7.27.2010

Showing My Ass to the World & Other Great Moments of the Pregnancy So Far

***From the Surrogate Sister***

Showing my butt to the world
You could say this was the worst moment and doesn’t even qualify for when I was pregnant, but it was too damned funny not to share. Before the implant, I went to NYU to get instructed on how to administer the new progesterone shots. The nurse said the easiest thing was for her to draw circles like mini dartboards on my ass so my husband could see exactly where to aim his shots. Later that day, we met my good friend Ann and my brother for a bite at Clinton St. Bakery. Afterward, we started on the long walk to the subway in the sweltering summer heat. Only two steps in, the kids began the round-robin complaint game. “I can’t walk one more step! Carry me!” So by the time we reached the throngs of Canal Street, I relented. As Olivia hopped up on my back, so went my dress up my back—exposing my entire ass for all the world to see—big bold Sharpie-drawn black circles and all. It’s one of those moments you thank goodness that New York is a big city and that you’ll never, ever see those people walking beside me again. I doubt they’d recognize my face anyway.

Seeing the fertilized egg on flat screen
I had no clue they would show me the fertilized egg on flat screen before they implanted the little bugger. That was amazing, honestly. To see the tiny egg with the six or so replicating cells inside on a huge screen above me was out of this world. It felt like a scene out of a sci-fi film set in the future. Of course, then, pregnancy will probably be obsolete and babies will be carried to term by large-bellied robots.

Telling H the News
I’m not sure if my parents and friends realize that H and I bought about five pregnancy tests but I’m sure they won’t be surprised. Most women have done it. The first one came up negative because I was just too damned impatient (what’s new) and had to try only five days after the implant, one day before any of the websites I’d scoured said a result would appear. The next one I tried the very next morning while H & J were fast asleep. There it was … this tiny microscopic thin pink line that you literally could not see unless you tilted the test back and forth in full light. But it was there. And having gone down this road a few times before, I knew exactly what it meant. H was a bit more skeptical until test four came back more solid. And then when the nurse finally called us to confirm the fact from the text results at NYU, we knew we were golden.

Seeing the heartbeat
Before the doc did the sonogram, he prepared me to not expect anything. “It’s really too early to see much,” he said. And then two seconds later, he says, “Oh look! There’s the heartbeat.” Even with it not being my own kid, there’s a sense of awe and amazement you get from seeing this tiny lima bean on the screen with that infinitesimal beating heart. It makes the whole thing real from that second on.

Being a Queen Bee
It’s as if someone just told me at 41 that I’m actually the daughter of a prince. I’m suddenly getting the royal treatment by my family. My husband, who has been my rock through this entire experience despite his occasional jabs about my mood swings, is taking a lion’s share of the kids work out of my hands, doing more around the house, and even tackling the dozen or so projects that have been on “The List” for ages. Our dad is as loving and thoughtful as ever, ringing me often to check in and make sure I’m feeling well. (Though he always did that before. I love him for that.) But it’s our mom, no surprise, who has been the most attentive. She stocked my fridge with groceries and cooked meals before I ever exited the plane from NY, took me shopping at Nordstroms, tended to me when I was down with the flu (despite her catching the same bug), and is spending tons of her free time with me and the kids, helping me get through the weariness of this first trimester. It would be nearly impossible to do this without their tremendous support. Thank you all.

Telling my sister and brother-in-law I saw the heartbeat
In some ways, it was a bittersweet moment considering they couldn’t be here to witness it. Like H said, there’s so much of this pregnancy they’re going to miss. The morning sickness, the hemorrhoids, the weight gain, the food aversions—yes, so much. I really feel for them. But seriously, it’s all those awesome moments they will only be able to experience vicariously through me. And it breaks my heart for them. Thus, this blog. I’m trying my best, in my way, to capture it here. So back to the topic, hearing their reactions was priceless. I couldn’t get a hold of H, so I called my brother-in-law. “Really? Wow! But I didn’t even know you were going into the doctor today!” J sounded like those people who would open the door to Ed McMahon. “Really? Me? That big check is mine?” My sister was next. She finally picked up, and immediately started crying for joy, making me cry of course. It was a beautiful, shared, quiet moment in time, and I felt suddenly close to her as I heard her jubilant and elated reactions on the phone. She said it made her whole week. It certainly made mine. It felt great.

