I Will Be A Better Mother

There are women who become mothers without effort,
Without thought,
Without patience or loss,
And though they are good mothers and love their children,
I know that I will be better.

I will be better not because of genetics
Or money
Or because I have read more books,
But because I have struggled and toiled for this child.

I have longed and waited.
I have cried and prayed.
I have endured and planned
Over and over again.

Like most things in life,
The people who truly have appreciation
Are those who have struggled
To attain their dreams.

I will notice everything about my child.
I will take time to watch my child sleep, explore, and discover.
I will marvel at this miracle
Every day for the rest of my life.

I will be happy when I wake in the middle of the night to the sound of my child,
Knowing that I can comfort, hold, and feed him
And that I am not waking to take another temperature, pop another pill, take another shot
Or cry tears of a broken dream.

My dream will be crying for me.

I count myself lucky in this sense;
That God has given me this insight,
This special vision
With which I will look upon my child.

Whether I parent a child I actually give birth to
Or a child that God leads me to,
I will not be careless with my love.

I will be a better mother for all that I have endured.
I am a better wife,
A better aunt, a better daughter,
Neighbor, friend and sister
Because I have known pain.

I know disillusionment,
As I have been betrayed by my own body.
I have been tried by fire and hell
That many never face.

Yet given time, I stood tall.

I have prevailed.
I have succeeded.
I have won.

So now, when others hurt around me,
I do not run from their pain in order to save myself discomfort.

I see it, mourn it, and join them in theirs.
I listen.

And even though I cannot make it better,
I can make it less lonely.

I have learned the immense power of another hand holding tight to mine,
Of other eyes that moisten
As they learn to accept the harsh truth
When life is beyond hard.

I have learned a compassion that only comes by walking in those shoes.

I have learned to appreciate life.

Yes, I will be a wonderful mother.

-Author Unknown

Snow

Snow2

 

In July 1978, less than two years before my birth, the first baby conceived by IVF, in vitro fertilization was born. Louise was born in England. More than three million children have been born using IVF in the years following. Six years later, the first baby was born having been conceived using IVF with an embryo that had been frozen. The embryo became a baby girl named Zoe, born in April 1984 in Melbourne. The same year in Australia a child was born with the participation of two woman, one provide an egg as a donor and the other carrying the child in her womb. More than three million children have been born in developed countries using IVF in the years following.

Cryopreservation, where cells or tissue are frozen to subzero temperatures to a point where all biological activity is paused, plays a central role in modern IVF procedures. Oocytes, or eggs from a woman, can now be frozen, as well as embryos and sperm. Oocytes are more difficult to freeze and thaw due to the large amount of fluid in the oocyte cell. When fluid is frozen, it can expand, causing damage to the egg. A method of freezing where ooctytes are flash frozen using liquid nitrogen, vitrification, has been developed in recent years, to allow cryopreservation of a ooctytes to be a feasible part of the IVF process.

Oocyte vitrification has become a new method for fertility preservation in young woman who may no longer have a plentiful supply of eggs when she plans to have a family. The method is newer than freezing of embryos, which has been shown to have comparable success rates to fresh embryos, but emerging results are encouraging. The first baby conceived using a frozen egg was born in 2002 and since then the technique is emerging as a means of hope for young woman who may see their fertility compromised by necessary treatment or early menopause. Early studies have demonstrated that frozen eggs may result in a pregnancy rate equal to that using a frozen egg.

At last, some good news.

In March 2008, I was advised to have radiotherapy in addition to surgery as part of my treatment, to improve my chances of recovery. Radiotherapy to the pelvis will, without intervention, cause a woman’s ovaries to be damaged beyond recovery, so that she will both start early menopause and no longer produce eggs viable for a pregnancy, surrogate or otherwise. As a result, a select few specialist fertility surgeons are now are able move ovaries prior to pelvic radiotherapy, out of the intended field of radiation. Initially this was an attempt to avoid early menopause, but has the happy side effect that a woman may well continue to produce eggs, which can then be collected using an IVF procedure, to conceive a child.

