Not a political post per se, but in defense of Tim Walz
Infertility is hard enough without the GOP getting involved, bro
Helllloooo substackers! I am Courtney. I am new to Substack. I do not know what I am doing. I do know I have a lot of things to say about certain parts of my life, that were brought fully top of mind by VP nominee Tim Walz a few days ago. Mr. Walz mentioned that he and his wife used IVF to conceive, and then the NYT wrote a long, circuitous piece about how they didn’t use IVF, but they instead used IUI.
Of course there were some ghoulish comments about how this made him a terrible liar, etc. Well. Technically, it wasn’t the full truth. More importantly, however, is the fact that IUI is basically the step that’s used before you go to IVF. It’s not as well-known a process, and why should he have to go through the explanation in the first place? It doesn’t change the fact that the GOP is kneecapping access to reproductive rights AND reproductive assistance as hard as they can right now. A person would more than likely receive IUI at the same clinic as they would IVF. And it’s a slippery slope after all, isn’t it. Why wouldn’t they come for IUI next?
All this to say I wrote something two years ago that documented my “infertility journey”. Sarcastic quotation marks because I don’t want to call it that. It was more like a “navigating a series of doctors and practices until I was finally able to receive the health care I knew I needed”. I have been too chickenshit to share it anywhere and also I subsequently had a baby, so I then became a combo of too chickenshit and too busy to share it anywhere. And forgetful! Becoming a parent is essentially like playing the world’s hardest memory game.
ANYWAY! Please read on to learn more about this. I will add that it is a long read, and definitely not my best writing, but I felt it needed to be shared. I went through a lot to get pregnant and deliver a healthy baby. If my words can help someone who is going through (or possibly about to go through) something similar, then I am glad.
If not, consider this a long vent session. Here is a picture of my baby as a page break, and also to help gas you up for this read.
I found out I was pregnant on Mother’s Day 2022, which also happened to be my 13th wedding anniversary.
James (my husband, with whom I share the aforementioned anniversary) and I had wanted this for a while, and it obviously was not a straightforward path to get here. For example: he and I both required surgical intervention to improve our chances to conceive. His surgery was on March 11th, 2020. Ruminate on that date, will you?
So, the timing wasn’t great! In addition, I had been fighting my own four (plus) year battle in trying to receive a diagnosis that wasn’t:
Dysmenorrhea
Running too much
Being “really in tune” with my body
A “really small” kidney stone
and
*shrug*
In 2018 I started visiting doctors in earnest to figure out what was going on with me. I had painful periods and obviously had not gotten pregnant yet, despite a few years of very casual trying and a couple years of more determined trying. And while having a baby was always part of the plan, I wanted a definitive diagnosis and treatment for my pain, which I suspected was from endometriosis.
A fun aside: endo cannot be diagnosed without a surgical procedure to confirm it is there! Great!
So, I began with my PCP, then went to a new obgyn (the “running too much” diagnosis came from an obgyn I stopped seeing, I’m sure you can figure out why), then an on-call doctor when I wasn’t feeling well one weekend (the kidney stone diagnosis, also incorrect) and had two different kinds of ultrasounds from a specialist, and was given the all clear, health-wise. Please remember this part of the story, it will come up later!
Then it was James’ turn. He saw a fertility specialist, which eventually led to his surgery with the incredibly poorly timed date. Just want to add that he did not have to jump through several hoops to make this happen. It was a much easier process for him.
Oops! Then the pandemic hit! So everything got put on hold until 2021, and I contacted a fertility clinic. I chose this clinic in particular because they employ a surgeon who is known to be the best in my region for endometriosis lap surgeries. Nine weeks and SIXTEEN forms later I had my telehealth intake appointment.
Right out of the gate, within maybe 20 seconds of introductions, I was told IVF would be my best hope at having a baby and wouldn’t ya know it? Pregnancy is a great treatment for endo! Cool, so the plan is to put me through an incredibly difficult and painful process to knock me up, then I have a baby, and then the endo comes back and I have an infant to care for? Pass.
This was not what the doctor wanted to hear, because I was a decrepit 39 year old with a uterus full of bats and spiders. She never did fail to remind me, sometimes more than once, at every appointment (all telemedicine, never met her in the flesh) how 39 years old I was. She also enjoyed showing me James’ test results after his surgery and telling me how they weren’t that bad, so this couldn’t possibly be his fault. Yes. I wanted to flip a table.
