Tuesday, April 30, 2013

Don't make me angry. You wouldn't like me when I'm angry.

In the next eight days, I have three papers due and two finals to study for, so I probably won't be updating again until that's all over with. But before I go completely silent for a week, I wanted to add this quick note that didn't really fit anywhere else.

Over the course of this journey that I have taken over the past two years, I was prescribed prednisone for nearly a full year, and I developed a love-hate relationship with it.

On one hand, prednisone gave me my life back in a way. The rash went away completely. I could walk, and I had full use of all my joints when I took prednisone. The pain all but disappeared. That alone made it worth taking. Over that year, without prednisone, I would absolutely not have been able to function.

But the side effects were a hell of a price to pay for the relief from the pain.

The most common side effect is weight gain. Not only does it cause you to retain fluids so your entire body looks swollen and bloated, especially your face, it also increases your appetite without boosting your metabolism. I would eat a big breakfast and be starving again an hour later. I would wake up in the middle of the night so hungry that I couldn't fall asleep again. There are a bunch of websites that will give you advice about how to avoid steroid-related weight gain and still satisfy steroid-induced hunger, and they are all full of shit. I was hungry all the time no matter how much Greek yogurt and fresh fruits and vegetables I ate. I had to get my driver's license renewed while I was still on prednisone, and I cried when I saw the picture with my sixteen chins. And while I'm not swollen and bloated anymore, I still haven't lost all of the prednisone weight - and with PCOS, I was not thin to begin with.

I also experienced insomnia, hot flashes and night sweats, and high blood pressure.

But the worst side effect of all, for me, was one that I didn't even realize I was experiencing until months after I had taken my last dose - it made me psycho. In a way that made the inconsolable crying jags from taking Provera seem like a relaxing day at the beach.

The craziness was subtle, though, and at the time there were very real, very valid reasons for me to feel, well, less than stable. Still, I look back and I'm kind of surprised that I never considered that my disproportionate anger and despair responses to various events might have been partially steroid-induced.

I'm also a teensy bit resentful that no one else caught that, either, or seemed to consider the possibility that I might have coped a little better had it not been for the 'roid rage. At least, not until after I pointed it out.

In any case, hopefully I was not on a high enough dose for long enough to cause any permanent damage to my body, like glaucoma or cataracts or bone density loss. When I went to the doctor several months after finishing my last course of prednisone, I was pleased to learn that my blood pressure had returned to normal.

Taking prednisone long-term to treat chronic inflammation and pain is a little like making a deal with the devil. It did give me much-needed relief, but at a high cost.

It is a drug that I'm thankful was available when I needed it, but I sincerely hope that I will never need it again.

Saturday, April 27, 2013

In Sickness and in Pain

Over the next month, my pain and ability to function became progressively worse. It started with one joint at a time, but as time went on, multiple joints would be affected at once. Usually the pain would only last in any given joint for a day or two at most, but I was constantly in pain somewhere in my body. Other than that first couple of days with my left hand, though, none of my joints seemed to be swelling. It also became increasingly clear that what I had assumed was acne on my face was actually a rash, and that was getting worse as well, especially around my eyes. The rash also began to appear under my arms and over my chest, but that didn't bother me much. On my face, however, it bothered me a lot.

When the day of my first rheumatologist appointment arrived, I was terrified of what she was going to tell me. It had taken three weeks before they could fit me into their schedule for an appointment, and that allowed me way too much time to do my own research on WebMD. I was Googling my symptoms compulsively, and the search results were not reassuring at all. Lupus, rheumatoid arthritis, fibromyalgia, dermatomyositis - each possibility was scarier than the last. There was also a type of arthritis that was associated with ulcerative colitis, which I've had since I was about twelve, but the arthritis symptoms typically appeared during a colitis flare up, and my case had been well-controlled by medication for years.

My appointment was at 2 PM, and I had taken the whole day off work, assuming that I would not be able to get through the morning and keep it together in public. I was right - I was a tearful mess the whole day leading up to the appointment.

