Sunday, March 22, 2015

My Favorite Post Ever: His Response

I've mentioned before that my husband has been the silent observer as I have publicly lived our lives online. Despite the fact that infertility hurts both partners, fertility often feels like a "woman's issue." We don't hear often from the men struggling with the heartache and disappointment that comes with this struggle. On top of that, my husband is a pretty even tempered and private person. This means even I don't always get to know the inner workings of his mind as I seem to express enough for the both of us. I guess that is why I am so excited he took the time to write his version of this journey. It is a bit long (as he has a lot of catching up to do) but this will be to this point and probably forever my favorite post!

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I’m not good at keeping a regular journal or Blog like my wife. But I think it’s important to record life’s important events and experiences. I’ve appreciated how Erin has been able to be so open with our experience with infertility. I’m a very private person by nature and I initially wasn’t all too excited about Erin’s openness. I figured, however, that if writing and talking about it was therapeutic for her then a bit of lost privacy was a small price for me to pay. I enjoyed reading her posts. As time went on I noticed that her sharing our story was not only benefitting her, it seemed to be benefitting other people, including me. Friends and acquaintances started opening up to Erin about their own struggles with fertility. Erin’s openness gave other people the courage to be more open, or at least to share their personal experience with Erin. My eyes were opened to fact that infertility is actually very common. It was just a fact; one of the many challenges that life throws our way; not something to be embarrassed about or ashamed of. When people asked me when we were going to have kids, instead of sort of shrugging and mumbling something about how we hope to someday have kids but the time’s not right yet, I started telling people that we’ve really been wanting children but we’ve been having trouble getting pregnant and so we’re doing in vitro fertilization (IVF) but that hasn’t worked for us yet, either. Erin’s openness has been a blessing for me.

As a husband on the IVF journey, I have felt more like a spectator than a participant. It’s my wife who has to have all of the medical exams, be on multiple medications, have daily hormone injections, have the side effects that come with the medications, take the blood tests to see if she’s pregnant, and
receive the phone calls telling her the results of the pregnancy tests, and then having the emotions of
wondering why it all wasn’t working. I think that was the hardest thing for me—watching her go through all of these hard things and wishing there was more that I could do to help carry some of the weight. Other than be emotionally supportive, give her injections (I hate causing my wife pain), and try to help more around the house, there really wasn’t more that I could do. About 10 days after each embryo implantation, my wife would go to the hospital for her pregnancy test, a blood draw to test her HCG level. As a doctor at the hospital (and with her permission), I had access to the lab results as soon as they were posted. Her blood draw was usually at 7:00am and at ~8:00am I would get onto the computer and check the HCG result. The results of the first three embryo transfers looked like this:

I would always try not to get too hopeful in order to not feel too let down if it was negative. I felt like I had my emotions pretty well in check, but each time it was negative I remember being surprised by how hard it was for me. Partly, I was sad for Erin because it meant having to go through the process again, but I was also sad for us because it underscored what we felt was missing from our otherwise very happy and contented life together. I would call Erin on the phone while she was still driving to work and let her know that the test had been negative. I would try to say a few encouraging words and prayed that she wasn’t too upset. She said that she was always glad to hear the news from me rather than wait for the nurse to call several hours later.

After failing three rounds of IVF, we had 3 frozen embryos remaining. The doctors, who almost always recommend only implanting a single embryo, recommended that we try implanting two at once. We had followed their advice in the past and decided to follow their advice again. Besides, maybe God wanted to send two babies to us at once and was just waiting for us to use two embryos. So on February 16, 2015 (President’s Day was fortunately a holiday at the VA hospital where I was working) we went through a similar routine to what we’d done three previous times: check-in, change (Erin into a hospital gown, me into scrubs), go into the IVF procedure suite, talk briefly with the doctors who show us a picture of our microscopic embryos and tell us they look good (of course!), watch the embryos be transferred under ultrasound-guidance, confirm that the embryo is no longer in the catheter, thank the doctors, wait 10 minutes before Erin can get up (during which time we would take some pictures and I would send text messages to my family that things had gone well), change, and then go to an Indian Buffet for lunch (I’m not sure exactly how we started that tradition, but we’ve gone with it).

