schizoaffective disorder, part III & recovery

PART THREE

A manic break, like I had in my first year of college, is what separates bipolar I from bipolar II. Bipolar II patients have hypomanic episodes in which one may experience elevated mood symptoms without quite the level of impairment that a full-blown mania imparts. I knew something significant had happened to me, I knew I had lost my fucking mind — possibly tipped off by other students, the school counselor had been after me, but I managed through dumb luck to evade her. I was definitely impaired enough to warrant hospitalization, even involuntary commitment, but by the time the men in white coats came for me I had crashed. A Tylenol overdose is serious, and I had waited three days to inform anyone I had done it, thus damaging my liver and landing me on the transplant list. After three days, I figured that I wasn’t going to die and I had started vomiting. Since our dorm had one community bathroom it seemed I couldn’t go unnoticed for too long, and I called 911.

Depression can distort your thinking, and I was hearing my voices ordering me to kill myself and was convinced my dormmates were plotting to kill me as well. I was absolutely terrifying. I had no toehold in reality; I was fully psychotic with both auditory and visual hallucinations and suffering paranoid delusions, and and my actions made complete sense to me at the time. I felt like I was nothing but a lunatic who would do nothing in life but drain the planet’s resources, and that everyone I loved secretly was hoping I’d die as well. Remember that when you accuse the suicidal or suicide victims of weakness, selfishness, and stupidity — I’ve been called all of the above and more from the moment the ambulances arrived, and I feel that’s it’s fucked up to make judgment on anyone’s character when their illnesses actually set these thought processes in motion.

Moving to Olympia was, in retrospect, a very bad idea. As I was misdiagnosed by my own designs — I was not honest with the stream of mental health professionals that suddenly appeared in my life and they missed out on seeing me at all manic. I never fessed up to my psychotic symptoms because they terrified me and I thought I’d be forever institutionalized. I was beginning to see my psychosis for what it was — an aberration, not part if the “normal” experience my friends were having. It was like putting on those purple glasses.

I wrote a lot about depression when I got to Oly because I was mired in it. I immediately realized my Pamelor was mucking me up even worse, keeping me crazier than I’d been without it and it made me extremely irritable, which was hard to live with due to the problems it caused in my relationships and friendships. Walls were punched, drinking glasses shattered. Antidepressants tend to push bipolar patients into mania and it got pretty scary in my head. I decided the pharmaceutical industry was a scam, discontinued it without telling anyone, and became a nice safe depressive again.

I didn’t know how the health care system in our country worked at all. I didn’t think I could get help without my parents knowing about it, and they were already skeevy about my transfer to The Evergreen State College but didn’t know what else to do with me. I remained depressed and suicidal during my time there, but for whatever reason my psychotic symptoms were manageable again. I did a horrible job making friends, because deep down I knew something was desperately wrong with me and that opened a chasm between me and the rest of the student population at Evergreen. Isolation is a huge problem for all those with mental illness, but it tends to be insurmountable as a psychotic. I sludged through a couple of very dark years before finding a general practioner to prescribe the antidepressant Celexa. And I started to feel better. A lot better.

I returned to the general practitioner a couple months later. I had developed an issue in which I was getting recurrent UTIs with no symptoms, and these would eventually spread to my kidneys, so I was frequently in the ER and then in the hospital. My doctor prescribed a prophylactic dose of the antibiotic Macrobid, and told me to take it every time I had intercourse. Since I was wildly hypersexual at the time, I cheekily asked him what’s the most I can take in a single day? He looked very alarmed.

“Has anyone ever told you that you are bipolar?” he asked with panic in his eyes, desperately scanning the pages in my chart (I’m old enough, this was before they had computers). I laughed hysterically, and he switched my Celexa to Wellbutrin. Again, antidepressants will push a bipolar person into mania, and I knew I was crazy again but he eventually said it was just the meds and it would go away with the switch in antidepressants.

And then I got a job as a phone sex operator at a fetish line…

Suddenly, I was having the time of my life. I got to talk to people that were into way crazier shit than I ever imagined. I covered the overnight shift, and stopped sleeping again. I was incredibly successful, as I am with most things I try (save for having a baby, but I’m putting that on the back burner right now). I went off my Wellbutrin and onto Paxil and my mood went from elevated to euphoric to completely grandiose, and in the business of being a phone dominatrix these qualities will serve you well. I somehow got promoted to manager, but my phone calls were racking in so much money for the company I still mostly spent most of my time on calls. When I wasn’t on calls, I was shopping, buying thousands of dollars worth of fetish wear and ridiculous things, like a $75 keychain.

One day, I was speaking to a regular client of mine who was a psychiatrist. Since I was so grandiose and an ardent feminist, I usually refused calls that cast me in a submissive role, but this poor dude was tormented. I’d walk him through horribly sadistic and misogynistic fantasies, and afterwards he would cry and apologize over and over for hurting me. One day, he started asking me a lot of questions and told me he suspected I was schizophrenic or bipolar because I answered very honestly (I prided myself on being completely honest with my clients). He begged me to talk to a doctor, and then apologized even more for traumatizing me. And just then it hit me that I needed serious help.

I might add, becoming a phone sex operator and subsequently a fetish model, was completely out of character for me, a former honor student. And it got worse. I started abusing drugs and alcohol, favoring the euphoria of cocaine and oxycontin, which I would crush up and snort (you can’t do that any more, they’ve added some sort of coagulent so it won’t go up your nose). I met a guy I thought was wonderful, a bipolar man who moved me out of my phone sex job (I actually had been living in my office) and provided all sorts of pharmaceutical enjoyment. He was most likely still married, despite claiming he was divorced. Since I mistook being manic and high for love, I decided I needed to get psychiatric help, since I didn’t want to fuck our relationship up like I usually did with boys. I’d also quit my job in a very dramatic fashion, and was unemployed. I was twenty-two years old.

The drinking and drugging made me very anxious, and very psychotic. I began having daily panic attacks, and couldn’t distinguish my hallucinations from reality anymore. I began having ideas of reference, which continue to this day — these are delusions in which you think every little thing in the universe pertains to you. It’s hard to describe. I go outside, and see a leaf twitch. This appears to signal a man to come around the corner, watching me. His appearance causes a car to drive by slowly and when it passes the driver signals a bush to shake in the wind, and in response a woman exits the building across the street. The whole experience is reminiscent of paranoia, and often will turn into full-fledged paranoid delusions.

The police become a regular fixture in my life. I am often picked up on the street and dragged to the Crisis Clinic in handcuffs, or else I am screaming in my apartment and the neighbors call the police and off I go on another ambulance, or, they manage to deescalate me and life goes on. The police here are well trained in dealing with the mentally ill, and I retain a pristine criminal record and am never brought to jail. Being a small Asian girl with a middle class upbringing, I am lucky in this regard.

My mom starts visiting regularly. I frighten her, one day finding myself unable to stop walking in circles for hours, the next by being unable to move and listening to Leonard Cohen’s Songs from a Room on repeat while screaming that I wanted to die — both these episodes required a visit from the CDMHP (County Designated Mental Health Provider, a woman in charge of evaluating whether or not a person needs to be involuntarily committed). I spend time in the hospital, while my mom sits hopelessly alone in my apartment, as I’m only allowed visitors for an hour a day. She bonds with my cat and ate at Taco Bell (she didn’t know where else to eat as the city was unfamiliar to her).

