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Half Baked
The Story of My Nerves, My Newborn, and How We Both Learned to Breathe
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ebook $9.99 $12.99 CADThis item is a preorder. Your payment method will be charged immediately, and the product is expected to ship on or around August 10, 2010. This date is subject to change due to shipping delays beyond our control.
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From the indignities of infertility treatments to managing bedrest and parenting a preemie (how does one wrangle an oxygen tank while changing a diaper?), Alexa recounts her rocky road to motherhood with a uniquely sharp, funny, yet poignant voice.
Excerpt
To my mother,
for believing I could
for believing I could
What the American public wants in the theater is a tragedy with a happy ending.
—WILLIAM D. HOWELLS
Prologue
When you give birth to a baby who weighs less than two pounds, no one knows what kind of flowers to send. A big, congratulatory bouquet of daisies, or an arrangement that strikes a more somber note? Perhaps something pretty but blue, like a hydrangea, or something tiny, like a bonsai tree. No baby's breath, since the baby in question is likely to be breathing with the aid of a ventilator. How do you say it with flowers, when what you want to say is "Congratulations on creating a whole new person! I hope she makes it through the week"?
The day after my daughter was born, I tried to modulate my expression while the doctors discussed her condition. A wall of IV pumps chirped mournfully in the background, and Simone lay sprawled in her isolette, her limbs glistening and bruised. There was grave talk of blood pressure and electrocardiograms, yet my brain played only a delirious loop of "I have a baby! A beautiful baby!" Maybe it was the hormones, or the morphine, or maybe my sputtering neurons simply couldn't comprehend the place they found themselves: somewhere between joyous, endorphin-soaked new motherhood, and the bleak landscape of tiny burial plots.
Gray areas were never my strong suit. Which is unfortunate, because gray areas account for about 96% of human experience. But in my mind, there were only ever two options: everything goes well, or the world is swallowed in a lake of fire. Personally, my money was on "lake of fire," and I figured it didn't hurt to be prepared. Why sit around waiting for fate to spring from what appears to be a perfectly ordinary birthday cake, when you could be researching signs your headache may be an aneurysm or cataloging suspicious moles? I diagnosed my own infertility by reading too
much and expecting the worst—the same way I'd diagnosed my first kidney stone ten years before. The doctor back then said "bladder infection," but I knew better, and two weeks and a trip to the ER later, I was proven right. Two weeks after that, in an airplane bathroom, I peed a tiny, tangible pebble of my victorious pessimism into a plastic strainer. Analysis showed the stone was mostly calcium, but it might as easily have been a crystallization of anxiety, turned to rock the way diamonds are formed—under extreme pressure, over time.
The list of things I found insupportably risky as a child included hand-springs, swimming underwater, amusement park rides other than the carousel, base—or any other—ball, tire swings, and bicycling on unpaved roads. And fireworks, of course, partly because of an episode of Lassie in which Timmy befriended a boy blinded by a firecracker, and partly because of my oft-stated maxim that while suicide bombers or errant landmines may be beyond our control, surely choosing not to detonate explosives for sport is a small, sensible measure we can all take to prolong our time on earth. Like whitewater rafting, or living in California or New Orleans, fireworks were against the code I lived by: Don't Borrow Trouble.
The mistake I made—and would keep making, over and over—was in believing that my apprehension had a protective quality; that preparing for the worst would arm me against misfortune. Regrettably, the disaster you expect is seldom the one visited upon you. Maybe that headache isn't an aneurysm, but the first in a string of debilitating migraines that will plague you for years. Between the best and worst case scenarios are the "moderately tolerable scenario," the "better than expected scenario," and "really bad, but at least it's not cancer."
The night before I started my IVF cycle, a bridge ten minutes from my home buckled and collapsed, sending a freeway full of cars sliding into the Mississippi. I'm sure some of those people were brooding as they sat in traffic, wondering whether their spouse was cheating, worrying about a cough they'd had for weeks (Lung cancer? Emphysema?), nervously massaging the steering wheel while playing an improbably terrible scene in their heads.
But I am willing to bet that none of them—not one—was expecting the concrete under their tires to give way.
And in an admittedly less dramatic fashion, I can relate.Your standard, run-of-the-mill human gestation lasts 40 weeks, and I had completed 19 of those when a woman walked up to me and chuckled knowingly. Strange women are always chuckling at you once you're pregnant, women who were pregnant themselves once, years ago. They see you trundling toward the bathroom, or being hoisted from your chair via a series of pulleys, and they laugh, thinking: You poor motherfucker.