I was optimistic about this time. For some reason, I felt more confident that it would work. I don’t know exactly why. Maybe it was that I felt we were getting close to the end of the line and I wasn’t sure how I’d react or what we’d do if it didn’t work. Even with the infertility, I have never really felt like we wouldn’t eventually have kids. I wondered why it wasn’t happening when we wanted it to happen, but I felt like it would happen eventually. So it must work soon, right? I remember trying to think about what we would do if it didn’t work: probably try one more time, using our last frozen embryo, and then maybe take a break for awhile, regroup. In the weeks preceding this, we had talked to my mom about how to start pursuing adoption. We weren’t sure we were ready at this point to fully commit ourselves to the adoption process, but we knew through the experiences of my parents and other relatives that there is a lot of work to do before adoption can become a reality and we thought that it would probably be a good idea to at least start looking in that direction. Maybe I felt more confident this time because statistically we were due for an IVF cycle to work (how many times in a row are we going to keep flipping “tails”?). Maybe the confidence came from the hope in the back of my mind that perhaps God was simply waiting for us to implant two embryos. I’m sure that most of my confidence was because I knew how many people were praying for us. One of the great benefits of Erin sharing our experience was the great outpouring of support from our friends and even from strangers. I know that our families were fasting and praying for us. I also know that people across the country, from a variety of faith backgrounds, were sending prayers to Heaven on our behalf. My cousin told me that she had said special prayers for our implanted embryos—“Maybe a bit unconventional so early,” she said, “but I felt no one is too young or tiny for God to notice.” Erin and I appreciated the special blessing she had been given the day before the implantation by our two faithful hometeachers (people from our church who are called to visit us in our home each month to offer support and share a gospel message with us). And I had the experience a few days before the implantation of hearing Erin pray one of the most heartfelt prayers I have ever heard, asking God to bless us and help us to become pregnant. These things gave me confidence. They made me hopeful. I still wasn’t 100% sure what was in store or what God had planned for us, and I’m sure that my faith wasn’t as strong as I would have wanted it to be, but I at least felt like we were sufficiently placing the matter in God’s hands. This provided some confidence and peace.

Then we waited. 10 days. It went by pretty fast. Erin commented several times that she felt peace. I was nervous when I thought about it, but it surprisingly didn’t occupy my mind constantly. The date of the pregnancy test was February 26, 2015. Unfortunately, I was scheduled for a full day of cases in the OR on this day and the first case would start at ~7:30am. This meant that I likely would not be able to check the results as I had done in the past. Erin had the whole day off work. She went in at ~7:00am for the blood draw. She texted me, “Now that the test is in, I feel surprisingly calm.” I told her to text me when she got the results, although I didn’t make clear whether I really wanted her to tell me the actual results via text message (“They’re just now bringing the patient into the room. I may have time to check, but probably not. I can call you after first case or I’m ok with text message.”). I tried checking the results on the computer at 7:45 am, right before scrubbing in for the first case. Unfortunately, the results were not up yet. I would have to wait.

The first case took about 90 minutes. Towards the very end of the case I felt my cell phone vibrate,
indicating a text message. It must be Erin with the results. After we had cleaned the patient and I had
taken off my surgical gown, I quickly checked my phone. It was from Erin at 9:15am: “I just got off the phone with the nurse. Call me when you are available.” My first thought was, “Oh no. She didn’t tell me the results. It’s probably because she doesn’t want to give me bad news via text message.” But then I immediately corrected my pessimism and thought, “Maybe she doesn’t want to give you GOOD new via text message!” Then I just didn’t know what to think and I was really anxious to call her. We first had to transport the patient to the recovery room and then I went to talk to the patient’s family about the surgery. Then I had a moment to call Erin. I was in a hallway next to a waiting room that had quite a few people in it. I saw an open and empty exam room and went inside for some privacy. I called Erin and she said, with tears in her voice, “It’s positive!” I was shocked and relieved and happy and excited! I said, “I didn’t think you’d be crying if it was positive.” I can’t really remember more of the conversation. I was kind of speechless. I remember feeling my eyes get a little misty. I didn’t have much time—I had to go and get the next patient ready for surgery. I hope that I was able to express a little bit of my enthusiasm; I mostly probably just came across as being stunned. This was the result when I looked it up later (very positive!):

The rest of the day was very busy. I remember just wishing I could leave work and go home and
celebrate. I wished that I could spend the day with Erin. I wished that I could call all of my family
members and tell them. I wished that I had time to read all the text messages that my phone was
getting. But it was a very busy day at work and I really just didn’t have time to process it all. But I was excited and happy. It was nice to finally get home in the evening and celebrate with Erin.

