Sunday, May 29, 2011

This Memorial Day, remember the diplomats, too


From the Dallas Morning News:

WASHINGTON — They are the proud, the few and the unarmed. They dodge bullets in the mountains of Afghanistan and brave the deserts of Iraq. They serve as America’s face to the world, from violence-ridden Mexico to the financial hubs of Asia to the capitals of Europe. They promote American business and protect American citizens abroad. They are the men and women of the U.S. Foreign Service.

On Memorial Day, we rightly pause to remember those who serve our nation in military uniform. But we should also recognize the more than 12,000 members of the American diplomatic corps who serve in Washington and in 271 missions across the globe.

“They are the ones out there on the front lines trying to advocate and explain [American] policies, regardless of which administration they are serving,” said Karen Hughes, former Under Secretary of State for Public Diplomacy under President George W. Bush.

She praised the Foreign Service as “a very dedicated group of public servants” who “work and make sacrifices around the world in some very difficult assignments.”

You may think of diplomats as tuxedo-wearing statesmen sipping cocktails at summits in Switzerland, but American diplomats are deployed in places like war-torn Africa and Afghanistan, where they often face the same dangers as members of the military. One diplomat I spoke to said he has been shot at five times in the line of duty.

Yet, even as America’s engagement with the world is growing more crucial, budget hawks are circling over the State Department. Speaking to the National Conference of Editorial Writers this month, Secretary of State Hillary Clinton warned, “There’s a huge gap between perception and reality … and people think that we can balance our budget on the back of our foreign operations.”

The continuing resolution passed to fund the government cut $8 billion for the State Department and USAID — while increasing the Defense Department’s budget by $5 billion. The demands on the State Department are growing, but the budget isn’t. “It is so out of whack with what we have to be doing,” Clinton lamented.

Part of the problem is that many Americans misunderstand diplomats’ role. Diplomacy isn’t about throwing money at the world. Yes, foreign aid — which accounts for only about 1 percent of the total federal budget — is a useful diplomatic tool. But too often diplomacy is dismissed as wasteful global charity or useless hemmin’ and hawin’ at the United Nations. Whether working to secure access to natural resources (like oil), leading reconstruction in Afghanistan or screening hundreds of thousands of visa applicants, diplomats are producing concrete results. They are the facilitators of globalization.

In an interconnected world, diplomacy is becoming ever more relevant to the daily lives of Americans, especially when it comes to the economy. Diplomats pave the way for American businesses to make profits at home by expanding overseas.

“If companies want to grow, if we want to grow our GDP, if we want to be competitive on a global basis in the 21st century, people really have to step up to export and export more, because that’s where the growth opportunities are,” said Lorraine Hariton, U.S. Special Representative for Commercial and Business Affairs.

Texas definitely enjoys the dividends of diplomacy. According to the latest figures from the International Trade Administration and Bureau of the Census, in 2009 the Dallas-Fort Worth area exported $19.9 billion worth of merchandise. And because of the Open Skies agreements liberalizing international air travel,Dallas/Fort Worth International Airport will see “billions of dollars in new business,” Clinton said this month.

Members of the Foreign Service play a crucial role in making that kind of lucrative international agreement possible, part of a government-wide campaign to help American businesses increase exports.

“We need to set up partnerships and relationships all around the world so we can understand the market needs in Kenya as well as the market needs in Fort Worth,” Hariton said.

Indeed, to maintain America’s global competitiveness and to capitalize on the opportunities globalization creates, we need a well-funded diplomatic corps.

“Diplomacy used to be thought of as the quiet, behind-the-scenes, government-to-government communications,” Hughes told me.

It’s now so much more than that. “In order for America to enact the kinds of policies we want to enact around the world,” Hughes explained, “we have got to build a public case for those policies, for our values and for our interests.”

Our diplomats are out in the trenches doing just that, often at great personal danger — remember the Iranian hostage crisis? Foreign Service officers have also been the targets of drug violence, insurgent attacks and kidnappings. Yet they man their posts, safeguarding American interests and protecting U.S. citizens overseas.

This weekend, as we salute our military, we also owe a tribute to America’s diplomats, many of whom are in conflict zones riding in the same Humvees as the troops. The only difference is that they can’t shoot back.

*Clayton M. McCleskey is a contributing writer for The Dallas Morning News based in Washington. His email address is letters@claytonmccleskey.com.*
*I found this post at Life After Jerusalem

3dp5dt, FET #2

Well, I feel nothing. I had some slight cramping yesterday, nothing today. My mom and husband are taking good care of me (lots of pineapple core smoothies and water). Unfortunately all of us have come down with the bug that Kate has (fever, congestion, sore throat).

I’m still not feeling hopeful about this cycle.

Saturday, May 28, 2011

May 27, 2011

Yesterday was the 1 year anniversary of my medical evacuation.

Fortunately it wasn’t nearly as dramatic as it sounds. This had been in the works for months, as 'the Powers That Be' insisted that I deliver in the U.S. So, after months of planning, and moving to a new house the previous week, it was time to say goodbye. A temporary goodbye to the new house, my husband, and the cats.

It’s strange to think that just a year later, I’m lying on the couch, hoping and praying that we’ll be able to give our daughter a sibling (not feeling hopeful right now).

Thursday, May 26, 2011

FET #2

We were taken back to the OR and the embryologist came to speak with us. Unfortunately, one of the embryos didn't survive. She said it started to thaw, but under the microscope, it began to 'darken and disintegrate." I admit, I cried. I'm not very hopeful about this, given our history.

