Full disclosure

Jenn's story reminded me that I have one I need to tell y'all, too.

One evening, about two weeks ago, I was getting ready to make supper when I suddenly started feeling nauseous. Now, this *never* happens to me, unless it's hormonal. I have a cast-iron constitution -- I've never once had motion sickness or car sickness, and I almost never catch stomach bugs. Even when I was pregnant (with twins!), I only actually tossed my cookies a couple of times, although I felt queasy relatively often. So for me to feel sick, well, hmmm.

I laughed at myself, because, hello, infertile! And honestly, just to overshare, breastfeeding has really done a number on my libido. Still, I couldn't quite shake the what-ifs out of my head. Maybe the pregnancy and the breastfeeding had finally kicked my endocrine system loose, and things had started to work right. I haven't had a cycle yet, but some women do catch that first egg. Theoretically, it was possible, and I went to bed with it still in the back of my head.

I woke up at 3 AM, probably in response to a baby sleep noise. I couldn't get right back to sleep, and as I lay there, I swear to you, I felt something flutter in the pit of my stomach. In that instant, I was absolutely certain that I was pregnant, maybe as much as three months pregnant, and I lay awake for hours pondering the idea.

At one point I considered getting up and going to Wal-Mart for a pregnancy test, because it's not like I was sleeping anyway. I decided to skip it, because I didn't want to go to that trouble for a negative test. The next day, however, found me ginning up an excuse to go to Target. My six-year-old niece was staying with me for a few days, but happily, she doesn't read well enough to know that I lied about the "asthma test".

So, anybody want to guess what it said?

...

Negative. Blank. White as the driven snow. Of course it was negative. Honestly, how delusional was I to expect anything else? How stupid could I be, to just forget that it doesn't work like that for me? What made me think I could be something other than a pseudomenopausal freak?

Yeah, some issues there, maybe.

It's not like we were really trying. Had it been positive, I would have been happy, yes, but I think I'd also have felt a little shocked. We're approaching the point where we intend to get serious about it -- the girls' birthday is a mere six weeks away, and that's the point at which we'd always said we'd officially be ready to work on #3. I don't know that we're ready to book the RE appointment just yet, but I am working on weaning, to see whether my cycle will return naturally or whether we'll need to go that route. I'm just beginning to shift back into the TTC mindset, and it would probably have blown my mind to find myself already through the first trimester, with the girls not even a year old.

That didn't stop me from crying about it, though. I threw the test away and said a few bad words, at the stupid test and the stupid test-taker and the whole stupid thing, and then I cried standing in the shower. I looked at the test again later, just in case, and I told myself how stupid I was and cried a little more.

I have taken precisely one pregnancy test that didn't make me feel like a complete failure, and this one sure enough did. I'm not even really sad about not being pregnant, not yet, but it's the principle of the thing. Every negative test is the tangible evidence that I'm more or less incapable of executing the most basic female function, simple menstruation, without medical assistance.

It's still possible that my cycle will magically return when the girls are weaned. We're going to give it at least a few months, maybe as much as six, before beginning active treatment, and who knows what will happen. I have to say, though, that I don't have much hope. I don't believe that we will conceive another child without medical intervention. I'm reasonably sanguine about our odds with ART, and let's not forget that I have been blessed with two perfect daughters, but that doesn't entirely erase the disappointment I feel toward my body.

Divine intervention

In the comments to my recent "Lucky" post about sextuplets, Nico brought up the question of God's will. As it happens, I've had a half-written post on that very subject sitting in my queue for about two months, ever since I got into a tiff on the subject over at Amalah's. Seems like a good time to dust it off and finish it up...

When we were trying to get pregnant, I pretty much skipped the babydust-forum stage, because we catapulted so quickly into the deep end of the infertility waters. So, I'd forgotten just how many people tell you to try acupuncture, or Chinese herbs, or Randine Lewis and her stupid infertility diet, or that perennial favorite, God's will.

It's been on my mind a little bit, because I was just at La Leche League the other day telling a twin-mom-to-be how I cope with the inevitable do-they-run-in-your-family question. I told her that while I'm very open about infertility with acquaintances, I often hedge my bets with random strangers by saying "we're very blessed". This has the advantage of being true, while leaving out that one of those blessings is a good reproductive endocrinologist. It's not that I particularly care if they know, but people do say ugly things about infertility, mainly because they don't know any better.

