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.

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