Prior to this, I had read of egg freezing in news stories, but only in the hypothetical context of a healthy woman choosing to freeze eggs then pursue a career and adventurous life before having children later in life, after her natural fertility had reduced. I had no idea that freezing of eggs could offer a lifeline, literally a lifeline, to young girls diagnosed with life changing fertility relevant conditions. I was soon to become one of those girls.

My doctor told me that egg preservation was not necessary for me, as we would move my ovaries and therefore I would remain fertile and could just do an IVF cycle when I wanted to have a family, putting the embryos in a surrogate. This is true, but given the amount of absurd and unlucky things that had happened in the weeks prior, I was not soothed by this promise. As always, this path was not certain or guaranteed, just likely, and given the masses of bad news and luck I had felt in the preceeding weeks and months, I was not confident of landing on the most likely side of the line. My doctor happily referred me to a fertility specialist, in one of is many valiant and generous attempts to get me willingly agree to treatment. I saw the fertility specialist, a private doctor, the same day, while most cases wait three months to see him. As was to happen often in this time, I was the interesting case, a young girl, an unusual patient. I resented this as it just reminded me how extra unlucky I was to be the unusual one in statistics that said my case should not happen often, but it is true looking back that this very fact allowed me good access to medical professionals, personally interested in me and my case. Anyway, I went to see the Fertility doctor, he said sure lets freeze some eggs but maybe I should freeze them somewhere else, have I ever been to the USA, sure he’ll move my ovaries and while he’s at it he can freeze some ovarian tissue, just because he can. What, now?

Well, I would be freezing eggs with the intention of using a surrogate. Surrogacy is more common in the US than France and Switzerland where we were based, therefore we had to decide where to freeze them. IVF has to be timed with a natural cycle and can only be started on one or two days a month. We would have to wait for the appropriate day, so a delay of up to a month was possible. Usually this is no problem, but in the case where the IVF is being done for fertility preservation before urgent treatment, a delay is not good. I was very fortunate that the illness I has was considered slow enough developing, so that it was reasonably safe to consider a delay by some weeks. In some similar illnesses there is not a day to wait and no time for any preservation of ooctytes or embryos, or hormone treatment of IVF is likely to fuel the illness so cannot be used. For me however, a short delay and hormone treatment was a safe possibility. We did a blood test and realised that we could start a cycle that very day. There was less than ten percent chance this would have been the case. At last the statistics and my tendancy to be in the unusual case was starting to work in my favor.

My mind was already blown to new realms of normalcy and my doctor was finding this all very interesting and not in an average days work, so we planned an international cross continental IVF cycle. I would have the first part of the cycle with him in Europe, once the eggs were almost ready to be collected I would jump a plane to San Francisco, have them collected and frozen there. My doctor in Europe had contacts at a fertility clinic in San Francisco and was able to coordinate the efforts. The doctors in the US clinic were, for the record, amazing. They were flexible, positive and willing to work with me in this way. I had spent the last seven years talking about easygoing, smart and kind California life and my descriptions were coming to life now.

So I embarked on an IVF cycle. I have read descriptions of IVf as being difficult, stressful, uncomfortable, almost unbearable, but in truth, I found it easy. I had a hormone injection every day for about a month, the drugs come in syringes which I kept in my fridge where the food had previously been, I did the injections myself and really, its a tiny needle. Yes I felt it, yes it left some fairly impressive bruises, but with a little perspective, it was not painful or difficult. For the last couple of weeks I had a blood test every second day, which again is not a big deal once you get used to it, it was quite nice to get out for a walk really and if anything it encouraged me to eat and drink a little once I realised that my blood wasn’t going out of me if I was dehydrated. So we monitored the development of the follicles containing eggs using my hormone levels and a couple of ultrasounds, then once we anticipated they would be ready for collection within a week, I booked a flight to San Francisco for the retrieval.

My hosts and friends in San Francisco, Bryan and Whitney, and Bryan’s sister Tiffany who arranged for me to stay with them, deserve a story of their own. For here I’ll stick to the story of snow.