I am diagnosed with bipolar disorder and given meds. I have freaky reactions to a lot of them, and my new cocktail of pills messes me up even further. I try everything. I admit to my doctor that I hear voices, all the while taking illegal drugs. By now, my boyfriend has left me and I’ve become terrified to leave my house. I stop using coke and oxy, and start taking ridiculous amounts of benzodiazepines, obtaining them dishonestly through my new provider at the low income clinic and buying them on the streets. I continue drinking. Eventually, I am granted disability through Social Security for a diagnosis of bipolar I. The disability determination psychiatrist says schizophrenia would have to be ruled out. I often awaken in four point restraints in the ER, I am hospitalized a couple times.

And then I am prescribed the antipsychotic Geodon…

RECOVERY

Despite the major addictions to booze and pills, I start feeling a tiny bit better. The Geodon works fast. I had tried Zyprexa (it made me so confused my boyfriend caught me trying to pee in the trashcan — I really thought it was the toilet), Risperdal and Seroquel both turned me into a zombie and I would fall asleep anywhere — my boyfriend was continually carrying me home from various locales, after being unable to wake me. Within hours of taking my first dose of Geodon I felt sharper, unlike the other pills that seemed to work by dulling all my senses. The psychosis didn’t go away, but it was manageable. My moods stopped swinging, but I didn’t become super depressed. I attempt to regulate my alcohol and tranquilizer habits, but am unsuccessful. I enter a partial hospitalization program at the hospital across the street. I am still agoraphobic, but the hospital is so close to my apartment I am able to drag myself there. My Geodon dosage is increased, and increased again. I make a couple of friends.

Eventually, I am busted and it comes out that I have a dual diagnosis (this means you have both a mental illness and a substance abuse problem). I am sent to outpatient chemical dependency program, where I meet even more friends. Against all odds, I get clean and sober, throwing myself into twelve step work. My best friends from treatment are dead now, one from overdose on painkillers and one from COPD as a result of his smoking. I grieve, I meet new friends. There is a lot of grieving because addiction kills. This is still a reality in my life today. But back the…I was so so young.

My diagnosis is now in question as my care providers struggle with sorting out substance-induced symptoms from my mental illness. I now have Medicare and see my provider at the outpatient psychiatry clinic at the hospital I know so well. My new therapist (the old one was batshit nuts and would just show up at my house to meddle with my medications and bum precious cigarettes, which I could barely afford anyway) is one of the coordinators of the partial hospitalization program and sees primarily patients with diagnosed mental illness, especially psychosis. Initially, I am terrified of her but I learn to talk about things I’d never talked about before. I still experience constant auditory hallucinations, the occasional visual hallucinations and have those ideas of reference, and I’ve accepted that I always will. I’ve actually had them so long, I can’t imagine living without them. I believe that my drug use (especially stimulants) exacerbated my psychosis but there’s no fixing that now; what’s done is done. I also believe that drugs increased my panic attacks — to this day, I still experience them daily. My diagnosis now is schizoaffective, meaning I am bipolar and schizophrenic, but my schizophrenic symptoms are mild compared to other schizophrenics that I have met in recovery. Medication and regular talk therapy have allowed me to retain a good deal of functionality. I am still on disability, but have not had a major mood episode since starting Geodon until recently, when I realized losing four babies had sunk me into depression.

This probably all seems looney tunes to you guys. Sometimes, I cannot believe this is my life — I fucking am psychotic? Wtf? Sometimes I feel more comfortable conversing with the guy on the corner screaming that Mr. Rainier is going to blow up on Wednesday than the average college educated middle class lady who likes the same bands as me and shares my interests in literature and film. I definitely live life differently than I ever expected to, and there is a lot of grief in contemplating what this illness has robbed me of — a satisfying career, solid lifetime friendships, and now a family of my own. But I’m not alone. I have Geoff, and although I may occasionally accuse him of wanting to kill me, he good-naturedly takes care of me on the bad days and is here to celebrate the good ones. Life with a psychotic disorder is not the end of the world. My life is hard, but it certainly is worth living.

Today, I have to take care of myself. I deal with my symptoms by carefully structuring my day. For example, I have to go to bed relatively early at the same time every night. If I can’t sleep, I contact my prescriber to tweak my meds and start taking long walks in the daytime to wear myself out a little — regular sleep is vital to controlling my moods. Lack of sleep is both a cause and an effect of mania, and I have to be meticulous about my sleep schedule, no exceptions. I can’t travel too many time zones because it takes me about a month to get over jetlag.

I also need to take my medications at the same time each day. Geodon has a short half life, and you need to eat with it so it can absorb. Therefore, I must eat three meals a day at the same time every day or I start getting fuzzy around the edges.

My rigorous time scheduling can be awful inconvenient, but is essential to my wellbeing. In addition, I attend weekly psychotherapy sessions and track my moods carefully. I’m willing to do all these things in order to stay on planet Earth, even though I must sacrifice spontaneity.

I realize by posting this, I’m opening myself up to a lot of judgment from friends and strangers alike. I’m willing to take that risk because the mentally ill are getting a pretty bad rap in the press today, and I hope to be one voice out of many. So my backstory is a little seedy. I was young and sick. Despite living with a chronic illness that is really no different than any other chronic illness — well, I’m really just a normal girl that wants what everybody else wants. I live a somewhat dull life, I am clean and sober, I have never posed a threat to others, and I take medication like a diabetic takes insulin. My neurons misfire; my neurotransmitters are unbalanced just like an infertile’s hormones, to use an example part of my readership may understand. Yes, it’s a struggle, but I live an honest life now and have for over a decade. I have achieved a sort of partial remission, and although for the last three years I have been battling grief and trauma, the bottom has not yet fallen out of my mind. But I have to live like it’s always a possibility, which is a burden a lot of you wouldn’t understand. Still, I’ve learned to take care of myself. I think, even if I cannot conceive and carry the baby I want so desperately, I might end up being okay.

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schizoaffective disorder, parts I and II

PART ONE

Since I’m so done with pretending to be a fucking unicorn on infertility forums (that Scruffy, he tricks me all the time and I just need consistency), I wanted to talk about my psychiatric diagnosis and how it feels to be schizoaffective, bipolar type. A lot of people have never heard of this disorder, and it sounds rather ominous and intimidating and messy AF, what with the “schizo” prefix and all. But I’m not actually totally debilitated by my condition the way some people are, and I’m glad I get the medical, psychological, and social services to maintain a vague level of remission and normalcy — this is really just good luck for me, I don’t struggle as much as I could. I’m not homeless, like others that are beset with psychosis and although I can’t work right now, if you actually met and talked to me, you wouldn’t necessarily notice my symptoms. I might strike you as slightly odd, but honestly I don’t think that correlates with my diagnosis; that’s just me. If anything, you’d probably notice my anxiety, which may make you feel nervous as well.

A diagnosis of schizoaffective disorder pretty much means you have both a mood disorder and schizophrenia. You can be either bipolar type like me, with episodes of mania/hypomania and depression, or depressive type, with major depressive symptoms but no extreme “ups”. The illness can run very different courses for each individual patient, so it’s sort of a heterogeneous experience that can present in very different ways. Patients are often misdiagnosed with bipolar disorder or schizophrenia before it becomes clear that the two disorders are co-occuring. Schizoaffective disorder affects less than 1% of the US population.