The other embryo is excellent and she said there's no reason to think this won't result in a pregnancy, but I know she had to say that. She stayed to talk to us for quite a while, and tried to comfort me.

My reproductive immunologist did the actual transfer, and the OR nursing staff remembered us from last time, which was nice.

We're home and I've started the dreaded 72 hours of bed rest.

Oh, and to add to the fun, Kate is sick (congested and fever). I was up with her until 12:30 this morning. My husband took tomorrow off, and my mom flew back to Ireland on Sunday, so at least I’ve got some help.

Thanks for the prayers and good wishes. It means A LOT!!

Wednesday, May 25, 2011

nervous, scared, desperate (FET #2)

These are my feelings as we’re now 18 hours from transfer time. Of course, the embryos first have to survive the thaw. Knowing that these two were our slow starters, I honestly don’t know if we’ll have anything to transfer by the time we arrive at the clinic tomorrow.

It’s strange; I don’t remember being nearly this anxious during our last fresh cycle. I haven’t slept in days (stress? Prednisone side effect? both?). I think part of it is the sheer desperation of this cycle. We could very well be done; these are our last frozen embryos.

Our health insurance doesn’t cover IVF or meds, so just the expense of cycle after cycle is mind-blowing, add in that just any old IVF clinic won’t do, since I have the auto-immune issues. I HAVE to use a specialized clinic, which are unfortunately, very hard to find; in fact, almost impossible overseas.

We leave Dublin in August, so perhaps I could fit in one more fresh cycle, but again, the money. Then of course there’s the added stress of leftover embryos, would we leave them here and travel back to transfer, try to ship them to a clinic in a different country? There are just no easy answers, so I sit, and worry.

Our first frozen transfer was a NIGHTMARE, and I know, as hard as I try to change this, that some of the feelings about that time, and the circumstances, are at the forefront of my mind. The logical part of my brain says that our current clinic is much more advanced, the embryos are much better quality and we were not forced to rush into this cycle. The emotional part of my brains says, well, here we go again. Another failed cycle.

I'll update tomorrow.

Tuesday, May 24, 2011

Please Act Now!!!!! The Family Act of 2011, S 965

This is a ground-breaking bill intended to help millions of couples build their families. We, like millions of other Americans, are completely out of pocket for all infertility procedures and medications. We are very fortunate in that we've been able to afford the staggering cost of IVF. Unfortunately, that is not the case for many other couples. Please show your support, and help all of us build the families of our dreams.



Kate's first POTUS "Meet & Greet"

As most of my friends and family already know, we took Kate to her first POTUS (President of the United States) “Meet & Greet” yesterday. The Obamas were in town, and without saying too much, we were invited to the event.

Unfortunately it took place during Kate’s afternoon naptime, so she was less than thrilled to be there. I’d decided to stay toward the back of the room in case I needed to make a quick exit, however, during his speech, President Obama stated that he particularly enjoys meeting the children of the U.S. Foreign Service, so I made my way to the front, with an increasingly unhappy Kate.


The Obamas were only able to “greet” the people in the front row, and by the time I was up front, they were making their way toward the other side of the room. I handed Kate a bottle and made my way past some people who were more than happy to push and shove a woman carrying a small child.



Once up front, President Obama came over, asked Kate's name, and quickly realized that she was less than happy to be there. He made a comment about her being excited to meet him. Hey, at least he has a good sense of humor. We exchanged pleasantries, he patted me on the back, shook my hand, and that was that.

I have several pictures of him right next to us, but I’m still iffy about sharing pics of Kate on a public blog, so these (pics from the side and back) are all I’m going to post here. Hope to have some additional pics to share soon.

Sunday, May 22, 2011

Worth the read (immune issues and intralipids)

Please take a moment to go over to Dr. Sher’s blog. His latest entries cover immune issues and intralipids.

I have followed his work for years and recently learned that my RE spoke to Dr. Sher many years ago, while he (my RE) was still in training. My RE, not surprisingly, spoke very highly of Dr. Sher.

There is some additional information on autoimmune issues and intralipids in my history and under the “infertility resources” label, to the right.

the infertility alphabet game

This is a survey that seems to be very popular on the IF blogs, so why not…

A. Age when you started TTC: 32

B. Baby Dancing or Sex: Err, sex

C. Children wanted: 2-3

D. Dogs/Cats/Fill in Children: Two cats, Guinness and Bella. One adorable daughter, Kate

E. Essential Oils/Vitamins/Snake Oils: Levoxyl for Hashimoto's Thyroiditis. Vitamins: prenatal, folic acid, calcium, low-dose aspirin, and currently taking Heparin for the FET

F. Fertility Meds I’ve taken: Estradiol, Gonal F, Estrofem, Crinone, Progynova, Luveris, Gestone, Duphaston, Follistim Cetrotide, Lupron/ Diphereline, Novaril, Buserelin, Orgalutran/ Ganirelix, Estrace, Pregnyl

G. Gain: Oh yes. Fertility meds add weight.

H. HSG (Hystosalpingogram): Yep. I had it done in Belarus. Wowza, was that an experience.

I. Infertile Pet Peeves: the dumb things people say

J. Job title: SAHM!!

K. Kid’s names you’re afraid will be taken by the time you can use them: I’m not sharing. Though I will say that we like classic, traditional names

L. Length of time TTC: 4 ½ years

M. Miscarriages: 1. Early triplet miscarriage with IVF #1

N. Number of times you’ve switched OB/GYNS, REs, FSs: I’ve seen 4 OBs, 4 REs and 4 MFM/ Perinatologists (I’ve been pleased with all of them, and only switched due to moving)

O. Ovarian quality: Poor. Dominished Ovarian Reserve

P. POAS or wait for AF: POAS

Q. Quote from an obnoxious fertile: Oh where to start. I have an entire post about this.

S. Sperm: Great! This is not one of our issues.

T. Time you tried naturally: Approximately 14 months from TTC to IVF#1, though I did consult with an RE approximately 6 months after we started TTC.

