ordeal and the canceled transfer in December. The tone of her voice indicated she truly felt sorry for me. Pity was nice, I guess, but what I needed more were answers.

The sonographer quickly found three small follicles (nothing to write home about) on the left ovary. As for the right? It was playing hide-and-seek. The sonographer maneuvered the wand in a thousand uncomfortable positions and she simply could not find it.

“I think it’s right behind this bowel activity,” she said, indicating what looked like a pulsing tube on the screen. Basically, I think she was saying that I was full of shit. (‘Cause that’s not mortifying.)

She dug around a little while longer, then (I think) gave up, grabbed a screenshot of something oval-esque, and called it an ovary for the report’s sake.

“I’ll send this off to California right away,” she said. “Hopefully you can get going already.”

I had my doubts, but later that day, I received confirmation from the doctor that I could start Lupron and keep the February transfer date. Hooray!

My treatment coordinator soon called to make sure my concerns had been addressed. Since she asked, I told her that there was one other unresolved issue: I felt uncomfortable with our backup embryo option, the one that included an egg donor who had a relative with schizophrenia and an unclear family history of mental retardation. I wanted to see more profiles – specifically those with proven fertility.

To make things easier, I told her I was open to any race. It was something I’d been thinking a lot about over the past several weeks. White couples adopted BIPOC children all the time; why would this be any different? It would be challenging, of course, and my husband and I would have to educate ourselves and immerse our child in her culture, but we were willing and eager to do so if it meant a healthier baby.

Within hours, I had a new backup profile in my inbox.

This profile had already been successful for another West Coast IVF patient. Unfortunately, that was about all that it had going for it. The egg donor’s family has a history of obesity. The sperm donor’s family had a history of high blood pressure, stroke, pneumonia, melanoma and breast cancer.

I didn’t hesitate to turn that one down. There had to be better options. And since I’d complained, the clinic seemed more willing to offer them to me.

The next backup profile arrived – and I fell in love with it.

The egg donor was athletic, articulate, and creative. Her favorite movie: The Princess Bride. Favorite book: The Great Gatsby. Favorite season: spring. And her health history was impeccable. The sperm donor was fit, entrepreneurial, and clearly had a sense of humor (“Love dogs, think fish are hilarious, cats are demon creatures”). His personality absolutely burst off the page. His family health history wasn’t flawless, but there weren’t any concerning patterns.

I looked up the sperm donor’s ID on the Facebook group for the sperm bank. Picture after picture of babies made from his genetic material came up. The sperm donor’s genes were clearly the dominant ones in all of his offspring – but his genes and my family's looked nothing alike. The kids were adorable, but it would be obvious to everyone that this baby wasn't “ours.”

I was concerned about how this baby would handle questions about her origins. I thought of a line from the children’s book we have about donor conception that goes, “To make a baby, you need a seed from a man, an egg from a woman, and a nice warm tummy to grow the baby in.” I imagined our future child stuck having many interactions like this:

Random Person: Are you adopted?

Future Child: No, I’m donor-conceived.

Random Person: What’s that?

Future Child: To make a baby, you need a seed from a man, an egg from a woman, and a nice warm tummy to grow the baby in…

It seemed unfair to subject a child to incessant questioning, not to mention racism. And yet, I could feel the good vibes from this profile. It also had one current pregnancy, a better track record than our chosen profile, which had a negative pregnancy test and a chemical pregnancy to its name.

I had to ask myself: Did I want the fantasy of a baby (who might look like my husband and me) or did I want a flesh-and-blood baby (who would definitely not look like either of us)? I could clearly imagine myself with the baby from our chosen profile; I wasn’t sure I could see myself with the new one. (Though I know I would love any baby put into my arms.) 

The clock was ticking. My coordinator needed a yes or a no. And she needed to know which profile was primary. If I chose the new one to be my primary, I would have to give the old one up (because the new one had multiple female embryos available, so I wouldn’t need a backup). 

My husband was firmly on the side of the new profile, his reasoning being: if we’re going to do this, we want it to work. My younger teen agreed. My older teen and I were waffling. We didn’t want to let go of the old profile. But what if the transfer with the old profile failed? I’d be kicking myself for months over wasting all this time and money. 

I wished for the impossible (of course I did): that we could transfer one of each and let fate decide, but I was pretty sure the clinic wouldn't allow that, and I didn't want to risk twins. (Imagine explaining twins genetically unrelated to us and one another!)

Ultimately, I let myself be persuaded by reason. The new profile had the best chance of success, so that was the one I was going to choose.

But on the morning I was supposed to send back the confirmation form, my printer refused to print. I tried once, twice, three times. There was still ink in the cartridge, but the text wasn’t printing clearly. I signed up for a free trial of Adobe and tried to e-sign it, but the document wouldn’t let me edit a section of the document where I needed to print my name. “Is this a sign?” I asked aloud to no one in particular.

If it was a sign, I ignored it. I ordered a new ink cartridge, got it installed, printed off the confirmation page, and signed it along with my husband before the day was done.

“We’re sure about this, right?” I asked him.

“I’m done discussing this,” he said. (All this deliberation had begun to sour him on the whole endeavor. Topic for a future post...)