People get wiggly and antsy about the schizo part. Schizoaffective patients suffer psychosis with their mood episodes (like many bipolar I patients have breaks with reality while manic), but also suffer psychosis in the absence of mood symptoms. Psychosis is a scary word with a lot of stigma attached to it — however, it is a medical condition like any other, requiring treatment with medication(s). I take the atypical antipsychotic Geodon/ziprasidone and it works amazingly well for me, although I still have daily psychotic symptoms (manageable) that I’ll probably always live with. Psychosis, by definition, includes hallucinations (auditory being the most common but all the senses can be affected), delusions (false beliefs that to the patient cannot be disproven), and disorganized thinking.

I’ve had mood swings and hallucinations since I was a child. In bipolar children, mood swings can be experienced as temper tantrums and I was somewhat incorrigible in that regard. My parents brought me to many therapists, but I’m old enough to say that when I was a child, childhood mental illness was not a “thing” — all the professionals I spoke with told me my problem was that I was adopted and thus fearful of abandonment. This was patently untrue; I really was never resentful of my adoptive family, I never was interested in knowing my biological family’s identity or history, and my home was safe and secure for me. This line of reasoning totally fucked with my mom, though. I’m pretty convinced she still has lingering doubts about my feelings towards her as a mother. It wasn’t really helpful for me though either, as I did not receive treatment for my actual medical problem, nor was it recognized that I had an actual medical problem with mood dysregulation.

I did not realize as a child that my hallucinations were unusual. I thought everyone had them. The first hallucination I remember was seeing a man pacing around in my room every night. I wasn’t scared; he made me feel safe. My therapist likes to romanticize my New England upbringing and claims I told her I saw Nathaniel Hawthorne in my room — I’m not that crazy, I swear!

I also have always heard at least two voices narrating my life. These voices are not “in my head”. It is not internal dialogue; I hear them through my ears, indistinguishable from a real voice but at this point I can somehow filter them out.

People probably remember me as an odd child, but I navigated life pretty well back then. I was always an honor student and had lots of friends who would perhaps remember me for my impulsivity, but not much else.

I remember the day I realized these experiences were not normal. I compare it to the time I was sent to the eye doctor in the fourth grade, as I also am severely nearsighted. I failed the eye test in a most spectacular manner. The doctor seemed angry. This child cannot see a chalkboard! he exclaimed, There is no way she can be doing well in school. I made all “A”s, and I truly felt I could see the chalkboard (I’m dating myself) just fine.

Until I put on my first pair of carefully selected purple plastic glasses, that is. Um, okay. I guess I really couldn’t see the chalkboard. Like, at all, but had somehow adapted…

PART TWO

I pretty much cruised through adolescence, but not without what would today be considered red flags. I had periods of not sleeping for weeks, followed by crashes into deep depressions. I would stay out all night, and since my sister was undergoing treatment for myelodysplastic syndrome and needing a bone marrow transplant, my mom moved into Boston to be with her at the hospital, while my dad put in fourteen hour days at his fledgling and ill-timed small business. No one noticed I was barely ever home when hypomanic, and when I was depressed I would get to school, wait until my dad went to work and then walk home to sleep all day.

My sister didn’t make it, and passed in May of 1996. I was dragged off to college kicking and screaming in August. The stress and grief were unbearable, and I went crazy. I wasn’t able to make it to my classes — I couldn’t find them, and the map of our small campus was indecipherable to me, appearing like chicken scratches on old yellowed parchment. The thought came over me that I was there for a reason, some divine purpose. I began roaming around, ranting and raving, and was unable to sleep. Oberlin College had what seemed like multitudes of dining halls, and I could never figure out which ones l was allowed to eat at with my dining plan, so I subsisted on Lucky Charms from the quaint little five-and-dime. I spent large quantities of money, somehow, in a tiny town with no retail to speak of, and somehow was under the impression that I was doing just great! My stay at Oberlin was brief. After the manic break, I sunk into the deepest depression imaginable and overdosed in Tylenol. I’ve told that story. I left college in an ambulance, and landed in the psych ward. I was extremely lucky to be alive. Tylenol is a really dangerous drug on which to overdose.

Since Oberlin was demanding I stay two years in a psychiatric facility before they would allow me to rerun, my time in the psych ward was especially terrible. Terrified that I would never be allowed out of the hospital, I did the best I could to maintain a facade of sanity. I didn’t do the greatest job; at one point another patient and I got busted for ordering food from the fanciest restaurants in Cleveland and having a courier deliver it to the looney bin (we somehow pulled this off for four nights straight before our nefarious actions were detected by the overworked staff). The other patient graciously took the fall, though. I emerged with a diagnosis of major depression with psychotic features and was sent home to my parents, who could not afford a residential program for me. I sort of rallied, though I was flying high on the tricyclic antidepressant Pamelor, an older drug (Prozac and SSRIs were new on the market and the doctors in Cleveland told me that Asian people didn’t respond to them, which I’ve never heard since and doesn’t seem to be true). I completed a day program in Salem, MA (also called partial hospitalization). In September of the next year, I said fuck all this shit and moved to Olympia.

letrozole musings + reflections on anger

It is only CD 7. My last dose of letrozole will be this evening, and maybe my last full night’s sleep until next cycle. When I woke this morning, I couldn’t remember my dreams but had the distinct feeling that some entity had appeared during the night to warn me of impending heartbreak. I feel very discouraged and rue my last conception — before my BFP, I really was ready to throw in the towel on having my own children and was moving towards acceptance, and this last pregnancy was like a kick in Scruffy’s ribs and hope returned. It’s just that I feel so fucking happy when I am pregnant, almost euphoric on hormones and I can’t stand the thought of never feeling that way again. Women far more deserving than I am end up childless; the randomness by which loss mothers are assigned this fate sends my head spinning.

Trisomy 21, trisomy 4, trisomy 13. I wonder if I’ll rack up more entries on this list of fatal maladies that have taken my babies from me. In my gut, I feel I will not, that I will never conceive again despite the Femara. I’m unsure about my five month plan…I wonder if I’m foolhardy enough to keep trying into my fourth decade.

Waiting to see if I ovulate is hell. I’m not sure if my body is going to bounce back after this last d&c as quickly as it did from my d&e termination or my other d&c or my natural miscarriage. I’m sure it would have made no difference, but I deeply regret allowing my last procedure to be performed by the on call surgeon rather than waiting for my regular OB to become available, since I actually trust her.

And, I feel somewhat okay despite being haunted and beset with doubts about my future. I’ve been moody, but nothing like my last go-around on Femara. I haven’t snapped at Geoff and stormed out of the house without my phone. I haven’t had crying jags that lasted all day, I haven’t whiled away the daytime fantasizing about suicide. Maybe the increased dose of Paxil mitigated the depression this time, or maybe next month will be horrible and this is just a cruel trick by the universe to lull me into false feelings of security. It’s crazy that these two teeny tiny yellow tablets I take at bedtime for a mere five days a month can wreak so much havoc on my already dysfunctional brain, but this time they seemed to let me off easy…

Suspicious? Indisputably. So we wait, and see what the day brings.

*****

Despite many well-intentioned loved ones warning me that obsessively following the news will just exacerbate my depression, I continue to read and react to the plethora of bullshit that dominates the headlines, and even just my Facebook feed, which has even been effectively purged of assholes and women of childbearing years alike. Sigh. I don’t feel I’m being obsessive, per se, but I can’t imagine burying my head in the sand when there are just so many issues that personally affect me, all being addressed in a manner I find unacceptable. Rage at the many injustices of the world may be exhausting, but in my past experience I’ve learned that anger can save my life, and that remaining silent is anathema to my soul. However, I’m older now and haven’t gotten drunk and punched through dry wall in many years.