"You look exhausted!" said the chuckler. I gave her a wan smile. She eyed my belly, which dwarfed the rest of me, hovering over my torso like an eclipse. "Well," she said, "At least it can't be much longer! You must be due any day now!"
I was due on May 17th. It was December. Being pregnant with twins meant that even in the second trimester, I was the size of an orca.
"Actually," I said, "I still have a long way to go."
And I was right, in a way—just not in the way that I thought.
Part I
INNA GADDA GRAVIDA
CHAPTER One
Infertility has much in common with those reality shows in which the contestants eat live, writhing scorpions washed down with a warm tumbler of pus. In both cases one endures and even seeks out a series of indignities, all in the tenuous hope of receiving a prize that will make the process ultimately worthwhile. I once collected all of my urine for 24 hours in an orange vat shaped like a gas can, and then transported the sloshing receptacle back to the clinic on the seat of my car. I stage-whispered the phrase "SEMEN ANALYSIS" over the phone to a half-deaf receptionist, while my colleagues pretended not to listen. I welcomed specula, nozzles, small scalpels, catheters, thermometers, ultrasound wands, swabs, a syringe of radioactive dye, and—by my count—nine highly trained medical specialists into my vagina.
Nine. That's a baseball team.
But secretly, I continued to harbor a suspicion that—like the ulcer and the lactose intolerance—my barrenness would turn out to be a small thing I had blown out of proportion, requiring nothing more complicated than a prescription. As a little girl, whenever I feigned sickness to avoid an odious task, or lingered too long over a list of symptoms in my beloved Mayo Clinic Family Health Book, a mysterious mind-body alchemy would conspire to make me truly ill. Surely something similar, a combination of paranoia and magical thinking, was at work here?
The nurse poked my rear with a meaty finger.
"Right here. One quick motion, like you're throwing a dart."
I braced myself against the seat of the chair—the chair I was bending over, my pants around my ankles. I could feel Scott behind me, panic emanating from him in waves.
"You want me to…" he stammered. "I'm really going to inject her?"
I knew how he felt. I had assumed we would be practicing on a prosthetic ass of some kind. WHERE WAS THE PROSTHETIC ASS?
In the instructional video we'd just finished watching, the vaguely Swedish-looking actors approached each injection with barely contained glee, the wife straightening afterward to beam insanely at the camera. Scott and I had giggled through most of the film, but now, feeling the breeze on my naked legs, it seemed more sinister than amusing. Who were those people, and what the hell had they been smiling about?
Then: a tiny stab.
"Just do it," I hissed, annoyed at my husband for stopping with only the tip of the needle engaged.
But he hadn't stopped. It was all done, and now I was the one grinning like a maniac. I turned to see Scott looking smug and exhilarated. Maybe the Swedes were on to something.
Scott left for work, and I put my pants back on, moved to an exam room, and took them off again. It occurred to me that this was more or less how I had spent my free time for the past 24 months—moving from exam room to exam room, removing my pants. Thankfully, I did not have time to pursue this singularly depressing line of thought, because a nurse entered and snapped on a pair of gloves.
I had taken five days of a breast cancer medication used off-label to strong-arm my ovaries into growing an egg or two, and it was time for an ultrasound to see whether this pharmacological trickery had been successful. If it had, Scott would put his newly minted injection skills to use: a
shot of hormone would release the eggs, which I imagined floating down a fallopian tube, glowing roundly in the murky uterine half-light. My husband's genetic contribution would be delivered via catheter, and if we were lucky, an egg would fertilize and then implant, growing from clump of cells to creepy amphibiate embryo to fat, healthy human baby. After two years of diagnostics, we were dipping our first toe into the chemically polluted water of fertility treatment.
The ultrasound machine hummed as I positioned myself in the stirrups and craned my head to see the screen. My ovaries swam into view, lumpen swirls of gray studded with black. The nurse began to count and measure, clicking the edges of each large black oval that might house an egg. Eggs! I felt smug and fertile, like a chicken.
"Hmmm," said the nurse, "Huh." She frowned. I craned. She continued her clicking, and I began to feel a creeping sense of dread.
On its own, my body couldn't be bothered to mature an ovum more than once in six months, but a medical nudge had matured so many that my insemination was canceled, and when she entered, my reproductive endocrinologist warned that a lapse in chastity could land me with septuplets. For a desperate moment I thought septuplets might not be so bad—I could name them after the days of the week, or the moons of Saturn!—but that soon passed, and I sat dumbly on the edge of the table, holding my paper sheet.