I emailed the signed confirmation form to my coordinator. So that was that; we were letting go of the old profile and would be transferring a female embryo from the new profile in late February.

Only a few minutes after sending the confirmation, my treatment coordinator responded, confused. Did we want the new profile as the primary? Or as the backup?

I stared at the message for a long time, unsure how to respond. It felt like all day, the signs were saying, “Don’t let go of the profile you love.” Now she was giving me another chance to change my mind. Should I take it?

I typed up my email response, with two lines: “Primary” and “Backup.” I copied and pasted the profile numbers – the old one for primary, the new one for backup. Then I swapped them. But I couldn’t press “send.”

I tried to imagine how I would feel months from now, pregnant or not, if I let the old profile go. Even worse: what if someone else got pregnant with that embryo? What if I saw a picture of that baby in the West Coast IVF Facebook group? Would I feel like she should have been “mine,” just like I did with my baby’s only full genetic sibling who was growing up halfway across the country? (I would give anything to have had another embryo from her profile available. Then there would have been zero deliberation; only celebration.)

Something in me again said, “Try.” I had to give the embryo I wanted most a chance. If the transfer was unsuccessful, the new profile would still have an embryo ready and waiting. (Though the age gap between my baby and her little-sister-to-be would be close to two years at that point.)

I told my coordinator to keep the old profile as the primary and the new profile as a backup. And then I told myself to stop deliberating. (‘Cause that works.)

This process revealed traits in me I didn’t recognize – and didn’t like. I used to be so decisive and now I seemed so wishy-washy. Also: why, after I pushed and pushed to get what I wanted (in this case, a backup profile worthy of being a primary profile), did I reject it once I got it?

And, most pressing: now that preparation for the next transfer was underway, why did I suddenly feel so ambivalent about moving forward at all, with any profile? 

Thursday, January 28, 2021

New Year, Same Bullshit (Part Two)

Only a few weeks after my baby’s choking episode led to an ER visit, and the night after my baby had an adenoidectomy to prevent that from ever happening again, there I was on my knees, giving back blows to my baby until she threw up a pool of mucus. My husband had called 911, but the few minutes until the ambulance’s siren neared our house felt like forever.

Soon a pair of 20-something EMTs stormed through the door; one had a bright blue mohawk and the other was a nervous Nelly. Both acted as if they’d never seen a baby before. Nervous Nelly couldn’t get the pulse oximeter on the baby’s finger or get a look in her mouth with a flashlight. If these two were the rescue crew, I wanted to tell them to go the fuck home because they would be no help.

Nervous Nelly said another ambulance was on its way. Meanwhile, two pairs of cops arrived. One pair just came into the house, no introduction or indication of what the hell they were going to do in this situation. Their intimidating energy was huge and sucked all the air out of the room.

The dog was barking, the baby was crying, and we were all just standing around waiting for the second ambulance. Finally, it arrived, with two middle-aged EMTs. One was an Alpha asshole but the other one was kind and calm. They asked if we wanted a ride to the hospital (not because they cared but because they wanted permission to bill us). At that point, the baby seemed better. She gazed quietly at all these strangers in the house.

I looked to my husband. “Should we drive?” I asked.

“I don’t want her to choke on the way,” he said. “Or to get in an accident.”

He and the EMTs convinced me to go with the baby in the ambulance – my first (and hopefully last) ambulance ride ever. The vehicle seemed to be all metal on the inside and the lights were blindingly bright. The EMTs strapped the baby onto a stretcher, which was terrifying for her and me. She started wailing again, then choking. I told the EMTs she couldn’t breathe, but they wouldn’t take her out of the harness. Then she threw up mucus again, soaking her onesie. No one was reacting, but I was pretty sure this was not normal.

We set off. The Alpha EMT drove and the nice one sat in the back with me and the baby. The baby calmed down once we were in motion, though now I was upset. The EMT told me I could take my mask off. There was snot streaming down my face. He radioed some information – all in code, it seemed – to the hospital. He talked to the baby sweetly and stroked her finger. I couldn’t believe how unshakeable he was – or how he did this day in, day out, and stayed so incredibly chill.

Because we arrived at the hospital in an ambulance, it seemed like we got special treatment. There was no waiting for triage this time. We were shuttled immediately into a room in a part of the ER I hadn’t seen before. A nurse came in right away, with toys for the baby. A doctor soon followed. No one knew what exactly was going on, but the “episode” seemed to be over. The doctor’s best guess was that the baby had some post-surgery inflammation that made it hard for her to breathe and led to the vomiting, but that she was no longer in imminent danger. Since the baby seemed stable, the doctor said we could just continue using Afran over the weekend (but no longer than that, because it can cause rebound inflammation) and that we should call the ENT on Monday.

We were waiting on the discharge paperwork when a different, older nurse came in and said the baby was due for some Tylenol. I almost said, “We’ll do it at home. Just let us leave.” But I said OK, because I was being Minnesota Nice. The nurse held the baby’s head and I tried to squirt the Tylenol in her mouth, but the baby started crying and choking again. We managed to get the medicine down by taking little breaks. The nurse quietly said, “I’m going to go share what just happened in here with the doctor…”

And then the parade began. One doctor after another came in, all seemingly doing the same exam and offering zero solutions – other than staying the night for observation. At this point, it was around 2 a.m. so we were already halfway through the night by my estimation.

