So today is p+17, and it appears likely that it will also be CD1. Two more months of HCG, and then I'm going to ask my doctor about depo shots. As previously mentioned, I am planning to retire from IF treatment around my thirtieth birthday (if I hadn't been moving and busy and that sort of thing, and had done all six months of HCG as soon as I got the scrip, I could have had my little retiring-from-treatment party
on my birthday). Also as previously mentioned, I've already had two surgeries and don't plan on making that a regular thing; I promised myself that my very next surgery would be a hysterectomy. (And because some of these responses are just reflexes in the IF community at this point...no, another surgery would not help my fertility; no, the problem is not simply that the last surgery was done by
my doctor rather than
your doctor; and in fact, after the last surgery, my cycle didn't return for five months...five of the six months that would be my "best window" - for life, no doubt - in which to get pregnant. The only basis for more surgery at this point - other than a hysterectomy - would be insanity.)
But I'm only turning 30 - this is one of the few arenas in my life in which I wish I were much older - and I have a lot of time to go before menopause and (presumably) the natural remission of the endometriosis. As it is now, it is getting steadily worse - worse than it has ever been before. (SEE ABOVE ABOUT SURGERY. I WILL DELETE COMMENTS FROM PERSONS WITHOUT MDs RECOMMENDING THAT I HAVE MORE SURGERY!) Having a biological child is for me, at this point, not remotely realistic. I'm not particularly interested in adoption; my husband and I continue to discuss it, but while we're being relatively sporting about pursuing our waning options, both of us are expecting to live the rest of our lives childless.
So - please try to wrap your head around this; if you are infertile but have children, you might want to accept that that's just too difficult and go read another post (and no, I would not take this tone without a MOUNTAIN of evidence about people's inability to use their brains on this subject), by someone who has children or expects to have them - so: my future medical endeavors need to be directed to preserving my health and improving my quality of life, not having children, because I am not capable of having children. It's OK, go back and read it again. As many times as you have to. (It is difficult for me to accept that this is where I am headed, but it appears that for third parties, it is impossible. So, I'll wait.)
What I need to do, then, is halt the growth of the endometriosis before it gets far enough to cause uterine cancer, and put a stop to the cycle of inflammation so that I am no longer in daily pain for the first two weeks of every cycle. My life is not going to include children, but it includes a lot of other things, and none of those is improved by being in pain. Generally speaking, the way to halt - maybe even revert - the growth of the endometriosis is to stop one's menstrual cycle, since the upsurge in estrogen levels at the beginning of every cycle cause the endometrial adhesions (and the endometrial cysts - I would warrant I have several on my right ovary, since that area is frequently painful) to swell, causing an increase in the immune reaction that causes scar tissue to form on the internal organs. If I stop menstruating, I stop having estrogen spikes, the adhesions stop growing, and the scar tissue stops forming. With nothing to feed the adhesions, they may even shrink. Best of all, I wouldn't be in pain any more.
Obviously, I cannot be on depo forever (well...some people are, I gather), so I think I would talk to my doctor about doing six months or a year, then coming in for an ultrasound to see what's going on with the cysts. If it appears they have shrunk, I would maybe even consider doing another month or two of HCG; I understand that after knocking out your cycle, there is again a potentially "fertile window." That one might even be non-fictional in my case, in the sense that I might be both in the magic window and ovulating. Wouldn't that be nice. And as soon as the pain came back, I would go back on the depo; wash, rinse, repeat, until menopause, or the hysterectomy.
There are other inane things people say about this. One of which is that I shouldn't take depo (or should call it something else? It's high-dose progesterone, BTW), because it's a contraceptive. Hahahahahahahahahahahahahahahahahahahaha. Go ahead, take a look at my URL. See? Up there at the top of the page, in the address bar? I know, there are no spaces, it's hard to read. After the "http://" there's a four-letter word, then a five-letter word, then...you see? Yeah. So, that's what I have to say about me taking "contraceptives."
And for those who have hangups about giving money to the companies that manufacture contraceptives - do you know where your non-ART, super-holy, Catholic-approved drugs come from? What about the over-the-counter medicines you take? Where do you buy your jeans? What about your computer equipment? I took lupron before I was married because I didn't want to take depo shots because I would be giving money to those terrible people. Never mind that the exact same company probably makes both of them. I've never had such a bad reaction to anything ever. Surgery was pleasant by comparison. And I don't need the bone density loss, either. Plus, so far as I know, the sole perk of lupron (besides way more aggressive and harmful levels of hormone drug) is that it's not technically contraceptive - in a healthy person, it would probably prevent conception but not definitely. In the event of conception, however, it would certainly cause severe birth defects. If that seems morally superior to anyone, I recommend a course in basic bioethics. No, forget that - intro philosophy. Just start with logic.