On the surface, I’m not a rageaholic or anything. I am not afflicted by the road rage that has a vice grip on my family; I save my tirades and ravings for my husband and my therapist. I avoid hot button topics when I speak to my dad, who’s orientation on the political spectrum is unfathomable to me as he just hates everyone and has no opinions on issues aside from thinking everyone (myself included) is wrong about everything. Basically I try to limit our conversation to food and/or cats, and it keeps the peace at the very least. My therapist once noted that he seemed to be most closely aligned with Libertarianism, but I’m pretty sure that if I made a remark on that in his presence, he’d start an angry diatribe that might possibly go on for days, and with his hypertension…hooo boy.

Sigh. I probably carry as much anger as my dad. I’m very angry about Trump’s reaction to the amazing student survivors of the Parkland school shooting, and feel that it’s a disgrace (#youfucker the American public strongly supports efforts TO PREVENT US AND OUR KIDS FROM GETTING SHOT). I’m angry at proposed cuts to Medicare and Medicaid (so yeah, let’s cut funding to the supposedly dangerous mentally ill folk like myself but make sure we can buy firearms!). I’m angry about police brutality and excessive use of force (I know if I succumb to psychosis and the police are called, I might get killed and there’s so much racism in the mix), I’m angry about fucking restrictions on immigration, I’m angry the opioid epidemic is not being taken seriously, I’m angry that women’s reproductive rights are constantly under attack like we’re headed towards The Handmaid’s Tale or fucking something (important book, it scares the shit out of me), I’m angry that fucking Russia meddled in our democratic process and now we are being governed by an authoritarian with no heart or soul — and all of this is in addition to the ever present rage and hatred at the universe for taking away four babies that I loved.

I’m not sure how to navigate the world as an angry agoraphobe. What do I do with all these horrible feelings that cut deeper than the heaviest sorrow? I try not to snap at my husband. I put on Bikini Kill or X-ray Spex and scream along into my pillow. I pop tranquilizers twice a day and work on my breathing exercises. I write out my feelings.

It isn’t enough, it’s still killing me. And I’m still too scared to go out of my house.

*****

agoraphobia after trauma + on the letrozole rollercoaster

“I’d like to see you work on getting out of the house more,” my therapist said to me yesterday.

I groaned inwardly. “After my termination, I tried to continue my life as normal,” I explained, “I walked around doing my errands like normal, but I was bawling my eyes out the whole time. I once sat down on the floor at the Goodwill and couldn’t stop crying. Since I had been public with Molly’s story, I never knew who was judging me and I felt it was important for everyone to see me with my head held high.”

I felt myself getting choked up, “But I still start crying when I go out into the world,” I said softly, “When you’re walking around sobbing, you become completely invisible to everyone you pass by. I can’t handle how lonely that makes me feel anymore.”

My therapist nodded, calm and with understanding, “How long has it been since you lost Molly?” she asked me.

I practically whispered, “Almost three years.”

She told me I may not be ready yet, but I had to prepare for the time when I was. I reminded her that I’d also had three miscarriages. She nodded; she, obviously, had not forgotten. I sighed with relief. It’s not time yet.

Still, I wonder if it’s too icy to walk around the block. I’m not sure I’m brave enough to do even that. My home is warm and safe; my little cat never makes the type of insensitive comment that drives me to immediately isolate from humanity. He has never told me God has a plan for me (it’s a pretty shitty ass plan!), that it will happen when it’s meant to (for some of us, it’s never meant to), that at least I know I can get pregnant (you start a sentence with the phrase, “at least…”, I get stabby), that I have to relax and not stress (babies are conceived and born in war zones). He never looks at me with pity when I think of my termination and subsequent miscarriages and says, “I’ll hold my kids a little closer tonight,” (a statement that’s really just cruel). He is silent and only appears to judge me if I’m sneakily scarfing down a whole sleeve of Chips Ahoy or something like that. He thinks I should know better.

No, my little cat offers nothing but affection and reassurance. Why would I want to go out?

I know the longer I isolate, the harder it will be to rejoin the world. During the thrilling initial phase of my last pregnancy, all of this simply went away. I braved holiday crowds to do Christmas shopping with Geoff. I went to restaurants like I used to; I talked to friends. And it was easy, and it felt so good, and then the baby died again.

I often wonder if the world will ever take me back, or if I’ll even allow myself to be reintegrated. I look in the mirror, at the remains of a younger woman that used to have men chasing her like little puppies trailing behind some guy with a chain of sausages in their hand. My beauty and desirability was so important to me then, but now I can barely be bothered to get cleaned up and dressed. Why did I squander those years, when I may have still had good eggs left? I’m disgusted by how shallow I was when I was younger.

I vow to take that walk around the block before the week is through. I won’t interact with anyone, just move my body a little and breathe air that’s not stale like it is in my closed-in apartment. Maybe I’ll go in the early morning, to avoid passersbys. I can’t let infertility and recurrent pregnancy loss ensnare me and make me sick again, although I feel helpless to resist. I have got to keep fighting, no matter how lost and scared I feel. A walk would be step one. Here goes.

******

I didn’t make it very far until the tears started flowing. It was pretty slippery out there too. Ah, well, the battle against agoraphobia will have to wait.

******

Two temazepam means I get about a two hour reprieve from the letrozole blues. I try to make the best of my time, get some of these churning emotions written out and thus given form so that they can solidify into something a little less messy. I feel tremendous weight pressing down on me; initially, I thought it was metaphorical but I realize now it’s Femara-induced depression, and the good old fashioned leaden paralysis I know so well. So, I’m back on the couch, glad that the weight feels like it’s an external force because that means I’m not mixing up Femara depression with any worsening symptoms of my own illness.

Scruffy is grumpy without his booze and cigs, but he’s awake and alert and ready to push on. In case you’re wondering about Scruffy the Unicorn, I’ll explain that he is a representation of my hopes for a baby. When he’s passed out, I feel shitty and alone. When I’m pregnant he smokes meth and his enthusiasm is both relentless and unrealistic, one might even say delusional. He can prance around all he wants — my odds of having a baby are still slim to none. But I am fond of Scruffy, and feel better when he’s around even if the hope he offers is a big fat lie.

I’m being so meticulous about my basal body temperature chart, but I’m scared that after this fucked up menstrual period I won’t ovulate. I feel like I’m wasting Femara, suffering the side effects for no reason. Geoff has been, um, an eager participant in timed intercourse so far this month, but it’s only CD 5-ish. There’s absolutely nothing worse than timing intercourse through my fertile days. In fact, just thinking about it is stirring up panic. This is a hard life, with no hope of pursuing more aggressive fertility treatments due to my low income via disability. I wish I were not schizoaffective and could have pursued a high paying career when I was far younger, but probably wouldn’t have done so even if my mental health were pristine. Maybe some day I’ll finish my book, and someone will publish it and I’ll be in sugar. Very unlikely though — my story demands a happy ending, and I don’t think I’ll get that. Whoa, Scruffy. Here’s a Xanax. You need to calm down.

******

I’ve been active on infertility forums again, despite having learned that this doesn’t go well for me. Yes, it’s nice to have company to my misery, but the fact is that everyone will get pregnant and have babies and leave me behind. Three years of this, and still I make silly attempts to bond with other women with a lot more money than I have, and thus more options for treatment and success.