“What do you want to do?” the doc asked.

“I want to go home but I’m afraid to,” I said.

“Then you should stay,” he said. “Otherwise, you might just end up coming back.”

The dealbreaker for me was that they said if we stayed, an ENT would see us in the morning. At least that would be faster than waiting for Monday morning and trying to schedule an appointment.

The baby cycled from calm to crisis mode, because the health care professionals kept doing things to her. I was reminded of the “cascade of interventions” often referred to in unmedicated childbirth circles, in which one medical procedure begets another. First it was a chest X-ray to make sure she hadn’t swallowed anything (of course she hadn’t). Then a COVID test (negative). Then they wanted to do an IV but two nurses were unable to find a vein. The second time they attempted, they didn’t even use anesthetic, which was awful to watch because I knew the very first moment they caused her pain by the way her face contorted. Then they gave up because I was bawling and the baby was inconsolable. They turned down the lights and left us alone and she finally took a bottle and fell asleep.

Around 4 a.m. they transferred us to a room. The adrenaline I’d been running on had worn out. I was beyond exhausted. But the nurse had to go through the same 10,000 questions as everyone else and then her oximeter wasn’t working and she had to troubleshoot that before we could settle into the plastic-covered pull-out sofa. The baby and I slept maybe 90 minutes before she woke up, seemingly in pain and hungry. My husband, who had been sent home with a list of things to retrieve (the irony that we had been so well prepared for the surgery stay and now we had nothing, not even a bottle, was not lost on me) realized he’d forgotten the bottle liners and the nurse had to hunt some down (of the wrong size) while the baby fussed.

Finally, a bottle came together and the baby ate and we ordered breakfast. We felt normal for a little while. Then we waited. And waited. And waited. And waited. (Recurring theme.)

Around lunchtime, a team of six doctors crowded into the room. We repeated the events of the last 24 hours yet again. I tried to ask the same question, in different ways, several times, because the doctors didn't seem to get it. 

“We were in the ER several weeks ago because the baby was choking on mucus,” I said. “They told us to get her adenoids out. We did that, but she’s still choking on her mucus. Is it possible the adenoids weren’t the problem and something else was missed?” 

The group of doctors didn’t have any answers, much less a treatment plan, other than three doses of steroids administered over a 24-hour period, Afran for a few days, and Flonase for a month. But they wanted to see what the ENT had to say first before finalizing anything. The only problem was no one knew when the ENT was coming. (Must be nice to be making a gazillion dollars a year and have to answer to no one, even when you’re on call.)

Unfortunately, the ENT that came was not the same doctor that did the surgery. It was the emotionless, unhelpful ENT I spoke to on the phone the previous night. His bedside manner wasn’t any better in person, making me wonder why he ever chose to work with children. He towered over my husband, the baby, and me. His eyes were a weird tiger orange and he had pinpricks for pupils. I don’t know what drugs he was on, but they must’ve been good. He did not examine the baby or even touch her.

“How is it going?” he asked.

“Fine, now,” I said. “But she always does well during the day. It’s nighttime that’s the problem.”

“Do you want to go home?”

“Yes, but I want to understand where the mucus is coming from, especially since we removed her adenoids. Why is she still having the same problem?”

“Adenoidectomy doesn’t treat mucus,” he said. “In fact, I’ve never seen a child this young get an adenoidectomy. But I’m not surprised she’s congested. Try saline spray.”

“Saline spray? Are you fucking kidding me?” I thought. I’d been doing saline spray since October. For the record, I’d also tried vapor rub, three kinds of nasal aspirators, and an angled pillow.

The ENT was infuriating to talk to. It was as if he was saying, “This is normal,” and “Except it isn’t,” simultaneously. He told us to follow up with our ENT on Monday, which totally boggled my mind because they work for the same practice.

After he left the room, I watched him through the window in the door. He put on his jacket right there at the nurses’ station and went back to his Saturday. (Asshole.)

The group of doctors circled back. No one knew what was going on and they didn’t know how to help, other than throw the same medications at the problem that we’d already tried and that had failed us before. (Except for the three-dose steroids. Those were new.) They shamed me for co-sleeping, suggesting that I stack cans of tuna underneath a Pack ‘N’ Play mattress (I shit you not) and make her sleep there instead. They also said that if the sleeping situation didn’t improve, she likely had acid reflux (despite the fact that she had not one symptom) and we should see a pediatrician about it. (“Isn’t that what all you people are?” I wondered.)

After several more hours of waiting for discharge paperwork, we were handed a bundle of prescriptions and sent home.

A week passed. The another. While we didn’t have another “episode” requiring an ER visit, the baby now had a new snore and was not sleeping through the night. In fact, we’d reverted to a newborn-esque schedule, with her waking up two to three times a night because of the congestion and then needing aspiration and a bottle to fall back asleep.

