Thursday 16th September 2010

One year ago.

 

The best part about this bit is that you don’t know what anything means.

Anything at all.

“The pessaries can imitate pregnancy,” Shelley warned us, “so don’t assume that you’re pregnant just because you feel nauseated.”

Way to keep the spirits up, Shelley.

“Equally, don’t assume you aren’t, even if you start to bleed like it’s your period.  Whatever happens, you need to get the pregnancy test on Monday.  IVF hormones can mess with your system.”

No kidding.

The consumer information packet from Crinone freely informed us that anything that can go wrong with Suse’s mind, body and spirit is probably due to the pessaries.  And don’t forget, this is the one that had the pamphlet with a woman hugging her belly, as she grins happily at the ground like she just found a piggie bank.

Or just before she doubles over in crippling pain.

 

* * * * *

In the last few days, Suse has had:

- Continuous nausea;

- An insatiable appetite for Rice Bubbles;

- Lethargy and tiredness;

- A swinging mood;

- Frequent abdominal pain (which can be misconstrued as either period pain or pregnancy pains, dependent on your swinging mood);

- prize-winning, yet very tender breasts;

- a nose like a blood hound.

Last night, as she got into a friend’s car, she began:

“My God, Ella, how do you drive in this thing?”

“Sorry?”

“It stinks.”

“Of what?”

“Well, someone’s dragged dog shit in with their shoes and wiped it on the car mat in the seat behind me. There’s been an over-ripe banana eaten in here,” she says, craning distractedly to look for it, “the skin was left in here for a while.  That shirt in the back seat really needs a wash, and this,” she says, taking the disposable cup from the console and pointing at it, “this soy latte had burnt beans when it was made.”

Ella looked at Suse for a second, before bursting into laughter.

“What?”

“You’re so pregnant,” was the response.

I guess only time will tell.

 

* * * * *

Wednesday 15th September 2010

One year ago.

 

The lull that is the luteal phase has come, and it feels strangely anticlimactic.   Following two full weeks of action steps, there’s not really a lot to do this week.

It leaves a guy wanting.

There’s only the Crinone pessaries to administer.  And as much as I like to help – there’s helpful, and then there’s wrong.

It’s not quite like giving a needle.

I enter the bedroom, to find Suse on the bed, a plastic pessary in one hand, the consumer information in the other.  She sighs heavily.

“Very common side effects,” she announces, “Include cramps, abdominal pain, pain around the genitals and the back passage, headache, breast enlargement and breast pain, feelings of severe sadness and unworthiness,” she say, looking straight at me, “decreased sexual drive, sleepiness, feeling emotional.”

She takes a breath.  “…Constipation, nausea, passing urine at night.”  She flicks the page over.  “Common side effects: include bloating, pain, dizziness, vaginal discharge, itching of the vaginal area, vaginal thrush.”  She sighs again, taking another deep breath, “diarrhoea, vomiting, painful sexual intercourse…”

“…What sexual intercourse?”  She looks at me daringly.  “Only joking,” I say, offering my palms up conciliatorily.

“…And painful joints.  Please note – this is not a complete list of all the possible side effects.  Others may occur in some people, and there may be some side effects not yet known.”  She looks at me.

“Are there symptoms they left out?”

“Sorry?”

“I mean, can you think of anything else that could possibly go wrong with your mind, body or vagina that they haven’t already listed?”

Suse looks at the sheet for a moment.

“They haven’t mentioned heart attacks.  Or stroke.”

“Or leprosy.”

“Or consumption.”

“Better email their legal team tomorrow.”

 

* * * * *

We’ve both tried to remain busy.  Suse has to reprimand an employee, while I meet with an old boss because I am a long time between reprimands.

We pass the time, any way we can.

The latest newsletter from IVF Friends arrives in the mail.  This time, they’ve abandoned the snow theme, instead brandishing the cover with a sleeping kitten, lying between bedsheets.

The pictorial symbolism of this rag is overwhelming.

Within, I find a four-page article called ‘Secret Men’s Business’, written about IVF from a male perspective, published in The Age in 2004.  It is a riveting read.

