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April 2004

In Which I Contemplate My Feet

Although you wouldn't know it from the past few months, I am not generally an acquisitive sort of a person. I don't like shopping for clothes or shoes or gimcracks and when I am forced to do so I am a big fan of places like TJ Maxx and Target. Unless it is a wedge of cheese or a bottle of wine I hate spending more than $10 on anything. OK, the new necklace clearly does not count as it is... you know, forever, and how else can two months salary last forever and why shouldn't he show me he would marry me all over again and I was already using my right hand as my voice and if you have yet to recognize the fact that I am repeating the diamond industry's brilliant marketing campaigns (truly) this is going nowhere. Anyway, I like it.

Two days ago I bought a shirt for $2.98 that looked just fine after I spent a few hours with cuticle scissors and a needle removing the sequins and beading. It was almost my last craft project, ever, as I held the needle in my mouth as I was snipping and inadvertently stabbed myself right in the center of a canker sore I had lurking on my tongue. The pain combination was so potent I practically passed out and it was only Steve's pleading that prevented me from ending it all right then. That and the fact that I was almost done de-uglifying the shirt and I certainly did not want to be buried in anything half-covered in sequins. Yuck.

I am trying to build up to the fact that although I am about to write copiously about shoe shopping, this in no way defines me.

I keep mentioning my wide feet, partly because I am bewildered by them and partly because I find them sort of funny. How did this happen? I am a little person. Dainty, even. And yet I have hands and feet like shovels. Why? I spent my girlhood buying shoes like other people. I don't recall my mother turning away with a tissue while the shoe salesman gravely slid a sizing device ever wider. I used to be normal, I swear it. I spent high school and college in a pair of Tretorns that I would only replace when they literally fell apart. After college I started buying shoes at Payless and I do remember being pleased that they carried a lot of wide sizes because every now and then I would need to go a bit wider in the toe. The good thing about Payless is that their shoes are like $0.45 a pair. The bad thing is that they blow up after you wear them for six weeks.

After I had Patrick it became apparent that I could no longer just walk into a shoe store, even Payless, and ask if they had these in black. I could barely cram my toes through the opening before the shoe was forced to just dangle there, limply. I am the other step-sister. The W-i-d-e footed one.

Enter Zappos. I love Zappos. They are an online shoe store and they epitomize everything an Internet retailer should be. Huge selection. Low prices. Phenomenal search engine. Free shipping and free return shipping. AND for the past few orders I placed they shipped the shoes overnight. For free. Just because. Sigh. I big heart Zappos.

Steve needed some new running shoes this week so I ordered them for him and got a couple of things for myself too. They arrived yesterday and despite the fact that I have finally resigned myself to being an E (a wide wide, or possibly a wide wide wide) two of the three pairs felt like my bones were being broken in them. Gr-e-e-at. I have gone from freakishly wide to... god only knows. Elephantine. I've graduated from what Steve obnoxiously calls my shuu-muus to donning tied burlap sacks like the Clydesdales wear.

Utterly despondent, I forced myself to go to an actual shoe store yesterday afternoon. I selected an establishment that seems to cater to the disabled and the elderly. We got along fine. After trying to cram my foot into a little number in size 6.5 ww, the saleslady suggested we measure my feet to figure out what we are dealing with. It turns out I am actually a 7.5w, still wide of course but closer to average. Did you know that your feet can keep growing as an adult? Doesn't that seem like a complete waste of bodily resources? I hate to think that all of the calcium I consumed in an effort to avoid osteoporosis was misallocated to support a foot-growth initiative that no one wanted. I feel like a Tyco stockholder.

So this is my two-part public service announcement: if you wear shoes, try Zappos; and if you are having trouble wearing shoes get your feet measured.

That is all.

Pop Up

Patrick and I spent large chunks of the afternoon fooling around with the camera. This is the only picture in which he is not trying to rip an ear off my head. Not because he is malicious, mind you, just to see if he can. Patrick is at the height of an experimental phase (I hope it is the height) and we are all his lab rats.

