Starting a family is a funny and complicated thing. After a lifetime of working hard to make sure I did not get pregnant, it was a surprise to find out that getting pregnant would be so difficult.
Infertility is all too common these days. What we learned along our journey is that there are a wide variety of factors that cause infertility. Discussing infertility is rather taboo, and living with infertility feels shameful and isolating despite its near epidemic prevalence.
Now that my personal health matters have been properly diagnosed and managed, and now that I am late in the third trimester of pregnancy, I feel much more comfortable and confident reflecting on our two-year journey toward parenthood.
This post is not a “pity party,” but a proud moment: I finally feel comfortable enough to openly discuss our journey, and I hope that others who have suffered through similar journeys will someday (soon) not only feel like less of an outsider in our society but will be able to reach their ultimate goal of parenthood as we are hoping to do in the next couple of weeks.
Besides, it’s always easier to tell a sad story when everyone already knows the happy ending. . .
When we returned to California from Amsterdam, I already knew something was wrong. I immediately sought out an OB who could look into the problem, and I settled for an appointment with the first doctor who could see me. She ran some lab work and concluded that I “probably have a tumor” next to my brain, and that I needed a referral to an endocrinologist to confirm. The news sounded terrifying, and to make matters worse, that lovely doctor took her sweet time – about 10 days – before processing my referral despite daily inquiries and hours of sitting on hold on the phone begging for my case to be expedited. Meanwhile, we did our best to keep from scouring the internet to try and figure out what this all could mean. Did I have a brain tumor? Did I have cancer? Would I need surgery? Could this be fatal?
I eventually was able to get an appointment with an endocrinologist. One of the first things the endocrinologist told me was to “relax” because endocrinologists only treat “treatable” conditions. She explained that based on my lab work, I probably had a non-cancerous tumor on my pituitary gland. I learned that such things are treatable with medication taken orally, and that I was likely not a candidate for surgery. I also learned that these tumors are very common. It turns out that pituitary gland tumors might be present in up to 15% of the general population, but that they are typically small and many people can go their entire lives without showing symptoms.
In my case, the tumor was discovered because I had a symptom – infertility.
I was scheduled for an MRI of my brain, which confirmed what the endocrinologist suspected: I have a prolactinoma, a small tumor on my pituitary gland that secretes the hormone prolactin.
You may have heard of the hormone “prolactin.” Prolactin is the hormone that pregnant and nursing females produce to enable nursing. You may have also heard that it is not possible to get pregnant while a woman is nursing. While not 100% true, this rule generally exists as an evolutionary development; a woman who is nursing one child would have difficulty sustaining a pregnancy due to the demands on her body.
In short, my tumor was tricking my body into thinking that it would not be a good idea to be pregnant.
I was prescribed a pill that slowly works over time to inhibit the secretion of prolactin. By keeping the tumor from doing its “thing,” the tumor would shrink over time. The medication has been around for many many years, and has a very high rate of success.
I began taking the medication in October 2013. The drug made me foggy-headed and dizzy much of the time. Also, I was not allowed to have any alcohol while on the drug, which really put a damper on the craft beer tastings we had come to enjoy while living in Amsterdam!
And, nearly as soon as we became more comfortable with the diagnosis (“microprolacintoma”) and the prognosis (“totally treatable, not cancer, should be able to regain fertility, need to abstain from alcohol for a while, need to get used to the idea of MRIs and pills for many years, but I will mostly lead a normal life, etc”), we started getting the medical bills.
We learned a lot of hard lessons about the American healthcare system, which is unfriendly and usurious under the best of circumstances. We felt like we had been hit with a one-two-three punch: the shock of reentering an American lifestyle, an (initially) scary diagnosis, and thousands of dollars in medical expenses to boot. Gee, isn’t it great to be “home?”
On top of it all, (wait, there’s more?) we came home to new upstairs neighbors who broke several of our homeowner’s association rules regarding noise transmission, which made living in our home extremely difficult. We tried talking to the neighbors about fixing the problems, and we even offered to help pay to fix the problems, but the neighbors were aggressive and threatening toward us. One night I had a full-on panic attack, and another time we even had to call the police when our neighbor cornered Eric in the parking lot with threats of physical aggression.
We knew that our first six months back in the States would be a challenging transition for us just as our first six months abroad were a difficult transition, but truly our first half-year back was more difficult than we could have ever imagined.
I continued to take my medication. At first my prolactin levels dropped rapidly, but the decline eventually plateaued and we grew frustrated with the care I was receiving. The endocrinologist would hold my hand and tell me everything would “be ok,” but I did not want everything to work out “eventually.” At the rate the drug was working, it could take another two or more years to achieve the desired result – all the while feeling fuzzy-headed due to the side effects of the medication.
I mentioned previously that infertility is isolating. While we were very happy for our friends and family who seemed to be getting pregnant as easily as one catches the flu, every phone call or email announcement was excruciating for us. Some people – tactless colleagues who did not know better or friends and family who just wanted to be supportive – asked questions about when we would start a family, made suggestions about when to try various medical procedures that were entirely inappropriate for my condition, or started encouraging us to think about adoption.
Everyone was well-intentioned, but each successive comment felt like a stab.
Mother’s day and Father’s day last year were especially rough.
By April 2014 we were fed up with the slow progress and we sought out a new doctor – a “reproductive” endocrinologist – at UCSF. At our first appointment this doctor sat us down in his office, took out a blank piece of printer paper, and drew a diagram for us about what was happening to me physiologically. Instead of holding my hand and offering empty comfort, this doctor spoke to us about actual science. We immediately felt more comfortable and optimistic, and as if we would finally start to move in the desired direction. This doctor prescribed a different, newer drug which had been shown to achieve the same results in a faster time with fewer side effects.
