Tag Archives: foster care

Fertility Friday: Creeping arrogance and why I’m not ready for the “logical” next step.

Many moons again, I very seriously did not want children. I had a vision of my life that included a big city, well-tailored clothes and sky-high heels, perhaps appearances on Saturday Night Live — most likely as a host.

Delusions of grandeur I suppose.

But I came down out of the clouds and dove head first into science.

I had a new vision of my life. Long hours in the lab, strokes of pure brilliance that led to world-changing discoveries. Maybe making SNL only as a weekend update, a joke about how someone so pretty ended up being a surprise genius.

Ok, fine…

Guest star for one sketch, but only as my busy and important schedule allows.

Clearly not cured — delusions still present.

I don’t think I ever said most of those things out loud, but we all dream, don’t we?

There are some things I did say out loud though.

While in my first delusion — no children. I didn’t want them. I wouldn’t have time for them and I had never felt maternal in the slightest. My sister would be the one to have 2.5 babies, a dog, and a house with a white picket fence. My high rise, luxury apartment building would be no place for a crib.

By the time I’d made it to the second delusion, I could see myself actually getting married and maybe having a family. But as a selfless world-saver, who was I to bring my own child into the world when there were so many others that needed love? No, I’d adopt. Maybe from a third world country. That’s what I’d do. It’d fit with the image. And no one could tell me it wasn’t a good thing to do.

And there was a  point, on a day where I’m sure that I was trying to impress someone, that I know I said it out loud. That someday, I’d adopt because there are just so many children in this world that need love and I’d undoubtedly be in the position to give it to them.

 

In the years immediately following, I thought relatively little about that incredibly vain comment. I was too busy slogging my way through grad school. Perhaps the most beautiful thing about that slog was that it thoroughly cured me of my aforementioned delusions for two reasons. First, I tried living in DC, the big city of my first high-heeled fantasies and found it to be a poor fit for my real-life personality. I’m a midwestern girl through and through and after a year or two on the east coast, I knew I’d be back near the Great Lakes before too long. And second, after six years of 24/7/365 hard work and intense scrutiny, normalcy was all I actually wanted — a job that felt meaningful without requiring hand-cuffs to anything round the clock.

I found all that and more happiness than I had imagined, even in my wildest delusions, in moving to Marshfield, in marrying Seth. And then we tried to do the next bit… the baby carriage. And I fully recognized the arrogance of my earlier comments, in thinking that I ever even had a choice.

It’s taken on a whole new meaning now, as we accept defeat and think about what comes next. Adoption is not necessarily off the table, but it’s certainly not a Right Now thing and it’s also not as simple as going to the baby store and picking out a baby. There’s an awful lot more to it than that and perhaps more than anything, it’s not about saving anyone but myself, my husband’s and my dream of having children. What better to exemplify the difference between 20ish and 33?

 

The reason I bring it up again, especially because it’s mortifying to admit the things I thought about once upon a time, and even worse to cop to the horrifyingly arrogant things that I said, is because the universe seems to be hammering it home to me at the moment. It’s this lecture from others that I most dread, and yet the phrase I most often hear — there are so many children out there that need love, you know!

YES! I do know. In fact, I know it so well that I said it myself more than a decade ago, like I knew what it meant.

Now, it actually makes me angry. Oh really… if there are so many kids that need out there that need love, then why don’t you adopt? What makes you so special that you get to have biological children, the regular way? Are you going to give me the $40,000+ and make sure a family picks me, considers me worthy, helps me to get through that agony and sits with me as I worry that a birth-mother might change her mind? Are you going to walk with me as I explain the concept that looks to any adopted child like not being wanted? And if they are a different color than me, are you going to make sure your children are sensitive to that or do I have to make sure that mine is extra-resilient?

Why do you get to assume, now that I cannot have children of my own, that the unloved children of the world have somehow become my responsibility?

That’s really the crux of it. That because the choice is gone, there is now a responsibility instead. That in trying as hard as we did in the first place, we somehow signed a contract that leaves us bound to the notion of children by any means — because so many children need love.

And consequent to that sense of responsibility shirked… comes the guilt.

I mean, there are a lot of children that need love and I do want children. I do have a lot of love to give. Is it, then, my responsibility? Is it the right way forward? Should we even have the right to think about it? Or is it simply a given that we ought to accept and move forward with.