Also, I don't want to hear about my diet. I eat some healthy food and some food that I enjoy although I know it is not healthy. If food makes me sick, I stop eating it. No doctor I have ever visited has suggested that I am allergic to gluten or dairy (or anything else), nor do I have any symptoms that suggest I am (endometriosis doesn't count until you can show me a peer-reviewed, published, duplicated, blind study - I believe they call that "science") and I am not taking medical advice from a non-doctor who has performed no tests on me nor even met me. I'd have to be an idiot - and, if you're taking medical and dietary advice from the internet, you are an idiot. That's not more judgmental than what people (and I mean specifically infertile people and usually Catholics, though there are others) say to me about my diet and health; it's just a whole lot more accurate.
So, moving on. I spend a lot of time concerned that I am guilty of immoderate rage. Things make me really angry on a regular basis. On the phone just now - for example - I was furious that the city utility bill site was incompetent and wouldn't read my address right. It was super-picky, but I had actually missed a digit of my seventy-digit account number, so it was my fault. The real problem is, though, that I was clearly exasperated when the woman picked up the phone, and I was short with her. I felt bad about this after I hung up; I tried to be nice and polite and thanked her after it got sorted out. But, of course, the reason I was so irritated when she answered was because I had then been on hold for over 15 minutes.
And ten minutes before that call, I opened a letter from my mortgage servicing company, telling me that the state refused to allow it to pay my property taxes out of escrow, saying that they were not due. The letter instructed me to call and inform the company if I had not separately paid the taxes, and it would track the problem down. So I called Wells Fargo. Menu #1 was stupid but it offered an option to do with mortgages. I chose that. I entered my loan number and the last four digits of my SSN. I got another menu. All options stupid again; one offered "property tax information." I chose that. It played me a recording that said no taxes had yet been paid and offered to let me listen to the menu again. (I am not omitting any relevant menu options from this narrative, and yes, I called the phone number in the letter.) I dialed zero repeatedly and eventually got a guy. I told him that I got the letter, and I hadn't paid the taxes myself. He asked me to confirm my name and I did. He then said that the mortgage servicing department could help me, and he would transfer me. At this point I informed him that I was not calling to seek his help, but offering mine; I was merely answering a question and I had now done so; I had already been through two sets of menus (following the number that I was directed to call!) and I had things to do today other than be on hold with the bank; and he could pass along the information I had provided, and I hoped he had a nice day. Then I hung up. I inspected the letter to see whether there was anywhere I could email this information. Since there wasn't, I decided to let it go. I may call the state property tax people; I haven't decided. As far as I am concerned they are all in the wrong, and they can jolly well sort it out.
After this I felt bad for being harsh, and pondered my immoderate rage again. And then I thought of something.
What if it isn't me?
Sure, I have an option, as a Christian, to take these small torments and offer them up as mortification. But in my view that is, in fact, an option. Offering them up wouldn't mean that they are just. They are not. It is my perception that I am increasingly surrounded by injustice, absurdity, and plain incompetence and stupidity on the part of many - almost all - of the people and entities with which I am constrained to deal. While I do not do my own job perfectly, I endeavor to be prompt, thorough, and accurate, and I encourage my clients to call me if they need any assistance. I answer my phone, messages (at work - I do not listen to voicemail messages on my own cell phone), and emails promptly. I also endeavor to behave logically; if, for example, I am informed that someone's address has changed, I understand that that applies to all places where I might use the address. I don't require seventy forms to effectuate the same address change.
Regrettably, I cannot say this about all the offices at the place where I work. And I cannot say this about almost any company with which I do business. If they can be reached by phone (which is rare), they will immediately inform you that you have contacted the wrong person and (despite their own representations about their phone system) you must call someone else and wait another twenty minutes. That person will require you to provide again every piece of information you have previously provided, to his colleagues and to his automated system, and he will be unable to understand the spelling of your name on the first three tries, and, ultimately, unable to help you. He will then suggest that you use a web-based system to which you do not have access, and in order to access which you will have to place yet another call for information. Partway through this exercise, it will occur to you that your life would be substantially improved by foregoing this service altogether so that you may avoid dealing with the intractably incompetent - even if that service is water, electricity, a home loan, or health insurance.
In short, what I'm saying is that the world is getting substantially worse, and the problem is not a loss of faith, war, famine, dairy, gluten, "global warming," or any of the other scourges we're taught to fear more than the fires of hell. It's customer service. Which I think is probably actually in hell; and, consequently, whether I'm right or wrong about the rage thing, I'm probably well-prepared for the next life.
