I used to have low bars to clear in order to be my doctor. Do you have a medical degree? Do you know which area my heart is located? Do you own a thermometer? I didn’t have any major medical issues, therefore I hadn’t given much thought into choosing doctors.

But now I woke up at 5 a.m. with my heart pounding. The anxiety hit as soon as I unjumbled my thoughts. What was I worried about again? Oh yeah–the fact that I couldn’t get pregnant. Thud thud thud. I would go down to the gym and try to run it off. But you can’t outrun infertility anxiety.

OB #2 called my house and apologized for the mix-up. He told me that I wouldn’t be charged for the visit (er…want to tell that to your staff who sent us bills for the next six months?). And he recommended another doctor–one who took my filthy HMO–that he had trained years earlier.
This is what I can say about OB #3: he moved quickly. He ran tests the first month we were with him, found my lack of progesterone, explained the reason for my nine day luteal phase (as well as those interesting 18 dpo charts), and referred me out to an RE. But…since every RE worth his/her salt has a waiting list…we could always try a few fertility drugs right here in the OB office…

And, come on, it’s like dangling cocaine in front of an exhausted grad student three days before exams. In all honesty, would you say no if someone offered you a little non-monitored Clomid? Or a round of progesterone. With no directions. Suffice to say, if I knew then what I know now, I would have waited. The problem is that the education I have now came from the mistakes I made along the way–the questions I didn’t know to ask or the things I allowed to happen. If I could do it all over again, I wouldn’t do those things. But I wouldn’t know that these things were detrimental to my journey unless I did them. As my middle school French teacher always chirped after one of these obvious statements: n’est pas?

I stuck with OB #3 through the pregnancy and the six-week post-delivery appointment. A misprescribed medication and my OB answering my complaint with, “well, you didn’t die” ended that relationship.

So what did I learn from my three OBs? Talk to a lot of people so you know the right questions to ask. Be assertive. Stick to your guns. Don’t tolerate someone blowing off your fears without explanation. Learning these lessons has also opened a world of doctors to me because I don’t need them to have a nurturing personality anymore. I could care less if they go home and say to their spouse: “you wouldn’t believe the psycho who came into my office today.” As long as they are giving me excellent medical care, running tests to diagnose problems, and taking my fears seriously, I’m fine going to them.

Then why am I throwing out my latest OB conundrum? The one that is nagging me day and night because I know what I have to do, but I’m balancing out three other elements (1) money, (2) ties to my RE, and (3) searching for a new OB when you’ve already seen the winners I’ve had over the past two years.

Which brings me (in the most convoluted way) to the question that lies at the bottom of my question: why can’t two doctors come to the same opinion?

And what’s the whole deal with reproductive immunology…

This and more in the next post. Damn this story is long.

…and now back to the program.

I spent the night with seven vials of blood in my refrigerator, which the nurse promised was just like having it at the lab. Except, you know, it was in your house. Next to a head of lettuce. And an open jar of mustard. And it’s seven vials of your blood.

I should explain that they gave me my blood to take with me because it was unlikely that they would be able to get another seven vials of blood from me the next day. I have only one good vein for drawing blood and it’s in my left arm. They’ve never been able to draw blood from my right arm without collapsing the vein. They’ve tried the back of my hand and once suggested a vein in my forehead. Regardless, once you draw blood from me, you best use it because you’re not getting another seven vials for quite a bit of time.

This is certainly not the most heartbreaking thing that happened on our journey, nor was it the most painful, or even the most bizarre. But it was this surreal turning point for me where our journey no longer resembled anything I ever imagined it to be. I thought we’d have this great conception story that involved a romantic trip to a bed and breakfast. And we were getting farther and farther from that image.

And I was freaking out.

The next morning, I gathered up my bag of blood and took it a few miles away to an HMO-approved lab. I walked in and tried to speak to the receptionist, but she told me to sign in and refused to listen to me. A few times I stood up again and tried to speak, but she cut me off and told me to sit down. I was getting extremely anxious because the blood had been out of the refrigerator for a long time. I finally pushed my way back to the front and tried to speak to her again. She snapped at me: “What part don’t you understand? You show up without an appointment and expect that you can push your way to the front of the line? Every person in here wants lab work. You need to wait your turn.”

“But I don’t need an appointment. I need to drop off blood.”

We went around like this several times with me repeating that I needed to drop off blood and she insisting that everyone in the room needed to drop off blood and I was now looking at a two hour wait.