We returned to the ENT. He said the next step would be a sleep study to rule out sleep apnea. (Another night in the hospital. Oh, hooray.) I agreed, but when I called to schedule the sleep study, I was told we would have to wait until six weeks post-surgery or we might get an inaccurate read.

And so, we soldiered on. Sometimes I coped just fine with fragmented sleep. I got up, ran, and went about my day, juggling parenting and working from home like an expert octo-mom. Other days, I found myself reverting to self-destructive coping mechanisms, like baking a batch of cookies, then picking and eating the chocolate chips out of them (an old anorexic pastime). Or I zoned out by buying baby stuff online that I would inevitably return when remorse hit. I tried to pray but just ended up crying. I came to dinner puffy-eyed and defeated more than once.

To say the month has been rough would be an understatement.

Just when I hit what felt like rock bottom, I got an email from my West Coast IVF treatment coordinator: I had a new transfer date

Saturday, January 23, 2021

New Year, Same Bullshit (Part One)

The calendar may have changed to 2021, but 2020's mindfuckery rages on.

It didn't start this way. On New Year's Day, I was hopeful. My mouth was no longer in agony. In fact, most of the time I felt nothing at all. So on the first Monday of January, I sent an email to my treatment coordinator at West Coast IVF imploring her to reschedule my embryo transfer as soon as possible.

Meanwhile, my baby had an adenoidectomy scheduled. I packed up all her stuff (it's amazing how many things a baby needs just to get through the day) as well as pajamas, a change of underwear, and a toothbrush for myself. On a Thursday morning, I awoke at 4 a.m. for a run, and after getting myself and the baby ready and in the car, my husband drove us all to the children's hospital.

I was amazed at how well everything was going. The baby had blissfully slept through the night, and even though she was going on 12 hours with nothing to eat or drink, she was a content little love bug. She even seemed amused by all the sights and sounds as we checked into the hospital.

We were taken to a pre-op room, where we changed her into a hospital smock and she was weighed and had her vitals taken. The ENT came to check in with us, as did the anesthesiologist. Then we had to wait. And wait. And wait. We read every book I'd brought with us, played with every toy, sang all the songs. The baby was starting to get fussy. I really didn't want to send her into surgery more upset than she had to be. Finally, an operating room opened up and a small group of masked women in scrubs came to get her.

“Does she have a pacifier?” one of them asked.

“She’s never liked them,” I said.

“A lovey?”

I shook my head.

“A favorite blanket?”

No again.

I’m her comfort object,” is what I should have said.

The goodbye happened too fast. I kissed the baby’s face through my mask and handed her off. She didn't start crying until she was down the hall, but when she did, the sound echoed in my ears. Then my husband started crying, and I did, too.

Thinking it would be a while until the surgery was complete and the baby woke up, my husband left to run home for his cell phone charger (I'll spare you the argument about how I'd kept a list on the table for the past week of things to bring to avoid this very scenario). About 10 minutes after he left, as I was struggling to get on the Wi-Fi network so I could do some work, the ENT appeared in the doorway. The surgery was already done. He said the baby’s adenoids weren’t that big and that she had done wonderfully. She would be awake shortly.

A nurse came to fetch me not too long after, saying that they usually don't let parents into the recovery area but that the baby was "unhappy" and needed her mom and a bottle. As we walked down the hall, I again heard that heart-stopping cry.

We turned toward a recovery room, where a nurse was holding my blanketed baby against her bosom and swinging her back and forth aggressively, trying to calm her down. I didn't know the baby would be ready so soon to take a bottle, and I assumed the hospital would have bottles of pre-mixed formula available, so I didn't have one made yet. But they didn’t have formula at the ready. They didn't even have water available so I could mix my own.

I dropped to the floor and rummaged through my suitcase to prepare a bottle, making a huge mess in the process. Luckily, the nurses didn't care; they just wanted the baby to calm down. They helped me get in a hospital bed, handed her to me, and she quieted immediately. She sucked down her bottle and fell asleep.

The nurses wheeled us up to an overnight room, and took the hospital bed away, which peeved me because I'd told them that we co-slept and needed a bed.

The rest of the day was mostly uneventful. The baby seemed like her usual self, following her schedule of play, eat, sleep. I was impressed by how well we were all coping, despite being cramped in a tiny room with nowhere for the baby to crawl except the cage they called a crib. 

In the afternoon, the ENT swooped in, saw how well we were getting along, and told us we didn’t need to spend the night. We were more than happy to agree to going home.

We packed up all our unused things and headed out. I couldn’t believe how well things had gone. I felt like we had gotten away with something. (If it seems too good to be true…)

Reassured that we had finally “fixed” the baby's breathing issues, I decided to push on that other issue: rescheduling the embryo transfer. After we arrived home, I emailed my West Coast IVF treatment coordinator to ask for an update. No response.

My husband says I should not connect things that are likely coincidental, but I can’t help it. I look for signs and patterns in life, either to explain away why things happen or to feel more in control amidst all the chaos (or to blame myself for the bad stuff). So here is my theory: I poked a stick again at the baby dream, and God came down – hard – in response, as if to show us how full our hands were already.