It marvels at the fact that men tend to remain peripherally involved, that we usually remain externally unemotional throughout the process, that we don’t like to talk about or share their experiences, and that our stories remain largely untold.

Unless, I guess, you’re me.

 

* * * * *

Wednesday 1st September 2010

One year ago.

 

Today is the first day of spring.

But, as I wake up at 2.11am to the sound of my wife crying, it doesn’t seem that we’re out of winter just yet.

I hug her to me.

“I feel absolutely awful,” she sobs.  I feel bloated like a whale.  My skin is crawling – tingling – like there’s ants all over me.  I feel like shit.  And I can’t get to sleep.  I’m exhausted, so exhausted, but, I just can’t fall asleep.”

She rolls into another burst of tears, like an overtired child who’s eaten too much birthday cake and drunk too much soft drink, and now she’s banged her head against the shed.

That’s how it is for Suse.

She’s just banging her head against the shed.  Over and over.   Just trying to get to sleep.

Within minutes, in my arms, she has sobbed herself to sleep.  She breathes heavily, deeply, in exactly the same way that banged-headed child would.

As I hold her, I love her even more, ever more.

This beautiful, imperfect wife of mine, who shares her fears, her insecurities, and her failings, only with me.

Only with me.

 

* * * * *

I get the call at work at about eleven.  “Hey love,” I say.

“Hey.”   She sounds washed out.  She sounds a million miles away.

Ironed flat.

“How’d the ultrasound go?”

“Well…”  She sighs deeply.  She’s sighing a lot at the moment.  “They said one was 22mm, one was 18, two were 16, and then there were three smaller ones that were all about 12.  So they reckon there’s only four that are going to be any good.”

I feel the frown on face.  “Which side?”

“What?”

“What side were they on?”

“I don’t know.  Does it matter?  All I know is that there are only four that are going to be ready.  Well, there are three more that are smaller, but it’s line-ball whether they’ll be big enough.”

“Right.”

“Are you disappointed in me?”

“What?  No.  I’m disappointed.  But not in you.  It’s…just…”

“…I’m disappointed in me.”

“Why?”

“If you had a low sperm count, you’d be disappointed in yourself.”

I catch myself nodding.  “I’m just…I didn’t expect this, I guess… Four?”

“I fucking know!  There were twelve good ones on Monday, and now there’s only four!  She said we were lucky, really, because any less than three and they don’t go ahead.”

“Way to go on the positive spin, Shelley.  Well we got that, I guess.”

“Yeah.  Woo hoo.  So.  I get my final injection tonight.”

“What time?”

“7pm.  Thirty eight-hours before collection…”

“…Which makes it 9am Friday.”

“Yep.”

“Okay.”

“Fucking four.”

“I know, honey, but we only want one baby at a time.  We don’t need anymore than that.”

“It’d be nice though, wouldn’t it?  To have a few spare on ice, so we don’t have to go through all of this again so soon?”

“We won’t need to.  We’re going to get pregnant.”

“Sure, sure.  Positive, positive, blah, blah, blah.  But if we don’t, you’d prefer it if you didn’t have to have me loopy like this too often, wouldn’t you?”

“Is that a question?”

“Oh, yeah, and get this,” she says, diverging.  “I told Shelley how shit I was feeling, and she was surprised.  Like this was unexpected.  Surely I’m not the first woman on IVF to lose it with the drugs?”

“I don’t know, Suse.”

“Anyway, I’m done for today.  I’ve called the girls at work, and I’m having the rest of the day off.”

“Good one, boss.”

“I’m getting a massage, and I’m growing these last three eggs to full size.  This is my priority.  I’m damned if I’m going to come out of an anaesthetic with only four eggs.  I’m planning on seven.”

“You go, girl.  I’ll back you all the way.”

“I’d better go.”

She sounds totally deflated.

“Love you.”

And so do I.

Fucking four.

* * * * *

 

Monday 23rd August 2010

One year ago.