 

Fortunately, my rational, 33-year-old mind, can bring me back to reality… and the creeping arrogance recognizable even in these considerations of responsibility. The fact of the matter is, no matter how much love I have to give, I will never be any child’s savior. To assume that motherhood via fostering and/or adoption is something I should do, or the right thing, the logical next step, or really anything other than a privilege and the ultimate fulfillment of love and family, is not ok.

Yes, there are a lot of children in this world, with families and without, that need love. But more than that, children deserve real love. They deserve to be wanted, to be dreamt about, to be wishes fulfilled. Not responsibilities to be met, logical next steps, pet projects, or consolation prizes. So until we are in the right place, heart, mind, and soul, I won’t stop being angry over that little lecture. And I won’t commit to the next step, no matter how logical it may seem to anyone else.

 

One of the most interesting things about infertility to me has been the way it has forced us to make decisions intentionally. There’s nothing wrong with having sex, getting pregnant, and raising children. But at a certain point in that process, nothing’s going to stop the train — and the train is a big one, a looooong one, an expensive and noisy and time-consuming, loud, and messy one. There’s little time to think, prepare, or even react. You just do. Or at least, I imagine that’s what it’s like.

When the train isn’t coming, you suddenly have a thousand different choices about how to get from point A to point B. Starting with, is point B even the destination you want? Have you considered C? What about D? Maybe even just staying put? Perhaps a train’s not even the best way to get there. Maybe a flight would be better — but can you afford first class or should you go economy, and potentially go more than once? Would it be worthwhile to rent a car first, see how far you can get that way before deciding on something more pricey? Perhaps you could rent or buy transportation from someone else? This metaphor is getting out of control… but I think you can see my point.

When things don’t “just happen,” it all becomes rather complex and you are forced to stand there on the platform and consider all the alternatives, with nothing but time to do so. Maybe even running head-first toward 9 3/4 once or twice, just to check and see if that’s an option.

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Of course, standing there, you understand that there are many children who need love… but are you the right person to give it to them? Genuinely and as deserved? Another decision, one that takes time and discernment. Not lectures, not logic.

The Precipitate’s Not the Problem: An Infertility Primer for the Non-Infertile

“If you’re not part of the solution, you’re part of the problem.” – Your Mom

Or maybe not your mom. Maybe it was your dad or a great auntie. Maybe a principal or a well-meaning member of the safety patrol. Whoever it was — someone said it to you at some point. And you got the point. Unless you’re trying to fix the problem, you are the problem. We’ve all internalized it. And since no one ever ever wants to be the problem, our natural inclination is to offer solutions, to fix it.

And then we all grew up a bit. If you’re anything like me, you became even nerdier. Maybe you even got into the chem scene (which makes chemistry sound cool, don’t you think?). If that’s the case, you may have latched onto this alternative adage — my personal favorite:

“If you’re not part of the solution, you’re part of the precipitate.” – All the Nerds

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It made you laugh and laugh (not as much as the ether bunny or the ferrous wheel, of course), but you knew deep down that it was only a chem joke. Not a real life lesson.

Or is it?

I posit that it’s a better saying, really. More accurate for particularly complex problems, like infertility. Because to extend the chemistry metaphor a bit further — in the case of infertility, there are only two solutes in solution. My partner and myself. Anyone else can really only be part of the precipitate. A precipitate can’t fix anything, it just hangs out in the tube, separate. But that doesn’t make it part of the problem.

{Image Source -- Thanks Dartmouth Chem Lab}
{Image Source — Thanks Dartmouth Chem Lab}

In the wake of our most recent crappy news, we’ve been offered a lot of love, a ton of support, and so very many ideas for next steps — ranging from “just relax” to offers of surrogacy and referrals to adoption case workers. These fixes come from a place of love, good intentions, and probably also a subconscious devotion to the first quote above. Unfortunately, it’s no one’s problem to solve. Instead, it’s Seth and my path to walk and because I know it’s hard to understand, hard not to want to fix, I thought it might be nice to share some aspects of infertility from my own perspective.

But you ain’t got no eggs!

Infertility happens for a million and one different reasons. Or even for no discernable reason at all. There’s male factor and female factor infertility. One or both partners can be affected. There can be no eggs, poor eggs, an inability to release eggs. Similarly, no sperm, poor sperm, immobile sperm. It can be mechanical — related to the shape or size or functional ability of the uterus, the shape or size of the vas deferens. It can be scar tissue, the result of surgeries, childhood radiation treatments. Genetic, chromosomal, hormonal issues. All of the above, none of the above, anything in between, or something else altogether.