I finally burst into tears, in front of the entire waiting room and held up my bag of McBlood. “But this has been out of the refrigerator for an hour and it will go bad if I keep sitting here.”

Can we say horrified? She finally realized that the bag I was carrying contained my own blood. I don’t know what she thought in that moment. That I stuck a butterfly needle in my own arm back at home?

She opened the bag and told me the blood was unusable. And even though I could clearly see that it no longer even looked like blood–it had separated into a watery substance and black clumps–I told her that she was wrong. She was wrong and the OB nurse was wrong and my insurance company was wrong and everyone waiting in the waiting room that morning was wrong and the fact that I had to go to work after dropping off seven vials of unusable blood was wrong and the fact that I couldn’t conceive was wrong.

I would probably still be back in that waiting room delivering my long list of what was wrong when an elderly lab technican from Sierra Leone came into the waiting room and put his arm around me saying, “please stop. I’ll redraw the blood. I can’t stand seeing you cry.” Which was–by far–the kindest thing that had happened in the last 24 hours.

He couldn’t draw blood, nor could the other technican who gave it a whirl. Five needle sticks and several yellowing bruises later and I wasn’t leaving until they drew this blood and ran those tests and told me if there was anything else I could possibly pass along to this child I couldn’t conceive. On the sixth try, they drew the blood and I left, crying the entire ride to work.

And the lab botched the tests. But we wouldn’t know that until after we had gone through the first two week wait. And then there was the second two week wait. And then there was the repeated tests when I finally reached OB #3.

Will her Jewish panel come back showing even more genetic illnesses she can pass along? Will OB #3 finally take her fertility seriously? Stay tuned for the conclusion of All My Not-Yet Children as well as the question at the end of this tunnel-like story.

Or perhaps this post should be labeled: Cautionary Tales of Doctor Shopping. This is a long idea. It may take me a day or two to think this through. But it has a question at the end of the tunnel. So bear with me.

Doctor shopping. I recommend it. Even if it did lead to me DRIVING HOME WITH MY OWN BAG OF BLOOD. You can’t help but shriek those words. Because…I mean…I drove home with a bag of my own blood in a white paper bag as if I had just gone through the drive through at McDonalds. My McBlood Vials.

Sometimes you guys write me and ask for advice and sometimes you guys write me with stories that completely freak me out about your medical care. And it all leads to the same place–don’t stop looking until you have a good doctor. The best you can afford or the best that is covered by your insurance. And by “best” I don’t necessarily mean the one with the best pregnancy results. I mean the one that fits your personality best. My current OB is not the best fit with my personality, but he comes with many other strings that tie me to my RE. And I’m not sure to sever or persevere.

My first doctor was the OB that I had for many years. She was usually fantastic–very thorough, very thoughtful. She was cautious–a good fit for me because I’d rather have someone err on the side of too many tests than miss something completely. She was kind–one time I was late and the nurse was going to make me lose my appointment as well as pay the copay. My doctor stepped into the receptionist’s bay and shook her head. “We’ve made her wait numerous times. And traffic happens.” Loved her.

But then things started to feel wrong with the TTC process and one day I called her about the fact that my charts often showed elevated temperatures long past 14dpo–sometimes 18–21 dpo. And she said everything was in my head. I sat down on a bench outside the food store while she told me that I was just too stressed out about trying to conceive and I needed to calm down and stop charting.

And that was the end of that OB.

Which is not to say that you should drop doctors if they don’t agree with you–there are plenty of times that I have been worried about something and a doctor has disagreed with me. The difference being that I can handle being wrong, but I can’t handle being ignored. Not when it comes to my health. She refused to acknowledge or explain what was happening on the charts. Which is what led me to choose a different doctor even though she had been a fantastic match for me for many years. Fertility is tied to time, and I didn’t have time for her to come around and decide to do some testing. I needed to find a doctor who would work with me to get to the bottom of the problem.

Bring in my second OB. He was my OB for one glorious day. One glorious insurance-botched day. I found a great doctor that everyone loved. His receptionist said that he accepted my insurance. She took my card when I came to the office and xeroxed it. We filled out paper work that stated my insurance. I think I was pretty upfront about my insurance.

The appointment was fantastic. He spent over an hour speaking with us. I spent the first half of the appointment shooting out my questions like an auctioneer until he told me to slow down. Relax. This was my kind of doctor. One who seemed to have nothing else to do but humour all of my “what ifs.” And I had a lot of what ifs.