“So this is the needle,” says Shelley, pulling out a blue, wide-barrelled pen.  I look across at Suse, who wears a glazed expression.  It’s not that she’s concerned about the needle, it’s just that she’s a little overwhelmed with information.  “You open the container, take off the cap, undo the chamber, pull out the cartridge, and place it in here.  Then you take a needle, and you screw it on here – after you’ve wiped it with an alcohol swab.  When you’re done with that, take off the plastic lid, revealing the needle.  Dial it up to 300 micrograms, just like this.  If you overdo, it, wind it further, like so, and just reset it, like this.  Take a grab of some of your stomach – anywhere below the belly button line – and place it in, inject, and hold for five seconds.  Take it out, recap the needle, unscrew it, and put it in the sharps container.  And then do the same the next night.”

I look at Suse.  Her eyes are open, but not much else is.  Shelley does this for a living, but somewhere along the way, she’s forgotten that this is the first time we’ve heard any of this.  I’m a doctor, I’m familiar with injections and this equipment, and yet I’m running to keep up.  Shelley’s explained the pack, our terms and conditions, the costs, and she’s up to our regime.  We’re to start on the Puregon, and then the Orgalutran.  After this, we’ll have Ovidrel, and then finally the Crinone.

We’ve got a pretty simple regime.

Supposedly.

“Make sense?”  I look across at Suse, and she looks back at me.  I expect to see fear.  But I don’t.  She’s clearly overloaded, but I see that twinkle.

She’s excited.

“You’ll remind me of anything I this that I don’t remember?” she says.  I nod.

“Good,” says Shelley quickly.  “So, you get four boxes, three of the 900 microgram chambers, three uses each, and one of the 300.  Got it?”

Again I nod.

“Good.  So onto the Orgalutran.  This is a once-only use.  The needle is slightly bigger and hurts on the way in, more than the Puregon, which is more like a diabetic’s pen.  So in that way it’s similar to the Ovidrel – which is the one we give exactly thirty-eight hours prior to collection,” she says pointedly.

I look and nod.  Shelley’s voice trails off.  I watch her animated movements, almost like a cartoon.  Someone has their hand up her, controlling her like a puppet, but there’s no body attached to the hand.  Or someone has pressed play on a tape, and although her lips are moving, the sound has gone dead.  I look across at Suse.  This time she’s the one listening.  She’s nodding with every word, taking it in.

This is my permission to vague out.

I look out the window at Melbourne below.  It’s sunny and warm, the warmest day in weeks.

It’s nine days till spring.

“Does that make sense, Mark?”

“Absolutely,” I say unconvincingly.

“So the Crinone is inserted with this applicator.  It releases progesterone directly through the vaginal wall…”

I look across at Suse, who smirks at me, the good student who knows how not to get caught.

Hopefully we can share our notes before the exam.

 

* * * * *

On the way out, Shelley hands us another folder.  I think that makes three that we’ve been given along the way, as well as two more we’ve nbought ourselves, just to hold all of the information.  This one is white with a peach trim and banner, declaring the motto of our year:

‘Life Starts Here’.

When I open it up, I see that it is full of brightly coloured drug flyers, interspersed with admission paperwork, some after-hour contact numbers, and, just for good measure, yet another document reminding us of potential risks.  This one quotes the incidence of twins from IVF at 16.4%.

Fuck me.  First it was 3%, then 10%, now 16.4%.   By the time we have a baby, it’ll be 1 in 2.

Luckily, there’s even a DVD on how to use the Puregon Pen.  Clearly, no one can stay awake for all of Shelley’s talk.

The drug propaganda is worthy of note:

PUREGON: A green covered booklet, with a simple yellow heading.  The drug name is at the bottom centre.  As it’s a plastic pen they’re selling, the name is written in cursive, as a reminder that you’ll be stabbing yourself with a biro.

In the centre is a picture of a couple.  They’re sitting on a set of steps, with smiles on their faces.  They’re well cast; he looks a little bit weird and awkward, like maybe his sperm count is a little low.  The hints of highlight in her hair are almost mistakable for grey.  The shot is cropped just below the shoulders.  I can almost hear them saying, ‘We may be thirty-eight years old, but we’re happy, even though we haven’t had kids.  If you want, imagine I’m thirty-eight weeks pregnant, or if it helps, I’m still barren.  We’re unassuming, and normal.  Apart from my impotent husband, that is.’