At some point this evening I realized that we had completely forgotten about daylight savings and the little crumbcake was about to go to bed at NINE-THIRTY. This is very very late around here. Not for me, since I am more bat than human what with the insomnia and the drinking, but everybody shorter than me is supposed to be firmly ensconced with a teddy by 8 at the absolute latest.

Daylight savings sucks ass.

Did I ever tell you about the time Steve and I went to a New Year's Eve party in Indianapolis? We drove from Chicago and got a rather late start but still managed to squeak in before 11. It was sort of disconcerting to find the entire party clutching champagne glasses and clustering around the television waiting for the ball to drop in Times Square. Our hostess, frostily, observed that we had made it "just in time." Just in time to watch New Yorkers kiss each other? Who cares? This was the Central Time Zone and we had a good hour of drinking ahead of us. Or SO WE THOUGHT.

As everyone left the party a few minutes later we learned that Indiana sticks to God's Time. They don't DO daylight savings. What the hell? It's like saying you don't believe in goats.

And A Few Remaining Pieces

But how did you FEEL about the scuba magazines, Julia?

All right, fair enough. I should probably write a bit more about the RE visit. It felt like a non-event, frankly, but I suppose it was productive. I went in knowing that there is really nothing we can do to improve our odds and lo! There is really nothing we can do to improve our odds. However, the genetic testing will give us a bit more information, nudge us slightly towards or away from future IVF. The research article, for those of you who opted not to read it (for shame- oh? you tried to click on the article but it just took you to a message board because I screwed up the link? sorry, I fixed that) concluded that IVF success rates are miniscule when the percentage of genetically abnormal sperm is greater than 65%. So although the RE said that we had a 1 in 4 chance of a healthy pregnancy with IVF that was more anecdotal than anything. If the testing shows that Steve is 70%-80% abnormal our likelihood of having a pregnancy result from IVF is much lower.

On Monday I will call the RE's office and find out what we are supposed to do for the test and when. I will also get them started on getting a referral written for it. I am anticipating that everyone involved will be thoroughly confused by the fact that they cover basic sperm testing but sperm fluorescent in situ hybridization with specific one and four chromosome probes? Not so much. I look forward to the ensuing conversations and assume that it will be a few weeks before either the insurance company says OK or I have to write a check for it.

On Monday I will also call my OB and talk about scheduling something to rule out any lingering uterine scar tissue. My RE referral was just for a consultation, so for now any more or less routine gynecological matters will be handled by my current OB/Gyn. I like him and am quite comfortable with his ability to identify any problems. Speaking of liking people I guess I would give the RE a 7 on a scale of 1 to 10. I was very impressed by the fact that he accepted my article and agreed to act upon it. I was even more impressed when he spoke to his colleague about it immediately and called at 7 am the next day. I do not know if I will end up doing very much with this guy, but I think I could. He seemed fairly smart and I like smart. He also was not remotely sympathetic and I liked that too. I have people to stroke my hair and buy me presents; my physician just needs to know his way around Rome.

Steve and I talked about it and we have come up with the following plan. Once I am done selfishly indulging my every little whim (July maybe, or September) we will try one more time to conceive a child by frivolously having sex. It will be “fun.” If this results in pregnancy but ends in another miscarriage then we will look at the results of the genetic testing. If Steve falls somewhere below that 65th percentile we will try an IVF cycle. If he is above that... well... we do not know. See how we feel I suppose.

I like this plan. I am not quite ready to miscarry again right now but I think I will be in a few months. In the meantime I am wearing my new necklace with pajamas and leaving next Saturday for another trip to San Francisco. As I said, I have a few more months of heart-stopping selfishness to get through first.

The News That Done Broke

As advertised, Steve and I went to see the reproductive endocrinologist yesterday.

