Tuesday, December 1, 2009

Lost, and Lost

On Thanksgiving morning, after reading Bella the comics, I picked up the local section to peruse the obits as is my wont. Imagine my surprise when there, staring back at me, was the name and a picture of my RE -- yes, the new local one we only just saw recently. Twelve days after we last saw him and he cheerily dismissed us to the OB, he had a heart attack while on vacation and died at the young age of 60.

I'd like to paint a heart-tugging tale using wide brush strokes and deep shades about how he helped create life before departing this world himself (and I'm sure he probably did), but that wasn't so much my experience with him. Ironically we ended up not needing his help in that critical regard, if you catch my drift. (At least I thought this was so ironic, I was set to mail in my picture to some cheapy dictionary with the subtitle "Irony Exemplified: geriatric fecundity" under it, when the resident biologist informed me that it wasn't remotely ironic at all and in fact made perfect sense. So maybe I'll get to that bit of narration here or later, we'll see how it goes.) Not to mention I spent a fair amount of time grumbling about his super-sized practice and their propensity to lose stuff. There was also his utterly classic deer in the headlights look about three minutes into our initial consultation. Here I've been wondering how to start this story, if at all, and this provided me with an apt segue. So here we go.


The decision to try and have another child began with candlelight, a bottle of wine, Barry White in the background, and numerous phone calls to various medical institutions. First there was Children's, where I told our point person to tell everyone else that we were thinking of doing this (I know, how private and romantic and spontaneous and all! We'll name the baby after our genetic counselor's phone extension, how's that?), and the plan was that if there were still eggs in the basket, we'd try with our own genetic material. He recommended an RE's office, and I called them next and blindly agreed to go with whomever they scheduled me with. The next call was tough, to the old RE in our old state, who was never informed of what had happened. I didn't recognize the receptionist who told me to fax over a release for our records, so I did with a very short explanatory cover letter and no less than 10 minutes later my phone rang and here it was old RE himself on the line and the first grief-stricken words practically shouted into the phone were, "My God, WHAT HAPPENED??" I cried. He expedited my record release.

I strolled into the new RE's office, with the game plan already composed in my head: I'd go through my reproductive history Greatest Hits!, and stress that what I really wanted right now was information. I'm practically moving with a walker after all, so I wanted to know my FSH and whatnot, and I'd make a decision from there about whether to try or not and how, and with whose gametes. It sounded good to me.

I didn't get much beyond the part where I hand him the pathology report "in case you're interested," when I noticed his eyes were as big as dinner plates and he had picked up the phone and was punching numbers. "You need to speak to Dr. [HotShit]." Butbutbutbut, I stammered, we've talked to the greatest minds in the country, we've thought for 2+ years, I'm FUCKING 40! HELLO!?, we really don't want to talk to another doctor! What on earth could Dr. HotShit tell us we didn't already know or have thought about, and who was she anyway?

Too late, he cut right into my protestations, he handed me the phone with Dr. HS's scheduler on the other end. As a bone I suppose, he told me to come in on CD3 for the usual.

I was a wee pissed. I called my Children's guy to see what the deal was with Dr. HS, and firstly, it was noted she was actually mentioned at the end of the pathology report as someone to send it to. I picked it up, and there in fact was her name. Huh. And my Children's guy went on and on about what HS she really was, and this would be a good thing, and ugh. I decided if this is what it took for the RE to move forward with me as a patient, we could at least sit in this person's office for a few minutes.

Dr. HS's waiting room was completely unremarkable, replete with one of those brochure centers with pamphlets titled, "Chromosomes: The ABC's of X's and Y's," and while we waited for her assistant to intake us, I told Mr. ABF if she made us watch a Troy McClure filmstrip on basic genetics and amnio, I was walking. He said he'd hold the door. We went back, assistant nicely took our history, and went to get Dr. HS.