My reproductive endocrinologist was a former veterinarian, but I had-n't doubted her credentials until that day, when she looked at me with her kind, dog-loving eyes, and agreed that the best way to avoid a litter would be to skip directly from the kiddie pool of insemination to the bends-inducing sea of IVF. This was more than a few days of pills and a catheter snaked through what I'd once called my private parts. A cycle of in vitro fertilization would mean surgically removing my eggs, fertilizing them outside my body, and replacing an embryo or two. Left alone to pull on my pants one final time, in defeat, the worry began. I had pushed my doctor through diagnosis, requesting specific tests and deluging her with photocopied journal abstracts. Had I been too convincing? Had this erstwhile vet
misread the evidence? Had I thought my ovaries into mutiny? Maybe it was a mistake, and I wasn't infertile at all. Oh, how we'd laugh, someday!
Leaving the clinic, a packet of IVF consent forms and informational material poked out of my handbag, including a thick sheaf about the egg retrieval procedure. It featured an illustration of the large ultrasound-guided needle used to access the eggs, a contraption that resembled a penis with a spear extending from its head, or maybe a narwhal. Looking at it made me deeply uncomfortable, though not as deeply uncomfortable as I imagined I'd be after its use. I was so accustomed to overreacting that it was a shock to realize that for once—maybe for the very first time—I was even worse off than I'd expected.
Like tax law, IVF is generally only interesting to and understood by a small, obsessive coterie of practitioners. To the rest of the world, the world that doesn't spend its lunch hours reading back issues of Fertility and Sterility, in vitro fertilization is a nebulous medical procedure, more science fiction than science. I was born only a year or so before the original Test Tube Baby, and when I was young the term was bandied about frequently in the news. Back then I imagined Louise Brown's conception as something between cloning and the creation of Frankenstein: a whole, miniaturized infant growing in a glass vial. She'd be yawning pinkly and bobbing in her fluid, while bespectacled, white-coated men wrote things on clipboards.
But by the time I was officially diagnosed as an evolutionary cul de sac, I knew more about fertility treatment than most physicians, thanks to the Internet and my subscription to a variety of medical databases.When I was-n't reading about egg quality or the lifespan of human sperm, I was entering increasingly frantic keywords into search engines late at night, a glass of wine at my elbow. "Ovulation induction treatment" I typed, "polycystic ovaries protocol success rate." As the hours wore on and my glass emptied, I used my computer less for data collection than as a very expensive Magic 8 Ball: "When will I have a baby?" I queried uselessly, "Pregnant teenagers:WHY?"
Six weeks after the ultrasound that sealed my fate, I received the medications for my first IVF cycle. If ever there is a test of one's desire to hear
the pitter patter of little feet, it is opening a box the size of a schnauzer to find it entirely filled with needles.
"This seems…wrong," I said, hoisting a fat plastic bag of syringes. "I can't possibly need this many." Scott came up behind me to look, and began to laugh. I threw an aggrieved glare over my shoulder.
A second schnauzer-sized box was almost empty, the bottom lined with ice packs protecting a few slender packages of medication. The free needles would displace my food processor and hand mixer in a deep kitchen drawer, but all $1400 of fertility medication fit neatly into my refrigerator's butter compartment, each $60 vial an inch tall and the width of my pinkie. They were suspiciously nondescript for agents of reproduction, and I would have liked a little drama, say in the form of trumpets that sounded when you popped the plastic cap: Dun duh-da DAAAH!
I once had a secondhand microscope and a case of vials not unlike these, each (with the exception of the one holding a whole dead bee) containing something unrecognizable to the naked eye. There were brine shrimp in one, tiny protozoa in another. When I peered through the eyepiece at a drop from the vial labeled "pond water," a formerly uniform liquid leapt to life: whip-like organisms squiggled across the surface, tiny fronds clustered in a corner. I tried to think of the expensive thimbles in my butter compartment as similarly filled with unseen potential, but it was hard, without the trumpets. Maybe if they'd been bigger, or carved from bone. Maybe if their labels had read "CAUTION: CONTAINS HUMAN BABY PRECURSOR !" instead of "urofollitropin for injection." Maybe if I hadn't been so uncomfortably aware of the provenance of the contents—which was, technically, the distilled and powdered urine of post-menopausal nuns.