I’d write more if, frankly, the last two weeks hadn’t been such hell. Suffice it to say, getting a dreadful flu with a relentless cough that blessed me with six sleepless nights in a row and a perpetual feeling of nausea—at week 6 in the pregnancy, no less, when I was already feeling queasy—and requiring antibiotics to overcome it was no fun at all. Here’s hoping the rest of T1 goes smoothly…

7.24.2010

What a Difference an IVF Makes II or They Don’t Make a Greeting Card for This

It must be the utter clarity and focus that a synthetic hormone-fueled pregnancy brings, or maybe it’s just all the free time that being a mother to two kids under ten years of age (both of whom are on summer break) brings, but my sister’s synopsis of IVF was spot on. I must admit, I’ve been having a hard time getting blog posts started and staying on track. I’m not sure if in attempting to tackle an admittedly HUGE topic all at once I’m psyching myself out, but it has been a challenge to synthesize this process into cogent sentences for this blog. Being the little sister and all has it’s perks however, and I am taking full advantage by riding the coattails of A’s post and posting my take on things.

Hands free pregnancy
Most people have a clear memory of the night/day/morning that they conceived their child, and if they don’t, then they definitely remember the hangover from the next day. Sometimes I feel as though I got the shaft. Sure, there was the month of hormone injections and a swollen belly that I liked to rub, imagining all 30+ eggs safely ensconced in there. I told my family that it was the closest I’d come to actual pregnancy so I was going to enjoy the hell out of it, Lupron-tinged mood swings notwithstanding. But I was in an anaesthetized slumber when the eggs were taken (and while my husband fulfilled his role in the process, alone), and had to work the day the implantation took place. I was bitterly disappointed about missing it, as was A and the amazing Dr. N. (she’ll get at least one post), especially when A told me that she got to actually see the embryo. Dr. N. gave her a photo of it (a nebulous cluster of bubbles) to give to me, which I carefully packed in my bag to show my husband the next time we were to see one another. A life lived long distance has definite drawbacks. And since this pregnancy is not occurring within me physically, it follows that many of the milestones that I always assumed I’d be present for are happening in my absence.

This s**t is expensive
When my sister first offered to surrogate, I offered everything I had (and a great deal I didn’t) as possible compensation. If she’d do this for us, I would take her shopping in NYC for a new wardrobe, buy the family tickets to the Addams Family on Broadway, take my nieces off her hands every summer, pay for their college educations. Never mind that between my less than stellar salary and the fact that JP and I just got married and are streamlining down to a single income in a few months, said money is a pipe dream. In fact, if I sit down and crunch numbers, I really have no idea how we’re going to get married, have a baby the most financially impractical way possible, and start a new business all in a single calendar year. Getting A knocked up wasn’t exactly cost effective and no part of it was covered by insurance, due to an infuriating loophole that doesn’t classify cancer patients under the standard definition of “infertile.” So even though I wanted to give A the world in exchange for giving us our firstborn, we couldn’t afford much. Which, upon sustained reflection is about right, because, really, what amount could I give that would make this a fair and balanced equation in my head?

Leave Me Alone
As A mentioned, no one bats an eyelash when two people decide to have a baby. In the absence of a womb however, our parental intentions became public domain. And everyone was so serious about it, with the psychologist trying to dredge up some long-buried slight within our family dynamic that could potentially blow the whole deal. (In the therapist’s office, we tried to hold it all together, really we did, but as soon as A sat next to JP on the sofa, I think a smart-ass comment about wife swapping flew out of my mouth and it was ON after that). Our family and friends are also curious about the entire process and I can’t say that I blame them; not only does our baby come out of a test tube, but this entire process contains elements of a bad sci-fi film. I don’t begrudge people’s curiosity and interest, since 99% of the time it comes from a vested interest in myself, JP and A, and in our happiness. What we miss out on is the sacred aspect of a couple’s privacy that is generally afforded to them in the initial months of pregnancy. What we get in return is an absolutely worthwhile trade-off, but the degree to which others are involved by necessity, often falls beyond my comfort zone. To say nothing of my husband, who is far more private than I.