However, after a two-hour appointment that included an in-depth interview about my pain and functioning, a physical exam, x-rays, and assorted lab work, the rheumatologist tentatively agreed with my primary doctor that I was likely suffering from reactive arthritis, and it would probably clear up on its own in two to three months.

That wasn't a guarantee, though. My rheumatoid factor test had been negative, but that didn't necessarily rule out rheumatoid arthritis. I learned that rheumatology is really a practice of ruling out. If the symptoms went away after a couple months, it was reactive arthritis. If they didn't, or if new symptoms appeared, it would be time to consider something else.

Still, I was relieved. I could get through a couple months. The doctor gave me prescriptions for heavy-duty anti-inflammatories and a non-narcotic painkiller called tramadol, and I left feeling hopeful that once this cleared up, I would be able to get back on track with the baby plan.

What I found, though, over the next several weeks, was that nothing seemed to help the pain, and it kept getting worse. By mid-August, I'd developed pain in my feet that made every step feel like I was walking on a bed of knives. For about two weeks, I was barely able to walk, and was completely unable to work. Just walking from my bed to the bathroom was pure agony. The joint pain continued to migrate from joint to joint, but the pain in my feet was constant. The only way to alleviate it was to stay off my feet. The rheumatologist called in several different types of anti-inflammatories, and I tried some vicodin that I had left over from a dental procedure years ago, but none of the drugs had any effect.

On Wednesday of the second week that I'd been unable to work, I called to make another appointment with the rheumatologist because I could no longer take the pain. They couldn't get me in until Friday. I called my mom at work in tears, because I couldn't think of anything else to do, and the pain was completely unbearable. She ended up asking to leave work early, and she took me to the emergency room.

The ER was a big fat waste of money. I paid $200 to have the bitchiest, most patronizing nurse practitioner I have ever met to take two minutes to glance at my feet and tell me that it was probably plantar fasciitis. She gave me a prescription for vicodin (despite my telling her that vicodin didn't help), and referred me to a podiatrist.

The podiatrist agreed that it was, indeed, plantar fasciitis, but he refused to even consider that it might be related to the joint pain, as I kept insisting it was. (Spoiler alert: as it turned out, I was right - but I didn't know that for sure for many more months.) He gave me exercises to do and recommended that I buy a pair of cross-trainers. I did the exercises, but refused to budge on the shoes - if I was going to spend a ridiculous amount of money on shoes, they would at least be work-appropriate. I ended up buying a pair of Danskos, which several people had recommended to me. When he saw them, he shook his head at me and told me that slip-on shoes were bad for plantar fasciitis, and I told him to fuck himself, but only in my head. The one thing of value that I actually got out of those podiatrist appointments was cortisone shots, but that was a month or so later. I'm getting ahead of myself.

When that Friday appointment in August with my rheumatologist came around, I begged and pleaded for prednisone. I knew the side effects weren't pretty, but thus far, it was the only drug that had even the slightest impact on the pain. I'd already spent literally hundreds of dollars on co-pays for prescriptions that had no effect. The rheumatologist relented. She started me on a 3-month course of 15 mg a day, and gave me instructions to start tapering off the dose after six weeks.

Within two hours of the first dose, I was able to walk without looking (and feeling) like I was 80. Within a day, there were still twinges of pain here and there, but I was able to return to somewhat normal functioning. I was able to go back to work on Monday.

But by that time, I had already fallen seriously behind. My job primarily involved doing home visits with clients, and we were expected to complete approximately 15 home visits per week. We had a bank of days that we could use for when we didn't meet the numbers (whether it was to take sick or vacation leave, or because we'd had excessive client cancellations and no-shows), and by the beginning of September, only two months into the fiscal year, I'd already used all my days, and my numbers were still too low.

In addition, all the medical bills and prescription co-pays had completely decimated my savings.

Still, I kept telling myself that once this reactive arthritis had cleared up for good, I could get things back on track.

But the worst was still to come.