He agreed that things looked strange on my charts and he ordered some tests to be done during the next cycle. Towards the end of the meeting, he told me that he wanted to screen me for a few more genetic illnesses since I tested positive for Tay Sachs. I called my insurance company from his office to clear the tests with them and they told me it was covered as long as I used a certain lab. I informed his nurse while she was drawing my blood and she said, “we wouldn’t participate with that lab. It’s a lab for HMOs. And we don’t accept HMOs.”

Screeeeeeeeeeeeeeeeeeeeeeeech!

One tear-saturated conversation later and I was being shown the door with the blood they had already drawn before they realized that I couldn’t be their patient. Even though we had spoken on the phone, even though they had xeroxed my insurance card, even though I HAD WRITTEN MY INSURANCE INFORMATION ON THEIR DAMN INSURANCE SHEETS, they had no idea that I had an HMO.

My husband had left during the discussion and was now circling the block since we had to move our car from its parking space on the street. I went downstairs with my McBlood and climbed into the waiting vehicle.

“What’s that?” he asked, pointing to the white unlabeled bag.

“My blood,” I told him. “Just drive.”

A cliffhanger–tune in tomorrow to hear what happens when you show up at a lab with a bag of your own blood.

This is where I was this day five years ago. I was teaching. We were having a weekly assembly called “town meeting” where the kids got up and gave annoucements. Another teacher walked by me with a boom box. I suddenly remembered that I had forgotten to reserve one for class that day and I asked her if I could use the one she was carrying when she was finished. She gave me a strange look since I obviously didn’t know yet why she was carrying a radio into her office. She slowly said, “sure.”

Another teacher came and tapped me on the back and said, “can I speak to you outside for a moment?” And because I had no confidence, I immediately started thinking, “what did I do wrong?” We went outside and she told me and as I started crying, I saw them gathering the kids whose parents worked in the Pentagon. We knew about the attacks before they were on the news because another teacher had been on the phone with a parent when the plane hit the building. They were discussing his son, his learning issues, and a new plan for helping him with his studies. This child was now being brought to a separate room while they tried to contact parents and see who was still alive.

And I’m writing this now as a mother and I am scared shitless. Of what has happened in the past and what could happen in the future.

I was given a few minutes to make a few phone calls and then I went back to the theater to sit with my students as the rest of the school poured through the doors for a special meeting. My students were confused. Why were the upper schoolers coming to our assembly? And why were they sitting in the back? And why was the principal coming in? And why were some of the kids being taken one by one out of assembly? They knocked shoulders with each other as they whispered like anxious cows sensing that they’re about to be led to slaughter.

The principal told them, and the kids began crying, and some kids just collapsed on the ground. And that’s where I was on September 11th–weeks before my wedding and watching children learn about the Twin Towers and the Pentagon and the planes.

Did I know before that moment that sometimes parents die and leave behind children? Of course. There is cancer, car accidents, and suicide. I have had other students lose their parents in other ways before. But nothing made me worry–even now, 5 years into the future–about leaving behind my children than that day. I didn’t even have children yet, but I worried about them nonetheless while watching these kids who strutted around the Commons with confidence on any other day cling to my sleeve like five-year-olds saying, “I just want my mom. Can’t you tell my mom to come faster?” And knowing that not all of their parents would be there to pick them up that day. I had never been with a child when they were waiting to hear if their father would ever be coming to get them.

The New York Times ran obituaries of people who died in the Twin Towers. I only read them for a few days because I couldn’t handle reading about 26-year-old widows who had lost their husbands before their first anniversaries during the attacks. But there was one that changed the entire way we lived our lives. This woman had gotten married in August and her ketubah (a Jewish wedding contract) was still at the framers. Her husband was now dead, and her ketubah was still being framed. I refused to relinquish the ketubah after the ceremony. I wanted to take it to the framers and wait there until it was finished and put it up immediately. Instead of waiting a year, we started trying to have children a few months after the wedding. If there was a chance that my husband was going to be taken away from me, I wanted to have a piece of him with me. His DNA in our children. That was probably what pushed me towards treatments rather than adoption. Isn’t it strange–how one path can seem like the right path and then suddenly there is a world events and it changes your life choices. I wanted his DNA.