Oh ho ho! you are saying, this is what they call artistic license! But it's true: having no more practical use for them, post-menopausal women pee out vast quantities of the hormones used to grow eggs, and around 1950 an enterprising Italian gentleman discovered a way to extract these hormones for use in fertility treatments. He needed a reliable urine source, and nuns were the obvious choice, as they are clean living and dwell in packs.
I wondered how they did it, these nuns. Did they take turns lifting their gowns to squat over a collection vat, rosary beads swaying forward?
How did they reconcile their donation with the Pope's "MORTAL SIN!" stance on IVF? Would it help if they knew the Vatican once owned the largest manufacturer of fertility medication? Were they regular nuns, chatting from behind a bathroom stall, or the sort that have taken a vow of silence, the only sound the splashing of urine into a sterile container? Should I have used synthetic hormones instead, or was this a welcome human touch to a subtly dehumanizing process?
As a child, I played dolls with a fervor and commitment to my role that was unparalleled among my contemporaries. The fastest way for a playmate to invite my scorn was to say "Let's pretend it's the next day!" or "Now it's time to put the baby to bed!" One needed only to glance out the window at the glaring noonday sun to see that the latter was untrue, and while my disbelief could be suspended enough to allow for the pretense that a plastic toddler was my own, living flesh and blood, I took even sham motherhood very seriously.
I attended a daycare program—the glumly and unimaginatively named "Extended Day"—and often exasperated the staff by refusing to retire my pseudo spawn to a cubby. Not only did I resent being shuffled from mandatory activity to mandatory activity by adults with a wildly inaccurate estimation of just how enjoyable "capture the flag" really was, but I also felt they were perpetuating a dangerous misconception. One couldn't leave a REAL baby in a cubby, at least not without inviting the interest of local law enforcement. Having children was a responsibility, and when you tired of warming bottles or rocking fractious infants, you could not simply imagine the hours away.
Responsibility or not, having children was what I wanted most of all. I spent hours deciding upon their future names and debating the question of how many, exactly, I would bear.The summer before second grade, I convinced a friend that I was pregnant—the mechanism was unclear, though I recall something about a toilet seat—and before some older girls overheard us and spoiled it all with ridicule, I spent an idyllic week patting my belly and discussing whether I ought to find a nanny or take the baby to school with me in the fall. But eventually it was time to put aside childish things,
and move on to writing execrable poetry, and then to experimenting with drugs and mooning over unsuitable boys.While I still planned to have children one day, I figured I would wait until I was too old and unhip to do anything else—probably sometime in my thirties. It would be a nice distraction, then, from the fact that I was no longer any fun.
This plan persisted until I was twenty-four, when the pathway to my rational, highly evolved neocortex—the part of one's brain that lounges atop the rest reading magazines about Danish design—was hijacked by a squelchier, more primitive portion, capable of emitting only one, deafening command.
"BAAAAABY!" it cried while I was doing laundry, or driving to work.
"BAAAAABY!" it moaned at the throngs of pregnant women that had appeared, overnight.
"BAAAAABY!" it would bleat as I shopped for produce, drawing me inexorably to the smallest, most adorable fruits—clementines, apricots, and tiny Saturn peaches.
It was unsettling to find myself in the grip of a passion beyond my control, my formerly many-branched personality pruned to a single, fertility-message-board-reading stalk. I studied the work of psychologists and anthropologists looking for an explanation, books with titles like Maternal Desire, Mother Nature, and On Fertile Ground. I perused academic papers on behavioral endocrinology and the interaction between mother apes and their infants. I learned that injecting prolactin into castrated male birds will cause them to grow broody and hover over nests of young, just like their female counterparts, and that the big eyes and large, bald heads of human babies were engineered to appeal to adult humans, just as the golden natal coat of certain monkeys endears them to their parents.
Shockingly, none of this information did a thing to quiet the insistent yodeling of my biological clock, which I pictured not as sleek and digital, but rather the sort of thing The Professor might have cooked up on Gilligan's Island, out of a coconut. How sophisticated could it be, if it insisted upon sounding a call I had no means to answer? It was a cruel evolutionary misstep, to divorce the desire to reproduce from the ability to do so. Thank God for nuns.
CHAPTER Two
The morning of my first injection I rose early, poured a bit of rubbing alcohol onto my kitchen counter, and wiped it down with a paper towel. I opened a sterile syringe and drew up my dosage, just as the Swedes had shown me. I applied ice to my abdomen for a few minutes before using an alcohol wipe to clean the patch of skin. Then I grasped a pinch of belly fat and swiftly jabbed the needle into my flesh, a wee hara-kiri. As I depressed the plunger, I felt an unexpected steely thrill. Had I been a cartoon, my chest might have visibly ballooned as I pressed a cotton ball to the injection site, and it was all I could do to keep from pumping my pale fist in the air.