Thursday, April 25, 2013

Baby Fever and the Oncoming Storm

Once I knew I was going forward with the baby plan, it became difficult to think about anything else. I didn't tell many people, because I didn't want to face the questions if I didn't end up pregnant. My immediate family and a handful of friends knew, and that was the extent of it.

But it was tough to contain my mounting excitement. I could no longer go to Target without a trip through the baby department, looking at clothes and cribs and car seats and baby bathtubs. Hell, I would even wander through the baby food aisle at the grocery store, debating the nutritional value of the different brands and wondering if I would actually be able to stay on top of making my own baby food from organic fruits and vegetables.

I kind of had a one-track mind.

You could even probably say I was obsessed.

I had full-blown baby fever.

In the past, when I'd thought about having kids someday, I'd always imagined that my first child would be a baby boy. However, knowing that this was probably a one-shot deal and I would probably only have one baby, I started to envision a different future, with a baby girl.

I pictured her at different ages and stages, what her personality would be like, the baby and toddler clothes that I would dress her up in, how I would fix her hair, what her little voice would sound like. My biggest mistake was that I named her.

When she wasn't even a reality yet.

I had a boy name picked out, too, but it was the girl name that I was really set on. I had my whole future - and hers - planned entirely.

My body had other plans.

Looking back now, I can see that there were warnings in the weeks after my first appointment. Little signs that trouble was brewing. Still, I doubt that anyone besides a complete hypochondriac would have paid much attention before the storm hit.

I blame a lot on the Norethindrone. I don't know if that's completely fair. I've never been able to find any research linking Norethindrone with what happened to my body over the next month, but I also think the timing was too suspect for it not to have been involved somehow. I think it's entirely possible that there was some kind of interaction between the drug, my immune system, and my stress response to other events that hit at the same time.

Of course, I suppose it's also possible that what happened was always going to happen, no matter what I did or what medications I allowed into my body.

I actually considered not taking the Norethindrone, though, and just starting on the birth control instead. I wish now that I had done that. It may not have changed anything, but at least now I wouldn't still be questioning whether I'd had a direct hand in what happened to me by taking that drug. But I decided to go ahead and take the Norethindrone because I was going back to the doctor in 3 weeks, and if I hadn't had a period by then, I knew he would have a lot to say to me on the subject. Basically, I took it to keep from being lectured.

The doctor prescribed the Norethindrone because I had specifically requested that he not put me on Provera, which I'd taken several years before, and it resulted in some sort of horrific hormone-induced psychosis. I'd spent ten days bursting into inconsolable tears at the slightest provocation. It was not an experience that I wanted to repeat. Of course, what I didn't know at the time was that Norethindrone was essentially the same as Provera, just with a different delivery system.

The first sign of trouble was that my face broke out. Horribly. Of course, with the influx of progestin in my system, I naturally assumed that this was acne. I was wrong.

A couple nights, I came home from work feeling out of sorts, and discovered that I was running a low-grade fever. Each time, I was fine by morning.

On the 4th of July, I noticed that my right knee was hurting for no apparent reason. The pain wasn't horrible, just enough to be a little annoying, and nothing that I did seemed to alleviate it.

Meanwhile, I went for my follow-up appointment the week of the 4th. I joked with the doctor that the Norethindrone hadn't really worked for me either, because it was like my entire adolescence had been condensed into two weeks. And I told him that I'd made my decision. I was even pretty sure that I'd settled on a donor by that time. All that I needed to work out was the money. I had some savings, and was applying for medical financing. I would just need to save up for a few more months, and I was hoping to get it together to do my first cycle in October.

The doctor approved of my plan and told me to schedule my next follow-up sometime in September. I got all my preliminary lab results that everything was good to go, scheduled the September appointment, and left.

The weekend came, and I was out all day Saturday. When I got home that afternoon, everything seemed okay, except that I noticed that the baby gate I used to confine my dog to the kitchen was no longer in the doorway, and instead was propped up against the wall. Mostly, this just confused me. I live right next to a historical cemetery, and I like to think that friendly ghosts frequent my house sometimes. It wasn't the first time something strange had happened in my house. Little things happened here and there - lights that I was certain I'd turned off were on when I got home, doors that I'd closed were open. The only part that was throwing me was how the gate ended up propped against the wall.