I started to write up all of the details last night but bored myself into a heavy slumber. I only awoke when my face smashed down on the keyboard, leaving me with two black eyes and a thirst for fortified gin. Everything after that is a dim memory.

The RE's office had an impressive collection of scuba-related reading material and six chairs in the waiting area. The place was deserted. The chairs were arranged in sets of two and were so close together that, had there been another couple present, we all would have been touching knees. It was setup for a prayer circle, maybe, or a rugby scrum.

We met with the nurse first and she reviewed the medical history form I had filled out. It was tedious. She read over my list of pregnancies and said that we had been through a lot. I said, "Yeah, I guess" and looked out the window. I felt quite remote, like we were just pretending to be infertile in order to come back and rob the place later (Ask Me About FOLLISTIM LUPRON Name-Brand Drugs Rock-Bottom Pricing.) She repeated my answers to each line with an upwards inflection and I said "Yep" to indicate that I had not been dishonest when I filled that form out two weeks ago.

What? Gall bladder surgery in 1997? Did I say that? Well, that was a fucking lie, sorry.

Eventually, mercifully, we were released to the RE and he cut right to the bone of the matter.

"You are in a unique situation," he started. "Unique, but not rare."

Steve and I quirked an eyebrow apiece (two eyebrows in total) and let it pass.

"You have three options."

Steve leaned forward; I leaned back.

"One: Keep trying on your own. There is no technology we can insert into the process that will increase your odds of a healthy pregnancy.

Two: Try IVF with PGD. IVF is (blah blah.) PGD is (yeah yeah.) The problem is that your odds of success are worse than they should be. For reasons as yet unknown, balanced translocation carriers not only produce unbalanced rearrangements they also produce a disproportionately high number of embryos with other genetic anomalies. A couple in your age range has about a 50% success rate with IVF. For you I would halve that. Say 1 in 4.

Three: Donor sperm."

Clear? Clear. As I see it, we have a better chance each cycle of producing a healthy baby via the traditional "Slammin' the Wall" method than through IVF. The probability of producing a genetically normal embryo is identical. MORE genetically normal embryos might be produced with IVF but the advantage of that would be offset by any of the non-genetic factors that can cause an IVF cycle to go awry. Do you see what I am saying? If conception occurs then an egg will either have been fertilized with a genetically normal sperm or a genetically abnormal sperm. The cells will then divide properly or improperly. IVF under these circumstances just adds additional risks of either not getting to a point of conception at all (a canceled cycle) or having the created embryos deteriorate as they await genetic testing. At least that's my thinking. Bear in mind I am just an English major. And, of course, the miscarriage rate is much higher for our natural pregnancies than it would be for an artistically staged one. We knew this already.

After he presented our options, I told him we wanted to have Steve's sperm tested to determine what percentage of abnormal gametes we are dealing with. He did not understand, I must have phrased it poorly, so we tangoed around his small office knocking over pictures and lamps until I shamefully pulled out this research article I had hidden in my handbag. I was hoping it would not have to come to that, but once I drew his attention to the table on page 6 things improved dramatically. "OH!" he said "OH! How interesting! I am surprised I missed this article." Yeah, well, we cannot ALL be on top of the latest research in reproductive endocrinology, don't feel bad.

He said he would talk to his cytogeneticist the following morning and get that guy's thoughts. Either they could do this or they would find someone who could. Okey-dokey. Mission accomplished.

He left a message this morning saying that they could perform the test here, and that the genetics guy thought it was a terrific idea. Steve emailed me this information after deleting the voicemail. I said, great, but what exactly are we supposed to do? Who do we call? Who can help me work this through the insurance company? Where do we take your sperm and in what container (a horseradish jar? a Dixie cup?) and when? Details, I know, but someone needs to think of these things.

And yes, Steve often communicates with me via email despite the fact that he is within shouting distance ALL THE TIME. Freak. Oh, maybe that was hurtful, you know, since he is an actual freak. I should email him about that.