The chaos started around 10 p.m. the night after we came home from the surgery. The baby kept waking up, seemingly unable to get in a comfortable position in bed. She was only calm if I was holding her upright, which didn’t make sense to me because I thought the adenoidectomy meant there should be nothing blocking her airway. I tried to suction her nose with both a bulb aspiration and an electric aspirator but didn’t get much mucus out. The electric aspirator always freaks her out, so I tried to calm her down with a bottle, but she couldn’t swallow.

Then she really ramped up. I paged the on-call ENT, who was not our usual doctor. He sounded completely checked out, like he was on copious amounts of the narcotics I would have liked to get my hands on during my dry socket ordeal. He told me to do a couple sprays of Afran and to sleep upright in a recliner. This did not sound like a long-term solution to me; it sounded like a Band-Aid.

“I’m just confused,” I said. “Is this normal for a child that just had an adenoidectomy?”

“No, it’s not normal,” he said.

So if this was abnormal, why wasn’t he more concerned? He was as calm as if I were complaining that my kid had a cold.

I did the Afran as instructed and the baby totally lost her shit. She was crying and gulping for air so hard I was worried she wouldn’t be able to breathe. Remembering how unhelpful an ER visit was the last time this happened, I instead put her in the bathtub to calm her down. That didn’t help. Now she was so distraught she started choking on her own mucus.

“Call 911!” I screamed at my husband. Crying, I got on my knees on the floor and gave the baby back blows until she threw up. It was at least a cup of mucus.

I could hear my husband talking to the 911 operator downstairs, but I couldn’t hear any sirens yet. The ambulance couldn’t come soon enough

Sunday, December 27, 2020

A Kind-Of Christmas Miracle

The much-anticipated embryo transfer has been canceled.

The deciding factor was yet another visit to the dentist, where Dr. DeVille’s boss finally dared to show his face and confront the mess that is the hole in my mouth. He tapped my teeth and did the “ice cream test” (not as tasty as it sounds) and poked around before deeming the extraction site infected. He prescribed another round of antibiotics, this time amoxicillin (because penicillin is for lightweights – my words, not his). I was instructed to take the antibiotics for 10 days, which meant I’d be medicated through the new year. If the pain didn’t go away in a week, he said, I should see an oral surgeon.

I contacted my treatment coordinator at West Coast IVF to inform her of my current medication status. I had hoped that we could simply delay the embryo transfer a week (do endometrial linings hold up that long?) but nope. She said we would have to cancel. Upon the resolution of my oral ordeal, I could reschedule.

Six weeks of fertility medication wasted. A baseline ultrasound for nothing. Airfare refunded and hotel reservation erased. Fantasies of a fall baby now crushed.

All because of one fucking little tooth.

I thought I would be bawling and inconsolable upon cancelation of the embryo transfer, but what I felt was closer to resignation. I was tired of playing “beat the clock” with my body. I knew canceling was the right thing, even though it broke my heart. That afternoon, I took the baby out for an extra walk. We’d had very mild weather for December in Minnesota, and I wanted to soak up the fresh air before a forecasted snowstorm came.

As I turned the stroller towards our home street, the sun was setting, everyone's Christmas decorations were lighting up, and the song “What a Wonderful World” came on Spotify. I cried a couple of tears because, all things considered, it was a wonderful world and I have a wonderful life. I was about to celebrate my baby’s first Christmas. There was so much to be thankful for. And yet, precisely because the world is so wonderful, I felt that aching absence of our baby-to-be. I just wanted her to be here already, to share the holidays with us.

Instead of paralyzing me, the cancellation of the embryo transfer mobilized me. I was determined to heal, no matter what it took, so I could get another transfer date on the calendar. I called the oral surgeon and bullied my way into an appointment the day before Christmas Eve. At that appointment, a very young, sweet assistant with a glittering engagement ring took a 3-D image of my mouth and listened to me recount each traumatic procedure and dental visit I’ve had since the extraction. Then she asked me to swish with some awful solution that tasted like semen. Then the oral surgeon (a DDS and an MD, because why be one kind of doctor when you can be two?), who resembled a huskier version of actor Damien Lewis, embarked on solving the mystery of my mouth pain.

At first, he thought a whitish hook shape on the 3-D image was an errant nerve ending that had somehow been left behind after the extraction. But then he texted Dr. DeVille’s office – apparently, they’re on a personal-cell-phone-texting-basis – and looked at some more X-rays and declared it an “aberration.” His next best guess was that the prior clearing out of my dry socket was insufficient and that perhaps food or debris had been left behind. He hesitated, but finally said, “If I were you, or you were my sister, I’d recommend going in there, cleaning it all out, and starting the healing process over from square one.”

“Oh, man,” is all that came out of my mouth when I heard that.

Those first few days, post-extraction, were so hard – liquid diet, no movement, sleeping propped up, narcotics ‘round the clock (if I was lucky enough to get them). I really didn’t want to go back to that place. I wasn’t sure I could come out of it again.