Still, nothing else seemed amiss, and all the doors had still been locked when I got home. Nothing was out of place downstairs. I called my mom and told her that my house ghost was acting up again.

"Are you sure no one broke in?" she asked.

"I don't see how they could have," I replied. "I haven't been upstairs yet, but nothing is missing downstairs."

But when I got upstairs, I immediately realized that I had been wrong. I was greeted in my bedroom by empty spots where my TV and video game system had been.

After I called the police, I realized that the bathroom window, which looks out over the kitchen roof, was open slightly. That was how the thieve(s) had gotten in. I could have sworn I'd had all the windows locked, but I can only assume that I missed that one. Or maybe I just hadn't thought that one was important, because it was so small that I hadn't imagined anyone could actually fit through it. But it was easy enough to access because you could climb onto the kitchen roof from the next door neighbor's backyard without being visible from the street.

In case you're wondering, the window has been locked ever since, with the little pull-out pieces in place so that the window can't be opened more than an inch and a half.

All in all, I figured out that about $2,000 worth of stuff had been stolen, including my great-grandmother's amethyst and diamond ring, which was by far the hardest loss to take. A TV could be replaced. The ring could not.

I'm pretty sure the stress of the break-in played a part in that brewing storm, too, because it hit the very next day.

But even the first wave seemed relatively innocuous at first.

On Sunday, my mom and I tried to go to local pawn shops to see if anyone had tried to pawn GG's ring. Pretty quickly, we realized the flaw in our plan, which was the fact that none of the pawn shops were open on Sunday. So we spent the day thrift shopping instead.

As the day wore on, my left hand, which had been hurting since I'd woken up, swelled to double its normal size. By the end of the day, I wasn't able to move it at all. Eventually, I figured out that the pain was radiating from one of my knuckles, but my entire hand was throbbing. Still, I wasn't thinking too much of it. I'd had unexplained episodes of tendonitis before, and I assumed that's what this was. It always cleared up with a short course of prednisone.

By the next morning, though, I was achy and feverish with a sore throat, and my hand was still throbbing. I called in sick at work, and made a doctor appointment. Nothing terribly eventful happened at the doctor's office. My rapid strep test was negative, but the doctor gave me antibiotics anyway in case the culture was positive, and started me on a five-day course of prednisone.

It was another day or two before I realized that something was still not right. With my previous experiences with tendonitis, it had always cleared up almost immediately with prednisone. This time, after a couple days, my hand was feeling a little better, but pain was jumping around from joint to joint. One day it would be my right elbow, the next, my left knee. By the end of the five-day course of prednisone, it was clear that nothing was getting better - it was only spreading around my entire body, and I never knew where the pain was going to hit next.

And I was starting to panic.

I went back to the doctor with another sore throat and continuing joint pain, and he ordered both another throat culture and a blood test for strep, as well as some other blood work. The throat culture was negative but the blood test for strep was positive. He suggested that I might be experiencing something called reactive arthritis, which is when the body has a malfunctioning immune response to certain infections. It was self-limiting and usually lasted a couple months. However, when my blood tests indicated abnormally high levels of inflammation, he referred me to a rheumatologist.

It would be months before I would have any definite answers.

The Final Answer

My appointment with my doctor was first thing in the morning on a day that I'd taken off work, so I had to wait the whole entire agonizing day before I could talk to my mom. However, luckily it was mid-June, and my best friend, a teacher, was on summer vacation, so she answered when I called from my car in the Walgreens parking lot while I was waiting for my prescriptions to be filled.

I was still a little breathless when I filled her in on what the doctor and I had talked about, and I admitted that my decision was pretty much already made. How could I not pursue this, knowing that I only had a few years left?

