I haven't been blogging more than occasional bookmarks, and I'm sorry, but life has been very difficult for the last few days for people in my life. I've been in the strange position of being the anchor, the earthy one who can make some things better, but unfortunately not everything, and it's taken a lot more effort than I realised it would.
Of all that's happened this week, the worst has been the emotional rollercoaster Dwana has been on. For those who haven't been reading, my friend Dwana, who is quite possibly the most loving person I've ever known, has had a long fight against endometriosis pain, infertility, etc. She started having problems from age 13, and doctors long told her never to expect to have children. But things have changed over time, and methods have progressed so that for the last couple of years, she's had real hope of having a child, but with the catch of a window as the endometriosis grows. The more surgeries she has, the less the chance of having a baby. So with several surgeries already, it's a race against time, even though she's only 29.
A few days ago I was catching up on some of my reading, and on one of the library social lists, there was a huge discussion about people who go through fertility treatment, about multiple births like septuplets, and most who wrote in thought people who go through such treatment must be incredibly selfish, especially with all the children in the world who need adoption. They made it sound like adoption was as easy to do as picking out a dog at the pound. They haven't a clue. Dwana has taught me that.
Dwana has always wanted to adopt, regardless of whether she has a biological child or not. She is the least selfish person I've known, and one of the bravest, and the thing is most people have no idea what sorts of things she gone through. She has a very severe case of endometriosis, and also has been newly diagnosed with polycystic ovarian syndrome, which has actually turned out to be more of a problem. She did attempt to conceive naturally, but they couldn't take a long time, given her health issues, and so moved on to insemination where they take the husband's sperm, wash it, spin it, and then insert it via catheter in the hopes of getting the egg and sperm to unite more easily. That didn't work. After two cycles/four attempts, they decided to do in vitro.
People have misconceptions about in vitro. They think, for example that those huge multiple births are a result, when really, those are usually the result of fertility drugs boosting the number of eggs and then either natural or assisted insemination. Such multiple births can be dangerous for both the mother and children, and are usually recommended to be 'selectively reduced', as in abortion of some of the foetuses, as a means to increase the successful outcome. People with religious beliefs against abortion probably should think very carefully before doing something like that. Also, most doctors these days try to prescribe treatment in such a way that such huge 'litters' are avoided in the first place. Certain factors, such as which drugs are used, the amount, etc., can be balanced to help with the desired outcome, depending on what the exact health issue the couple is dealing with is.
In in vitro, though, stronger drugs are given, but eggs are removed technically before ovulation, then inseminated in the lab and the resulting embryos are allowed to grow for a few days. Then, a few (usually two, three tops) are put back into the woman's womb and any additional ones are usually frozen.
Sounds simple, right?
What that doesn't cover is all the shots you have to take. Since Dec. 22, Dwana took 75 shots in her belly or butt, as medical science basically took control of her endocrine system through a series of injections. Her husband had to learn to give the shots, and their schedule revolved around them. Everything went according to plan until they went to retrieve the eggs. The surgery went fine, but Dwana went into hyperstimulation syndrome, which is a potentially fatal condition where fluid begins to collect in your abdomen and chest and you can become severely dehydrated. She wound up spending several days in the hospital and had pneumonia, but improved enough that they could go ahead and put the embryos back in.
So then it was a waiting game. Three little embryos, but waiting to see if they would implant. She did have the symptoms (spotting, cramping) and then started in on morning sickness, although in the afternoon. Monday she went in for a blood test, and shockingly enough, it came back pregnant, although the levels were a little low. That seems to be the norm with in vitro pregnancies. Judging from the levels, it was a singleton, so no triplet jokes. She was trying to stay guarded, but everyone involved, directly or those of who are in her cheering section were excited.
Wednesday she went back for another test. She had an awful moment before the test where she and her husband were driving and they watched a cat struck by a car. The driver had just sped up and run away. They stopped and tried to help it but it was too late. They were both very upset. Dwana and I react the same exact way to the death of an animal; we become nearly hysterical. She was still very upset and I think in the back of her mind, saw it as an omen. When she went to call for the results of the test, I was with her. The levels should have doubled or more. They fell by 30 points. That means she'd miscarried, probably within the morning before. An already terrible day just came crashing down.
The ironic thing is that if this had been a 'normal' pregnancy, she wouldn't have even known she was pregnant, because there was no missed period, and she wouldn't have shown up on a home pregnancy test. There are a lot of missed miscarriages at that point. We knew she was at a high risk for miscarriage due to the scar tissue from the surgeries, but every step was taken to try to help it along. And to have such happiness follow such a letdown...it was hard.
The good news is she knows she can get pregnant...and she has eleven frozen embryos, so several more attempts can be made without risking hyperstimulation again. I suspect she won't try that again, given how her body reacted. But all is not lost. It just doesn't happen to help too much at the moment.
I took her over to where her husband works so she could tell him in person. I feel so badly for them. She has to go back tomorrow to make sure her levels are at zero, or they have to do a D&C--and risk further scarring.
Monday they'd gone out to celebrate. Wednesday it was comfort food and spending time together as a couple, starting the grieving process.
There are some who wouldn't understand, who would say that it wasn't as if it were a viable child, or for that matter more than a few cells. And there's some truth to that. But there's so much hope invested in a pregnancy; and it's not false hope, but completely natural. She is glad that if it had to happen, it did so early. And I think in the end, she is glad she knew about the pregnancy, so it gives her hope for the future.
In the meantime she's taking a couple of days off from work. It's harder when two people in your department are pregnant and you work in a children's hospital; I think she needs some alone time. Her sister stayed with her today. I've checked on her, and I'm sure her family and other friends have, too.
I feel so helpless. At the time, when she needed me to be strong, I was. I could be sympathetic but had the distance she needed; her family are as invested emotionally in this as she is, after all. Most of her other friends have had recent pregnancies, all with their own challenges. She's got an incredible network of people who care for her, many of whom have gone through aspects of her experience, although not the total package. I haven't. I know that I can't really understand what it's like. I haven't been pregnant or dealt with that loss. But I think it helps her to know I care. I just wish there was something I could do to help her more.
We talked on the phone last night, and for the first time, I cried with her. I'd gone home and thrown myself into cleaning (and now have a spotless kitchen as a result) but then finally sat down, sorted through the emotions, and called her. Please don't think I'm doing this 'it's all about me' thing; I'm not. She may eventually blog about her own feelings. I can only describe mine. I'm just, well, surprised at everything that was milling about inside. I guess since I know I'll probably not have children, and Dwana is the first friend that I really felt should have children, I've tied my emotions into my support for her. I'm so sad for her, but hopeful, too.
My feeling is that it will happen. She was so sick when this pregnancy started, my hope is that on a normal cycle where she hasn't been dealing with such stress, a pregnancy will take. I have faith that it will happen.
Knowing Dwana has changed me on several levels. Certainly she is a far more complex person than this one issue, but the fertility issues are a big part of her life, and I've learnt a lot about what people go through and the intense disappointment and hope that they live with. Dwana is the second person I've known who went through infertility treatment, but I've had a much more intimate look at it with her. The very idea that she can keep her optimism and humour is amazing to me, and I really admire her for it. I only hope that in the end, this dream is realised for her.
It seems like it's been Friday the 13th all week. Can we have a little good luck, please?
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