I stuck to my guns and insisted that I wanted to treat the endo first, and try to get pregnant second. This is going to sound ridiculous, but deep down I felt like I knew that if we solved the root cause of my problem, that we could probably conceive without IVF or IUI. I had to trust myself first and push back on the doctor’s insistence that we should go right to IVF. It was difficult, but ultimately proved to be the right decision. It can feel impossible to tell a doctor that you know what’s best, but sometimes you have to do it!
After the intake, it was time to start The Series of Appointments (*royal fanfare*)!!! First of all, despite the bad first impression with my doctor (who, really, only met with me a few times via zoom and ordered all the actual work and tests the rest of the team did, while constantly reminding me that I was basically the oldest woman to ever want to have a baby), everyone I dealt with directly at the office was WONDERFUL. Caring, compassionate, laughed at my jokes (this is important), and they LISTENED and UNDERSTOOD when I talked to them.
I went through all the usual groundwork: pelvic exam, pap smear, ultrasound (PS, the nurse counted my eggs during the u/s and I have plenty of good eggs, so again, score one for me and my bat-free reproductive system), and bloodwork. OH the bloodwork. SO much bloodwork. I am not scared of needles, they really don’t bother me too much, so normally getting stuck up like a human pincushion would not be a big deal. However, I have what some medical professionals refer to as “crappy little veins”.
Allow me to elaborate. The phlebotomist looks for a vein. The phlebotomist can’t find a vein. The phlebotomist calls over another phlebotomist to look for a vein. One of them puts a warm pack on my arm to wake up my crappy little veins, which are hiding deep inside of me, scared of being drained of their precious life force. Sometimes a third phlebotomist comes over. I’m the Where’s Waldo of veins. Eventually one of them finds a vein! O happy day! I get the needle stick. No blood comes out. Repeat process!
First of all, I do want to say thank you to every last phlebotomist at the clinic. They were patient and kind and taught me that the “good” vein in the left arm kind of swerves off to the side a little bit. This proved exceedingly helpful sometimes! Sometimes they got it in one! Most times, though, it took at least two sticks, two arms, and two phlebotomists to secure the vials. One time they had to get the boss phlebotomist and she had to use a vein in my hand! I thought this would be a lot worse that it was, turns out it was fine.
The bloodwork was to measure all sorts of things. Vitamin D levels, hormone levels, and some other things I do not remember. After one particularly long and pokey bloodwork session, I was asked to come back ~12 hours later because my estrogen levels “weren’t where they should be”. Another important note here is that most of my bloodwork had to coincide with where I was in my cycle. If you missed the window, you had to wait till the next cycle.
However, being of a curious mind, and not wanting to drive another 40 minute round trip to give away more of my blood, I proceeded to contact my patient care coordinator (repeatedly) to ask why it had to be so soon, and if I should be concerned, and if I could see those lab results, along with the rest of my lab results. I finally got some answers… after my husband called and asked all the questions I had been asking for the previous two days. He was accommodated like I had never been!
I learned this piece of advice from my sister-in-law, a nurse and a new mom herself. If you’re not getting the answers you need, have your husband call. I realize this works a lot better in a cishet couple and therefore is not an option for everyone, but if you can get a white man to intervene when you’re having trouble getting answers from a medical professional, it seems to work really well. (For more information on this topic, you should check out this excellent episode of Last Week Tonight: Bias In Medicine: Last Week Tonight with John Oliver (HBO))
In addition to all these medical procedures that I had at least some passing familiarity with, I also had to have a hysterosaplingography, or a sono HSG, if you’re into the whole brevity thing.
“Courtney, what happens during an HSG???” you might be asking. Well, even if you aren’t asking (In which case, why are you reading this???! Go watch a movie, The Batman is on HBO Max and it’s pretty good! Colin Farrell is The Penguin!), I am going to tell you. An HSG is a procedure where saline is injected into your uterus to show the doctor the inner shape and detailed condition of your uterus (in my case, I thought it looked like a cave, this is not another plug for The Batman, but if you don’t wanna hear about my cervix I would implore you to stop reading now and go watch The Batman instead), and to ensure your fallopian tubes are not blocked.
Naturally, before I had the HSG, I researched it and watched a few youtube videos of young women dealing with infertility sitting in pristine white rooms talking about their experience, how it felt, what it was like. They said there was a lot of pressure, but it wasn’t too bad. They said you could drive yourself home afterward. They said it felt like bad cramps. In summary, they fed me a line of bullshit. (Ok, maybe they didn’t, but I am not here to put a brave face on the parts of this that were straight up awful, I am here to tell you the truth.)