I live way down in the Bible Belt, and around here, everything from failing ovaries to falling arches gets chalked up to The Man Upstairs. When one of Amy's commenters (whom I am sure is a very nice person, undeserving of my ire) trotted out the $DEITY theory of infertility, it punched a big old button of mine, and I've been stewing about it. I'm probably engaging in the infertility-blog equivalent of arguing about abortion, not to mention preaching to the choir, but hey, that's why I have this blog-type thing, right?

I'm a Christian, if not a very good churchgoer, and I do believe that God has a master plan for us all. What my dad's death taught me, to be later hammered home by infertility, is that His plan isn't necessarily all puppies and sunshine. Bad things happen to us that are more than just learning experiences. Maybe God *doesn't* mean for you to have a baby, and it's not so that you can devote your energies to world peace, or give a home to an adorably malnourished orphan, but a loss you'll mourn the rest of your life.

I was raised Episcopalian, and you can probably guess that I read too much C. S. Lewis at a tender age. I take the viewpoint that sometimes, God really does want us to suffer. Yes, He loves us each and every one, but that doesn't mean He isn't sometimes a right bastard about it, at least from this end of things. Not every cloud has a silver lining; not every loss is an opportunity in disguise; sometimes there just isn't a happy ending.. Grief and loss are real, nasty, traumatic things, and you don't just get over them, or get the karmic equivalent of a lollipop after the doctor's office. To suggest otherwise is, I think, demeaning to the experience of pain.

So in the large sense, yes, I do think that being handed the burden of infertility is a manifestation of God's will. Being omnipotent and omniscient and all, He could have made things turn out differently. Anyone who can make an immaculate conception happen can certainly kickstart a pair of stubborn ovaries, yes? If I didn't get pregnant very easily, it was because God wanted me to go through that very unpleasant experience, for reasons of His own which may or may not ever become apparent to me.

However, saying that I was meant to experience infertility is not at all the same thing as saying I was meant to remain childless. When someone gets cancer, and is cured by chemotherapy, do we talk about how God really meant for it to be his time? Was it a thwarting of God's will when my preterm labor was stopped at 32 weeks, or should my babies have been born and died, as were the aunts I never knew? For that matter, should I have died as a child from one of my numerous serious strep throats, and never lived long enough to think about babies in the first place?

Why is infertility different, other than that most people have very little idea of how ART really works? I'm not saying there aren't good-faith arguments to be made against it; I obviously don't agree with the Catholic position, but I do respect that it's a legitimate attempt to construct a well-reasoned position. However, it's a rare person who brings up the God's-will argument and then backs it up with anything besides the mere existence of infertility.

I actually think God has an incredibly large role to play in infertility treatment. Who decides whether a given egg fertilizes, in utero or in vitro? Who causes it to implant and develop into an embryo? Who is responsible for combining the chromosomes in a fashion compatible with life? Who determines whether a chromosomally normal embryo's heart begins, continues, and occasionally ceases to beat? Who determines which babies will be born prematurely, and which of those will survive? Hint: it's not your friendly neighborhood reproductive endocrinologist.

The RE's vast Frankensteinian powers boil down to this: getting all the necessary ingredients together in the right place at the right time. He can get the eggs out of the ovaries, get the sperm in the vicinity, point a couple embryos in the direction of the uterus, and hope they stick. To call that "creation of life" is about like saying that dumping eggs, flour, butter, and sugar in a bowl together creates a cake. If you're not the religious sort, you can ascribe it to chance; but I am, and that's where I see God at work, in the spaces between the science.

To bring this back around to the sextuplet situations, I actually do agree with the parents who said that it was God's will for them to conceive high-order multiples. As I previously noted, the odds of sextuplets are tiny, even when conditions are right for it to happen. Who decides which mothers will come out on the ugly side of the odds? Really, there are only two answers: the randomness of the unordered universe, or the hand of the Divine.

So no, as a Christian, I don't think it's necessarily a violation of God's will to turn to infertility treatment, any more than undertaking any other medical procedure. God has his hand in all things, and he determines which pregnancies will develop, just as he does which treatments will work, which diseases will be cured, which therapies will be discovered. It's our responsibility to put the conditions for success in place, but He still controls the final outcome.