And like so many doctors I've met on this road, she walked in the room, the spotlights went on, the music swelled, and the dry ice rolled. She said all the right things about being sorry and asking how we were doing, and then quickly ran through Maddy's history. She knew it cold. Even the really recent parts. And even though this woman has multiple degrees including one in genetics, she also was of the opinion that it was probably placental abruption and/or infection, and we were totally reasonable in wanting to get pregnant again. Not that it mattered -- she could have told us the opposite and I'm not sure if I would've changed my mind, but nice to know Dr. HS thought I wasn't insane. We then went into what would happen on a subsequent pregnancy, at the end of which I may have slightly, just a tad wee bit begged her not very subtly to be my MFM. I may have been on the floor with my arms around her pants-leg. And she agreed on the spot, and her assistant piped up that all I needed to do was call her and she'd schedule everything.

No going through the front desk, no hand-wringing explaining my past to a new MFM. It was like being handed the golden ticket.

With a small caveat: Dr. HS wanted to run "some tests" before I got pregnant. Sure! Whatever. Run away. We'll just get them coordinated through the RE's office because how hard can that be, right?

So I do have RE to thank for that connection, even though I'm pretty sure he set it up because he thought we were despondent batshit crayzees who didn't know a chromosome from a allele.

My other great memory of RE was him calling me from home on his day off to tell me my CD3 results. "How old did you say you were? Because you have the levels of a 20 year old." I sat with my jaw on the floor. (And it stayed there until a few weeks later when he told me my progesterone results, which were like the levels of a cardboard box. But whatever, let's focus on the positive.) And, it turns out despite still being a good 18 lbs overweight (e.g., over what I was before getting pregnant with Bella), my glucose/insulin levels were fine, totally normal, that is to say, better than they were. To make even more clear: the whole reason for my 2+ years of infertility prior to Bella, and the raison d'etre behind seeking secondary infertility treatments before Maddy had vanished. RE said something about an IUI, but certainly didn't think I'd have a problem getting pregnant, and definitely no need for meds at the moment.

By now the candles are stubs, the wine is long gone -- the bottle kicked under the table, and Barry is hopelessly stuck on the same endless loop of "Can't Get Enough of Your Love," but we look each other in the eye and decide to do this thing. Let's just get this pesky bloodwork out of the way.

It took my nurse what seemed like ages to find all the right codes and stuff for the myriad clotting, circulation, autoimmune, and general antibody screening tests that Dr. HS wanted, and I finally went in to the lab and they took a gallon of blood in small individually marked vials and I went home to wait by the phone and fix the Barry recording.

And I waited. And waited. And I called the nurse for results, and she said they weren't back, call next week. Next week I started the daily stalking routine and she finally called me back (now over three weeks later) and said, "I called the lab. They never received them, they were all lost en route." Well fuck me, there went a cycle not to mention a gallon-sized zip lock of filled vials. That can't be good for anyone. Back I went, drained my arm, and again sat by the phone to wait.

And then August hit.

There was no way we could go in August. I didn't even call to see if the test results made it, and they certainly didn't call me, and I hardly cared. There was no way I could even think about doing anything in August, including, you know, that. At least that much. Poor Barry got put back on the shelf. But hey look, how convenient, the next cycle starts Bella's first week back in school! I'll call then.

And the first day of school rolled around and I packed up a lunch and stereotypically forgot my camera and we headed in for the Kindergarten parents' coffee reception where I guess we're supposed to stand around and cry or something, and on the way in I merrily started doing math in my head so I could call the office when I got home and . . . I was late. Well, I was on cd28 according to my really bad August math, and for someone who never makes it beyond 26, that's . . . suspicious.

Just for good measure, the lab ALSO lost my second beta draw, forcing me to drive in early on a rainy Saturday morning hoping we could all do math and figure out doubling/tripling over three days instead of two. I casually asked if the lab was like this, big and overworked and overused by multiple offices and prone to just chuck things in the trash when they didn't have time to get around to them, and they stared at me and insisted that they'd never heard of anyone losing results ever. That losing two sets of stuff within the space of two months was really unheard of. Must be me, then. How auspicious.

And hahahahahaha and progesterone supplements, here we are.