As I processed everything I was thinking and feeling aloud, she was supportive. It was not the first time we had talked about the possibility of one of us doing this - we were the girls making contingency plans when we were in high school: "If I'm not married by the time I'm....." So it was not entirely a surprise that I was bringing this up. We weren't on the same page by the end of the conversation, we were on the same page from the very beginning. I was going to do this.

I was worried that my mom would be a harder sell. Mom was adopted, and was thrilled with my foster-to-adopt plan. The day after I had contacted the local child welfare agency to request the paperwork to start the process, I called my parents, and Mom answered the phone with, "Do you have a grandchild for me yet?" She was joking, but I knew she loved the idea that I would adopt a child in need.

I had texted her right after the doctor appointment and told her that I needed to talk to her after she got off work, but then I had to wait until after 5, so I had a whole day to plan what I would say. I was already at my parents' house waiting for her by the time she got home.

She was concerned, but not terribly so; I'd told her in my text that it was nothing bad. I launched right into it, giving her a quick rundown of my conversation with the doctor.

"The thing is," I said, "adoption will still be on the table when I'm 40. This won't be. And I think if I don't at least try, it will be something I'll always regret." It surprised me that I started to tear up as I spoke, though it shouldn't have. I'd been running on adrenaline all day. The emotion was bound to catch up with me at some point.

Mom hugged me, and immediately said, "Then you should go for it." Just like that.

"But, what about the people who will say this is selfish?" I sputtered. "The ones who will say that I shouldn't do this when there are so many children who already need a home?"

"Let them say it," she said. "You would be an amazing mother to an adopted child, but that doesn't mean you're obligated to adopt. If you can make this work, and it's what you really want, you should go for it."

I will readily tell anyone that my mom is awesome, but this is definitely near the top of her highlight reel of awesome parenting moments. She had my back, no questions asked.

Well, no questions about my motives or intentions, anyway. She did ask all the right questions about how it would affect me, which were, "So what happens if you try, and you don't get pregnant? Is there a limit on how many times you'll try? How will you feel if you have to give up?"

All things I had already thought about, and had answers ready. Three attempts was usually the maximum. I definitely wanted to try once, and failing that, would hope to be able to stretch my finances to at least two attempts. Three was probably completely out of my budget. Unless the prices dropped significantly, IVF would not ever be a consideration. If two attempts did not result in pregnancy, that would be the end of it. It would be tough, but I would at least know that I gave it a shot. The thought of never trying and spending the rest of my life wondering "what if" was worse than the thought of trying and failing.

At the end of the day, I was hopeful and excited. Honestly, I had no doubts that I would try and be successful. Of course it would work. This was the sign I'd asked for, wasn't it?

Little did I know that the opportunity to try would be ripped away from me in a matter of weeks.

Tuesday, April 23, 2013

The Sign

WARNING: I'm going to talk about things that a lot of people find yucky. Like periods and spotting and pelvic exams. It's not gratuitous; it's completely relevant, but I'm not going to mince words, either. I will be as descriptive as I think I need to be. You've been warned.

One of the most common symptoms of PCOS is irregular and sometimes absent periods. In my case, when I'm not on birth control pills, I tend to have a period about once a year, but sometimes I've gone more than two years between periods. And I know, in my head, that this is not a good thing, because failing to shed the uterine lining at least once every three months can lead to all kinds of problems, like endometrial or uterine cancer. Still, at times, it has seemed ludicrous to me that I was spending $30 a month to make myself have a period when most women would pay good money to go a year or two between periods. So, sometimes I didn't take the birth control pills. Sometimes for a long time. Like two or three years.

Which was the case in May 2011, when I started spotting. It wasn't a period, it was too light for that, but it didn't stop. Day after day, a constant light flow of blood. By the time this had gone on for six weeks, I knew I couldn't keep putting it off - I needed to go to the doctor.

I thought this might be the sign I was asking for, and I also thought I knew what the sign meant. I was convinced, absolutely convinced, that the doctor was going to tell me that I would never be able to get pregnant.

I was prepared to hear that.

In an odd way, I was looking forward to hearing it. Because if that's what the doctor said, I could move on with my foster-to-adopt plan with no reservations.