9 out of 10

 

ORGALUTRAN: By the same company, this one is has a yellow background with orange writing.  The drug name is in smaller print, again centred at the bottom.  The picture at the top is one of a dirty great needle, photographed on a clinical white background.

Read:  ‘This is a needle that you have to have.  And it will hurt.   No point bullshitting.’

8 out of 10 (for honesty)

 

OVIDREL: This one’s by a different company.  It’s an all black background, the drug name written vertically down its right hand spine.  To its left is the photograph of a stunning woman in a red dress, her hands under her chin in clutched prayer.  It looks like an ad for a new brand of Christian fashion apparel.

3 out of 10.

 

CRINONE: By the same company as Ovidrel.   Yet another good-looking woman in a red shirt, this one with her arms wrapped around her unpregnant midriff like she’s got a gut ache.  And yet she’s grinning as she stares at the ground like she’s just seen $100 – not like she’s just sprayed a dose of PMS up her vagina.

2 out of 10.

 

When you open the Crinone and Ovidrel brochures, on the first page we get to meet the Merck Serono Fertility women, each with their own name.  As well as Ovidrel and Crinone, we have Cetrotide, Gonal-F, Luveris, and Serophene.  Each of these oddly named women is a vacuously ecstatic twenty-five year old model.  Cetrotide is touching her declotage like she’s just can’t believe how good it is to be alive, and Serophene holds her head in her hands like she’s just won the Miss America pageant.  Liveris is clapping her hands with glee, her mouth wide open as people only ever do in photo shoots, while Gonal-F is pumping her fists at her side, with an expression like she is actually having an orgasm.

I want to punch them all.

Drug companies, read this:  IVF is hard.  It may be about women’s health, but for God’s sake, don’t trivialise it down to a tampon commercial.  I want odd-looking, late-thirties couples and a horse needles on your branding, not models having orgasms.

This is IVF.  We don’t do regular orgasms any more.

 

* * * * *

 

Monday 2nd August 2010

One year ago.

I pick up the phone and dial.

“Hello, Shelley speaking.”

“Hi Shelley, my name’s Mark,”

“Hello, Mark.”

“And my ID number is 181769,” I say, my fingers slipping across my laminated card.

“Oh, yes, I remember you,” she says curiously.

“By my number?”

“You’re Susan’s husband, aren’t you?” she asks, ignoring the question.

“That’s right.”

“Yes, I’ve seen your paperwork recently.  Dr Fleischer has set up a regime for you.”

“Right.”

“Yes, you’ll be on an antagonist regime.”

“That sounds like my wife.”

“Sorry?”

“When she’s hormonal,” I add laughing, “that sounds like Suse.”

“Oh, no, I’m talking about the medication she’ll be on.  A hormone antagonist.”

“Oh, right,” I say stupidly.

“She’ll be starting with injections of FSH to stimulate her follicles, and then she’ll take the antagonist injections of Orgalutran.”

“Orgalutran?  Wow.  Sounds like a Transformer.”

“No, that’s the name of the antagonist injection,” she repeats plainly.  “To halt her ovulation from progressing.”

“Oh, right,” I repeat.

“And then, a few days after that she’ll have the egg collection, and then a few days after that, the implantation.”

“How many days are we talking?”

“Hard to say.  The FSH starts on day two, and goes for nine days.  The Orgalutran goes for three to five days, the eggs are collected on about day thirteen, and we reimplant them on about day eighteen.

I scribble notes wildly, arrows across the page, trying to understand.   “So, ostensibly, we could be conceiving…” I say, flicking through my calendar, “…On what date?”

“Depends on Susan’s period.”

“And when will that be?” I ask, before I realise what I’ve said.  Shelley doesn’t even bother answering.  “Sorry about that.  I meant, when do we need to see you?”

“On the day the injections start.”

“Which will be when?”

“On day two of her period.

“And when will that be?” I ask again. “Just joking,” I say, trying to cover. This times, she lets out a little squawk.