So, I arrived in San Francisco on a Saturday. I went to the clinic the next morning for blood tests and an ultrasound. My doctor in Europe had monitored the development of a number of possible follicles and eggs. All eggs have to develop at the same pace as there is a small window where an egg can be retrieved and used, but the final stage is prompted by a hormone injection, exactly thirty six hours before retrieval, so all must be collected at once. If an egg is underdeveloped it will not fertilize, if it is over developed it will be spontaneously released before it can be collected, or will not fertilize when collected. The process of IVF is one of monitoring and adjustment, to allow a number of usable eggs to be collected at once. When I arrived in San Francisco I had thought that there was perhaps four or five potential follicles developing in each of my ovaries, as this is what we had seen in the previous weeks in Europe. On the first day I saw a doctor in San Francisco, he ran the tests then told me from what he observed he thought there would be at best four or five eggs, most probably two, possibly none, and that in this case he would advise abandoning the cycle completely when there was no time pressure and careful consideration of whether the financial costs and potential false hope of a very small number of eggs were worth it in a case where time did count. I was devastated. This was a problem I had not anticipated and I had anticipated all the problems in the world it seems and I was just exhaused with things going against me.

I decided to go ahead anyway, as there was no other option except to give in, something I just could not do. My hormone doses were doubled and we carried on, till the retrieval was schedule for the following friday. We did the massive hormone injection thirty six hours before and I went for the retrieval. Bryan came with me and I took my white bear. For the procedure I had a sedative, I think because I was shaky they gave me enough that I don’t remember anything for the half an hour it took. As I came round, Bryan popped his head round the curtain smiling as always. “It’s good news”, he said, “do you want me to tell you?”. “Yes” I answered before he had finished even asking. He answered, in his soft, kind, lovely deep Californian voice, “Nine. You’ve got nine”.

I don’t remember what I said. I know I was elated. I had been desperately hoping for five, the best I had been told to expect. At last, my body and I had got something right. Not only right, we had kicked medical ass. The embryologist came to see me and said I had seven excellent quality eggs and two a little less mature but still very strong valuable.

Now the good news was just raining down like gold.

He gave me a photograph of them taken through a microscope and predicted an eighty percent chance of a pregnancy with them. As he drew his finger around the circles  he said with a smile, “You could very well be looking at your future children there”.

As we left the clinic Bryan suggested a drive around San Francisco. I asked for the Golden Gate Bridge and made him drive us across one of my favourites places in the world on that beautiful sunny day twice. Twice for twins.

There are no problems, only solutions

The illness came to me in January. It began with a small abnormality, a small number of changing cells most likely, usually go away on their own, easy to treat if we so desire, nothing to worry about. I knew right then, immediately, I just knew. “I’m not having the surgery” I said, not really listening to anything else he was saying. He rocked his head back, leaned back in his chair and laughed, then adopting his serious voice “This will not effect your fertility at all”. He took some cells and some blood, to decide whether he wanted to treat or whether it was so minor we should just leave it to correct itself. “Nine times out of ten we do nothing, there is nothing to worry about”. I already knew.

I left in a daze and went on to work, I remember what I was wearing, dark blue jeans, a light blue sweater. A friend saw me arrive, saw my dazed face and the plaster on my arm from the blood test. “Oh, you are pregnant!” he said. For the first time in my life, I wished that I was.

Two weeks later I went back for the results. It was more serious than the doctor had predicted, high level changes or possibly more, localised and noninvasive. This is still nothing to worry about, we will treat it he told me, with a minor surgery to take away the bad cells. So we did.

Two weeks later I went back. I was slimmer already, without realising it I had already stopped eating. “It’s bad news” he said. I assumed he meant we didn’t remove all the cells and needed to repeat the process to take the remainder, as I had been told this can happen. No, it was not this. The cells had penetrated and were in numbers that no longer suggested our previous worse case scenario. It was invasive. I didn’t understand what this meant at the time, still protesting that another small surgery was all that was needed. I was the unlucky one he said.

No one ever told me, “You have cancer”. But I did. I was 27 years old.

