You Probably Need a Will, So Here's How to Have That Potentially Awkward Conversation with Your Family
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My mom is in town! She gets to finally meet Dashiell, who she has only thus far spoken to on the phone, when she called to ask for my hand in marriage. Mom calls him ‘Dash’. (Btw, a friend has pointed out that after the wedding I’ll be ‘Mrs. Dash’.) She also gets to meet Rodney, which is exciting for everyone.
My mother has had a small collection of very barky, very fluffy Maltese dogs, a heritage Rodney can partly claim. Currently my mom lives with Clara, a trembling bit of fuzz who poops on a poop pad in the kitchen and refuses to walk on a leash. She just sits there on the sidewalk, all leashed up, trembling. She’s like an annoying San Rio character. My mother doesn’t like walking her anyway, because they live in Florida and a hawk could come out of the sky and gobble little Clara up in a single gulp. But, anyway. My mom is down with Rodney, and is oblivious to his bad, barky ways.
My mom is also in town for our injection workshop at the fertility clinic. Rather than dump her at a café or leave her home with Rodney, we take her along. I’m really glad we have the opportunity to show her where we’ve been going and what we’ve been doing. IVF is alien enough, even to us, but for my mom, across the country in Florida and prone to mother-ish nerves, it’s been full of unfamiliar unknowns. Which equals worry. Now she’ll be able to see firsthand how sweet the clinic is, with its artful ceramic vegetable tiles lining the entry and the big landscaped courtyard. She’ll be able to see that it’s a legit place, and that the people are friendly.
Plus, my mother is a nurse, so she’s sort of in her element in the clinic, though she’s on the other end of the caretaking spectrum, working with people on their way out of this world, not folks looking for a way in.
The nurse who leads the workshop sort of resembles Sandra Bullock, or at least Sandra Bullock would be a good casting choice when this blog is made into a movie and they need someone to play the nurse in the injection workshop scene. The workshop is in a conference room with a long, wide table, and bulky chairs crammed along the perimeter. Soon every single chair will be taken by a people and their partners, all of us seated before a plastic bag full of fake medicine and very real needles.
“At the end of the class you’ll all have the opportunity to give yourself a subcutaneous injection,” she promises. She goes over the different reasons we all might be here today. “Some of you are coming through to freeze the embryos for future use,” she says, and I wonder who’s the genius in the room hooking that up for herself. I swear, if this test tube baby winds up being a girl, I am hauling her into the fertility clinic on her 18th birthday and tossing some eggs in the freezer so she can go out and be a fuck-up and have fun like I did for my whole life up until last year. Then when she finally calms down and decides she wants kids she can just defrost a couple and have at it.
Nurse Bullock is explaining the uses of the various medications, using the euphemism ‘quiet’ again – the Lupron is to ‘quiet’ our ovaries, the Medrol to ‘quiet’ our immune systems. It’s still creepy, even when being delivered by Nurse Bullock’s big, cheerful voice. Maybe even more so. She’s got long, thick dark hair and great eyebrows. She’s wielding a syringe: ‘This is an insulin syringe, short, needle. You use this with the Lurpon.” Those are the shots I’ve already been giving myself, no big whoop. Someone asks about side affects. “Maybe you’ll get night sweats – who knows?” I’m actually prone to nightsweats – my mother has been telling me I’m peri-menopausal for like ten years now – but I haven’t experienced anything so far.
“Throw that bad boy in the sharps container,” Nurse Bullock says of the Lupron needle, and moves onto Ganirelix, one of the medicines Dashiell will be on to help her body create one million eggs. There is a lot of information coming at us, little bits of this and that, like how I’m we’re only allowed to use Tylenol while on the meds, not Ibuprofen. We learn that the terrifyingly long needle in our meds packs is a mixing needle, not a shooting needle, thank goddess. We use it to draw up sterile water from one little vial, and then inject it into the vial containing the medicine, which is a powder. Once it’s liquefied you draw it up into the syringe and then swap out the needle for one that is considerably less horrific. It’s basically the size of the insulin syringe I’m using on my belly. Dashiell will shoot the Ganirelix into his belly.
I actually get a little bit confused during the powder-mixing part, but Dashiell assures me that she’s got it down, so I don’t worry about it. Nurse Bullock is talking about how the Ganirelix makes the ovaries swell. “You can sometimes feel them on the outside of the body she says,” and then I throw up in my mouth a little. No, I don’t. But, like, my soul does. That sounds awful. Who wants to be able to touch any of your internal organs from the outside. The thought makes me dizzy. Beside me, Dashiell shudders. It’s all deeply gruesome.
Nurse Bullock tells us about Ovarian Hyperstimulation Syndrome, when the medicine makes your ovaries go completely haywire and you begin producing a bazillion eggs instead of just the zillion you’re hoping for. “It’s common to people with polycystic ovaries, you know if you are at risk,” she says. As far as we know Dashiell doesn’t have that condition, and no one has told us anything about it, so I guess we don’t have to be too concerned. Another side affect is shortness of breath, which does concern me, because Dashiell can get short of breath sometimes. It’s from being a Virgo.