The oral surgeon understood my disappointment. He said I could wait and see if the pain resolved on its own. But if I didn’t want to wait anymore (I’d been doing the wait-and-see approach for three agonizing weeks after all), he was willing to do the procedure – called “debridement,” which sounded to me like a wedding on horseback – for the price of an office visit. He even threw in IV sedation and bone grafting – to prevent another dry socket – for free. He also outlined his extensive post-op instructions: medicated mouthwash, a syringe to clean the site with saltwater, antibiotics, five days sans exercise, etc., which Dr. DeVille’s office could use a few pointers on. (Their after-care was basically: don’t disturb the site for 24 hours, take Advil and Tylenol, and cross your fingers!) The oral surgeon even gave me his cell phone number in case I had any questions or concerns later. All I could think was: where was this guy when I had the tooth extracted? I’m confident that in his care, I could have avoided three weeks of misery. Lesson learned: spend the extra money and go to the experts the first time. (If you can get a referral.)

The assistant brought in the consent form for the debridement procedure. It was all pretty standard – but then I got to the section on IV sedation. As nice as it sounded to check out of reality for a while, especially while my mouth was being excavated, the risks went from tolerable to terrifying. Nausea, vomiting, headaches, heart attack. Worst case scenario: you could die. My danger signals started going off.

A perky receptionist came into the room and said that if I fasted until the late afternoon, I could come back and get my procedure taken care of right away. I felt overwhelmed and weepy and afraid. So I told the truth: “I don’t know if, emotionally, I can do another procedure right now.” She totally understood and encouraged me to call my husband to talk it over with him. I did, and my husband said I should give the antibiotics a few more days to work, to rest over Christmas, and if I was still in pain, I could come back on Monday morning and go under the knife (or whatever scary instrument they use).

I heeded his advice, because I remembered one thing this tooth trauma taught me: don’t schedule procedures in the middle of the week – especially before a holiday – because if something goes wrong in those early days, you’ll be shit out of luck.

I scheduled the procedure for early Monday morning. Then I cried and prayed for healing. I was not optimistic that my mouth would repair itself in a mere four days. But I decided that Christmas Eve was a good time to test myself. Could I be off pain medication? How long? Initially, I made it 12 hours, my longest stretch without pain meds in over three weeks. I enjoyed a lovely Christmas dinner with my family – roasted turkey breast, Brussels sprouts with bacon, stuffing – and on Christmas morning, I woke up, amazed that I hadn’t needed to take any pain meds overnight. I got on the treadmill and while I could still feel my mouth pulsing, it wasn’t painful. So I tried running. One mile, then two. It had been weeks since I did any heart-pumping cardio, so I slowed down to a walk, but it seemed like another sign that I was on the mend.

I dressed the baby in a frilly red-and-black checkered dress and we all gathered in the living room to open presents. The baby learned to crawl just in time to make a beeline for the Christmas tree and is an expert wrapping paper ripper. (She also has several newly cut teeth as I'm losing mine. Ha.) Every year, we all write one another heartfelt letters; this year, my letter made my eldest cry. (Aw.) My husband and I referenced the same dreams for the future in our missives (and, yes, another baby is still one of them). His gifts for me were bittersweet, as they were safety items for my embryo transfer trip, like sanitizing wipes and latex gloves. 

It was a simple and lovely celebration. And I endured the entire day without pain meds. While the awareness of a tender, gaping hole in my mouth has never ebbed, I almost (dare I say it?) feel like a sliver of my old self.

To what do I owe this rapid turnaround? (Not counting the three-plus weeks it took to get here.) The wonders of antibiotics? The cessation of infertility drugs, especially estrogen patches? Mind over matter? A Christmas miracle?

I don’t know, but I am so grateful to feel like for once, real healing seems to be underway. I pray it is permanent.

My hope for this hellish experience is that, just like when we had to cancel our Minneapolis IVF cycle because of that mystery bump on my arm, this dry socket nightmare and subsequent embryo transfer cancellation will turn out for the best. Maybe it would have been too dangerous to fly right after the holidays. Maybe my body needs more time to recuperate before procreating again. Maybe the baby needs extra attention right now that I couldn’t give her if I’d gotten pregnant this month.

A reason why might only be visible in hindsight. And so, I wait.

They say time heals all wounds; that better not be just an adage.

As for rescheduling that embryo transfer? I'll keep you posted...

Sunday, December 20, 2020

The Center Will Not Hold

Be careful what you pray for. You just might get it.

Cut to Friday evening, me on my knees in my bedroom, begging God for a sign about whether or not to go ahead with the embryo transfer.

Two-and-a-half weeks post-tooth extraction, my mouth was still throbbing and I was still popping Advil and Tylenol every six hours. I had spent that afternoon shuttling my husband to and from a colonoscopy. It was the final of a trio of appointments he wanted to take care of pre-transfer. The first, with an ENT for snoring, was utterly unhelpful. (Flonase and a wedge pillow? Google could have told us that.) The second, with a urologist, got canceled – after which, his symptoms mysteriously vanished. And now the colonoscopy, which required a brutal combination of semi-starvation and an onslaught of laxatives for 24 hours prior – and after all of which, the results were inconclusive. My husband would have to repeat the procedure in three months.