U. Uterus quality: Great

V. Vagina: Err, yes, I have one

W. What baby stuff do you already have?: Everything since we have Lady Kate

X. X-tra X-tra Hear all about it! How many people know the ins and outs of our crazy TTC journey? I’m fairly open with friends and family, though only if they ask, or read the blog

Y. Yearly Exam (do you still go in even though someone sees your lady parts most months?): Yes.

Z. Zits: Only when I’m on fertility meds

Saturday, May 21, 2011

Welcome ICLW!

After a long absence from blogland, I’m back. I couldn’t think of a better way to jump back in than to participate in ICLW this month. Looking forward to reading some great new blogs, and catching up with old friends.

The quick run down…

2005- married

2007- started TTC

2008- IVF #1, early triplet miscarriage

FET #1, failed

2009- IVF #2, success

2010- welcomed our beautiful daughter, Kate

2011- FET #2, in progress

For a more detailed history, click on the infertility label to the right.

blog housekeeping

As I’m just now catching up on blogs, I need to do some housekeeping. Over the next few weeks, I’ll be going through my blog list, adding and deleting. This is for both FS and IF blogs. Since I’m doing ICLW this month, I hope to have some great new IF blogs to add. There seem to be some up and coming FS blogs too. Stay tuned. Housekeeping is underway.

Friday, May 20, 2011

FET #2, Appointment #3, and a bad day

Yesterday I had the final ultrasound before transfer, which is scheduled next Thursday. The nurse said that the lining is “perfect.” 9.1mm. I stopped the Buserelin injections and will begin the Crinone and Gestone PIO tomorrow.

I also had a mini ‘feeling sorry for myself’ moment the other day :( As I was putting on my nightgown before bed, I caught a glimpse of my stomach in the mirror. Bloated and bruised. Then I pulled the sheets back on the bed, and saw blood stains. Apparently my heparin injection sites bled the previous night, all over my brand new, high thread count, WHITE sheets. So, I did what any other infertile woman would do, I cried. It only lasted for a few minutes, but it’s just so unfair.

Of course it doesn’t help that I’ve been trying to catch up on blog reading and EVERYONE seems to be pregnant right now. Insult to injury is reading things about pregnancies happening at a bad time, being a surprise, or hoping for one gender over the other. Since I can’t even begin to imagine what it’s like to have any of those feelings, I think the best thing to do is sign up for ICLW through Stirrup Queens. Reading blogs is fun, and even better when you share common interests, ups and downs. Plus, with the limited amount of internet time I seem to have, I’d rather support ladies who really need it. Here’s to a great week of blogging!

Tuesday, May 17, 2011

Flying “home”

After several months in the U.S., it was finally time to return to Dublin.

4 suitcases

a stroller and full-size stroller bag

laptop bag, diaper bag, backpack, purse, breast pump bag

car seat and of course, Kate

Since my husband was only able to spend about two weeks in the States, Kate and I would be flying back to Dublin, alone. I had spoken to the airline numerous times requesting assistance between gates, only to be told repeatedly that there was nothing they could do to help. Finally (lucky phone call #8) someone took pity on me and offered to have a wheelchair waiting at the gate. YAY! At least I could stack bags, and maybe a car seat, on top of it.

We arrived at the airport and aside from checking-in, the first order of business was to get the stroller into the stroller bag so it could be checked. Now, common sense says that we should have already done this or at least known how to do it. Well, yes. Except that the stroller bag hadn’t arrived until the last minute (another fiasco) and I was busy packing and pumping. My mom came to the rescue, again, and figured out the stroller, including taking the wheels off. I love my stroller, but it is far from easy to travel with. While she was doing that, I was busy with the check-in agent. She couldn’t find Kate in the system. After the first supervisor came out to help, we were asked to step aside in line. As I turned around, who should I see behind me, my high-risk OB (the one who was supposed to deliver Kate). Sure enough, she was on our first flight. I was definitely a bit anxious about that. Would she judge my parenting? Would Kate cry on the flight?

Forty-five minutes and two supervisors later, we were ready to go to the gate. The story I was given was that the agent couldn’t find Kate in the system because she was looking her up as an “infant”, which only brought up “lap babies”; Kate was a ticketed passenger. I’m still not sure I entirely believe this, but whatever, by then we were late.

Knowing that I had to haul a laptop, diaper bag, purse, breast pump bag, chilled bin of milk, car seat, and Kate, through security, I requested assistance to the gate, and eagerly offered my mom. The check-in agent happily passed over the necessary paperwork and we were on our way.

Kate was less than thrilled to be removed from her car seat to go through security, but you have to do what you have to do. TSA was wonderful in their handling of all of our carry-ons, specifically the pump and milk.

Quick goodbyes at the gate and a friendly flight attendant helped me carry everything onto the plane. The things you can’t make up: we were seated in the row directly behind my doctor. I fastened in the car seat and Kate started to cry. EEP! My wonderful doctor turned around, smiled, and said that, “Yes, the first flight is always the hardest.” Sigh of relief.

Kate immediately settled down, until I had the bright idea to try to nurse her in the middle of the flight. We had less than an hour between flights in Chicago, so I knew I needed to feed her on our first flight. I took her out of the car seat, put on the nursing top, and she howled. I struggled for 15 minutes or so, declared defeat, and strapped her back into the car seat.