“That one, I can’t help you with.”

“Right.  Well, she’s like clockwork.  She’s just had her period last week, so…”  I stop myself.  “I won’t even hazard a guess.  Can I ring her while you’re on the phone?”

“Sure,” she says, sighing.

I pick up my mobile and speed dial.

“Hey, love,” she says.

“Hey, hon, I’m on the phone with Shelley, the IVF nurse.”

“You managed to get onto her?”

“Yes.”

“How many times did you have to ring?”

“Like I said, she’s on the other line.”

“Right.”

“And we’re trying to figure out the cycles.  Do you know when you’re period is due?”

“Ahh, I left my diary at home.  I’d only be guessing.”

“Well, have a guess,” I say.

“No point guessing,” Shelley says in the other ear.

“No point guessing,” I repeat.

“Hang on, let me get to a calendar.”

“She’s pretty much like clockwork,” I say again, “she’s just getting to a calendar.”

I sit there, waiting for a pin to drop.

“Maybe the 25th August?”

“Maybe the 25th,” I relay.

“Well, we can start with that,” Shelley says.

“We can work start that,” I repeat.

“What if it doesn’t work with my deadlines?” Suse asks.

“Like I said, hon, Shelley’s on the other line.  I’m going to finish this conversation and call you back.”

“Okay,” she says, hanging up.

“May I continue?” Shelley asks, like a teacher interrupted by a tempestuous student.

“Yes,” I say sheepishly.

“So, if day two is the 26th August,” she continues, “then we’d start the injections that day.  And we’d see both of you at that time.”

“Can we see you any earlier?”

“What for?”

“Well, Wednesday isn’t that easy for us.  But Monday 23rd might work?”

“Yes, you could, but you wouldn’t want to pick up the drugs until you know you’re not pregnant.”

“Why not?”

“Well, you can,” she says, correcting herself, “but if you do, and you find out you’re pregnant, then you’ve just wasted $2000.”

My head spins, doing the maths.  “The drugs are $2000?  I don’t think I knew that bit.”

“Well, yes.  But they’re subsidised.  The Government pays for them.  Unless you get them and find out you’re pregnant, in which case you foot the bill.”

“The drugs are $2000?” I repeat.

“Yes.”

“For how many injections?

“About six or seven.”

“Jesus Christ,” I say.

“No, Orgalutran,” she says, finding her humour.

“Maybe I was a bit harsh on the Government.  I didn’t know they paid that much for drugs.”

“Consequently,” she says moving on, “you want to know you’re not pregnant.

“Bloody oath you do.”

“So, I guess you could do a pregnancy test on the Monday morning?”

“To see that her period will come on Tuesday?  What if she’s out by a couple of days?”

“I thought you said she was like clock work.”

“Well, she’s not a Swiss watch.  I mean, what if she’s out this time?  What if she’s not due till Thursday and we are actually pregnant?  The tests aren’t as accurate that many days ahead,” I say.

“Oh, they’re pretty accurate,” she offers.

“They’re, like, 99%.  And sorry, I’m not a betting man.  I don’t even bother with the Melbourne Cup.  So for two thousand bucks, I want 100%.  I want a guarantee.  I want blood,” I say, a little too dogmatically.

“Right,” she says.  I can hear her tapping away at her keyboard, making a note:  ‘Idiot husband, unaware of periods, swears a lot.’

I think for a moment.

“How about we come and see you on the Monday, get the work up, give you the forms, sign our lives away, and then, if she’s bleeding on the 26th, we’ll pick up the drugs?”

“That sounds a little complex.”

“We live in Richmond.  The hospital is five minutes away.  It’s on the way to Suse’s work.”

“Who’s going to give the injections?”

“I will.  And if her period starts on the Tuesday, or the Wednesday, or even the Friday, I’ll give the first jab the very next day.  On day two of her period.”

“Oh,” she says.  “Okay then.”  She pauses for another moment.  “Right.  Well, that works then.  Well done.  Good problem solving.”

“Thank you.”

Problem solving is easy when there’s $2000 on the line.

 

* * * * *