I felt a bit . . . guilty? Like a liarliarpantsonfire? going back to see RE and I suppose he felt a bit smug seeing as all he did was point me in the direction of Dr. HS but given that the lab had lost a few results and I felt like patients in this practice really needed to be proactive (when I was about as passive as one could imagine), I'm wondering what would've happened had we really needed assistance. Would they have handed us a turkey baster, pointed us to a private room and gently reminded us to shut off the ultrasound machine when we were finished? RE personally did the first ultrasound to make sure the sac wasn't in my ear canal (not entirely a laughing matter when a resident on the second visit found the heartbeat but couldn't locate the yolk sac, which I really didn't think was biologically possible, but I didn't want to mess with the poor kid's head), and then on subsequent visits stood and chatted with us while residents had all the fun practicing "Find the embryo!" Last we saw him, he smiled, shook our hands, wished us luck, and asked to be kept apprised of what happened.

I'm sure in another life, I'd pull out all of the steaming hot omens in this story -- the wreckage left behind with missing test results and a dead RE aren't exactly good signs, are they. But that was the old me, and the new me understands all the pregnancy omens in the world are contained in a small box of ashes in a bowl on a shelf in my family room, and what happened here was just life.


Although not exactly personally responsible for what lies inside, my RE was a remarkable person. According to his obit, the first in vitro baby in Philadelphia was born in 1983, and RE headed up the IVF center -- the only one in the region. He was considered an IVF pioneer by his peers (and I googled his peers and saw their publications, and damn that's one peer group) and led the center until taking over reproductive surgery. He is survived by his wife, two sons, a grandchild, and I imagine countless, thankful parents and their offspring. Including the girl born in 1983 whose embryo RE apparently looked at under a microscope, a girl who is now a woman with a child of her own.

Thank you, RE, for everything.


loribeth said...

Never underestimate the power of Barry White. : )

I'm sorry to hear about your RE. Sixty is not that old, & if that first IVF baby was back in 1983, he must have been a pretty young dr then!

As you said, beyond his own biological family, I'll bet he leaves a lot of grateful parents & children behind.

Michele said...

I know when you see your little boy you will think of this kind RE, who I hope now watches over said boy and helps get him here safely.

Sending big hugs...

angie said...

What a long strange trip it's been for both you, little boy growing and the RE.

I love how labs never lose blood draw and somehow telekinetically you can eff yourself over by willing the blood through a wormhole. WTF? I know that isn't the main gist of your post, but it still chaps my ass to get blamed by testy phone answerers at doctor's offices for their incompetence.

I think it is cool that even though the RE didn't specifically help, he referred you to someone who was ended up being MFM soulmate. That is worth its weight in gold. xo

m said...

We were actually in the office when they received the news of the unexpected death. To say people were shocked and upset is an understatement.

You MUST email me the real name of Dr. HS. I think I need to track her down once we finally get to the MFM stage of it all.

erica said...

I'm still smirking over the Troy McClure filmstrip.

And this - "But that was the old me, and the new me understands all the pregnancy omens in the world are contained in a small box of ashes in a bowl on a shelf in my family room, and what happened here was just life," took my breath away, because, well, yes.

k@lakly said...

It takes a village AND some Barry White right? Oh yea, and the good old fashioned add a bottle of wine and stir.
Glad he was able to point you in the right direction and that he left such an amazing legacy behind his too short of days lifetime here.
And Dr. HS sounds full of the awesome. I hope this pg proves to need as little medical intervention as the um, getting there, (there being knocked decidedly up) did and that little man of yours screams his way into your arms in due time.

ezra'smommy said...

What a wacky and wild journey. Just glad you found your way to Dr. HS and sending you great big wishes for an uneventful rest of your pregnancy.

Aunt Becky said...

"Can't Get Enough of Your Love, Baby."

moplans said...

I was holding my breath all through this. what an epic adventure this little one is already.

c. said...

...and the new me understands all the pregnancy omens in the world are contained in a small box of ashes in a bowl on a shelf in my family room, and what happened here was just life.

I like this, Tash. Incredibly so.

Three cheers for RE, though I'm not sure they are entirely appropriate at the moment.

Which Box said...

wow, and wow.

Natalie said...

Great post, Tash. What a journey, indeed.