It's not always a particularly comforting thought, if you're the one who gets the lousy outcome, but it's what I believe to be true.

Crying it out with two

In the previous post's comments, Eva asked where Claire was while Katherine was sobbing and wailing. I completely forgot to talk about the twin aspect of this, and I really should have, because it was a big mental stumbling block for me. In practice, it worked itself out pretty well.

The girls sleep in the same room, and this has been a problem at times. Katherine is the heavier sleeper, and will often snooze right through her sister's crying, but Claire usually wakes up when Katherine does. This may also have something to do with Katherine's vocal abilities -- I think she'll make a fine opera singer someday, because the child is LOUD. So when I was pondering CIO, I knew that the second baby was going to complicate matters a good bit.

I should expand a little bit on the first night of the New Sleep Regime. When G got home from work at 7 PM, the babies had been up since 5 AM with no naps at all, and were both screaming from sheer exhaustion. I was feeling awfully ragged myself, and I said, let's put them in the car and drive around while we talk about crying it out. I knew the girls would probably wake up when we brought them in the house (they are still in the infant seats, though not for much longer), but that way, I figured at least they'd have gotten a car nap while we decided what to do. We drove around for a while, and while Katherine woke back up when we got home, Claire actually stayed asleep. She spent the whole of Katherine's bedtime struggle downstairs in her carseat, and once Katherine was asleep, we were able to transfer her to her bed without waking her.

On subsequent baby-downings, we simply got Katherine settled down first before putting Claire down, and that has worked pretty well. We did have a backup plan in place, though, which was to put one girl in the nursery and the other in the pack-n-play in our bedroom. I think that if both of your babies are lighter sleepers, it might be wise to plan on separating them for the first few days of the sleep experiment.

One of the sleep books I skimmed, I don't remember which one, actually specifically addressed the question of multiples, too. It suggested simply doing it one baby at a time, sorting out the sleep problems of one twin before moving onto the next. This seems pretty self-evident, and I've heard it mentioned in the context of potty training, but I'm not sure that I would have come up with it on my own in re sleep.

One other thing I thought of re multiples and sleep is that, as a mother of twins, I'm already somewhat more accustomed to hearing my babies cry than a singleton mother would be. You can't always sort out the needs of two babies at one time, and while they haven't exactly learned to be patient (as well-meaning people say they will), I have at least absorbed the lesson that they won't die from it. It's not like we're talking about bawling alone for hours, and I don't think that crying in the crib with Mama right there for reassurance is fundamentally different from crying on the floor while Mama's taking care of sister.

What's surprised me most about this whole thing is how quickly the girls have adapted to it. In less than a week, we've pretty much managed to sort out all of our sleep issues, and you can all start hating me again (as I write this, they have been napping for over two hours). I would absolutely not have done this for more than a short time if I hadn't seen that it was working. I figured a couple nights of crying wouldn't scar them for life, but I was not prepared to do so night after night after night. If you're thinking about trying it, I think you'll know relatively quickly whether it will work for you; if it does seem to work for one baby, it's worth making some temporary accommodations for the other one.

We cried it out

I spent all of last Friday in a funk about the sleep thing. I realize that, compared to a lot of twin moms, I have it really unbelievably easy. The bad bedtimes are a recent development, not something I've been suffering through for ten months. More, as a general rule, they stay asleep once they go to sleep, rather than waking multiple times to nurse. So I probably shouldn't have bitched too much about it at all.

However, that said, I was getting frustrated already. I didn't have any post-bed time to do household necessities like cleaning, laundry, and cooking supper, to say nothing of spending time with my husband. I could certainly handle that for a while, and I wasn't at my breaking point with it. No, what bothered me was that bedtime was getting worse instead of better, and it had been affecting their daytime behavior as well. Katherine had been getting to be super-cranky, and was becoming increasingly touchy about being put down. Claire took it a little more in stride, but she was obviously getting sleep-deprived as well.

I talked to my mom, who told me to let them cry. I talked to my sister, who told me to let them cry. I talked to my friends, who pretty much all told me to let them cry. I went to the bookstore and skimmed all the sleep books, all of which advised me that the bedtime battle would have to be fought, though they differed on the amount of crying required. And at the end of the day, after the babies had taken no naps and were screaming for no reason other than sheer exhaustion, I decided it was time.