Nurse Bullock busts out a new euphemism: ‘Selective Reduction.’ It means abortion in the instance of having popped too many eggs into the uterus and surprise, they all implant. Maybe this is more of a concern for people who aren’t doing IVF but are using drugs that make you ovulate more than one egg. From what I’ve seen the clinic is pretty intense about not transferring more than one egg during IVF, not unless there have been a few failed rounds and shit needs to be ramped up. She quickly moves on to cover ectopic pregnancy, when the egg swims back up the fallopian tube and begin to grow there, putting everyone’s life at risk. Anyone can have an ectopic pregnancy, but the risks for an IVF conception are considerably higher, probably because the egg is just floating around in there until it latches onto the womb.
“Every week we see someone with an ectopic pregnancy,” Nurse Bullock pronounces. Damn, I didn’t know it was THAT common. There’s something new to worry about. She tells us to watch for a ‘severe, one-sided pain’ and also ‘don’t go camping in Yosemite.’ Ectopic pregnancy is the reason you have to stay local for the two weeks following your pregnancy test. Providing your test comes back positive, of course. She ends this list of possible horrors with tales of Ovarian Torsion, when the ovary twists on itself, cutting off its blood supply. “I’ve only seen it twice in the past ten years,” she reassures us. “It’s very, very rare. If you think you’re having Ovarian Torsion, you’re not.”
Nurse Bullock moves on to Novarel, the brand name of the ‘trigger shot’ that needs to be administered at the EXACT TIME the nurse tells us, thus triggering the ovaries to release all those millions of eggs. She drives the importance of the well-timed shot home by sharing the tale of a woman who did her trigger shot a half hour early. “By the time we got her into the retrieval room, her eggs were gone,” she says darkly, and me and Dashiell trade ‘DAMN!’ looks with each other. One woman nervously asks if it would be appropriate to carry the shot with her if she’s not sure where she’ll be on the day she’s to shoot it.
“You can bring your HCG shot with you,” the Nurse nods. HCG, the trigger shot, is Human Chorionic Gonadotropin, a hormone. “You and your partner can slip into a bathroom together and do it. Slip out after ten minutes, tussle your hair – “ she gives us a saucy wink. Who is this woman? I can’t tell if I love her or not. I mean, she’s fine. But do I LOVE her? Hmmmmm . . . .
“Now, Progesterone,” she says, taking us from Dashiell’s meds over to mine. “Is administered with a one-and-a-half-inch needle that can go down to the muscle in your butt.”
“Bummer,” Dashiell says, looking at me tenderly. The thought of sinking that needle into my ass makes these skeevy, anxious feelings climb my chest up my throat. You can tell who in the room is also on this protocol by the looks of terror in their faces.
“If after three weeks it really isn’t working for you, you can talk to your team,” Nurse Bullock says, providing a little out that I know I’ll never take. I’m prepared for everything to suck. It’s fine. If it gets us a baby on the other side, it’s fine. “Progesterone isn’t the unhappy hormone, but it does slow everything down,” she continues. “You can expect constipation. It slows your G.I. tract down.
For the transfer I will get a single Valium, and immediately I want to start jockeying for two. I don’t know if this is because I am a total drug addict, or because I am so scared of pain and fear my pill tolerance is high enough to warrant another. I don’t know what the transfer will feel like. Maybe it won’t be much different than the vaginal ultrasounds I’ve been getting, or maybe it will be more like that torture chamber where they tried to put a balloon into my cervix and I wanted to die.
Nurse Bullock moves onto the men. She tells them it’s not necessary for them to hoard their sperm in the days leading up to their procedures. “You don’t have to save up for a couple weeks, because then your sperm is going to look like this.” She crosses her eyes, sticks her tongue out and makes her arms all crooked and droopy. Okay maybe I love Nurse Bullock. At the very least she has found a way to make this presentation entertaining for herself, and that I admire. She speaks to the men about the rooms where they’ll ‘make their deposit’: “Nobody’s knocking on the door saying ‘hurry up’. There’s a lot of material, and you can bring your own material - nobody’s going to laugh.”
Once the men have been assured that no one will be laughing at their pornography choices, Nurse Bullock moves onto the egg retrieval. It takes only ten to twenty minutes, and is done with a sort of vaginal ultrasound wand that has a needle affixed to it. The wand gently probes into each follicle, aspirates the eggs out, and then the eggs get handed over to the embryologists. Then she moves back to the Progesterone shots.
“I’m not gonna lie,” she tells us. “I’ve had them. It was the most painful place I’ve ever gotten a shot.” Dashiell, who has organized the contents of his baggie into a meticulous order in front of him, lifts up a very long needle. “This one goes in your ass,” she says. I wonder if I can get her to do a pervy doctor role play with me when we do it. Every night. For two and a half months.
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This is what Dashiell’s workspace looks like . . .
A big bag of chocolate candy gets passed around. It’s time for a break.