Watch and Wait
It is a plight acknowledged by dad’s everywhere: once the 6 week sonogram has confirmed that a baby does in fact exist, the role of the dad is reduced to a strictly supporting role. Given that my top shelf genetic material has been combined with the best of JP’s, I now occupy a similar position. My work is done (for now) and all that is left for me to do is keep tabs on A’s life without being too intrusive and pissing her off. Legally speaking, vessels trump genetic material (we will have to make provisions to adopt our child after A gives birth). A similar line of logic naturally follows for navigating this pregnancy, and I have felt conflicted by my own emotions given that the focus should be on my sister. A has been unfailingly generous in allowing for my own adjustments to the emotional spectrum of this experience, however. This spirit of generosity arises from our parents and the community in which we were raised. I am filled with pride when I think about the incredibly supportive and selfless community of people who are waiting to welcome one more in 9 months minus 6 weeks. And although the baby will be mine and Jeremy’s, it will have had the benefit of 9 months with my sister eating what she eats, listening to her voice, the music of my nieces, and being surrounded by the people I love most, all the way across the country. I will struggle over these next months, living so far from A and our baby but am content in the knowledge that he or she is in the very, very best of hands.

7.21.2010

What a Difference an IVF Makes!

***From the Surrogate Sister***

When I first offered to be my sister’s surrogate, I thought, they’ll dose me with hormone pills, insert the turkey baster, inject the little spud, and after a try or two, I’d be pregnant. Little did I know what I was in for. And now, after going through this process, I now have a monumental amount of awe and admiration for every woman who has willingly tried in vitro fertilization and/or surrogacy.

My previous two pregnancies were easy. Easy to conceive (thank goodness), easy to carry (relatively) and easy to give birth (one natural and one C-section). That’s perhaps why I was so willing to carry the load for my sister.

Yet in the IVF / Surrogate world, it’s an entirely different universe. Here’s how my expectations collided with my new reality most glaringly:

First, Your Head Gets Shrinked
No one evaluated my fears, hopes and dreams before I conceived my first child. Although with some awful parents I’ve seen, it probably wouldn’t have been a bad move. But when you’re a surrogate, everyone down to your mailman has to get a psych evaluation before the implant is a go. Separately and together. I learned something new about my husband, too: he hates psychologists. He hates the way they dig and dig trying to find some little speck of dirt they can focus their microscope on. He took to it like mob informant being questioned by the police. He gave up nothing. When our brother found out we had to go, his response was most apt: “Just don’t tell them about the voices.” I so wanted to.

You Become a Pincushion
First, you start taking daily shots of Lupron in your stomach. I took the shots every single day for weeks. And weeks. On top of that, I needed to go on hormone drugs and get my blood tested multiple times for my “levels,” the nurse told me. All of this was to make sure my uterus turned into a 4-star hotel deluxe suite for the incoming embryo. I'm convinced people around me started to worry that I was either ill or shooting up heroin given how many times I showed up with big Band-Aids on my arms. For someone who has a longstanding dread of needles (just looking at one inserted into skin makes me feel woozy and faint), this was not fun. Thank goodness for my husband, who administered the shots with aplomb after being trained by nurse mom. And after a while, I—unbelievably—started to get used to them.

The Hormones Don’t Just Make You Bitchy...
...they make you mad, cranky, impatient, moody, and my personal favorite, an emotional weeping mess. Anything will set me off—commercials, bad news in the papers, a sweet story, anything. When I took my daughters to see the live action Peter Pan, I was bursting into tears so often it was embarrassing. Honestly, if anyone is even considering doing this, my suggestion is to get a mega-pack of tissues at Costco. When I told our friends Neal and Robin at dinner one night how hormonal I was, and how my husband was a saint to endure my mood swings, Neal rightly said, “Of course he doesn’t mind. He gets to exact his revenge by stabbing you with a needle every night!”