I don't consider myself hard-core AP, although I probably fall more to that end of the spectrum -- I'm nursing twins, I cloth-diaper to some extent, I make my own baby food, I have only the loosest of daily routines. Sleep has always been the area where I diverge the most sharply from Sears & co. We decided to use a co-sleeper until the babies slept through the night, however long that took, but moved the girls to their cribs in the nursery after that, at about 12 weeks. I did bring a baby into the bed at night sometimes, if she woke and needed nursing, but I always tried to transition her into the pack-n-play in our bedroom. Between my husband's heavy sleeping and the space requirements of two wiggly babies, not to mention the horror stories of all our friends whose school-age children sleep in the bed, the family bed was never an option for us.

That didn't mean, however, that I thought cry-it-out was a good plan. The babies were too small, and wouldn't understand why we were abandoning them upstairs. I couldn't figure out how to get a solid enough bedtime routine in place. I didn't think they'd actually give up and stop crying, and I didn't want them to cry until they threw up. They were sick, and sick again; the bad bedtimes were just a phase; maybe they were teething. I had a million reasons, some good and others not.

When I thought about it, I came to the conclusion that at ten months, they might be more emotionally ready to handle this. They are showing clear signs of understanding simple language, enough to recognize "time to go night-night". A bedtime routine has (finally) begun to form around supper, bath, and snuggle time. What ultimately decided me, though, was that there has been so much crying going on during the rock-to-sleep process. I hated the idea of leaving them to wail, but frankly, if they were going to wail anyway, I might as well have it do some good.

Friday night, I took Katherine upstairs, told her it was time for night-night, and laid her down in the crib. Then I stood there for 40 minutes, patting her back and singing to her, laying her back down when she stood up, until she finally quieted down and went to sleep. The next day, we repeated the same routine for naps, and while Claire fought hard, Katherine went a little easier. That evening, the crying was down to 20 minutes, and they slept from 9:30 to 8:30. They took two solid, simultaneous naps the next day, and then on Monday evening, the magic happened: I put wide-awake babies in their cribs, closed the door, and walked away. Claire cried for less than a minute, but Katherine didn't so much as make a peep. Last night, there was three minutes of crying, and 10 hours of sleep.

I started off staying in the room with the babies until they fell asleep, since I hoped that would keep them from feeling abandoned. After two days, though, I started to think that maybe that was only helping *me* feel better about it, and that it just aggravated them to have me almost within reach. I decided to do the Ferber-style periodic checkups after that, but I didn't -- they never again cried for long enough to merit a five-minute checkup. They have cried for longer than five minutes a couple times, but it's a few cries and then silent periods, rather than five steady minutes of wailing.

I have to tell you, it's absolutely wonderful, being able to put them down awake. As good as the bedtime is the newfound ability to nap -- no more cranky napless days and non-consecutive naptimes! We are now working on slowly moving bedtime earlier (currently, it's 9-ish), and I think I'm just a few days away from achieving baby sleep perfection. Everyone in the house is much happier with the new regime, I think. G and I have gotten some us-time back, and Claire and Katherine are less fussy now that they're getting the sleep they need. If I've left them with deeply rooted trauma to their fragile psyches, it's not showing.

It's not the right thing for everyone, by any means, and it's not always the right time to do it. I'm really glad I didn't start the sleep training until they were getting older and more independent -- I would not have felt good about doing that with a five-month-old, but it's a different story when they're almost toddlers. It was the right choice for us right now, though, and so far, it's working out so incredibly much better than we could have imagined.

Had a bad day

Exhibit A:

The babies had no afternoon nap yesterday, went to bed at 7:45 PM, then woke back up at 8:15 PM. Claire went back down at 11:30, while Katherine fought until 1 AM. She then woke back up screaming at 5 AM, and by the time I got upstairs to get her, she'd woken Claire up too. Neither of them really went back to sleep, despite our efforts to juggle them in and out of our bed.

Bedtimes have been getting worse and worse lately, and I'm about to the point where I'm tempted to do cry-it-out. They (usually, last night excepted) stay asleep once they've gone down, but I cannot get them to go down in the first place until 10 or 11 at night. They won't go to sleep by themselves any more but insist on holding and rocking and nursing, pop awake when you try to put them down, and wake the other baby with screaming. I've ascribed it to the 9-month sleep regression and to teething, but with no teeth appearing and going on six weeks of bad bedtimes, I'm getting increasingly frustrated.