When we landed, my wonderful doctor offered to carry some of our bags up to the gate. Thank you! She gave me a hug, said she’d see me this summer (I hope), and said goodbye. A nice young man was waiting with a wheelchair, so we loaded it up and set off for the next gate. As we were walking, a passenger from the previous flight came over to us. He told me that I was doing a great job and that he hadn’t even realized there was a baby on the flight. Liar, liar, pants on… No really, thanks for the compliment. I’m positive he was just being polite and obviously, very kind, but the fact that he went out of his way to say those things made me feel so much better. Mr. middle-aged businessman, if you happen to be reading this, thank you!

At the next gate, the young man offered to leave the wheelchair for me to use, which I gladly accepted. We had a few minutes before boarding, and I needed some water, so I walked over to a little cafĂ© and quickly realized that traveling with a baby, pushing a wheelchair full of stuff, did not make for an easy in/ out experience when buying water. In fact, there wasn’t enough room to get the wheelchair into the store. A woman noticed that I was alone, and offered to watch Kate while I went in to pay for the water. I must have looked at her like she had three heads, because then she offered to take my money in to pay, while I stood outside with Kate. Yes. I will trust a stranger with $20, not with my newborn. She returned with the water and change and said that she was on my flight, loved babies, and that if I needed anything, to come and find her. Very sweet.

I pushed the wheelchair back to the gate to enquire about pre-boarding and maybe getting some help with the bags. The gate agent was beyond rude. She accused me of having too many carry-ons and started to lecture me on traveling with less stuff. I pointed out that Kate was a ticketed passenger and that according to the airline baggage policy, we were actually under the limit of carry-ons (diaper bags and breast pumps don’t count).

The flight was full, completely full, and I admit that I was a bit anxious while pondering who would be seated next to us. I was praying for the president of LeLeche League. Due to all of the feeding issues (again, another post) and the length of the flight, I knew I would need to feed Kate and pump several times. Well, I didn’t get LeLeche League, but I did get a nice woman who didn’t seem overly irritated about being seated near an infant. I was also grateful for the young guy seated in front of Kate. Upon sitting down, he looked back, saw the car seat and asked if he would be able to recline. I apologized and said no, but offered to buy him a drink for the inconvenience. That was that. Another sigh of relief.

Fortunately, the flight crew was awesome; all men, and one in particular was taken with Kate. He stopped by often to make sure that I had enough water and that “little miss sunshine” as he called her, was okay.

It wasn’t an “easy” flight, but it could have been so much worse. Kate basically slept and ate, the entire way to Dublin. I didn’t even attempt to breastfeed her. Even though she had her own seat, there just wasn’t enough room. I did have to pump a few times; thank goodness for a small portable pump and a nursing cover. The woman next to me didn’t even realize what I was doing; she made a comment about me being cold when I put the nursing cover on. That was it.

We landed, and I had planned to be the last one off since I had so many bags to gather and didn’t want to be in the way. The woman next to me ended up waiting with her relatives to help me, but the flight attendant offered to do it. As we came down the stairs, there was another young man with my last name on a card. It turned out they were expecting us. Hallelujah. Dublin Airport, you are the best!! The young man loaded us into a van, drove us to the main airport, then helped me inside. Yet another group of men were waiting and found a baggage cart for me to use. I piled everything onto that while they “oohed and ahhed” over Kate. I made my way to customs and waited, and waited, and waited. By this time I was starting to feel sick, really sick (feverish, shivery, dehydrated). After I’d been in line for almost 45 minutes, a custom’s agent approached me and asked if we were traveling alone. He then opened up another line and let me through.

My husband was waiting in baggage and THRILLED to see his little girl, and perhaps his wife. I’d purchased one of those “I Love Daddy” bibs for Kate to wear when she saw her daddy for the first time, in almost two months. We found the bags, went to the car, and drove home.

That’s when I realized, I had the flu, oh and to add to the fun, clogged ducts. I fed Kate, took ashower, pumped, and promptly took the first, and only, nap I’ve had since she was born.

At least we were finally “home”.

At some point in the near future, I will do another post on helpful hints when traveling with a newborn.







Monday, May 16, 2011

FET #2, Appointment #2 (ultrasound, blood work, and intralipids)

This morning I had another appointment. They took more blood, ultrasound was fine, and I had my first intralipid infusion for this cycle.

I found out that my fabulous American RE is moving back to the States. I asked the nurse if she could have him stop by, so I could say a quick goodbye. He soon appeared and sat down to chat for over 30 minutes. It turns out that he’s moving to California, to be the IVF director for a major clinic. He didn’t tell me it was a major clinic, but I recognized the name as soon as he said it. I can’t say I’m terribly surprised, given his extremely impressive CV.

We talked about living overseas, the field of reproductive medicine, and of course, the upcoming FET. I admitted to him that I was nervous, given the outcome of the previous FET. We discussed how very different the circumstances would be this time, and he went to his office and brought back some published literature for me to read, frozen versus fresh transfers. We said our goodbyes and he mentioned that we were taking quite a souvenir from Ireland, Kate :)

One question for the FET experts. When did you have your last ultrasound before transfer? I’m scheduled for transfer on the 26th, last scan on the 19th. Doesn’t that seem like a long time between scans? For my previous FET, I had scans every 2-3 days. I guess my concern is that the lining could drastically change during that week, though when I spoke to the nurse this morning, she said it wouldn’t. Thoughts?

Next appointment is Thursday.