The new drug worked so efficiently that I never had to return to that doctor’s office for a follow-up.
Almost exactly one year after we returned from Amsterdam, our luck started to turn around. Summer 2014 was very special for us. I was feeling more like myself on the new medication (still no alcohol allowed though), our troublesome upstairs neighbors moved away, I picked up a new client in my fledgling business, and to top it off. . . I became pregnant.
I do not know if this is common among women who suffered any period of infertility, but it took me several months to truly believe that I could be pregnant.
In July 2014, I had a sense that I might actually be pregnant. I took an at-home test, and then another. . . I showed the result to Eric. Beaming, he looked me in the eyes and jokingly said, “so, is it mine?” What a charmer.
I had some complications early on which were stressful and left us feeling uncertain, but through it all we just tried to keep reminding ourselves that this “IS possible.” Maybe not now, but eventually, this COULD happen.
The complications eventually worked themselves out. I was lucky enough to not experience any “morning sickness.” I was very tired and forgetful from weeks 8 to 12, which was mostly just embarrassing because we did not yet feel comfortable sharing the news with our family and friends. I experienced some side effects like round ligament pain and feeling lightheaded when I stood up too quickly – pretty standard stuff – but mostly I just felt curious, excited, and hopeful.
We first shared the news with our parents who were both shocked and thrilled. Eric and I had a lot of fun coming up with surprising ways to break the news. For our parents, we snuck print-outs of a sonogram or a baby crib into cards or other materials our parents were reading. For our siblings and some of our close friends, we casually dropped the news into an otherwise regular conversation. It was a lot of fun to share such happy news with the people who had been so supportive during our difficult year, and it was a thrill to finally share some joyous moments with everyone.
The second trimester was easy enough. I changed OBs because I could not bear to think about my original OB – whose 10 day referral delay made our lives so miserable – coaching me through delivery. We found a wonderful OB practice, and the baby continued to develop properly.
At around 20 weeks, we found out that our baby is a boy. I spent the rest of that day dreaming about our future with our son. Periodically, a new detail would startle me and I would stop dead in my tracks. Scenes would flash before my eyes in vivid glimpses paired with moments of panic. For example, I imagined myself planning a Bar Mitzvah. . . followed by the thought of “forget that, we need to find a mohel!”
We would be thrilled regardless of the baby’s sex, but in particular, having a boy means it is possible that the Frank family name might live on. It is an old-fashioned joy steeped in traditions to which I do not necessarily subscribe, but it makes me smile nonetheless.
As autumn grew colder and I began wearing more layers, it still was not apparent to any average passer-by that I was pregnant. In fact, it was only at about 32 weeks that I could no longer close my jacket around my growing belly! It took a long time to accept the exciting fact that I was actually pregnant after so many months of “trying,” and the fact that I could “pass” as not-pregnant added to the delay of reality sinking in.
Around 28 weeks, as we approached “viability” and as I started really feeling squirms and kicks, I ramped up our preparation. We had been thinking about moving out of our condo and into a house, but given the current real estate market we decided it was time to invest in our current home instead of focusing on finding a new home. I spent hours (days. . . weeks. . . ) reading online reviews and revising a baby registry.
Around 30 weeks, the discomforts of pregnancy really started to kick in. Though still minor, they were a sign that a baby was truly just a few weeks away. For a few days my wrists hurt, but since “pregnancy carpal tunnel” is apparently a thing, I just figured it would be a new inconvenience. A few days later, the numbness set in. I still wake up several times each night because one or both of my arms has fallen asleep. There are even parts of my dominant hand in which I no longer regain feeling at all.
Yoga helps. I found a yoga studio nearby and have been attending prenatal classes a few times each week. It has been fun to get to know other women who are due around the same time as me, and to commiserate over the inconveniences and discomforts and worries we all share. Acupuncture helps, too.
I knew that having a baby would be a lot of work, but I had always assumed that the busyness came with the actual baby. It turns out our lives have become quite hectic in preparation for our little one!
Between doctor’s appointments, classes at the hospital, yoga, acupuncture, getting our home ready, and wrapping up projects at work, our lives have been extremely busy. When we have free time, we eat out or catch up with friends as much as possible since we know these things will soon be more difficult to do.
Now that I am in my 39th week, the discomforts have become more overwhelming. Apparently I have taken to snoring “like a chainsaw,” so Eric often sleeps in our guest room. In addition to the soreness from loosened ligaments and increased body mass, in the last couple of weeks I have enjoyed indigestion, more arm numbness, and a variety of other ailments – I will spare you the lovely details. However, looking back on the entire pregnancy, I feel grateful that I have had a relatively easy 9 months. While I experienced many typical pregnancy discomforts such as heartburn and bloody noses, most were short-lived. A bonus side-effect has been that I have been free of migraines during this time! As far as pregnancies go, I feel lucky to have had an easy one, and even more lucky to have had the opportunity to experience this joy in the first place.
So now, here we are, all wrapped up and ready to go. We are ready to meet our long-awaited little miracle. . . whenever he decides he is ready to join the party.
We are feeling simultaneously ecstatic and frightened. Our contemporaries will understand when we say we feel like that famous scene from Saved By The Bell, “I’m so excited. . . I’m so excited. . . I’m so. . . scared!!!”
Oh, and to answer a question posed earlier. . . yes, the baby is Eric’s.