Exhibit B:

Katherine's been sick with some unspecified viral fever thing, and during all her comfort nursing, she managed to give me yet another blister. She chewed me up pretty thoroughly last night during the seven hours I spent trying to get her back to sleep, and by the end of the evening, I was starting to develop a plugged duct. Today, it's like I stuck a sack of heated marbles under my skin, and the only reason I'm not officially calling it mastitis is because I haven't gotten a fever yet. I'm sure it's probably coming, though.

Exhibit C:

Our house is now on the market, and I did some aggressive yardwork last week to get it all ready. Somewhere in the process of trimming the wax myrtles, digging up a mostly-dead juniper, and tearing down a cat briar infestation, I also managed to get into poison ivy/oak/sumac. It's all over my hands, arms, torso, and legs, even a bit on my neck and jaw. I finally broke down yesterday and started using steroid cream, which is helping, but it's been a miserably itchy ten days or so.

Exhibit D:

I'm getting the medical runaround with regards to my knee. Dr. Busybusy, my orthopedic surgeon, made me wait three hours last time to see him, and told me to do physical therapy. When the physical therapist did some strength testing and said that PT wouldn't help my knee stability, Dr. Busybusy said to go do it anyway. I'd do it if I thought it would help, but when the PT tells me it will only be a waste of time and money, I'm inclined to believe her. I've been doing some strengthening exercises on my own at home, but I can't tell that they're helping any.

My followup with Dr. Busybusy isn't until July 30, when I would doubtless wait another three hours to argue with him about the usefulness of PT. Since each appointment gets me approximately 3.5 minutes of his time, I think it'll take another two or three appointments to come to any useful decision. So I've decided to switch to another practice instead, but it seems to require an act of Congress to get my medical records sent over to the other practice, which won't see me without them because of how recently I've had surgery.

Meanwhile, the knee is getting worse by the day. It's going wonky on me (giving out or hyperextending) at least once a day, and I've taken several spills. Something got twisted funny in it yesterday, and I couldn't straighten it for a couple hours, until I finally moved it just so and whatever-it-was settled back into place. I worry that I'm going to fall on the stairs while carrying a baby; I've done it without carrying a baby, and had a close call or two with a baby. I worry that I'm going to break an arm or hurt something other than my knee, in one of those falls.

And this is shameful to admit, but the times that I have fallen, I've caught myself hoping that the ligament will just go ahead and tear the rest of the way. It's not like it's working anyway, and if it's a complete tear, we can stop dicking around about whether to reconstruct it. I haven't had a functional knee for a year at this point, and I am getting so very tired of it.

Baby food without extra kitchen time

My friend Stacey had a time of it last week, making homemade baby food. Since I did some cooking for the babies this morning, I thought I'd post what I usually do, in case it's helpful to anyone else.

A few introductory notes: I don't go out of the way to buy organic everything, and I use frozen and canned foods. My biggest reason for making homemade baby food is that I have control over the ingredients and quality, so that it tastes good and contains a relative minimum of crap. My babies are now ten months old, and they self-feed and eat a wide variety of flavors and textures, spread into three meals a day.

Breakfast is protein, grain, and fruit. Sample meals: jarred applesauce & oatmeal, plus diced cheese; cottage cheese & peach puree, plus cheerios; plain yogurt & pureed blueberries, plus cheerios.

Lunch and dinner each include protein, grain, vegetable, fruit, and dairy. I usually start with a finger food -- diced kiwi or banana, soft cooked carrots, pasta shells coated in grated parmesan, diced colby jack cheese. After that it's a meat puree mixed with pureed vegetables or beans, and we finish with a fruit, alone or mixed with yogurt or rice cereal.

So, today I set out to make:

• sweet potatoes
  
• broccoli puree
  
• chicken puree
  
• oatmeal
  
• pear puree
  
• pasta shells
  
• lunchblock
  
• carrot, celery, and onion puree
  

Sounds like a lot of cooking, doesn't it? Well, I accomplished almost all of it in one hour in the kitchen, and about 40 minutes of that was spent actually feeding the babies their breakfast. Here's what I did:

• Put the babies in their high chairs with a big handful of cheerios.
  