PS- Fran, I didn’t work with Dr. L this morning, so I didn’t have a chance to pass on your message. I just briefly saw her in the hall.

Hoping and praying I need more of this in a few weeks!

Late Pre-Term info

I’ve received a few comments and emails regarding “late pre-term infants”, so I thought I’d share the limited information I have. Personally I’d never heard the term. I was under the impression that there were preemies and full-term infants, which I thought was 37 weeks.

While taking a breastfeeding class, the director of lactation services informed us that there is a relatively new category called “late pre-term”, babies born between 36-38 weeks. I wrote it down in my notes, but didn’t think about it again, since Kate was supposed to be born at 39 weeks.

Shortly after she was born, the staff brought in the following form (I hope it’s big enough to read)

Kate born in the 37th week, and did have several of the issues listed on the paper. Would she have had them if she were born at 39 weeks? It’s hard to say, maybe, maybe not.

The first, most noticeable issue was temperature regulation. A nurse was just about to take her away to the special care nursery to go under the heating lights when a wonderful lactation consultant/ RN suggested Kangaroo Care. A few hours and lots of cuddle time later, we narrowly missed special care by .1 degree.

She also lacked the suck, swallow, breathe coordination. To keep herself alive, breathing was of course most important, and fortunately not an issue. We had to work on getting her to suck and swallow. For the first day, aside from practicing breastfeeding, she was fed pumped milk by syringe, then graduated to little bottles. They did test her blood sugar before she ate every time. Poor girl.

At some point they tested her bilirubin level which was high, so she was diagnosed with jaundice. As for weight loss, she lost a total of 11 1/2 oz, but weight loss is common in all/ most newborns, so I wasn’t concerned.

Throughout this time I spoke with a few pediatricians and found out that “late pre-term” is a well-known term in their field. One friend, a practicing pediatrician said, Technically, a term baby is 38 weeks (some would even say 39). There has been a reclassification of the 36-38 weekers as "late preterm" since they tend to not act like term babies (keeping temps up, eating well, sleeping easily, etc). We don't worry about 36-38 weekers as much as say... a 30 weeker, but we do realize that there are still some adjustments that baby needs to make."(Hope you don’t mind being quoted, S)

A few other people told me that you would never hear a neonatologist refer to 37 weeks as full-term, as they see too many of them in the NICU. Apparently 37 weekers have a 50% higher mortality rate than 40 weekers.

Here are a few articles I found, and that is the extent of my knowledge on the subject. I’m just beyond grateful for a healthy, thriving little girl. I’ve always been a fan of letting babies stay inside and grow as long as possible, this information definitely confirms that opinion.

From the CDC: “Term” births (37-41weeks) have traditionally been viewed as one homogenous group [8]. There is, however, growing evidence of increased neonatal morbidity among early term (37- 38 weeks) infants, compared with those born full term (39-41 weeks) [37-39]. In response, organizations such as the March of Dimes are recommending that researchers differentiate between early and full term births [40]

New Research Shows Why Every Week of Pregnancy Counts

Rethinking the Definition of "Term Pregnancy"

A Push for More Pregnancies to Last 39 Weeks

The Late PreTerm Infant and Breastfeeding

Sunday, May 15, 2011

I recently did a little shopping …

Yes, it’s that time again. Frozen Embryo Transfer #2. I really struggled with when to do this. I’m A. getting old, and B. we are leaving Dublin this summer. I had two consults with my wonderful RE, and after discussing the pros and cons, agreed that now is the time. The biggest issue was that I wanted to breastfeed Kate as long as possible. A lot of the meds used for IVF and FET are contraindicated while breastfeeding, and with my supply getting lower and lower, it was time to stop.

As for shopping…

Crinone: 90 units

Heparin: 14 vials

Estrofem: 168 tablets

Buserelin: 4 vials

Prednisone: 175 tablets

Gestone PIO: 30 vials

I’m already taking folic acid, prenatal vitamin, aspirin, calcium, etc, etc, etc…

The pharmacist was fantastic. She stayed in weekly contact during the months of trying to put my order together (apparently there was a Gestone PIO shortage in Ireland), and since I was buying everything at once and don’t have insurance coverage, she gave me a 10% discount. When you’re spending several thousand dollars, every bit helps. Thank you, C!

Last week I had my first appointment (ultrasound, check meds, hand over a small fortune). The clinic has moved to a new location which is phenomenal because it’s A. closer to my house and B. has a big parking lot!

The new clinic is absolutely gorgeous and it was strange to see so many familiar faces, though I saw several new faces in the nursing department. I waited and hoped that I would be working with someone I’d worked with in the past. Imagine my relief when the fabulous Dr. L (AKA finder of missing right ovaries) called my name. It was great to see her again, catch up, and show her pictures of Kate. She asked if she could keep them, which I thought was very sweet.

The ultrasound was “perfect” according to Dr. L. I have all of the necessary meds, and then I stopped in billing so they could empty out my Irish bank account.

Tomorrow I go back for another ultrasound and the first dose of IV intralipids. Here we go again….

A few things

Until I’m caught up, posts will be all over the place, some current, some old.

Since I won’t be posting pictures here, and to make things less confusing between this blog and the new blog, baby girl will from now on be known as “Kate”. No need to ask questions, just accept, her nickname is Kate ;)

Thank you for the warm welcome back. I’m looking forward to catching up, and commenting, on your blogs. I’m slowly getting back into this.

As for the new, private blog (with pictures), I think I’m going to use WordPress. From what I can tell, you will need to create a WordPress account to view the blog. I know this will be a huge pain for those who don’t already have an account, and I am sorry about that. I still haven't made a final decision though, so there's no need to rush over and create an account, yet.