For starters, in addition to crappy little veins, I also have a crappy little cervix. The cervix is, for lack of a better description, the main entrance to the uterus. To do an HSG, a tiny tube is inserted into your cervix. My cervix was too small for that tube. And it was too small for the next smallest tube, and the next smallest tube after that. The tube that worked? A tube used for lacrimal glands, aka the miniscule gland found in your eyelid that makes tears.
So I had to lay on the table for what felt like an eternity before they could even gain access to the uterus. I have a Secret Service cervix. Then, finally, they got through, and they pumped it full of saline, or so they said. From what I felt, they put a claymore mine up there and then detonated it. It seemed like an eternity, but was probably only like one minute, tops. Listen, if you have to get this done, it hurts. Take ibuprofen beforehand. Bring someone with you. Be prepared to spend the rest of the day on the couch or in bed, preferably with a heating pad. If you’ve had an IUD inserted before, I’ve heard it’s pretty similar to that. Tell your friends with a cervix that they’re strong and cool, do it now, I’ll wait.
The result of the HSG was a mixed bag (Kind of like my uterus! Hey! I’m here all week, please tip your servers). My fallopian tubes were clear (good!), but I had a uterine polyp (bad!). Please note that at this point I’d had two separate ultrasounds that were unable to detect the polyp. Uterine polyps, according to my doctor, are not painful, and some people have them for years and don’t even know (I probably fall into this category). And how could they know? You have to get an HSG to find the damn thing!
Weirdly, the polyp was kind of a blessing, because it meant surgery either way, and I didn’t have to have ANOTHER discussion with my doctor about how I do not want to go straight to IVF. The polyp could have been preventing me from getting pregnant, and as such, it had to go. While the surgeon was in there, why shouldn’t she also take a look around for endo?
I scheduled the surgery and waited 3 excruciating months until the date. Excruciating for two reasons: one, I hadn’t had surgery since a tonsillectomy at age 7, after which I had a violent reaction to the anesthesia and puked for what felt like 500 hours, really excellent turn of events after THROAT SURGERY, so my anxiety level was not great; and two, I had to take a completely vile medication that is essentially one of the only medications on the market made specifically to treat endo.
I had to take that medication for 12 weeks. It was horrible. It made me nauseated, hot, sweaty, and moody. I woke up drenched in sweat most nights. I was counting down the days until I didn’t have to take it anymore. It did not do much to help with my symptoms. Zero stars, ten thumbs down. I could write an additional essay about the trials of dealing with getting these meds from Walgreens, but we’ll save that for another day.
The surgery came and went, and overall, it was pretty uneventful. The surgical team was listening to Earth Wind and Fire’s “September” in the OR. I was so scared that I couldn’t stop shaking (this may also have to do with the fact that the temperature in the room was approximately 37 degrees). One of the OR nurses stood next to me and held my hand to help calm me. Someone give her a medal! The anesthetist is possibly a wizard, because whatever she gave me knocked me out cold and I had no nausea or vomiting afterwards. My surgeon was caring and thorough and said I have stage II endo. She removed what she could and separated some adhesions, aka body parts sticking together (!!), that I had. Adhesions are common with endo, another fun fact for you.. Oh, and the polyp was benign, yay! It took about a week after the surgery before I was back to my usual self.
After the surgery were a couple more appointments explaining how IUI works, what I’d have to do to prepare (more meds! noooo!), etc. Let’s just say I was not looking forward to attending more appointments, getting more blood drawn, taking more medications, etc.
However, we were incredibly lucky to have bypassed all that with a vacation to Florida! I’ll let you, the intelligent reader, figure that one out.
Anyway, this is all to say that infertility is common, I’m not special or different or suffering any differently than other people who have been or are or will be infertile, but damn, we should say how difficult it is! The narrative has always been that we should feel blessed and lucky and not complain that we have these treatments and care, but I say screw the narrative. Talk about how hard it is! Your experiences and willingness to share them might help someone, you never know.
Be honest about how you’re feeling, and what you want or need. Don’t be afraid to stand up for yourself and ask for help if you need it. This is not an easy journey and you shouldn’t have to hide that pure and simple fact. For me, even getting to the point of pregnancy was a years-long quest that shouldn’t have been so difficult. Then I had to be pregnant and deliver a baby! Another story for another time. I will add a note to say that if you think your epidural isn’t working, repeat that fact to whomever will listen, loudly and often.
I don’t know when this summary of my experience turned into advice, but here we are. I hope you had fun reading it, and if you didn’t, don’t say I didn’t warn you to quit and watch The Batman instead.
Thanks for stopping by,
Courtney