We started out with “unexplained” infertility (i.e. everything seemed to be just fine). While it’s good to have nothing obviously wrong, lack of diagnosis makes treatment much more difficult — everything is just a guess at that point. However, after lots of tries (see below), we ultimately ended up with a diagnosis of diminished ovarian reserve. That means that despite being just 32 (and only 27 when we started trying to conceive), my eggs are just about out. The tank is approaching E and the few eggs I do have left are poor in quality — hence the miscarriage late last year. That’s our reason. And ultimately, it has the greatest impact on our potential solutions. So while I appreciate the offers of uteri for rent and the like, that’s not actually going to help me one bit. My body is technically quite capable of carrying a healthy pregnancy, we’re just missing half of the equation.

Grieving the loss of imaginary piggies.

Miscarrying last September was really hard. It was the most difficult experience of my life to date and the grief still comes so fiercely sometimes that all I can do is hold on and ride the wave for a while. I still had hope though, I thought that pregnancy would be followed by another. That we would have our own children. As it turns out, though, the lack of eggs means that the thing I’m really grieving is an imaginary future — one that was never going to exist, but always felt real to me in my mind. I’ve spent years wondering about the curly blonde babes Seth and I would someday bring into this world. I’ve always imagined us like Piggy and Kermit — all the girls would be pigs, all the boys would be frogs. Would they have my green eyes or Seth’s blue? My ready, beaming smile or Seth’s slower, more mischievous, lopsided grin?

Imaginary future... {Source}
Imaginary future… {Source}

And then just like that — I’ve been removed from the equation. No piggies at all. I can’t pass on the Vonck mouth. My genes won’t ever go anywhere, no matter what we decide to do next. That’s a hard pill to swallow. Something I have to wrap my mind around. Another loss to grieve, but how? There’s no memorial in the cemetery for this loss and it’s hard to know how to let it go.

All magic comes with a price, dearie.

After more than a year of trying to conceive on our own, we sought medical care for infertility and decided early on that we wanted to exhaust our possibilities to have biological children. And exhaust them we did. We’ve spent many, many, many thousands of dollars on diagnostic testing and assisted reproductive technology ranging from simple clomid and timed intercourse to intrauterine insemination (IUI) and finally two rounds of in vitro fertilization (IVF) over the course of 4+ years.  Side-effects, needles, injections, ultrasounds, surgeries, procedures, tears and snot and stress and rage and bloating and month after month after month of disappointment. We did it all for a chance — all at great cost.

None of it worked for us. Now we know why. And because we’re quite certain that we do indeed want to be parents, we’re left looking at the next set of alternatives.

Egg donation, adoption, fostering. And even those options have sub-options — fresh or frozen, international or domestic, public or private. And those sub-options have sub-sub-options — how do you pick a donor? Physical characteristics? Genetics? Occupation? Personality? Psych profile? And if you adopt — are you prepared to wait for an eternity? Are you willing to let a birth parent pick you? What if they change their minds? What if you fall in love with a foster child and then they get sent back to their biological parents (Wisconsin focuses on reunification whenever possible)? Can you bare that? Can you bare any of it?

It’s a lot to think about. So much to process. And all of it — every last option — comes at great cost. Physically, emotionally, financially. On top of everything we’ve already been through, every time we hear “at least” (e.g., at least you know you did everything you could, at least you can afford it) or “just” (e.g., why don’t you just adopt?) it’s like salt in the wound — minimization of everything we’ve done so far and the difficult road ahead to family. Yes, we are fortunate that we can consider options, but that doesn’t make the necessity of considering them any easier.

It’s not you, it’s me. 

The ugliest truth about infertility is that it colors everything. Over these last four years, infertility has become increasingly woven into my being and I have a hard time separating who I am from this thing I can’t do. I’m not proud to admit it, but in the face of cutesy pregnancy announcements, #blessed ultrasound pictures, and bow-decked baby bumps, happiness for those that I love and a sense of jealousy and bitterness are always there in equal measure. Of course, I wouldn’t wish infertility on my worst enemy, but that doesn’t mean I handle fertility with any kind of grace and I’m issuing a blanket apology for my poor reactions. It’s not you, honestly, it’s me. And presumably, someday it will get better, easier, to just be happy.

But here’s the most important thing: the announcements, photos, bumps, hashtags, motherhood memes — none of them have anything at all to do with me. So you shouldn’t stop doing them. It’s all worth celebrating and my scroogey attitude shouldn’t take away from that.

Conversely, radical self-care and self-preservation means that some Facebook friends are hidden and I won’t be RSVPing yes to a baby shower or making any more baby blankets for the foreseeable future. It’s too painful. I don’t ask for forgiveness or even understanding, just patience.