If anyone has another suggestion (besides posting pictures here) regarding blog websites, what's easy to use, not so easy, etc, please leave a comment or email me.

Thursday, May 12, 2011

the birth story, or what could be titled, I don’t need to read about labor and delivery,

and other lies I told myself.

On a dark, stormy, Monday night last summer, I took a shower, gave myself a heparin injection, set the syringe and vial on the table, and felt a pop. Sure enough, at exactly 9pm, immediately after doing my evening heparin injection, my water broke.

I called my mom (who had just driven home and was an hour away), called L&D, took another shower and went down to the hotel lobby to have them call a taxi. Thinking back, I don’t know why I didn’t call the taxi myself. It really was like a scene out of a movie. People checking-in at the front desk, young guy nervously offering a bottle of water to the visibly pregnant woman surrounded by hospital bags.

In the end, the hotel employee suggested their driver take me to the hospital, so the Hilton shuttle driver grabbed my bags and we went out to the parking lot. As I was getting in the van, I noticed a USA Today newspaper in the backseat. I sheepishly suggested that perhaps I should sit on it. Much to my relief, the shuttle driver and his wife have 6 children, so he understood. During the short ride to the hospital, he had very comforting things to say. When we arrived, he insisted on carrying my bags into the hospital. Since it was getting late, I had to be admitted through the ER. I thanked the shuttle driver, who again, offered some kind words, and started to walk toward the admit desk. While I had fortunately stayed dry during the ride to the hospital, I was not so lucky while standing at the admit desk. I asked for the ladies room as I dropped my bags, and ran.

After a very quick admission process, I took the elevator up to L&D. They started the fetal monitor, and told me that I was ½ a centimeter dilated. Fortunately the doctor on call was one I had previously seen and really liked. In addition to OB/GYN, he’d done an RE (reproductive endocrinology) fellowship. Ironic, no? I told the nurse there was no reason to have him come in, to let him sleep, and that I would wait for my regular doctor to arrive in the morning.

At midnight, 6am in Dublin, I called my husband to tell him the news. I could hear the disappointment in his voice, as he knew he’d miss the birth. I tried to be strong and remind him that we knew this was a possibility, and it was just part of the Foreign Service life. At that point, the plan was that my OB would arrive around 6 and I’d have the c-section shortly after that.

My mom had arrived at the hospital by then and I told her to go to my hotel and get some sleep, since her house is an hour away. The hotel was fairly close, so she’d be in the area and ready to come back for the c-section in the morning.

I started having contractions and the nurse thought I might be more comfortable walking around, so I did a few laps around L&D. A bit later I felt like something was really happening and asked her to check me again, 4 centimeters. She said I wouldn’t make it until morning and that she was calling in the doctor and anesthesia team; she was also going to call my mom and tell her to come back for the c-section.

As soon as the nurse came back into the room, I asked her to check me again. She said she didn’t want to because she had “just checked me and there’s no need to risk infection by checking too often". I told her I really wanted her to check, so she reluctantly did; I was at 9. I called my mom and told her to come back ASAP.

The OB and anesthesia team arrived a few minutes later and things got busy. I obviously couldn’t have the c-section because I still had a ton of heparin on board, so they said it was going to be a med free, vaginal birth (there wasn’t time for any drugs, plus the heparin was still in my system, so no epidural either). They said if there were more time, I could have a c-section under a general, but I obviously didn't want that, plus she was coming too fast and the OR wasn't ready. I thought my doctor was going to faint when he heard that the OR wasn’t prepped.

I had been admitted into one of the old rooms, used for overcrowding and c-section recoveries, so they had to move a labor and delivery bed into the room. The new bed was too big for the room, so they had me switch to the other bed and announced we were moving to one of the nice, new, big rooms. Yay, as if I cared at that point ;)

My mom came running down the hall as I was being wheeled into the new room. As soon as the bed was broken down, I was told to push. Pushing was difficult since I didn’t know how to push (I skipped the labor and delivery chapters in the books since I was supposed to have a scheduled c-section). The anesthesiologist ended up holding one of my legs since she was already there with nothing to do. There were two other doctors, the nurses, and my mom in the room. I just kept looking down at the OB saying “I just want to go to the OR”, “I wish I could have some drugs”, and “I don’t want to tear.”

Forty-three minutes after I started pushing, baby girl was born. She was absolutely perfect. The doctor told me it was the “most awesome birth he’d had in a long time” and kept telling me to tell my other OB that it was “awesome.” He also said I was very polite because I always said please and thank you, didn’t swear, yell, or call anyone names, and then he asked if I was a perfectionist. Err, yep. He said he was too, which was a relief because we were having this conversation as he was stitching me up. The nurses also commented on my polite nature and thanked me for not calling them names. Do people really do that?!?!

Unfortunately because I was full of heparin and everything happened so fast, I lost a lot of blood. One of the nurses commented that it looked like a crime scene, which I didn’t appreciate (more about my post-partum care in another post). The other thing I just want to mention is that a lot, most as I’ve found, people think that fast labors and deliveries are a good thing. This was actually listed as a complication on my delivery report, “precipitous labor”. Apparently it’s very uncommon for a first delivery (less than 1%) but knowing my history, should we have expected anything other than uncommon? I was also told the contractions during a precipitous labor are a lot more intense and painful, but since I have nothing to compare it to, I’ll just say that yes, it was intense.