The NYU Nurses Put Your Number on Speed Dial
In some ways, it’s great. They check in on you frequently to make sure you stay on course with your meds and know what’s coming around the bend. If I only had someone to remind me of all the other events in my life that I seem to forget, I’d be set.

Everyone Knows Your Business
At least in my case, they did. I realized that if I didn’t tell people in advance that I was going to be a surrogate, I’d be hit with a hailstorm of questions later. So little by little, I told people. And mom told people. And then they told people. And so on, and so on. But then, it was like having sex (kind of) with two doctors, a psychiatrist, your sister, your sister’s husband, your parents, all of your friends, your kids, your kids’ teachers, everyone else your kids blabbed to, and a bunch of other strangers—in the room with you. Everyone knew what I was up to when I left for NY. For weeks before and after, I was terrified it wasn’t going to work on the first try not just because it would be disappointing for my sis, but also for the mountain of phone calls and e-mails I’d need to make afterwards with the news.

What They Don’t Tell You about the Progesterone Shots
A few days before the embryo transfer, you stop taking Lupron injections and start stabbing your butt with progesterone shots. The nurse seemed almost gleeful when she asked if I’d seen the needle they use. When I said no, she said, “Follow me.” Of course, I’m thinking, why the hell am I following her? I don’t want to see that damned thing! She led me into the lab, reached into a drawer and pulled out a syringe with a long, long, long needle…a seriously big f—ing needle at least three inches long. You’ve got to be f—ing kidding me, I thought. And I had spent all that time moaning and groaning about the Lupron shots with that teensy weensy needle? That was the size needle you get for a dollhouse compared to this monster.

Your Husband Can’t Be There
When it’s finally time for the embryo transfer via turkey baster (actually a tiny catheter that they insert into your uterus), it’s just you and a room full of medical professionals. Very romantic. And as opposed to lingerie, you’re head to toe in surgical drab: poofy shower cap, flimsy medical gown, and brown skid-proof booties and all. Very sexy. The best part was texting my husband after it was over: “The deed is done.” He responded immediately, “Was it good for you?”

You Wait for the News…with a Team of People
After the transfer, the waiting begins. After conceiving our first child, no one knew my husband and I had had sex, except for perhaps the next door neighbors. Here, everyone knows what you’ve just done. It’s odd. Waiting to see if the line turned pink on the test with my sis and brother-in-law in the next room I felt a mixture of exhilaration, embarrassment, fear, concern for my sister, concern for me, concern for how my girls’ would react if it didn’t work, and most of all, hope.

My Husband Was the Last to Know
It’s a really strange feeling when you are the bearer of the good news and THE bearer of the child, but not the “owner” of the news that you’re pregnant. It wasn’t my right to tell anyone, I felt. It was my sister’s. I only realized after she called her husband and our parents that I still hadn’t told my own husband! What’s been funny in the few weeks that’s followed is that people are just as confused as to how to react. At first they say, “Congratulations” and then retract it saying, “Well, I guess that’s not right. I should say ‘congratulations!’ to your sister!” But perhaps my husband is having the most fun with the news of all. He’s delighting in telling his customers, “My wife is pregnant. And it’s not my child!” Only after they realize he’s totally serious, he clues them in. Evil.

So I suppose, what I should do now, if I haven’t done so already, is wish my sister and my brother-in-law a tremendous congratulations from me to you! I love you both, and can’t be more happy for the two of you. And me...and us...I guess!

7.16.2010

A Collaborative Approach to Parenthood


The biggest advantage to surrogacy thus far, from my end at least, is the look on peoples' faces when I say, "My husband and I knocked my sister up." And the really twisted part is that for me, the abnormal word in that sentence is "husband" and not "sister." I was just married less than three months ago. But in my mind, my sister has been my number 1 surrogate pick for nearly two years now.