I was sent to see another doctor, this time there was no two week wait and I saw him within days. There is a possibility we can save your womb he said, opening my files. Ah no, he then added almost instantly, we cannot. “Dont even suggest it” I said, interrupted, holding my hand up to gesture to him to stop. I recall asking him how long I had left. “A year, maybe two” he replied. The rest of the appointment is a blur. It was March.

In the next weeks, refusing to believe what I was told and with my life collapsing in around me, I saw endless cancer specialists, some at my request as I desperately searched for another way, some I was sent to by my oncologist, who in my desperate shocked blur I had not fully realised was an oncologist, in attempts to convince me that there was something wrong. I collected all my paperwork meticulously, obsessively, researching new treatments, sending it to specialists and pioneering specialists the world over. The responses were always the same. A genuinely sad no.

The fertility aspects offered some hope, I would remain fertile, just unable to carry. I would use a surrogate, it would be no big deal. After all the bad news I was unable to accept this. I had been told at every step that I had nothing to worry about, then at every step the opposite was true. So I asked if I could do an ivf cycle and freeze some eggs. Sure, but there is no need they said. In truth I needed to do something and I was not willing to do what they asked. I could not go back to my life as it was before, as I was unable to eat, sleep, or focus on anything else.

So I embarked on an ivf cycle. I have heard many complaints about this process, but in truth I found it easy. I had injections everyday, blood tests every second day, scans twice a week. I then flew to California, to meet with a fertility clinic there. The USA has more progressive laws and technology for egg freezing and surrogate use, so I had made the choice to travel there.

I arrived in California with a small white leather handbag holding pyjamas, underwear, syringes, drugs and my teddy bear. I no longer needed anything else material. A friend whom I had met in my sunny days as a student at the University of California had put me in touch with her brother and his young wife, who met me at the airport and took me to their home.

…..B&W…..

Once I arrived back in Switzerland, I waited two days, then went to hospital. The nurse came to my room and asked if I was ready. I was sobbing already and said No I could not do it, I would not do it. She gave me medication so that I would sleep, telling me I had to do it and that the medication was so strong that I would sleep and would not need to know. I tried to calm down and rest but the sobbing and panic consumed me. I did not feel calm or sleep. The nurse returned and was shocked to find me awake, saying in French that she did not think it was possible. Again, sobbing, I said No, I could not do it, I would not do it. She began to take me, I sobbed, I was shaking, I whimpered, I said No, please, No. The nurses were crying too. When they passed me over to another set of nurses, I grasped the blouse of the nurse who gave me the medication and said “No, Don’t let them take me”. She undid my grasp, I grabbed her with my other hand, she did not look me in the eyes, tears streaming down her face, peeling my hands away from her again and again as I begged her not to let them take me. All the nurses were crying. I remember the sparkle of the diamond earring od the nurse I begged the most desperately, who cried the most tears. Then she was gone.

I was shaking and still sobbing, recoiling from needles and cold hands. No, please. Someone gave me an epidural, I was shaking so much I had to be held still. At the same time there was an IV in my arm. I do not remember the anaesthetic taking effect.

I woke in the post op room. I was wrapped in blankets and wires. I knew immediately. A male nurse came to me as not for the first time, I was sick from morphine. He put his face close to mine so he could hear my tiny voice. Is it done, I whispered. It is done, he said. In the next room a baby was screaming. Is that a baby, I whispered. Yes, born two hours ago, he said. Close the door, I said. Excusez nous Madame, Excusez nous, he said and softly closed the door.

It was the first, and last time, anyone ever said sorry.

Next thing I know I am back in my room, it is dark outside, and I am alone.

I am crying, sobbing, whimpering. My heart is exploding. My primal instincts are ripping me apart fibre by fibre. Despite an epidural, a morphine IV and sedation drugs, I am in terrible pain. I can barely focus my eyes on the outline of the Saleve against the night sky, I see only the blurred blue light from a lookout post high on the mountain. Alone in the dark room, curled up in pain through my body and ripping my soul, under the dark night sky and the blue light on the mountain, one by one, I feel my babies die, that night.

And now, after telling of everything but the illness, after refusing to even say its name, I must tell of all of it.