All roads lead to Rome.

Ultimately, there are a lot of different paths to parenthood. At present, I struggle because I don’t like any of the choices. Or, more accurately, I don’t want to have to make a choice. I will come around though. I always do, but as I said above, there’s no “just” about any of the paths. Once pregnancy via sex and waiting is off the table, nothing feels simple anymore.

In my present state of mind, egg donation proves that Seth really should have married someone else and fostering/adoption is unlikely to work out considering that even God wouldn’t choose me to raise a child — why would anyone else? Thankfully, Seth is much more capable of rational thought at the moment and I’m slowly starting to wrap my mind around some of the options. One foot in front of the other, all the way to Rome.

Not everybody wants to go to Rome.

But then again — Rome isn’t for everyone in the end. And there’s nothing wrong with making that decision for yourself. Families come in all shapes and sizes, Seth and I are a family all on our own and puppy makes three. Ultimately, though, the societal assumption is that if you’re infertile, you want to have children in any way possible and there’s the tendency to push couples struggling with infertility to pick a road and get to parenthood, one way or another.

Right now, Seth and I are pretty certain that we want to find a path to parenthood, but I think it’s really important that people accept any choices we do decide to make from the perspective of the precipitate. These things are incredibly personal and based only a little on biology, medicine, and rational thought. More than anything, we have to trust our emotions, our hearts, and each other to make the right choices for us moving forward. We both have to be on board with something 100%, no judgement if not.

The same goes for any other couple, any other family, and if you find yourself interested in learning more, I highly recommend perusing CNN’s recent infertility awareness week series. I shared this article on Facebook this morning and got a great response to it:

When you ‘come out’ about infertility

And there are several related articles written by or about couples who’ve made a variety of different choices that make great points about why people don’t talk about infertility (and why they should), how a “happy ending” to infertility can mean different things to different people, and how varied infertility experiences can be.

 

I’ve been spending a lot of time lately with the writing of Brene Brown and Anne Lamott and Jenny Lawson. Brave women who share their stories in an honest and beautiful way — they’ve opened me up to a whole new level of comfort in the idea of vulnerability and struggle and story telling and I think that for me, infertility is another avenue for that. The ranks of the infertile… not a tribe I’d have chosen to join, had it been a choice at all, but it’s a fierce one and I’m in good company. Someday, I’ll have a very intentional family and Seth by my side and I’ll be in good company then too. Thanks so much for being here through it all <3

 

A science project with a missing piece. Where are my shoes?

My sister-in-law Kayla, Sister Athletic Trainer, is an absolute genius at puzzles.

I don’t mean that Kayla likes puzzles, although I suspect she does. I mean that she is literally a puzzle genius. She can walk by a table holding a 12,000 piece puzzle entitled “sky on a cloudy day” and find at least 6 pairs of matching pieces before I can even figure out which way to orient the picture on the box.

I am not being facetious.

Maybe Kayla has just had a lot of practice. She has spent three of our last 11 week long cottage vacations doing puzzles as she recovered from major knee surgery (as good as she is at puzzles, she’s not exactly awesome at keeping her own ligaments from tearing). Maybe it’s a gift from God or something. (Drop Dead Gorgeous reference… anyone?) I don’t know. But she’s real good.

At the moment, I feel like I’m staring at a complicated and beautiful puzzle and all that I have left is one particularly challenging bush or patch of sky or something. Once I get a couple pieces in place, the whole dang thing is going to fall together, but I can’t figure out where to start and I am le frustrated! (The “le” is intentional– I’m pretending that the word frustrated is French.)

Here’s what’s up:

In my job (like my real J-O-B) I work as a scientific research writer, which basically means that I help clinicians and scientists to write grants and manuscripts (and yes, sometimes even eulogies and other speeches and such) about whatever scientific endeavor they favor at the moment. I’ve worked on tons of different things. It’s awesome, really, because as much as I dig STDs, 6 years of nothing but gonorrhea and chlamydia got to be a little bit much. I’m not that into it. In my current job, I get to learn about new and interesting things all the time– oncology, genetics, bioinformatics, cerebral palsy, Alzheimer’s disease, chronic kidney disease, pancreas divisum, diabetes, neuroprostheses, patient navigation, and the list goes on. It’s awesome… like being in school minus the grades plus a real salary. Life is good.