With the implantation of two (good-looking) embryos, the next question was whether we were
pregnant with twins. The high HCG level at the initial pregnancy test was suggestive of multiple embryos (we looked up a paper about it). I think we both felt that twins made sense: Erin is a twin (so it runs in the family, right?), we put in two embryos, high HCG. They tested Erin’s HCG again 4 days later and the result was really high:

There was the recent story of the couple in Utah who implanted two embryos with IVF and ended up
with quadruplets. We joked about triplets or quadruplets, but realized the likelihood was very small. It would be twins. I remember also thinking multiple times, “We shouldn’t assume it’s twins because I don’t want us to feel any disappointment if there’s one baby. One baby would be blessing enough!” So it was with the question of whether it would be one baby or twins that I accompanied Erin on the morning of Thursday, March 19, 2015 to her first ultrasound appointment after being pregnant. I was excited to find out but knew that I’d be happy with either outcome. The ultrasound started and they quickly found the fetus. Even at this early stage, I was amazed that it was already taking shape and the heartbeat was easy to see. They looked around for another fetus and I wasn’t seeing anything initially so I started thinking there was just one there. I thought, “One will be good.” Then they found another. That was really exciting. “Great! Twins!” The second looked similar to the first. They labeled them “Baby A” and “Baby B” and took measurements and recorded the heart rates. Then the ultrasound tech focused in on a small little thing near Baby B. I saw her and the doctor look at each other and whisper something about “a third?” I thought I saw what they were seeing, but wanted to wait and hear what they said. They focused in on it more. It was smaller than the other two, but it’s shape and heartbeat were clear. Baby A and Baby B were the embryos that had been implanted. Baby B and little Baby C were identical twins (the embryo had split after implantation). They took measurements of Baby C. They initially forgot to get the heart rate and so Erin had to come back from changing so they could get the heart rate. Then they sent us to a clinic room to wait to meet with the doctor. Once again, I was speechless. I think Erin was too. I think we were both shocked. We had gone from wondering if we’d ever get pregnant, to now being told that Erin was pregnant with triplets! How do you process that? I was wondering about the size of Baby C. The doctor addressed that when she came in. She told us that Baby C is lagging ~1 week behind the other two and that there is a good chance that it will resorb and that we will end up with twins. However, there is also a chance that it will survive and we’ll continue to be pregnant with triplets. They want to do another ultrasound in ~10 days to see how things are progressing and hopefully we’ll know by then what Baby C is going to do.

I’m looking forward to the ultrasound because I’m curious what the future holds. I still don’t know how to process the idea of triplets. Actually, I don’t really even know how to process the idea of twins or even of being a parent at all. It’s too early to have sunk in. Maybe it doesn’t sink in until after you hold your baby/babies in your arms. Maybe it doesn’t even sink in at that point. I’ll have to wait and see. After we found out that there are three babies, I remember wondering to myself, “What should I pray for now? Should I pray for Baby C to continue to grow, knowing that that makes for a riskier pregnancy both for Erin and the other two babies?” Then I realized that my prayers should be prayers of gratitude and that whatever is best will happen. It is in God’s hands now. In my education and profession, I have the privilege of seeing the miracles of modern science and medicine. It is very powerful. Erin would not be pregnant now without it. However, the struggles that we’ve had getting pregnant even while using modern medicine and then the presence of triplet when only two embryos were implanted (“1+1=3” says Erin) have been reminders to me that, ultimately, it is God who is still in charge. If He wants us to have triplets, we will; if He wants us to have twins, we will. And, either way, I will be grateful for the miracle of it all and excited for the adventures ahead.


Suz said...

Great, touching post. Your journey, every step of the way has been touching and fun to be included.

Susan Rugh said...

We are so happy for you both! What a family that will be. Good luck on your journey,