Time line:

9:00pm: water broke

2:47am: nurse called my mom to tell her I was at 4cm (though it was around 2:30 when she actually checked me)

2:57am: I called my mom to tell her I was at 9cm

3:15am: started pushing

3:58am: My sweet girl was born!

It was suggested that I also add my initial reaction. When she was put on my chest, we just looked at each other like, WHOA, what just happened? (I have some great pictures of our expressions to each other). I just looked at her and said, "Wow! You were worth it". And she definitely is!

Tuesday, May 10, 2011

apology, and a bit of an explanation, part 1

I finally sat down and checked the email address I use for this blog (I haven’t actually read the emails, yet). WOW! My sincere, sincere apologies. I had no idea that I had that many readers or that so many people cared about me and baby girl. I think between all of the adjustments and the exhaustion that it never occurred to me that people would actually miss me or be concerned.

My plan is to go through the account, one by one, and you will receive a personal email in return. Again, I’m so sorry, and yet so thankful.

Now, on to the explanation. Before I begin, please know that I’m not trying to make excuses for my absence, though it will probably appear that way. So again, I’m sorry.

Part 1, the U.S.

I’m sure that living in a hotel suite sounds great (to be fair, in some ways it was), and I did the best I could, but it’s just not like being at home. I also didn’t have everything done the way I should have. Even toward the end, it was really hard to believe that I was actually going to have a baby. Taking care of the last minute details was really hard, because I thought something bad was going to happen. I also wasn’t sleeping at all, so when I did go into labor, I was already exhausted. My doctor continued to offer me Ambien at my appointments, but I just wasn’t comfortable taking it, so I declined.

The time in the hospital was absolute chaos. There was medical personnel in my room almost nonstop, add in the lactation consultants (LCs)/ RNs who were also in the room, basically nonstop, for 14 hours a day. I was trying to manage paperwork issues (yes, The Powers That Be expect you to work on their paperwork while still IN the hospital) and a new baby. Made even more fun by a horrible internet connection and non-existent cell coverage.

Things were a bit more complicated because she was late pre-term. They had to do glucose tests on her before she ate, constant vitals, and then she wouldn’t regulate her temperature. One nurse was just about to take her away to the special care nursery, when a fabulous LC, also an RN, suggested Kangaroo Care. While it was wonderful to have baby girl so close, I couldn’t do anything else while lying with her on my chest, under a mountain of blankets.

We had major feeding issues, so again, the LCs were in my room constantly, and when I wasn’t trying to feed baby girl, I was pumping. To add to the chaos, my husband didn’t arrive until almost 40 hours after she was born. He was so jet-lagged, he could barely keep his eyes open. Oh, and then she was diagnosed with Jaundice. Fun times.

To sum it up, as we were walking out of the room when I was discharged, I noticed a tv cabinet. I LOL and thought, you’ve got to be joking. Who has time to watch tv with a new baby.

My husband was with us for about two weeks. We did the best we could, but jet-lagged husband + stressed out, new mom, neither of whom have any baby experience, = an interesting time. As I said in the previous post, the time in the U.S. was busy. There was no down time, or at least I don’t remember there being any. It seemed like every day we had at least one appointment, if not more (medical, lactation, and breastfeeding support group twice a week).

The paperwork for The Powers That Be took up a lot of time, too. Apparently the pediatrician is supposed to be a mind reader, and so instead of just checking a box under a question AND writing “okay” on the newborn medical clearance form, he was supposed to give a detailed account that yes, baby girl was fit for travel. So that was yet another appointment (to go back and have him write a detailed note to MED). Plus every time she had a billirubin check, I had to call Washington to update MED. Ugh. It just seemed like everything was far more complicated and took more time than it should have. Add in that I was feeding her and pumping every 2-3 hours, which took at least an hour, then washing pump parts, etc.

I also learned very early on that my child doesn’t like to sleep, nor does she like to be set down. The first night “home” from the hospital I honestly thought the hotel staff would knock on the door and tell us we had to leave. She was just inconsolable. As it turned out, the hotel staff was WONDERFUL. I’ll post about them separately. Even though they told me not to worry about her crying, I did my best to keep her quiet, out of respect for the other guests. Most of my nights were spent rocking her, walking around the hotel suite, and listening to “The Vacuum” and “The Womb”, both downloaded from iTunes.

The saving grace in all of this was my mom. She lives an hour away from the city I was in, but she drove in nearly every day, and even stayed with me many times, after my husband flew back to Dublin. While my husband was still with us, my mom would drive in and drive us to every.single.appointment.all.day.long. This on top of running errands and taking all of our laundry back to her house to wash and iron. She brought meals, lattes from Starbucks (she knows how to keep me going), and overall just did anything and everything she could, and somehow made it seem like she was never around, giving us the chance to bond as a new family. Mom, you are the best.

Another person I’d like to recognize is one of my BFFs. She just happened to be in the U.S. on home leave, and drove 8 hours, each way, to attend my baby shower, and visit with me. The visit was much too short, 24 hours, but it was right before I was to leave for Ireland and she was to leave for her next assignment. It was really awesome to see her and she was truly a zero-stress visitor. I told her what hotel I was at and she made reservations for herself just down the street. I told her the name of the location of the shower and she said not to worry, she’d find it (I was a bit frazzled when she called and not that familiar with the city, in the first place). She got on famously with all of the shower guests and when asked to give an impromptu speech, did so with such elegance and poise, everyone was moved. Her words brought me to tears. She has been with us through this entire horrid journey of infertility (we’ve been at previous posts together) and it was breathtaking to hear her put her thoughts into words. Later that night, my mom offered to stay with baby girl so I could go have a bit of time with BFF. We went to dinner and had a fabulous time. It was the first opportunity we’d had to openly talk since everything happened in Belarus. The following day we met up again for lattes, my mom took us to lunch, and it was time to say goodbye. It was just so great to see her and she was awesome about doing everything around my pumping, nursing, crazy new mom schedule. C, thanks so much!