I'm not saying that it wouldn't be a painful thing to face. But I'd been facing it already, and the uncertainty was the hardest part. Ending the uncertainty would be a relief. It would be closure.

But that wasn't what the doctor had to say to me.

And I have to say here that even now, this still kills me. This was hands down the cruelest turn of events in this whole process. Because if the conversation had gone the way I thought it would, that would have been the end of it. No more agonizing, it would just be over and done with. But to have the opportunity that was presented in the conversation that followed, only to have it snatched away again in an incredibly painful, life-altering way, was an experience that I don't know if I will ever completely heal from.

After my pelvic exam and vaginal ultrasound (which, for anyone who has not had this particular experience, is exactly as pleasant as it sounds like it would be), and after I got dressed again, the doctor came back in and said, "Have you thought about trying to get pregnant?"

I was completely taken aback. And not even by how stupid the question was. Of course I'd thought about it. There probably wasn't a single day of my life that I hadn't thought about it at least once. I pointed out that there was no one who could be the father, and the doctor countered with, "What about using a sperm donor?"

I pointed out that my single social worker income would be a barrier, and asked how much it would cost.

And the number he replied with was much lower than I anticipated. I was going by the cost of IVF, which typically runs anywhere from fifteen to twenty thousand per cycle. The procedure the doctor was describing to me, intrauterine insemination, or IUI, was far less invasive, and ran about one to two thousand per attempt.

This was something I might actually be able to manage. At least for one or two attempts.

He answered the rest of my questions thoughtfully and patiently, while my mind reeled, trying to wrap itself around how different this conversation was from the one I'd anticipated. I asked about the odds of multiples, because I knew fertility drugs would have to be involved. He said the chance of twins was less than 8%, and the risk of larger multiple groups was even lower.

I asked about my odds for success.

"At your age, with Clomid," he told me, "your odds are excellent. But after 35, your odds for success will probably be less than 5%. So if you decide to go forward with this, you'll need to do it soon."

He gave me pamphlets and information on donors, and told me to think about it, and schedule another appointment in about 3 weeks.

He also gave me a few prescriptions, one for the birth control that I would need to go back on to keep my uterine lining healthy until I was preparing for my first cycle if I decided to pursue IUI, and one for a drug called Norethindrone that I was to take before starting the birth control to jump start my period and get rid of all the excess crud that had built up in my uterus at that point. I think the Norethindrone may have played a part in what happened to my body over the next several weeks.

I scheduled my follow up appointment and left, my mind still reeling, thinking about the conversations I would need to have with my mom, with my best friend, to help me make a decision. But I think I knew even then that I wouldn't be asking them for help in making a decision. I would be asking for their approval and validation.

Because the reality was, my decision was made before I even got back to my car.

Monday, April 22, 2013

The story I've wanted to tell from the beginning (but that I've been avoiding)

When I started this blog, about a year ago now, I'd had a hell of a year. And I don't mean that in a good way. And after starting the blog, my life fell apart even further, which was a big part of the reason that my posts stopped for many months (not that I think anyone was really waiting with bated breath for my next posts). But the thing is, when I first started this blog, there was a particular story that I wanted to tell. Just to get it out, really, to have the words that had been going through my head out in the open. I wanted to tell the story for my own sake, although I certainly think that others may be able to take something from it. My biggest hope, though, in wanting to tell my story, was that it would be a therapeutic process for me.

So, of course, I put it off. I wrote funny (I hope) little fluff posts, to avoid the elephant in the room. And maybe there was a reason for that, because I'm in a much different place with it now than I was a year ago. I'm not completely healed. I don't know if that can ever happen. But it is not nearly as raw as it was a year ago, and maybe I needed that extra time for the perspective to be able to tell the story.

And this is infertility awareness week, which seems like a good time to tell this particular story.

There is what seems to me a very logical place to start, but every time I try to think about how to structure my story, I realize that another important piece of it is even further back in my life, and the story keeps getting longer. I probably won't be able to fit it all into one post, so this may be a multi-part deal. And I'll start at that logical place I mentioned, but it's probably going to require a few flashbacks.