And it gets to me. Is loneliness really such a heavy burden to carry? I live in terror of other people’s positive pregnancy tests…I’m sure I’ve upset women with my own, but my babies die every time. And in the end, I end up lonelier and sadder and yes, full of rage.

day two of letrozole, round four

I have no idea what cycle day it is, as my period is back after a mysterious two day absence, but I took my second dose of letrozole last night. Outside it is cold and snow is quietly drifting down to blanket the Westside in something like purity. I am huddled under blankets, shivering because my Restoril gives me the chills even when it is sunny and warm. My little cat hunches down by my belly. I can barely move. I feel like absolute shit.

I’m just back from therapy, where my therapist reaffirmed my schizoaffective diagnosis. I feel a little disappointed that I’m stuck in such an ominous category, but it’s not really debatable. I rarely have mood episodes since starting Geodon in 2001, but I suffer psychotic symptoms in the absence of mania or depression; hence, “schizo”. I don’t really feel like I’m too crazy these days, but I am always very aware that I do not handle stress well and that this quest for a child could cause the bottom to drop out of my mind. I have to stop if that threat draws near, and I’m wondering about the wisdom of taking oral fertility medication when it has such deleterious effects on my mental wellbeing.

Still, we sally forth. This cycle is probably a bust, and who knows what the next will bring, but I just can’t give up when every cell of my being is screaming to grow a baby. This is what we’re meant to do, they remind me. My ovaries shrug. Good fucking luck, they respond, while surreptitiously rearranging their chromosomes with reckless impunity. I see my egg’s chromosomes fitting together like a puzzle, but the puzzles are assembled by someone who is three sheets to the wind and doesn’t give a fuck.

The Restoril is kicking in, bringing a delicious sleepiness. Most of the time when I feel bad, sleep is the only thing that makes me feel better. But I’m terribly agitated, my thoughts spinning out. In a few days, I will start peeing on sticks, trying to predict my ovulation by detecting the surge of a hormone called LH. Geoff and I have intercourse every other day throughout my cycle, but it’s handy to know we did it in the couple days surrounding ovulation, because that’s what gets you pregnant. It sounds simple, not as harrowing as it actually is. We have been living with our sex life on a schedule for three years — it sure sucks the joy out of fucking, no matter how much we try to change things up, add props, whatfuckingever.

What a drag it is getting old.

*****

and she wakes… + memoir of a tfmr

It’s amazing how much a good night’s sleep can chase away the anxiety and reignite hope. Last night was my first dose of letrozole, and I slept for ten hours straight which is definitely some sort of miracle as I usually can’t even get the three hour block of sleep required to effectively track my basal body temperature to confirm ovulation.

This is so refreshingly familiar to me, the temping and tracking my menstrual cycle, planning intercourse when I’m fertile. I can’t even imagine stopping right now, fortieth birthday notwithstanding. I have been trying to conceive a healthy baby for three years now. It’s become a lifestyle and I’ve become comfortable with grieving and despairing and all the terrible shit that comes along with it. In a way, the sorrow and yes, rage, that accompany my little rituals feels safer than giving up and my addiction to hope brings comfort as well as the pain.

When I am pregnant, even through the terror of loss, I know the suffering is worth it. Only thing is, and this may sound contradictory to the previous paragraph — the pain lasts so much longer than the joy.

I’ve had a lot of readers say that they’re glad I haven’t given up the fight. I have ambivalent feelings about that. Eventually, if I want to save my soul, I will have to give up or I will go mad and that’s not a figure of speech. Oh, “madness” sounds so dramatic and glamorous as compared to the clinical terms my psychologist would use while assessing my illness. Through this entire cycle of hope and desperation, through all my bereavement and the exhilaration of success that precedes grief and torment, I have always been a girl with a severe mental illness. That’s irrefutable; the one constant throughout these miserable years has been my ominous diagnosis of schizoaffective, bipolar type. It certainly gums up the works, the frantic attempts to link up my medication prescriber and my psychiatric obstetrician and make informed decisions about medications, and to assess the risks of medications that make me barely functional.

I am enjoying my morning today, though, and as I know from hard living, today is all I have. This feverish longing for just one baby could destroy me but as of yet, it has not gone away.

*****

For some reason I am rather suddenly remembering every minute detail of my termination for medical reasons, those two horrible days that left me forever changed. These memories, for quite some time, crystallized in my memory until they were a sharp and painful mass that I learned to be able to tuck away safely in some of the squishier parts of my conscious mind, occasional feeling the hard edges and feeling pain, but otherwise moving on. This was after months of sobbing all day and being able to think of nothing else, all the while holding my head high because at the time, I had inserted Molly’s sad story into actual legislative discourse on Planned Parenthood and the controversy of fetal tissue donation and felt my small town was judging me accordingly.

We went to Tacoma for the dilation and evacuation procedure, to a dumpy and squat little building that served as an abortion clinic as our local hospital is Catholic and the abortion clinic in Olympia did not perform second trimester terminations. I felt apprehensive upon our arrival — the neighborhood we drove to was full of shiny new medical facilities and our clinic was a shack tucked into a street full of palaces. There were anti-abortion protesters who were agape upon viewing my small but unmistakable baby bump, and the clinic required you to use an intercom system to gain entry. I was a wreck, and Geoff spoke unintelligible words into the little speaker.

Suddenly, the door sprung open. A black woman hustled me inside, introducing herself as Tanya, the clinic’s grief counselor. I remember being surprised at her title, as my previous experience with abortion was notable for the staff’s indifference for patients and as she guided me through a lobby full of desolate looking women with no grief counselor to reassure them, Geoff remained at the front and I assumed he was taking care of payment details (I think it was $1k but I can’t remember, nor do I know where the money came from — he told me he’d handle it, and he did). Tanya said there were no other second trimester procedures scheduled, and I’d have a waiting room to myself. Upon entering the private waiting room, where there was a worn but comfy couch and a couple chairs, as well as a television, I was given a Valium. Geoff joined us, and he was offered coffee. I, as the patient, hadn’t had food or drink since the night before, since I was having twilight anaesthesia for the procedure.

Tanya held my hand and told me it was best that I start grieving now, while I was there. No problem. She and Geoff both held me as I sobbed and sobbed.

Tanya explained what I would be undergoing that day, and upon my return the next. Forms were signed — I didn’t read them. That day, they would insert laminaria sticks in my cervix to dilate it, but I would be “asleep”, and they would give me an injection to stop Molly’s heart. I was assured that both the Valium I had been given and the anaesthesia I would receive would both cross the placenta, and that Molly would feel no pain. She rubbed my back while explaining, and it was so comforting. I wanted my mom with me, but I was not speaking to my mom, and Tanya was a fair substitute.

I knew from prior internet research that Geoff wouldn’t be able to be with me. When I had learned that at home, I had been very frightened but Tanya said she’d be with me the whole time, and I felt okay about that. I was led down a short hallway to a room with an exam table and a chair for Tanya. Everything looked old, but clean. I asked Tanya if it were possible that I’d die, and she said no, they were there to take care of me. The doctor entered.

“I read your story,” he said to me, holding up a photocopied document. It was something I’d written at Geoff’s behest, an application for financial assistance that I’m not sure we were ever granted. “I am so sorry.”

