Friday, August 28, 2020

The Wrong Kind Of Bumpdate

Before I knew it, I had a bump.

Unfortunately, it wasn’t of the baby variety. It was a hard mass on my forearm.

My acupuncturist first sounded the alarm. “You should get that looked at,” she said.

So I did, at a sliding-scale community clinic because I was trying to save money for IVF. A gangly, aloof doctor prodded the bump and asked me to flex my hand a couple of times.

“What do you think it is?” he asked.

“A ganglion cyst?” I guessed. It was the closest (and least scary) diagnosis I had found on Google. The only thing was that ganglion cysts usually appear on the wrists or the hands, and mine was on neither of those areas. But I couldn’t even contemplate the alternative – cancer. A diagnosis that serious would warrant quitting the baby-making endeavor immediately.

“Yup. Ganglion cyst. You could have my job!” the doctor said cheerfully. “You know, in the old days, they used to just take a Bible and slam it down on the cyst so it would explode.”

That sounded painful but a lot less expensive than what he suggested, which was having it surgically removed. Unwilling to bankrupt my baby-making piggy bank for something as seemingly vain as having a bump removed, I made an appointment with a specialist to get a second opinion.

“This is not dangerous,” the specialist (who we'll call Dr. Trudeau, because he was Canadian) said after a quick exam. “You can ice it and wait for it to go away on its own, take anti-inflammatories for a month, or get it drained.”

Waiting wasn’t an option; every time I looked down at my arm, my heart raced and my mind whirred with worst-case scenarios.

“Can I take the anti-inflammatories if I’m trying to get pregnant?” I asked.

“I wouldn’t recommend it,” Dr. Trudeau said. “How long have you been trying?”

“We’re about to start IVF, actually.”

“Oh. My wife did IVF,” he said. “Nine times.”

My jaw dropped. Surely I heard him wrong.

“Yes, nine times. But we have a baby boy now.”

He pulled out his wallet and showed me a picture of his chubby-cheeked son. I said something complimentary.

“We used a surrogate on that last cycle,” he continued. Surrogacy was a whole other area of the infertility labyrinth that I had not yet explored. I would later learn that hiring a surrogate cost around $100K. “My wife is actually going to go in again soon so we can try for our second.”

I believe that sometimes God sends us the information we need in unconventional ways. This conversation felt like one of those divine messages. I’d been having doubts about doing IVF with my own eggs. I was scared of the aggressive medication protocol. Would it cause health problems down the road?

I'd also been digging into success rates through the Society For Assisted Reproductive Technology (SART), which compiles statistics on IVF patients. While the Minneapolis IVF clinic had the highest success rates in Minnesota, when I adjusted the search filter for patients my age with Diminished Ovarian Reserve (DOR), I found there were zero live births on a first cycle. None. As any infertility specialist will tell you, success rates tend to increase with subsequent cycles. But would it take nine times like Dr. Trudeau and his wife? We couldn't afford that. Hell, we could hardly afford to do it once.

Though I'd dropped $1,200 on the SIS, I had yet to make the down payment on IVF or start any drugs. There was still time to back out. But what would we do instead? It’s not like we had a better option.

But the IVF ambivalence wasn’t my main preoccupation at the moment. This damn cyst was.

“I’d like to have it drained,” I told Dr. Trudeau.

He seemed surprised but left the room to get a nurse to prepare everything he needed for the procedure. A few minutes later, he brought me to a room with an ultrasound machine and a tray neatly arranged with aspiration equipment.

“If it gives you any hope about IVF, my wife is 41 and our surrogate was 43 at the time,” Dr. Trudeau said as he spread a numbing agent on my arm. “We used to live in New York and no one there has babies young. Many women wait until their 40s to start trying.”

I nodded in recognition, though I also knew I did not want to be going through IVF in my 40s.

“I hope you don’t mind me sharing,” he said. “It’s just that no one talks about this stuff. My wife and I try to be open about our experience.”

“I appreciate that,” I said, though my attention had turned to the ultrasound screen, which Dr. Trudeau was using to guide the needle into my bump. He pulled back on the stopper of the syringe, but nothing came out except a little blood. He switched to a larger needle and tried again, but the same thing happened. He quietly cleaned up his equipment. Something had gone wrong; I just didn’t know what yet.

“You’re not going to like this,” he finally said, “but I think we need more imaging. I’m going to put in an order for an MRI.”

“What would that tell us?” I asked.

“What kind of soft tissue mass this is.”

“What kinds are there?”

The chatty doctor's sudden silence was terrifying.

“It could be a tumor,” he said.

My heart stopped. “This can’t be happening,” I thought.

“I don’t think it’s cancerous,” he continued, “but it could be a tumor. That’s why we need more imaging, so we can discuss options.”

I did not want more imaging. I did not want to “discuss options.” I wanted to wake up from this nightmare and go back to my incessant, silly worries about IVF.

Instead, I spent the rest of the day trying to find an affordable place to schedule an MRI, since my insurance was completely useless outside of a major catastrophe. The cheapest option was a chain of independent MRI clinics. Their estimate? $850.

My little bump was now a big ordeal. If this was (God forbid) cancer, there was no way I could move ahead with IVF. Even if the bump was benign, surgery to remove it was going to be costly. I was supposed to pay the deposit on IVF and start my medication protocol in a matter of days, but that seemed irresponsible now.

I knew what I had to do – cancel my cycle. My throat tightened as I called the Minneapolis IVF clinic to explain that we just didn’t have the money to move forward. (It seemed like an easier explanation than the mystery bump.)

“Are you sure you want to cancel?” the nurse asked. She sounded as upset as I felt. “Have you talked to our financial consultant?”

Yes, I’d talked to her, and she’d been completely useless. The irony of IVF financing is that they only offer it to people who already have perfect credit. Besides, it wasn’t (only) about the money. I had bigger problems now than old eggs.

I held my tears in until my husband came home. Then I doused him with huge, gulping sobs – not so much about the bump on my forearm as the baby bump that felt like it might never be

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