When most people hear that I am unable to have children myself, as the result of a radical hysterectomy at age 29 following a cervical cancer diagnosis, their eyes fill with sympathy and they murmur something about praying for me or adoption or even getting a pet. (The latter suggestion I would actually love, but my husband, Jeremy, rightly points out that between a new marriage, a new business, new co-habitation, and a new baby, maybe a puppy isn't the best life choice currently). And it's true; I have experienced a sense of loss. Following surgery, before my eyes even opened against the wall of anesthesia, I was aware of a dull ache at my core. Even in a semi unconscious state, my mind was taking inventory of what I was missing, sussing out the loss of this organ or that in a purely clinical way. In the days following surgery, the physicality of recovery was reinforced in the surprising amount of focus required to achieve the small benchmarks that connote recovery (standing, taking a victory lap around the hospital floor, eating solid food, learning to change the temporary catheter), and in the attendant reminders of my own fallibility. I remember noting an absence of grief in those days, but concluded that this was simply my body's way of compartmentalizing the sea change in my life, and that the emotional fallout was still to come.

I was correct in predicting that the processing of my emotions would follow the physical healing of my body, but not in predicting the instigators of this new phase. The experiences that I thought would be painful were often not. Shaving my head turned out to be a beautiful experience, thanks to Jeremy, who praised my pathetically pale scalp with the enthusiasm usually reserved for something more deserving, say Brigitte Bardot's posterior. But I was surprised to grieve over my isolation from my peers, over whether I would be able to hold onto my job undergoing treatment, and over the loss of a more carefree time in my life. In hindsight it is obvious that fretting the relatively small details was my way of coping with the macrocosmic gravity of illness while feeling connected to the more pedestrian preoccupations of my peers. Yet, I still was not grieving over the loss of my ability to have a child on my own.

Fast forward one year: the struggles described above have shifted as I have adjusted to post-treatment life, and fertility issues are sometimes among them. If I see a pregnant woman around my age on the street, I might feel a knot in my throat form and tighten; yet seeing my close friends go through pregnancy floods me with joy so unadulterated that there's no room for anything else. The sorrows I feel regarding the subject of my fertility have never been sharp planes and angles, but instead are contained, softened at the corners, and their acoustics are further dampened by the depth at which they do occur within me. This is partly because emotions rarely take the form you expect, but also because I was lucky enough to have had options. My doctors saw to it that I underwent fertility treatments before any permanent measures were taken and my sister saw to it that I felt reassured about my ability to have children someday. This security was something tangible and became a necessary touchstone that stood in defiance of the physical toll that cancer took on me. Scorched earth but never scorched mind, there were too many people who loved me to allow that to happen.

The differences between Alaina and I seemed to define our relationship growing up, and usually worked to our advantage. Our age difference of a decade kept us from experiencing much of the daily competitiveness that siblings spend years working to surmount. She was artistically creative, confident, ambitious, and fiercely protective, with a mane of black curls that people always wanted to touch. I was shy, less sure of myself at the time, looked inward for solace and found creative expression in writing. People always remarked how much we both resembled our mother yet how different we looked from one another. Until now. This is partly because Alaina shaved her head a year ago (in solidarity with me but also because at that point she would take any excuse to get a haircut). I believe that our physical similarities are also due to shared experience. We have shared in three decades worth of joy, pain, stress, life and death thus far, and a lifetime's worth in the past few years alone. And now we are having a baby, together, with Jeremy, as a family. Of course there are disadvantages to this situation...having a baby in absentia will test the outermost limits of the control freak within me. But it also reinforces not only the strength of Jeremy's and my bond, but also the community we have surrounding us. Just as family and friends are asked to support a couple at the time of their marriage, my sister has taken it upon herself to embody this sense of community in the most selfless sense. Which makes me endlessly excited to prepare for parenthood alongside Jeremy and Alaina. It is the ultimate collaboration.

7.12.2010

How Cancer Led to a Pregnancy

< * < * <  by the surrogate gal  > * > * >

It’s impossible not to talk about my decision to be my sister’s surrogate without bringing up the “C” word. It’s that nasty, ruthless, 6-letter word that caused everything else to transpire.

The evening before I found out about my sister’s cancer, I had been absorbed by a book—Lucia: A Venetian Life in the Age of Napoleon by Andrea Di Robilant. A good part of it was about Lucia and her sister, and how the two were devoted to one another. Having lived in the tumultuous time of Napolean and usually in separate countries, the mode and timeliness of their communications were restricted by how swiftly the messengers could deliver their posts. Often they’d be near desperation waiting for the next letter. They were close. They reminded me of my sister and me, living on opposite coasts. I recall thinking just before I turned out the light that night how incredibly lucky I was to have Heidi in my life. I resolved to call her the next day to tell her so. But she got to me first.