I'd always liked a rousing game of rummy, but anything more physical was out of the question. My mother, an avid baseball fan, was once hit in the neck by a line drive, and knocked flat and breathless. Medics carried her into the under-area (dugout?) and in time something horrifyingly livid developed atop her windpipe, the sort of bruise that has three dimensions. My mother and I had markedly different reactions to this event: she returned home ebulliently clutching an autographed ball, and I added "spectator" to the list of sports positions I had no desire to play.
In elementary school, I watched my classmates fling themselves around
on the monkey bars and envied their obvious ignorance of the danger all around them. My first serious boyfriend owned a motorcycle, and in retrospect, this alone should have told me it wasn't meant to be—sooner or later he would tire of my excuses (Groin pull! Improper shoes!) and find someone who enjoyed the feeling of the wind in her hair. I was not that person. I avoided things that made me anxious until they imploded into disasters that made me more anxious still: I lost a car to parking tickets and ruined my credit by fearfully stuffing overdue bills into a drawer, or consigning them to the recesses of my handbag with the redundancies of pens and lip gloss, the untethered dollar bills, and the wallet and calendar I was too forgetful to use. I was nervous and obsessive, but lacked the redeeming compulsion for organization that often accompanied these traits, instead bumbling through life like a precociously informed child: all the curmudgeonly dread of a 70-year-old, without the basic life skills. My ancestors were hardy pioneer stock, but my fear of driving and suspicion of bees, the wave of dread I experienced before making a simple phone call—all of this evidence made me suspect I was not only weak and ineffectual, but fundamentally unfit for the life of an adult human.
A week into my IVF cycle I hardly recognized myself. There I was, stabbing myself with needles—me! a girl afraid of Frisbees!—and it didn't faze me in the slightest. There are women who play rugby and balance their checkbooks yet blanch at the sight of needles, and many patients delegate the shot-giving to a partner. They take deep breaths and wait for it to be over; they close their eyes and visit their Happy Places. I, however, performed every injection myself, and performed it with relish. I did not require visualizations of white sand beaches, and after years of finding difficult activities that others dispatched with ease, it was exhilarating to be on the other side of the Frisbee, so to speak. I'd never felt so sure and capable, despite years of therapy. It appeared I could have saved considerable expense by cultivating a confidence-boosting habit of IV drug use or self-mutilation. I dropped my used needles into a sharps container with DANGER! printed on the outside, and while I may not have laughed at it, I often glanced smugly in danger's direction as I left for work.
For all my newfound bravado, the barrage of hormones began to take
a toll. The precision and ritual of injecting saline into a vial of powder or tapping the bubbles from a syringe had reminded me pleasantly of chemistry, my favorite of the sciences in school. But IVF wasn't chemistry, not really: it was biology, a class I'd hated for its surfeit of variables and mobiuslike feedback loops. Glancing from a textbook illustration of clearly labeled organs to the inscrutable mishmash of yellow and gray in my belated frog, I'd felt weary and overwhelmed—apt descriptors of my mental state after twelve days of injectable mother superior. My uterus twinged and cramped, and one ovary rested directly atop my bladder, creating the sense that I was perpetually near incontinence. Near-daily monitoring made me late for work, and no one likes to begin her mornings with a cold ultrasound probe to the vagina. Blood draws left my arms bruised and track-marked, but the suspicions of my coworkers were easily allayed by the bloating that left me far too zaftig for heroin addiction.
My ovaries responded slowly at first, and when my dosage was doubled I began waking with night sweats, a sheet clinging clammily to my skin. After spreading a dry towel on the bed I'd lay on my back, feeling my ovaries floating heavily in my pelvis like overripe fruit, my mind scampering ahead through all the ways that things could go wrong. I might get pregnant, but even then there were miscarriage, stillbirth, and SIDS to worry about—not to mention the inevitable misery when my baby left for college and stopped returning my calls. My anxiety was so practiced and efficient that I could begin with a small thing in the present, and be fretting within moments about hypothetical events 20 years in the future.
Genre:
- On Sale
- Aug 10, 2010
- Page Count
- 304 pages
- Publisher
- Running Press
- ISBN-13
- 9780762441594
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