Because I really love science and because nerdiness is my life, not just my job, I get quite invested in the things I do. And it’s all that much easier to get sucked in when I work with really passionate investigators… and so many of these investigators, just wow. These clinicians see a problem in their practice and come to us to either study the problem or solve the problem, and it’s inspiring. I have three projects swirling around in the back of my mind all the time right now. And there’s something about them that’s similar, they are related, they are somehow the answer to one another’s problems, but I can’t figure it out. That’s my puzzle. And it’s becoming my obsession. How can I make these things work together for the good of patients? I won’t know until I can fill in the sky!

Not long ago, I worked with a pediatric nephrologist and learned about Bardet-Biedl syndrome (BBS)– a rare genetic disorder that results in cilia malfunction and many consequent symptoms affecting nearly every organ system in the body. Because the disease is so rare, finding care for these kids, especially coordinated care with specialists who truly understand the disease, has always been a major problem for BBS families. Recognizing that challenge, Dr. Haws started The Treatment Center for BBS at the Marshfield Clinic to provide coordinated, comprehensive care for patients around the country… and even around the world. It is the only BBS clinic in North America and has already served 16 individuals from 14 different families in its 3 clinics to date. I helped Dr. Haws capture survey results from providers and families that participated in the clinics and the comments from the grateful families were overwhelming. I was particularly struck by the woman who blogs here at 71toes.com (polydactyly is a common symptom of BBS and her family of 7 was no exception– how clever!) as she documented her family’s participation in the clinic. So cool!

Coordinated care for kids with special medical needs… it’s a thing that’s done well for many kids at Marshfield Clinic. But what about kids in the foster care system?

I have also spent a lot of time working closely with the medical director of the Marshfield Child Advocacy Center. She is totally committed to creating a Foster Care Medical Home (FCMH) for kids in the foster care system in Central Wisconsin. Medical homes are a really effective and interesting way to make sure that healthcare needs are met in a timely, consistent, and patient-centered manner and it’s something Marshfield Clinic has really embraced in recent years resulting in huge cost savings as well as huge reductions in the need for emergency care and hospital readmissions. We don’t have one for kids in the foster care system, though, and they likely really need it. At the moment, I’m working with Dr. Iniguez to complete an American Academy of Pediatrics planning grant for the FCMH and we just completed our third of four focus groups with foster care providers and past participants. Holy… wow! These families. I mean, I was into it before, I thought it was a great idea… now? I’m smitten! I want this to succeed, to help these families, so very, very badly! I am committed. But how? Where do we find the funding? Whose going to coordinate the care? Can it be like the BBS clinic?

And finally, behavioral health. I told you about my big fat $1.5 million HRSA grant? The one that kept me from blogging for over a week, right? What I didn’t tell you was this: due to a “misinterpretation” of the guidelines, the grant was triaged without being reviewed. WTF, right? I know, I’m furious, but trying to be cool about it… because the program is just way too important to let die now. Yes, it was a big mistake. No, I was not at fault (thank goodness, right?!). But dang, do I ever feel responsible… disappointed… dejected even. It was unpleasant news for everyone involved. And now we’re looking for another way. Another way to bring behavioral health services to patients in the primary care setting who desperately need them, but cannot get them due to the provider shortages we face in our area. How does this fit in? Well, you know who else desperately needs behavioral health services but can’t get them? Kids in the foster care system. These kids benefit tremendously from the notion of trauma-informed care… care that keeps in mind, always, that these kids have been through a really stressful, really awful situation and that those traumas subconsciously inform their every single action.

So, in conclusion, I feel like there’s something there… an invisible thread weaving its way through these projects and constantly tickling the back of my mind. It alerts me to the fact that there’s something in common, some answer that I’m overlooking, some person who needs to be contacted or informed or something. I just can’t find what that something is at the moment. I am missing a vital piece of the puzzle– I’ve got to find my special purpose! (The Jerk, yes?)

 

Two winters ago, my husband’s grandfather set up a card table in the living room and worked on a puzzle all winter to keep himself occupied while it was so cold. He did a bigillion piece puzzle or something and it had a lot of sky in it. Lots and lots of plain, blue pieces spread out on the table. And when he got to the very end? One was missing.

There was one piece of sky that was blank.

And it stayed blank for a while.

Until one day, Ed, my grandfather-in-law, bent down to put his shoe on and found a puzzle piece in it. It was in his shoe! Right there! All along! He snapped it in and the puzzle was complete.

I’ll find the piece. I’ll make the connection. We’ll make the foster kids a medical home and extend behavioral services to the population that needs it.

Where are my shoes?

Better yet… where is my sister-in-law???