There were plenty of not so enjoyable events and situations, but this is long enough, and it’s always better to end on a positive note, so… more later.

Monday, May 9, 2011

The blog wouldn't be complete without an update on Guinness and Bella

Guinness has proven to be a FABULOUS big brother. We are so proud. My husband thought we would have major jealousy issues since Guinness is such a “mama’s boy”, in his words, always snuggling on my lap and wanting attention. Within a day of being back in Ireland with the baby, I was in the bathroom brushing my teeth, when Guinness appeared out of nowhere, meowing as if the house were on fire. I turned the water off and heard baby girl crying. I went to get her, Guinness right on my heels, meowing all the way. He’s very protective of her. When she was 4ish months and moved into her nursery, Guinness slept right outside the door. I always have the baby monitor with me, but if I’m a second late in responding to the baby, Guinness comes to find me, meow, meow, meow.

I’m very sad to say, Guinness has been having a few episodes lately. He’s at the point that he knows to settle down and rest when it happens. The episodes are usually brought on by over-exertion (chasing Bella).

Bella is, Bella. She’s small and sassy. When the baby was little, Bella would crawl up on her while she was eating. Now that the baby is bigger and more active, there have been a few incidents of ear and fur pulling, and a chomped tail, but Bella has proven to be patient and comes back for more.Hopefully she will soon develop the healthy fear of the baby that Guinness has.

Their reaction when I came home from the airport with the baby.

Guinness helping me shop for baby girl

Bella making herself comfortable in the bouncy seat (hey, it's not like the baby ever used it)

Bella making herself comfortable in the stroller

Bella doing tummy time. Notice a pattern here?

Checking out the new big girl car seat!

Guinness jumped in, and was a little worried about getting back out before I put the baby down. Though it's fair to say, Guinness was probably in it longer than the baby has been.

All in all, the adjustment for the cats has been beautiful. They've done very well.

Sunday, May 8, 2011

Finally!

She is finally here, we are finally home and I am finally updating the blog.

I apologize in advance; I will not be posting pictures of my baby girl on this blog. I know that a lot of people are comfortable posting pictures of their kids, their names, birthdates, etc, on public blogs, I am not.

Since I do think that blogging is a great way to keep friends and family updated, and to record events, I will be starting a new blog, in addition to updating this blog more frequently. The only difference is that the new blog will be private and I will post pictures there. This blog will be primarily Foreign Service and infertility focused, with "some" baby posts.

If you would like to see the new blog, stay tuned. As soon as I start it, I’ll provide information regarding how to get access. I’m not trying to keep anyone out; I just want to have some level of control over who has access to the pictures. Therefore, if you are a friend, relative, fellow FS blogger, fellow IF blogger, belong to a message board I’ve posted on, etc, you are welcome to join the new blog. I will be posting many of the same things on this blog, just sans names and pics.

Now that that’s out of the way….

Where have I been, and what have I been doing?

I had a baby. Need I say more?

No really, it’s been busy, and as with EVERYTHING else in my life, nothing happened when or how it was supposed to, which in turn affected EVERYTHING else and of course, my plans. Did I mention that I’m a Type A, planner, list-maker extraordinaire? So yes, things have been a bit nuts.

Just to give you an idea of the last 11ish months. It can be summed up with Biophysical Profiles and non-stress tests every two days. Very fast, UNMEDICATED birth. Late Pre-Term Baby. Jaundice. Paperwork for the Powers That Be. Lactation Consultant appointments every 2-3 days. A baby that couldn’t suck, swallow, and breathe, Medical clearances. Dip passport paperwork. Numerous trips to the pediatrician. Reflux. Visitors. Post partum appointments. More paperwork. Did I mention paperwork? Baby showers. Researching countries, because oh, did I mention we also had to bid last fall? Now you FS types know why I haven’t been around ;) A family reunion. No layette shipment (after being told we would have one, and shopping for it). A domestic and international flight alone with an infant. Returning to a house I’d lived in 12 days before leaving for several months. Plumbing and electrical problems. Finding a pediatrician in Ireland. A baby who doesn’t believe in naps. Oh, then my husband was promoted, hooray, but out goes the bid list. More research on possible posts. Bidding. More paperwork. Visitors. The Dublin Snowpocalypse of 2010. No heat. Too much snow. A baby that refused to be set down. More paperwork. Medical appointments. Reflux med changes. Laptop meets ice water. Goodbye laptop. Starting over on a new laptop. Sorting over 10,000 pictures, no joke. More paperwork. Oh I’m SOOOOOO tired of paperwork. Whew.

I will post a birth story in the next few days. As I said, nothing happened the way it was supposed to. Baby girl came early and fast; my scheduled c-section went right out the window, as did the last few weeks of alone time I thought I would have to finish last minute things….

If anyone is actually still reading, I promise, promise, promise to post more frequently. We pack-out this summer, which always provides great blog material. We also have those two little embryos on ice, so more about that, very soon.

Hope you are all well!

Happy Mother’s Day!

Mother’s Day seemed like an appropriate time to make my comeback to the land of blogging. So, ta-da! Cats with Passports is back!

Happy Mother’s Day to all of the moms out there. Huge hugs to all of the women still suffering, and fighting, infertility. You are never far from my mind. Wherever you are, do something kind for yourself today.