The night before all this, my baby had woken up crying. She’d been constantly congested for two months, which the pediatrician said was seasonal, then strep. But the stuffiness didn’t subside after 10 days of antibiotics, so I took her to an ENT. He said her adenoids were slightly enlarged, but because he generally didn’t operate on babies under nine months old, we should try a steroid nasal spray instead. That had proved totally useless. Now, she had so much mucous in her nose and throat, she could hardly breathe. This made her panic and cry, unless she was upright, so I spent much of the night going back and forth from the bed to the rocker.

So by Friday, I was overwhelmed and exhausted and just imagining bringing another human being into the world felt absurd at best and irresponsible at worst.

My husband, surprisingly, did not feel the same way. When I picked him up from the colonoscopy, he seemed to not only be back to his boisterous, optimistic self, he also dropped this bomb as I pulled into the driveway: “I’m OK with another kid.” He said this from the backseat of the car, where he was entertaining our restless baby.

Since my tooth extraction, I had felt his enthusiasm for the next baby waning. At one point, I dared him to say I should cancel the transfer, but he couldn’t. (I suspect that’s what he’d prefer but he loves me too much to stand in the way of what I want.) Part of me wanted him to say it because I have been feeling increasingly ambivalent about – and equally unable to cancel – the transfer. It was like being in a miserable relationship and waiting for the other person to break up with you because you didn’t have the balls to end things.

But, now, he was on board with another baby and I was wary. Idling in the driveway – because we’re never alone anymore and have no opportunities to talk about Big Life Decisions – I expressed all my fears, which are primarily financial and/or health-related.

He said he had those fears, too, plus another one: the deteriorating state of our relationship. We haven’t had sex in weeks, and even before that, I can’t remember the last time I enjoyed it (second trimester of pregnancy, probably). Personally, I’m at a point in my life where I could never have sex again and that would be just fine with me. The feeling is not mutual, however. Even if we could set sex aside, we barely have any intimacy anymore. No more morning coffee chats, no leisurely walks or lakeside runs, no Sunday church services. The closest we have to "together time" is watching an episode or two of The Office in the evening while rocking the baby to sleep. And because of his snoring, my husband has been sleeping on the couch.

“I don’t think it means anything about us,” he said about our sleeping arrangements. “But I don’t like it.”

I was kind of OK with not sharing a bed with him, because I was still sharing a bed with the baby. I’m a light sleeper, and I can handle interruptions from one bedmate, but not two. The sleeplessness had been so bad before he moved to the couch that I'd made worthless threats to get my own room and let the baby and my husband figure out their own sleeping arrangements.

My husband asked if I’d noticed the distance between us. Of course I had. I just didn’t know what to do about it. We’ve been in crisis mode all month. Just making sure everyone is showered and fed and fulfilling their household and professional responsibilities has been daunting.

“I miss us,” my husband said.

I guess I miss us, too? But more than that, I miss myself. Somewhere in the pain and aftermath of the tooth extraction, I lost who I used to be. Now I often feel like a bitter, angry, singed version of myself, just going through the motions, just trying to get through one more day.

So there I was on Friday evening, on my knees, pleading. “Please, God, guide me. Speak to me. Let me know what Your will is. If I’m not meant to go forward with the transfer, make that clear to me.”

That night, about an hour after the baby and I went to bed, she woke up screaming. It wasn’t a hunger scream. It was a pain scream. I changed her diaper. I tried a bottle. She wasn’t having it. She wailed and wailed. I tried suctioning her nose and got some mucus out, but now she was so upset that the amount of mucus she produced overpowered what I was able to suck out. She started choking again.

I went downstairs, where my husband was retreating to the basement to watch a movie with my younger teen, seemingly oblivious to what was going on. I was going to chastise him for being unhelpful, but when I opened my mouth, what came out was: “I think we need to go to the ER.”

Which we did. We raced to the closest children’s hospital and my husband dropped us off at the entrance. I was asked to fill out a sheet with my baby’s name and her symptoms. I wrote “choking on mucus” in the hopes that it would get us to the top of the queue, but in the grand tradition of emergency rooms, nothing was treated like an emergency.

Though a green stoplight on the wall indicated the wait would be under an hour, I later realized they probably never updated it. The baby was calm for maybe 10 minutes, but then she saw a young dad and his 7-year-old-ish daughter in face masks hanging around the aquarium and she freaked out again. The pain wailing ramped up, and by the time we were ushed to a desk by a triage nurse, the baby was inconsolable. Halfway through the intake (which was near impossible to do through masks and over the sound of crying), the baby threw up a ton of mucus all over my coat.

Finally, we were taken to a room. A nurse came in and said she would suction the baby’s nostrils out. I held the baby’s arms down while the nurse hooked up a loud, scary machine and shoved tubes in her nose. It looked like some kind of torture device. I started crying, the tears dripping inside my mask. When her nasal passages were finally clear, the baby calmed down.

But then we had to wait. And wait. And wait. It was almost two hours before a doctor arrived, and when she did, she performed the usual ear, nose, and throat inspection but didn’t have any revelations. She suggested another nasal spray to dry her up for the night, followed by an X-ray to check how large the adenoids were.