They started an IV, which I didn’t even really register. I have tiny veins, and they always have to dig around to find them, but it has never bothered me.

“I promise I’ll take care of you,” the doctor said, and took my other hand. I felt very safe, even though a nurse had wheeled in a tray of shiny and intimidating array of implements.

“When are you going to start?” I asked him. He told me they were finished, startling me back to wakefulness. “Where’s Geoff?” I asked them.

I was back in the waiting room, in Geoff’s arms sobbing. I couldn’t believe Molly was gone.

Tanya had said it would be best if we stayed at a hotel that night in case I went into labor, and said the clinic would cover the cost. I wanted to go home. We weren’t too far away, as the clinic was in the southern part of Tacoma and I wanted my cat (not the little cat I talk about now, a different cat named Bandit). After some discussion, it was decided that that would be okay. Tanya gave me her cell phone number to call in case I did start having contractions, and I was instructed to eat lightly, but no food or drink past 8pm. I was given a script for painkillers.

That night was horrendous. Brutally painful cramps wracked my body. Geoff called Tanya to see if a heating pad (!) would help — stupidly, since I had been told no food or drink, we assumed I couldn’t take the painkillers, even though I’d been told to take my psychotropics as normal. Tanya said a heating pad would probably be useless, that she was so sorry but I just had to get through it.

I slept the whole drive up to Tacoma the next day. Again, Geoff dealt with the intercom as I stared bewilderingly at the protesters, wondering if they knew I’d do anything not to be there right then, and that my baby was already dead, and Tanya again came bustling out and whisked us inside. I couldn’t stop crying. There was a bruised and tender spot on my abdomen. They had said they’d stop her heart with an injection either in my abdomen or vagina, and I guessed they had done it in my abdomen, but I didn’t ask. Valium materialized. We were led to the private waiting room, Geoff again had some coffee — I wanted a cup so badly! We went into an office, where I was given Cytotec to dissolve in my cheeks to further soften my cervix. The pain was unbelievable. We signed more forms that I didn’t read, and I think that’s when we actually paid for the procedure. I decided Tanya was an angel of some sorts. I remember having to wait a while so the pills in my cheeks could start working, and being left for awhile watching COPS on the television in the now familiar waiting room. Geoff and I live a TV free life, so it seemed so novel and ultimately meaningless. Finally, Tanya came to bring me back to the same room. This time, I was terrified of being separated from Geoff.

I laid down on the table again. Tanya said she had a question, and anything I answered would be okay, but they were specifically looking for fetal tissue donations from women taking Category C medications during pregnancy (this meant there was not a lot of information to prove or disprove the medication’s safety during pregnancy), and my fistfuls of psych meds qualified me. It suddenly occurred to me why I had spent months researching the safety of my meds, and come up with no satisfying answers — it’s fucking unethical to test medications on pregnant women, duh. I signed my consent in hopes that Molly’s remains could be used to help other women like me. We had the option of cremation, but I was not okay enough to set that up and assumed it would be too expensive anyway.

“Good for you!” Tanya exclaimed as I signed the form, “This will really help someone.” She kind of shook my arm in her excitement. I hadn’t discussed this decision with Geoff, but was a little glad that the decision had been left to me. It was our baby to be sure, but my body. I know my husband well, though, and knew he’d accede to my wishes on the matter.

They started messing around with the IV and my recalcitrant veins and Tanya asked if I had any pets. I felt a rush of energy, and started enthusiastically telling her about Bandit and how she loved me but growled ferociously when Geoff tried to pet her, and then I was waking up again and they said I could start healing now. I felt physically worn out, in a lot of pain and they put something in the IV to help me feel better and started taking that out. I felt suddenly warm and fuzzy, and I practically ran back to the waiting room into Geoff’s arms to cry some more.

I’m sorry, but every so often I have to write out what happened those two days. I’ve described my eighteen week abortion over and over, and this time I really wanted to focus on the kindness and compassion of the staff at the abortion clinic because these really are our frontline warriors in the fight for women’s right to maintain autonomy over their own bodies and make decisions that are right for herself and her family in regards to reproduction. I was right; Tanya is an angel and I’ll never forget her or her tenderness or her soothing embraces (and I’m not one who is normally okay with physically affectionate gestures from strangers) and the doctor who performed the procedure was someone I feel fortunate to have on our team. Tanya called several times over the next few weeks to make sure I was physically and emotionally okay…my physical wellbeing was perfect with no complications but three years later, I am still struggling with grief. These people stood by my side in my darkest hour, and I will never stop being grateful.

grumpy

My period has been starting and stopping for three days now, but it seems to have stopped for good now. Whatever, close enough. Although I’m confused as to when exactly CD 1 would be, I’m starting letrozole tonight. I’m sure my lining is fucked up post-D&C, so I’m feeling pretty discouraged about the whole cycle but fuck everything anyways.

I’m in a foul mood already. I randomly threw up my anxiety medication this morning, and the world seems like pure bullshit with our illegitimately elected President and all of that. I’m not quite sure why I have a burning need to bring a child into this fucked up society, but I do. Against all odds, I believe in love and although I shittalk the brutal universe at every opportunity, I still believe that life is a beautiful and precious thing.

It occurred to me this morning that I have spent 47 weeks of my life pregnant (that’s minus the two freebie weeks you get with each pregnancy) and I do not have a living child. A full term pregnancy is about forty weeks. This strikes me as tragic, and self-pity sneaks in to ruin this already shitty morning. Geoff ran off to be social for awhile, and I’m here wondering if I can pull myself together enough to visit Don. I swallow another Restoril to replace the one I puked up. Maybe I’m getting sick? Ha. I haven’t been sick for a single day since I started dating Geoff. True love must bolster your immune system or something. I don’t know, sounds good in theory.

My little cat curls up with me. If he weren’t such an aggressively needy little thing, I’d become a cat lady and get more cats. But he’s enough to handle on his own, and he keeps me going through the toughest of times. I wish I could be satisfied with only his companionship, but I have a desperate need for human interaction — only when I try to interact with people, everything goes so so wrong. I cry, I get triggered, I have to run away in defeat and the loneliness just festers. Above all, I want a family. When my parents die, there will be no one around to remember my happy childhood, or my deceased sister. I miss her terribly these days; I long for one last conversation or at least some reassurance that in the next plane of existence, I will see her again. My parents are okay with just seeing me four days a year. What the fuck happened to us? We really were so happy.

And no matter how hard I work at it, I can’t seem to have a baby….

******

I’m feeling rather defeated today. Maybe this is how I’ll feel for the next five months; maybe I won’t get a break. I had forgotten what a beast depression was — usually I have issues with mania, and I’ve been grieving for years now but this is flat out, unglamorous, clinical depression, no doubt about it. I wonder when my psychiatrist will be back from Hawaii, whether she’ll be resistant to increasing my Paxil once again out of fear of pushing too far and making me manic. Don’t get me wrong, a little hypomania would be A-okay with me but my full-blown manias lead to bizarre and possibly dangerous behaviors when my brain splits from reality. I don’t need that, but this horrible melancholy is almost as bad.

And I’ve yet to swallow my two tablets of letrozole. That’ll be tonight, before bedtime, so cross your fingers and pray that three days of on and off bleeding counts as a true period. I just have to keep going…I’ve promised myself that much. Scruffy hesitates for a second before firing up his glass pipe and I’m unsure I can rely on the weirdo spurts of hope he bestows upon me in between drug and alcohol benders. You can kill the pain, he whispers, but I’m beyond his kind of chemical assistance. There is not one drug out there that is powerful enough to kill this pain and I’m confident I can maintain my sobriety as I near the end of this chapter in my life. Of course, since I got clean there are new drugs that I never had the opportunity to indulge in…but I figure at not-quite-forty, my days of experimentation are behind me.

