Remembering my angels on Mother's Day

Mother's Day. For women with living children and/or living mothers, it's a day of happiness and celebration. For anyone who's lost their mother, it's a reminder of what was taken away from them. For anyone who's struggling to become a mother, it's a reminder of what they've never had. For anyone who is only a mother of angels, it is a reminder of what could have been.

I am incredibly fortunate to have a wonderful mother who I love very much. I wish I could devote so much energy to celebrating today with her (albeit from afar), but it's too painful. I've explained this to her, and I think she understands. I hope so. I ask my little sister (who I usually boss around) to be in charge of a joint Mother's Day gift from both of us, because it's just too hard.

Today I was cleaning out my bedside table in preparation for our move. I came across the ultrasound picture I have of my second pregnancy. It's just a little black empty sac, but it's the only physical, concrete proof I have of any of my angels. That ultrasound was performed by a very kind OB attending who basically caught me in the middle of a breakdown, asked what was wrong, got an answer which probably made her wish she had never asked, and offered to do an ultrasound right then and there. It was too early to see anything but a sac, and it already didn't look very promising, but at least it calmed me down temporarily. She even printed a picture for me. Obviously, we lost that baby too. I kept the picture though. On purpose. I guess because it's all I have. I don't have pictures of a fetus, or of babies, or of children. All I have is one picture of one empty sac (I don't even have ultrasound pictures from any of the other pregnancies). But I loved that baby, just as much as all the "real" moms love their living children. So it will have to move with us to the US. It's all I have.

Today I remember my four angels, and what could have been.

Angel #1: BFP 1/31/12. EDD 10/11/12. M/C 3/23/12.
Angel #2: BFP 2/27/13. EDD 11/6/13. M/C 3/24/13.
Angel #3: BFP 12/24/13. EDD 8/31/14. M/C 1/17/14.
Angel #4: BFP 3/20/14. EDD 11/28/14. M/C 4/3/14.

Reflections on my Adventures Abroad

Almost 9 (!) years ago, right after I graduated from college, I moved halfway across the world to a country where I knew one person and didn't speak the language. In less than a month, I will be moving back to the U.S. In the past 9 years, I have:

Moved in with a boy.
Gotten married.
Learned a new language.
Taught an English class, adult swim lessons, and histology.
Published 3 scientific articles.
Applied to, gotten into, and graduated from medical school.
Been to the Nobel Prize Ceremony.
Run 2 half marathons.

But I think what I am most grateful for is the opportunity to travel so much. Before meeting my husband, I hadn't even been to Europe. Now, I've been to 30 countries, 15 of which have been during my time abroad. I've done some pretty awesome things on those trips. I've been skiing in the Alps, which was an amazing combination of breathtaking views and great skiing. I've seen a ballet at the Bolshoi, which was like going to the Mothership of Ballet, and was really freaking cool since I did ballet for most of my life. I've marveled in awe at the pyramids in Egypt, and watched the sun rise spectacularly over Mount Sinai. I've seen the ruins in Athens, and tried to imagine what life was like back then.

A lot of Americans never get these opportunities or, if they do, they don't take them for whatever reason. Mr. E and I love to travel, and have prioritized trips over all else, financially and time-wise. And it's been spectacular.

I've also grown immensely as a person. I've faced so many challenges during the last 9 years, everything from learning a new language to dealing with infertility and 4 miscarriages. I am a very different person than I was when I moved here, and I think I am a much stronger one. And I'm excited for the next adventure and next set of challenges!

PUPO!

I am officially PUPO (Pregnant Until Proven Otherwise)! 

I triggered with Ovitrelle on Thursday night, and started Lutinus (progesterone suppositories, 3x/day) this morning. At 2pm today, I had a 2-day, 4-cell embryo put into my uterus. It hurt a little bit, I felt a few pinches and some cramps, but it was fine. It was a surprisingly emotional experience. I'm not sure if it's because it feels like our only chance or what, but I was just overwhelmed by different emotions. Fear, excitement, nervousness, general unease.

After the FET, I got into my car to drive to work, since I'm working the evening shift tonight. Omni's Cheerleader was playing, and I turned it up and tried to enjoy my drive as newly PUPO. After that song, "I Can See Clearly Now" by Johnny Nash came on. I sang a long. And then I heard a line I had never noticed before: "Here is that rainbow I've been praying for." Naturally, I lost it and had a complete breakdown in the car. I am taking that as a sign.

Here's hoping I get that rainbow I've been praying for. 

I can see clearly now the rain is gone.
I can see all obstacles in my way.
Gone are the dark clouds that had me blind.
It's gonna be a bright (bright) bright (bright) sunshiny day.
It's gonna be a bright (bright) bright (bright) sunshiny day.

Oh yes, I can make it now the pain is gone.
All of the bad feelings have disappeared.
Here is the rainbow I've been praying for.
It's gonna be a bright (bright) bright (bright) sunshiny day.