It all started when I decided I was going to try to have a baby.

But first, I need to backtrack a little.

A little over two years ago, I was in an extremely good place in my life. Things that a few years earlier I'd worried I would never accomplish were falling into place for me. I was a homeowner with a career I loved. I was in my early thirties. Just a year or two prior I'd been afraid that I'd spend the rest of my life living like someone who had never matured past college - that I'd be fifty and alone living in a crappy little apartment on a month-to-month income because I'd never managed to settle down and get my shit together. But now, with a stable income and a house, I felt like I was in an appropriate place for my age.

So, of course, the question on my mind became, what's next?

I have always, always wanted to be a mother. More than anything else. And at nearly 32, with said stable home and income, it seemed appropriate to start considering how to make that happen. The fact that I did not have a husband, or even a boyfriend, or, hell, even an occasional date was simply something to work around. It would be ideal to have a partner, of course, but the truth was, being a mother was more important to me than being a wife. More than once, I have expressed the sentiment to close family members and friends that if I were given the choice by some higher power between having a child or having a husband, that I could only choose one, I wouldn't even have to think about it. Having a child would win, hands down, in any scenario.

I had been diagnosed with polycystic ovarian syndrome, one of the most common causes of female infertility, about a decade before any of this (and knew since early adolescence that something was not right with my reproductive system), and I already thought by then that I had come to terms with this. A friend of mine also had PCOS and had told me a great deal about the fertility drugs, followed by several IVF cycles and the heartbreak that came with them, that had finally resulted in her daughter. I decided after these conversations that I would never pursue IVF. Even though she got her happy ending eventually, I didn't want to risk spending tens of thousands of dollars that I couldn't afford and still come out the other end with a broken heart. If I met Mr. Right and got pregnant naturally at any point, great, but otherwise I would find a different path to motherhood - most likely adoption through foster care (because infant adoption is almost as costly - and in some cases even more costly - than fertility treatments).

And so, around Christmas of 2010, I decided that I wasn't getting any younger, and there was no reason I had to wait any longer to start the foster-to-adopt process. I could do that on my own, and I certainly wasn't ruling out having a baby someday by doing this. I could adopt a child now who needed a home, and if Mr. Right came along in the next few years, there was a possibility that I could still have a baby then.

I submitted my initial paperwork in January and was approved a few weeks later to take the classes. Because I had previously worked in the child welfare system, though, I knew one of the trainers who was teaching the next round of classes. I could not enroll in his class. This meant I would have to wait until July to start the classes - about six months away.

No problem, I thought. That would give me time to get all my ducks in a row, and refine what sort of adoption scenarios I was willing to consider. I was well aware that adopting from foster care usually involves children who have experienced significant trauma and who frequently have mental health diagnoses and behavioral issues. I was confident that I could handle the challenge - in fact, with my background in social services, I was sort of uniquely qualified.

However, having all those months of waiting also gave me time to come to some realizations that I may not have thought about if I'd jumped into the classes right away.

Like the fact that bringing an adopted child with special needs into my life would be a huge barrier to finding Mr. Right, far more so than having a biological child with ordinary needs would be. Dating as a single parent is bringing a hell of a lot of baggage into any potential relationship. Dating as a single parent with an adopted special needs child? I began to think it was probably unfair to ask anyone to take that baggage on. I didn't date that much while still childless to begin with, so I had to consider the very strong possibility that, by following this path, I was, in fact, ruling out the possibility of ever having a baby.

With that thought in mind, I suddenly found myself logging onto dating websites with an alarming, possibly desperate frequency. Okay, definitely desperate. And I began hoping for a sign that I was on the right path.

Around mid-May in 2011, I actually got a sign. And I've been resenting the trajectory it sent me on ever since.

Hopefully, someday I will look back at all this and realize that the reason for the events that followed was because there was something better waiting for me. If that is the case, I haven't discovered the something better yet.