I don’t think Paxil is strong enough to counteract the letrozole blues, either, for that matter. So, more suffering. That’s just the way it is, and there’s no guarantee that it will be rewarded.

******

I wish my mom wasn’t mad at me all the time these days. She really did used to be such a gentle soul, but life has hardened her like it’s done me. I know she disapproves of everything I do now, but I also know she truly does not want me to get hurt and expresses this by constantly reminding me that everything I do is wrong. I am, as I mentioned previously, not-quite-forty and should have fortified myself enough by now to not long for a tender word from my mom, but lately I’ve been feeling very much like a lost and injured child who cannot even make the simplest of decisions. And the contempt I hear in my mother’s voice every time I speak with her smarts.

******

…and I just tossed back my first dose of Femara. I hope I don’t get my real period in two days. I think my uterus still needs time to recover from my d&c, so all this worrying is probably for naught. Scruffy is passed out cold.

interlude

I try not to get on my soapbox too often here because it’s a lot more fun to alienate any asshole I happen to be “friends” with on the Facebooks, but I wanted to weigh in on the gun control discussion that is holding our nation in its grip right now. I am severely mentally ill. I have been diagnosed as schizoaffective, bipolar type, or sometimes just bipolar I (full blown psychotic manic episodes and depression, sometimes at the same time) because my psychotic symptoms, while they do occur in the absence of mood symptoms, are manageable. My illness is at least in partial remission because I willingly and responsibly swallow handfuls of pills a day (antipsychotics, mood stabilizers, antidepressants, anxiety meds) and attend weekly psychotherapy sessions. Unmedicated, I lose touch with reality and suffer from hallucinations and paranoid delusions. I am one hundred percent willing to sacrifice my right to gun ownership, and I will not permit my husband to have a gun in my home. I’m not very likely at all to lose my shit and go off on a shooting spree — when I have lost touch with reality in the past (I haven’t had an episode in at least fifteen years), my thoughts have been so disorganized, there’s no way I would have been able to plan out and orchestrate a massacre and have, like most psychotics I know, put most of my efforts and energy into obtaining cigarettes, most often unsuccessfully. I would be far more likely to hurt myself, and have never been violent to another person or animal. Still, just-in-casies, I should not have access to firearms, period.

This should be a no brainer. And I don’t want to take everyone’s fucking guns away, and neither did Obama. There’s a couple of issues at play here. The mentally ill, in general, should not be scapegoats as the cause of gun violence. People suffering psychosis are, for the most part, too disorganized to make plans and carry then out. The biggest predictor of future violence is a prior record of violence, not a diagnosis of a psychotic disorder. Therefore, it makes more sense to keep guns away from the violent, especially those, as has been seen, with a record of domestic violence. But, in order to keep psychotic, or manic, or severely depressed people safe, I’m all for limiting access to gun ownership for the mentally ill. I’m talking about organic mental illnesses that are treatable by medication, not personality disorders. Don’t scapegoat us. But if you’ve got a spare cigarette, feel free to let us bum one of those (I quit smoking, don’t worry).

What can be done about this huge ass problem with mental illness? It’s worth noting that there are mentally ill people everywhere, all over the globe…yet the United States is the only country that sees widespread gun massacres of innocent people, of child students and churchgoers and people just out to have a good time.

I can’t work. You can debate this if you want, but believe me, I have tried. It always ends in hospitalization, every time. I receive Social Security disability benefits, and my health coverage is through Medicare. Many of my friends are in the same situation, or worse. I am lucky; I married a working guy and my family of origin is supportive in treating my illness. We scrape by. But a hospitalization at this point would tank us. Not all of my friends with severe mental illnesses are as privileged.

Can we make mental health care more accessible and affordable maybe, if you are going to blame us? No, budgets for low-income mental health services are constantly being slashed. Even with private insurance, patients often cannot afford treatment for their mental disorders. So, to be clear: the mentally ill can often legally purchase firearms, but cannot access mental health care. Thanks, Trump.

This whole debate is ludicrous to me and these shootings keep happening. I’m not sure how these GOP politicians can sleep at night knowing that they are complicit in the deaths of innocent people. Really, it makes me sick. Feel free to unfollow me if you disagree with common sense gun restrictions and if you’re not also sickened by the constant news of massacres of children, you’re complicit too. And, please God, and i will partially quote my hero Andy Borowitz, if you are on my team and solidly blue, get out and vote in the midterm elections “like your life depends on it. Because it [literally] does.”

******

My period keeps starting and stopping, and I’m unsure whether or not I preemptively declared CD 1 yesterday. I am full of angst and running out of time. I, of course, messaged my REs office and was told CD 1 was the first day I require a pad or tampon, which I already knew, but I’ve needed a pad or a tampon at times, but not at others. I just want to start my letrozole, and be reassured that I don’t have scarring from my D&C that is blocking my cervical canal and preventing my flow from exiting. If I developed Asherman’s (scarring, or uterine adhesions), I won’t be able to afford an operative hysteroscopy to remove it and it’s game over.

I feel like crying, but the tears don’t come. I feel like hearing someone else’s bad news for once, I don’t care who, and it’s so fucked up to wish bad things on other people but I feel like everyone but me is doing just fine. I know that’s distorted thinking from the depression, and I can’t help confess my crabby ill will towards others because of the never-ending guilt. And if anyone else has felt similarly bitter, please…let me know I’m not alone.

I want to call my mom but she always makes me feel worse. Geoff said he’d make Eggs Benedict with avocado for dinner again (we are both gaining weight, which is okay because we’re both pretty skinny, but our hard as a rock mattress has become a thousand times more luxurious now that our bones aren’t grinding into it.. maybe that’s why I’m sleeping better). Sigh. Is it entitled to wish for a little bit of luck for my next cycle? I fear my body is still too out of whack for success, these fucking D&Cs screw everything up.

cd fucking 1 bitches

My period finally came today, and this latest miscarriage has quietly resolved itself, just another blisteringly painful memory for me to file away in this horrible chapter of my life. In two days, I again jump recklessly onto the letrozole rollercoaster and oh, those dizzying highs and lows reminiscent of when my bipolar was untreated but somehow worse because they are loaded with meaning! I am struggling to take care of my body and mind, longing to be in some sort of self-inflicted altered state as I approach the fourteenth anniversary of my sobriety and resorting to too much coffee and failing at my planned discontinuation of my anxiety medication. I am a mess, but a determined mess. I will fucking pull myself together. Five more cycles…then I can fall apart. I imagine it may even be a relief.

I try to gaze into the future. My biggest fear is that I’m in for five months of bfns. No, my biggest fear is that I’ll get knocked up immediately, then lose the baby and my remaining time trying. My body is wracked with cramps and it makes distracting myself from my recalcitrant reproductive system impossible. I’m trying to read a book, The Science of Evil, strangely enough written by some relative of the guy that did that Borat movie (I’ve been isolated from pop culture for decades now, I know not of what I speak), but I am having a hard time thinking of people as cruel when I’ve learned so well that the Universe is the cruelest force imaginable, cold and unsympathetic as it punishes me over and over for the indiscretions of my youth. A privileged viewpoint, I’m sure, but it’s what I have.