Look all around, there's nothing but blue skies.
Look straight ahead, there's nothing but blue skies. (Ies)

I can see clearly now the rain is gone.
I can see all obstacles in my way.
Here's the rainbow I've been praying for.
It's gonna be a bright (bright) bright (bright) sunshiny day.
It's gonna be a bright (bright) bright (bright) sunshiny day.
Real, real, real, real bright (bright) bright (bright) sunshiny day.
Yeah, hey, it's gonna be a bright (bright) bright (bright) sunshiny day.

April so far...

A lot has happened in the past few weeks.

IVF-wise, we have 3 frozen 2-day embryos and one frozen blastocyst. Not as much as I was hoping for, but I'm very grateful we have what we have. My ER was excruciatingly painful but I survived, and I did not develop OHSS. I got my period 7 days after ER and my ovaries looked normal on my ultrasound yesterday (they were around 20cm each at ER and 6cm each 5 days after ER). We are hoping to do a FET this cycle, but to do that I need to ovulate. Come oooon, ovaries!

We also spent a week in Austria. We went skiing in the Alps (wow!) and spent 2 day in Salzburg. It was wonderful to get away from everything and reconnect with the Mr. :-)

Roller Coaster

Last Friday was a total roller coaster!

The Bad News (8:30am):
I had a ton of follies on my right side (about 16, and about 4 on my left). Everything looked ok on Wednesday but I guess something happened in those 2 days. Due to that, they think my risk of developing OHSS is too high and they said I have to do a freeze-all cycle. Which means no embryo transfer. They switched my trigger to Suprefact instead of hCG (which greatly decreases the risk of OHSS). To say I was devastated would be an understatement. I was totally not expecting that since everything had looked ok up until that point. And since I knew I had matched, I knew I would be moving stateside in 2-ish months, giving us minimal time for FET(s). I was, and still am, totally crushed. But I've come to terms with it and am just hoping we can squeeze a FET in. In the mean time, trying to focus on...

The Good News (5:55pm):
I matched into an AWESOME program!!! It was my #2 choice, but my #1 was really a reach. While I'm a little hurt my #1 didn't want me (since I told them they were my #1), I am very, very, VERY excited about my program!!!!

So, that day was a mix of happy and sad tears, complete and utter disappointment mixed with joy and pride. Embryo Retrieval is tomorrow, hoping we get some good embryos that fertilize and divide well, and that we can squeeze in at least one FET before I leave. In the mean time, I've been researching shipping embryos.......

I am going to be a pediatrician!!

I just found out that I MATCHED!! I won't find out where until Friday, but I know it's in pediatrics since that's all I applied for. I get to spend my career making sick kids better! Hopefully in an ER or a NICU. I have worked so, so hard for this. I am so excited!

The Match is a legally binding application process. Basically, you apply to programs, and you get offered interviews. You go on the interviews, and then you rank the places you would consider training at in the order in which you liked them. The programs do the same, and rank their applicants. Then, you get matched by a computer algorithm. You get one spot, or no spot. If you get a spot, it's legally binding for both parties.
 
I went on 14 interviews. One of them was a prematch position, which means if they like you, they offer you a position outside of the Match. If you accept it, you have to withdraw from the Match. I didn't know this when I applied, but I went on the interview anyway, for practice if nothing else. The program was ok but didn't really have what I was looking for, especially compared to a lot of the other places I interviewed at. I was offered a position, but turned it down.

So that left 13. Of the 13, two were outstanding. Two were really great. Three were great. One was pretty good. Two were not very good. One was pretty bad. And finally, there were two that I got a really bad feeling at and knew right away I did NOT want to train there. I hemmed and hawed a lot about how many programs to include on my rank list. In the end, I decided that having a successful, meaningful career was more important than *just* being able to work in the US. I ranked 8 programs (all the way down to, and including, the "pretty good" program.) I felt this was the best possible balance between having the opportunity to work in the US, and still having a great career. I knew that the fewer programs I put on my list, the lower my chances of matching. But I knew I could get excellent training in Sweden. I felt good about my decision, even before I got the "Congratulations, you have matched!" email today.

So, Mr. E and I are moving stateside! We'll find out Friday where!

In other news, my follies are growing well. Four to five 10mm-ish follies on each side. So far I've been experiencing headaches, a nosebleed, sore boobs, and lower abdominal discomfort. Not too bad though. Next monitoring ultrasound is on Wednesday.

Privilege

As I wait for the email next week that will tell me my fate in the match, I have been reflecting on what it means to be a doctor. Even if I don't match into a residency spot in the US, I will (hopefully) have a great career ahead of me in Sweden. In the middle of my night shift last night, I found myself suddenly overwhelmed by the feeling of privilege. It is a great privilege to take care of people. To see them when they're at their most vulnerable. To try to figure out what's wrong with them when they suddenly get sick. To lay a hand on their arm and tell them you are doing everything you can. To help someone not suffer during their final hours. To then lay a hand on a family member's arm and tell them you did everything you could. I did all of those things, and more, in one single shift. It is truly a great privilege, and I know I am very fortunate to be able to do what I do.