• Turn oven on to 450F, throw three whole sweet potatoes on rack, and set timer for 1 hour.
  
• Fill two saucepans with water and set them on the stove to boil.
  
• Put 1 cup of quick-cooking oats and 2 cups water in a pyrex bowl. Microwave for 1:30.
  
• While oats are in the microwave, open two cans of no-sugar-added pear halves.
  
• Put oats in tupperware, give the pyrex bowl a quick rinse, and then dump the pears in it, juice and all. Microwave for 3:00.
  
• While the pears are cooking, roughly chop one onion, two carrots, and two ribs of celery. Throw these in a stockpot along with some dried parsley, thyme, a bay leaf, and salt.
  
• The pears are done, so drain them into a colander, then throw into the blender and pulse a few times until pureed. (You could also reserve a few and dice them up for finger food.) Put pears in tupperware and quickly rinse the blender.
  
• Rinse the pyrex bowl again, and put some frozen broccoli in it along with a little water. Microwave for 7:00.
  
• The two saucepans of water are boiling; into one, pour the pasta from a package of shells-and-cheese (I use Annie's Organic), then put half a package of small whole-wheat pasta shells into the other. Set timers according to package directions.
  
• Begin feeding the babies some cottage cheese mixed with pureed pears.
  
• Break quickly to drain the pasta when it's done, put the whole-wheat shells in tupperware, and mix the other shells with the cheese mix. Pack the shells-and-cheese tightly into tupperware as per the lunchblock link above.
  
• Resume feeding the babies, then bathe them both. (Hopefully, your babies are less messy eaters than mine, and you can skip this step.) Put babies in living room to play.
  
• Take the frozen broccoli out of the annoyingly-beeping microwave, drain if necessary, and puree it in the blender. Put it in tupperware and rinse the blender again.
  
• Put a whole chicken into the stockpot with the celery/carrot/onion mixture. Fill with enough water to come about halfway up the chicken, then cover and put on the stove to boil. When it boils, turn to a simmer and set a timer for about 30 minutes.
  
• At this point, the sweet potatoes are about done. Take them out of the oven, cut them open, squeeze out of their skins into tupperware, and mash them with a fork.
  

At that point, I left the kitchen and went to go take a shower myself. When the chicken was finished, I drained it (reserving the stock to freeze), then set it in the pyrex bowl in the refrigerator to cool. I pureed the celery/carrot/onion mixture (removing the bay leaf first!), then put it in tupperware. Later this afternoon when the chicken has cooled, I'll pluck the meat off it, use most of the meat in a casserole for our supper, and puree what's left for the babies. Not only have I cooked for the babies, I've gotten a head start on our dinner too!

I used a total of two saucepans, a stockpot, a knife and cutting board, a colander, and a pyrex bowl, so there weren't even all that many dishes to wash. I washed the blender by filling partway with water, adding a dollop of dish soap, pulsing it a couple times, and rinsing. Everything else went right in the dishwasher, so the kitchen cleanup was quick.

Since I mainly used canned and frozen vegetables, you'll see that there was a minimum of peeling and chopping. Almost all of the active kitchen time was juggling things in and out of the stove, microwave, and blender. I could easily have added another saucepan or two of boilable foods like rice and lentils without increasing my workload, or pureed a can of garbanzo beans.

I don't always necessarily do even that much cooking at one time, either. A lot of the time, I just put an extra pan of water on the stove when I begin to cook our supper, and then boil something or other in it -- beans, pasta, or the same chicken or veggies we're having. Or I'll just cook a bit extra for us, and feed it to them as-is, as long as it's not too highly seasoned (zucchini and broccoli work great here). If I'm having a grilled cheese sandwich for lunch, they get one too. I've got a watermelon in the fridge right now, and when I cut myself a slice in a little while, I'll dice up a bit for them.

Basically, I am very, very, lazy, and I want my family to eat well with a minimum of effort from me. I really enjoy cooking as a general rule, but baby food isn't all that exciting. I'll bake all day, or spend an hour improvising chicken-lemon-butter-pasta, but I have a limited tolerance for prepping and boiling vegetables. So I look for shortcuts, plan out my dishes in advance, and multitask to the best of my efforts, and I'm satisfied with how it's going so far.