*****

My sleep is much improved since I switched my Paxil time to evening and increased my dose. I am enjoying these wonderful sleepy mornings, bursts of slumber punctuated with marvelous dreams. The other morning, I dreamed I was ten weeks pregnant, ecstatic because my last three pregnancies have ended in the ninth week. Unfortunately, I was also being detained in North Korea while an obstetrician lectured me that I could only eat wheat crackers from that point forward. She kept showing me the crackers, but all she had in her hands was uncooked shell shaped pasta, and I was confused and frightened until Geoff finally showed up to bring me home. I woke up and started crying when I remembered my reality.

In another one of these idle dreams, I had made a friend with all these outrageous medical problems. For example, she still had her own teeth, but they were removable like dentures. It felt so good to have someone to talk to, and we spent a lot of time at my childhood home while stopping various injustices from happening when we witnessed them from the big picture window in the living room, like suburban couch potato superheroes or something. She then told me she had to leave, and I got on my bike (I have not ridden a bicycle since I was a child) and was cruising around my old neighborhood like I really did before my sister took ill, running into unsupervised babies everywhere and finding it puzzling. I finally saw my old friend Leslie (Leslie now has two beautiful children and, I shit you not, recently won $15 million on a scratch ticket) and her parents up by our old elementary school, and I felt so light and free on my ten-speed and was so eager to greet these people I haven’t seen in so long. I then ran into my old friend Erin, who has since changed her name and sort of fallen off the map and we all returned to my home, where my mother and the friend with removable teeth had arranged a surprise party for me. Again, I woke up and cried remembering how lonely I am now…

I know other people’s dreams are so boring to read, so thanks for indulging me. I really did once have everything I could have possibly wanted and I’m not sure how events transpired to make me quite so wretched… I wonder if these happy dreams are unhealthy, because of how sad it makes me to remember them; or, maybe I should just be thankful for the moments of respite they offer.

*****

My mom, in my earliest memories, was soft and kind. I remember walking the dog in the woods with her, and how she would point out all the different kinds of plants: the bittersweet with its bright autumn colors, the ferns with their curling leaves, and even the skunk cabbage. I remember her singing me to sleep while rubbing my little hands, and I remember the tenderness that disappeared when the first signs of my illness emerged from deep within.

I was prone to temper tantrums. I wouldn’t sleep. I didn’t respect her. I hated her, she wasn’t my real mother. We’d sit in various therapists’ offices, and the litany of accusations would go on for a fifty-minute hour. We both needed reassurance of each other’s love, and neither of us could provide them. You weren’t easy to live with, she told me recently. Neither was she. But I said nothing.

We talk often on the phone, and see each other three or four days a year. Since I started losing babies, there is a new hint of contempt in her tone when she speaks to me and I can’t shake the feeling that I disgust her. I can’t talk about that, I’ve never been through it, she says when I bring up my losses. I know she doesn’t want me to have a baby, and since my sister died there is no more softness in her manner; she is all hard edges and sharp angles in demeanor. All right, she has reason to be hard. And I don’t deserve to be soothed by her like I once was — I am a constant disappointment and she is bitter that I have taxed her resources over so many years.

She didn’t want me to get married. Just worry about yourself, she told me, maybe not realizing how badly I needed companionship. She now resents me for Geoff’s attentiveness towards me, rolling her eyes when he refills my coffee mug without me saying a word. Still, I think she’s become glad he’s part of us now, allowing her to abdicate any lingering sense of responsibility for my wellbeing.

My dad says we’re too alike, and I wonder if one day I’ll become hardened like she is. I spend a lot of time worrying that I already have.

I wouldn’t speak to my mother after my tfmr. I know she was relieved the pregnancy didn’t work out — when I told her I was pregnant, she just said, I don’t want you to get too excited. Too many things can go wrong.

Why would she say that? And why did she have to be right?

I’m concerned about the emotional effects of all these miscarriages, she keeps saying to me now. She’s rehearsed it, I can tell, she repeats it over and over, and hasn’t come up with anything further to say on the subject. Meanwhile, I feel like I’m dying. I thirst for kind words these days, and a simple, I’m sorry you’re going through this would be like a balm on my heart. But it’s too late for all that now. At seventy-two, she’s not going to change her attitude towards me. I long to sit next to her and cry while she rubs my hands like when I was a kid. But I’ve let her down far too many times, and now I’m old and superfluous to her busy life as a retiree.

valentine’s celebration

My husband is wonderful. We celebrated Valentine’s day last night, and he made me a wonderful steak and lobster tail dinner. How lucky am I to have him? It was a fun night…as I grew up in New England, I’m not sure of the proper etiquette for eating just a lobster tail and I think in restaurants they split it for you so you can access the meat. Anyway, I just barbarically ripped it up with my hands, as I am accustomed to doing, sending bits of garlic flying every which way but despite it being a puny Pacific Northwest lobster and not a huge ass beauty from Maine, it was totally worth it. The steak was good too, Geoff knows how to cook them nice and rare (when I cook steak, I usually will stare at the meat suspiciously, ridden with angst about how long to cook it and it always turns out too well done).

For paupers like us, this was a huge ass treat.

I often think Geoff and I love each other so much that we’d be okay without a little one running around our house and that would be fine except I’m constantly terrified that a tragedy will befall him and I’d be left alone. Also in consideration is my burning desire to make him as happy as he makes me, and having his healthy baby is the greatest gift I imagine I could give him (and myself). See, we haven’t had easy lives; we actually met in recovery. We had similar loving families of origin, but despite this, life threw us each calamity. I came off the rails when my sister passed away from MDS, and spent many confused years struggling with untreated mental illness and drug and alcohol addiction after I was sexually assaulted, became pregnant and had an elective abortion at twelve weeks (and how different that experience was than terminating a much wanted pregnancy more than a decade after!). Geoff…well, his story is his own to tell, but he had an experience so painful it is unimaginable to me and I would do anything to right the injustices he faced by giving him everything he ever wanted — unfortunately, my ovaries are shit and my eggs are apparently withering away as I write this, unable to do a simple thing like provide decent chromosomes. I take the blame for this. As I mentioned, I spent years treating my body like shit.

My little cat snuggles up, and as usual I direct my maternal instincts at him and dote on him as best I can. He purrs appreciatively, and the longing in my heart knows no bounds. Yes, I was once a wild young girl with no regards for my own future, but I worked my ass off in recovery and therapy, I take my meds dutifully, and I truly believe myself capable of being responsible for a tiny little human’s life. Yes, my bipolar may send me to the hospital again at some point, but I take care of myself believe we would be able to provide for a resilient family full of love.

Wishful thinking and an amazing partner…I am asking for nothing short of a miracle and that is a twisted reality.

*****

If anyone is wondering, I am 12dpo, not pregnant and anxiously awaiting my period so I can start my Femara and get back in the ttc game. My five month plan is contingent on my flow starting in a reasonable timeframe so I admit, at CD 37, that I’m basically tearing out my hair. At the same time, I dread the letrozole induced depression and the suicidal thoughts that accompany it (I am safe. I know the feelings are from an external influence). I have my shiny new bottle of temazepam to take off the edge, I am moving towards healthy living again and I’m ready to throw my heart and soul into this. I’ve dedicated three years to trying to conceive a healthy baby, and I won’t give up the dream quite yet.