The X-ray was another round of trauma. My husband and I were outfitted in lead aprons. (“Any chance of pregnancy?” the tech asked me. Loaded question.) My husband held the baby’s head and I held her arms. The tech strapped her torso and legs to a plastic board. Then the X-ray tech went behind the wall and took the pictures. The baby was wailing again, and by the time we finished the X-rays, she was all full of mucus because of the crying.

Back to the room we went. I paced the floor, bouncing the baby, trying to get her to calm down. Time moved so strangely. Despite the late hour, I didn’t feel tired, but my husband kept falling asleep on the couch. This made me mad, that he couldn’t even be present in the simultaneously terrifying and utterly bored state we were in.

At the three-hour mark, we still didn’t have a read on the X-ray or a treatment plan. My husband started roaming the halls and bothering nurses until the doctor came in. I was unclear on what the X-ray showed, other than the baby’s adenoids weren’t huge (which we already knew). Still, the doctor said we should follow up with ENT and schedule an adenoidectomy.

By the time we were finally released, the baby was so exhausted she started wailing again. She cried the whole way home. I drove as fast as I could, wondering what the hell just happened. “We sped to the ER to get help and now we’re speeding home because the ER was of little help,” I thought. Other than getting the snot sucked out of her, did we just cause her more upset? Should I have just put her in the bath at home and gotten her to calm down instead? Why can’t I make good decisions? Why does healthcare suck? Why do bad things keep happening? When is this fucking awful year going to end?

I silently screamed, “WHERE ARE YOU, GOD?!” at the black sky.

Back at home, I removed the baby from her bunting. Her onesie was soaked through with sweat from all the crying. I put on her pajamas and I could sense a shift in her, like, “Oh, I’m home. These are my pajamas. I’m going to bed now.” She had a few sips of juice and fell into a deep asleep.

I, however, was wide awake, my mind racing. What did this all mean? Had I asked God for a sign and this is what He did? Practically suffocated my baby? Why didn’t He just make my endometrial lining too thin? Or cancel my flight? Or close my clinic due to coronavirus? Why this heavy-handed, hurting-the-people-I-love tactic?

Before I finally succumbed to a nightmare-filled sleep, I set an alarm for Saturday morning because I had yet another appointment – to get my fucking throbbing mouth checked again. I returned to the emergency dentist who loved trying-to-be-cool country music because he seemed to be the only person who understood my pain.

His take: my dry socket had been very bad, and though it was showing signs of healing now, he was not surprised that I was still in pain. “No one knows how to cure dry socket. We just manage it,” he said.

I explained that I was feeling frustrated and impatient with the pain because I was going through infertility treatment, and had a transfer scheduled soon. I needed to be off pain medications by then. 

“I know this isn’t your area of expertise, but should I cancel the transfer?” I asked. 

The dentist was dumbfounded. He clearly had no experience with infertility.  

“Am I going to feel better in a week?” I asked, trying to phrase my question in a way he could answer.

“I’ve had patients who take up to four weeks to recover after dry socket treatment,” he said. In other words, I was barely halfway through the healing process. “Can you wait a few days and see how you feel and then decide?”

Well, sure, I could. But at this point, the pain feels like a part of me. I’m afraid it is never going to end.

A hygienist walked me out.

“Good luck on your transfer!” she said. “I hope it all goes well!”

“Thanks,” I mumbled, feeling more and more convinced that the transfer wasn’t going to happen.

“Do you have any children now?” she asked.

For some reason, I said, “Yes, two. They’re older.”

I don’t know why I said that. It just came out. I guess I thought if I said, “I have three,” she would look at me like, “It doesn’t sound like you need infertility treatments!” or “And you have to have another one?!”

It struck me that maybe I was being greedy, that no one “needs” four children. And yet, in my head, I’ve conceived of it as: I have two daughters, and now I am going to have two more. In my mind, they come in pairs, not all at once.

That night, the baby once again had trouble sleeping. She kept waking up crying, which made me cry because I was so exhausted. I tried a new electric nasal aspirator and it was useless. My husband ended up rocking the baby to sleep as I lay in bed, worrying. Then I constructed an elaborate pillow arrangement so the baby could sleep with her head elevated but without putting her at risk of suffocation (I hoped). As I lay there, wondering if I would ever sleep again, I said, “Fine, God. You win. I’ll cancel the transfer.”

But then we all slept. And morning came. And here I am – torn and conflicted and arguing with reality again.

On the one hand, adding another kid to the mix right now seems insane. On the other hand, I’ve come this far, my lining is likely raring and ready to go, my travel is all booked, so why not just go ahead with the transfer? It might not work anyway. And if it does, I guess I have nine months to figure out how the hell I’m going to juggle everything?! 

If I do back out, what is my excuse? The tooth or my baby’s adenoids? Am I postponing? Or canceling and asking for a refund? I don’t know if I can tolerate the ambiguity of just putting it off until I feel better. Because who knows when that will be? 

Do my emotions matter here? Because if I cancel, even if my brain “knows” it’s the right thing to do, I will be devastated.

One more question: Is faith in the fearless plowing ahead or in the thoughtful pause?

And how the fuck do I get any answers?