And now it’s worse. Because once you have that DNA, you realize that it’s not enough. There can never be enough. There is nothing you can do to protect your heart or make it easier or not get hurt. And that realization is just so scary. And living while trying not to think about that reality is so hard. And my heart is going out to all of the women today–those who have the DNA and those who don’t. Who are hurting. So. Badly.

We went out to Ben and Jerry’s for an ice cream cone this afternoon (and not to bitch, but my daughter ordered a kid-sized cone and I ordered a medium-sized cone and her’s was twice the size of mine. But I felt childish going back into the store and whining, “you gave my daughter more than me. That’s not faaaaaaaaaaaaaaaaaaaair.”). My son likes ice cream and picks at it very neatly (always in a cup). My daughter loves ice cream, loves getting it on her face and hands, loves narrating the entire cone experience.

Afterwards, I was not letting her back in the car in her sticky little dress so I had her stand on her chair while I took off her clothes and searched the diaper bag for a clean shirt. “I’m naked,” she exclaimed to everyone walking past. “I’m a naked Tallulah bird.” Which is a reference to one of her favourite Maisy books where her friend, Tallulah, enters her house, runs up her stairs, strips, and jumps into the bathtub. It’s an amusing tale that child and adult can enjoy on so many different levels.

She danced on the chair telling one and all, “it’s nice to be naked. I’m naked. Mommy, get naked.” I explained to her that once you’re old, no one wants to see you naked in public. And it’s actually a crime. Which I know because police once came when I was sunbathing topless up in my old state of Massachusetts.

We’re finally ready to leave, with my daughter dressed in one of her brother’s shirts and no pants (which she also has to call out to everyone as we walk past–“no pants! I’m not wearing pants!”), we had to walk past a couple about our age sitting at an outdoor table at a nearby restaurant. The woman watched us walking towards her, with my daughter chirping loudly about her pantslessness. She watched us for the entire walk to our car, not speaking to her husband. I tried to shake my wrist a bit, show her the pomegranate-coloured string, but I’m sure she just thought I had a nervous twitch. Regardless, she wasn’t watching me. She was watching my kids.

And then we got into the car and I saw her bring her head close in to her husband’s forehead. And she started to cry. And I felt like ass even though (1) I had been there and knew how she felt, (2) I was back in that infertile space again, and (3) I cannot hide my kids waiting for the entire world to not be infertile.

Brad Pitt (this is becoming quite the celebrity site) recently said that he wasn’t going to marry Angelina Jolie until everyone had the same right to marriage. And I would love to say something similar. I’m not going to bring my kids out in public until every stirrup queen has access to fertility treatments or adoption. But even having access isn’t enough. Having access doesn’t mean the problem is solved. It just means the financial headache goes away. It still isn’t a guarantee that the path you want will be available to you.

I am pretty sensitive about parading my children. Back when we went to synagogue, there was a portion in the service when they invited all the kids to go onto the stage and sing the prayer. One or two kids would actually sing the prayer. About twenty toddlers would run around on the stage, crashing into each other. And then a handful of mothers would bring their infants to the stage and hold them like trophies. Like they had just won the U.S. Open (and believe me, there was a big part of me wishing the kids’ heads would fall off like the top of the trophy did for Maria Sharapova. Made me feel great being that petty in synagogue).

And I promised my husband I would never be one of those women bringing up their child who obviously couldn’t participate. Those women brought up their kids to show them off. And I promised I would never treat my kids like that. We never parade them or bring them to events just to show them off. There are other people in our life who would like us to do this, but I won’t allow it because I know how it feels to watch a mother parade her kids. And it makes you feel like shit. And you never know who is around and what they’re going through. And I’m just not going to make someone feel like that on purpose. If we bring them to something, it is either because it’s for them or because we need to take them because we’re going ourselves.

But what do you do with the fact that even if you don’t parade your kids, you end up making a woman having dinner with her husband feel like crap just by walking past? Which was the whole point of the pomegranate-coloured string. Except unless you read this blog or someone who has posted it on their blog or had a friend tell you about it, you don’t know what the string represents.

Which is my question: how do we get the word out there? A newspaper article? A forwarded email? Because the reality is that there is an entire world of stirrup queens who are not going to a clinic or reading blogs or visiting bulletin boards. So while it needs to go out through infertile venues such as bulletin boards, clinics and organizations, it also needs to get out there to the general population. Which is where someone like today’s woman exists. Perhaps not yet part of the openly diagnosed infertile world, but hurting nonetheless when a pantsless girl walks by her.