I was driving on the freeway when Heidi gave me the news by phone. Cervical Cancer. Discovered through a routine pap smear. There’s this kind of panic mode you get in when you hear terrible news about someone you love and you don’t yet have all the information. You start hitting them with a barrage of questions. What kind of cancer? How did they find it? Are they sure? Have you scheduled a second opinion? What’s next? How long does that take? What happens next? When will you know what all this means?

Next came, the most harrowing series of questions for my parents, both long-time veterans of the cancer world. “What is happening?” “What’s the prognosis with a cancer like this?” “What do you know that you’re not telling her?” My dad is a retired oncologist while my mom is an oncology nurse who treats cancer patients and administers chemo. They had no answers. It was a watch and wait situation. What a fucked up coincidence to have their daughter diagnosed with the disease.

I can’t really recall what happened next. Much of the year and a half that followed was a blur of following Heidi’s ordeal from afar—the seemingly hundreds of doctor’s visits at Memorial Sloan Kettering; starting the CaringBridge site as a way for friends and relatives to keep tabs on her; stumbling upon another cancer in Heidi’s thyroid (just by chance and completely unrelated to the first cancer); the discovery of a more aggressive, often fatal cancer within the biopsy of her cervical cancer; a second opinion of the biopsy from a doc in Florida; multiple treatment plans discussed, dismissed and debated by her oncologist and finally, by the cancer board; and then my visit.

My trip to NYC in the fall of 2008 coincided with a doctor’s visit to her oncologist on the cancer board’s ruling. As we rode the 4 train to the office, her boyfriend Jeremy was busy conferring with Heidi and madly scribbling notes on what they wanted to ask him. I remember being taken aback by how invested he was, emotionally, in her. I adored him instantly. At this point, Heidi had not yet started her chemotherapy. What was in question was whether she could keep her uterus. An hour later, we were sitting in Dr. A’s office. The decision was not good. The board favored a hysterectomy. She was only 29 years old.

You could tell Dr. A did not agree with the board. It seemed painful for him to dole out the news. Heidi seemed in shock. Jeremy seemed angry; he threw a million questions at Dr. A as to why this had to be. It didn’t matter, though, the decision was made.

Returning from NYC to the Bay Area, I kept thinking about that decision. At this point, there was still so much ahead for Heidi—more chemo, radiation, surgeries, and ultimately, waiting to hear the final verdict on whether any of this worked and she was cured. But first, because of the severity of her disease and the board’s verdict, she had to harvest some eggs—and fast—before the hysterectomy.

I started getting phone calls from Heides about the harvesting procedure, how she’d found an outstanding doctor, Dr. N, at NYU, and how she was walking around NYC, rubbing her bloated belly—from all the hormone drugs—knowing that any one of the eggs that was forming inside her could be her future child. It was heartbreaking, though. Heartbreaking to think she might not make it through this, and that even if she did, she’d never, ever be pregnant. And who knows how, when, if she could ever find a willing surrogate if she did survive?

I decided I would do it. I’d be her surrogate. It was an easy decision, really. People don’t realize that. She’s my sister. I love her. It seemed like a simple, obvious choice to me. What’s a pregnancy when you’re battling cancer?

A week or so before I told her, Heides called to tell me that of the eggs she was harvesting, a batch of them would be fertilized by Jeremy, the human fertilizing machine. They weren’t even engaged yet. But I knew. I actually knew years before just by the way she talked about him, about the way he treated her. My mom, on the other hand, an eternal pessimist, kept saying through the cancer treatments, “I just hope Jeremy sticks with her.” “Mom!,” I said. “They’re freezing fertilized eggs! I don’t think he’s going anywhere.”

And he didn’t. Today, Heidi has completed more than a year and a half of clear scans (at 5 years, they consider her “cured”), and just married Jeremy in May. And as for me? I’m pregnant!