Trigger Happy!

Well folks... I've done it!  I've taken the plunge and there's no getting scared shitless and turning back now!

My second follie scan (last Saturday) was a bit of a bummer.  The nurse that did the scan (the doc takes the weekend off!) was hell-bent on bursting the hot air balloon of hope that I'd created for myself.  We only had 12 to 13 follies and she wanted to make sure I was very aware that of those follies, not all of them will yield eggs... and of those eggs, not all of them will fertilize... blah blah blah.  I felt like kicking her in the teeth.  Yes, thanks, I'm well fucking aware of my chances for failure here.  I know we may not have any to freeze and I may get a BFN or worse... a BFP with a miscarriage.  It's eyes wide open in my camp so fuck off and quit trying to bum me out!

Phew... sorry about that.  Hormones are kicking today. 

Anyway, my last scan (yesterday) was much better.  The doc was back and he said we had 8 follies at over 18 mm.  Somehow, even if the number was smaller, the fact that they were the right size was very comforting.  The number of follies isn't as telling as their size.  I could get fifty and if they're all immature, they won't help a bit.  I'm not saying I'm not still scared as hell.  There has been so much bad news around the forums the last few weeks, that I can't imagine how it would work for me.  But I'm trying to remember some very wise advice, which was to go into this without expectations.  The numbers don't really mean much.  You could get 20 eggs and one of them reaches the blastocyst stage.  You could get 7 eggs and all of them be perfectly viable, strong and healthy.  Even if you have some to freeze... they may not thaw.  Too many variables to worry about them all.  That's all any of us would do.

So... my advice to anyone going through this would be... try to take everything in stride.  Only get emotional about the facts... not the possibilities.  I know that's easier said than done but it's how to stay sane in this journey.

Anyway... the doc was pleased with my progress and said we were ready!  He checked my estrogen again to make sure and it was over 3000 (there was that stupid nurse again who wouldn't give me the exact count).  Your levels should be around 200-600 per mature follies so I was right on track.  No meds last night... just the trigger!  Ovidrel is a pre-filled, refrigerated syringe that is synthetic HCG.  It "triggers" your body speed up lining optimization and egg maturation.  It also signals your body to release any and all mature eggs in almost exactly 36 hours.  Now... I've wondered how, if all women are different, this works in exactly 36 hours to the point where you have to take it at a very precise time but whatever.  I may ask later.  Mostly, I don't care as I'm not going to argue it with them but I did wonder.  If anyone knows... comment away please.

So the big news... my egg retrieval is tomorrow at 8:15 AM.  Big fucking happenings here ladies (and possibly gentlemen)!  The only bad news I received isn't definite but apparently, my right ovary is the big producer (go fucking figure) and it's still hiding behind my uterus.  This means that in order for the doc to get to it, he'll need to move my shit around in there.  This may or may not work well enough for him to avoid sending the big, scary needle through my uterine muscle and causing more pain and a harder recovery than usual.  And to this... I say to my ovaries... challenge accepted!

My Ovaries are PISSED! (but cooperating :)

So... here we are, knee deep in the stimulation phase and we've had a revelation.  My right ovary works after all!!  It's sat there like a limp dick, cycle after cycle, shriveled and doing fuck all.  Lo and behold, add four parts Bravelle, one part Menapur to the mix and it wakes up, looks around shocked and we're off to the races!  That little fucker managed five whole follies yesterday, giving the workhorse lefty a run for its money!  Super exciting times here with the Goode gonads.  Estrogen doing well also; we didn't change a thing with my meds.  My body might actually be cooperating for once.

A quick note to those who follow for educational purposes... shots aren't shit!  The needle is so small, you don't feel it most of the time and when you do... it doesn't hurt.  The mixing part is actually fun.  Intra-musculars might (haven't had one yet) be a bit more of a pain but sub-cutaneous are easy as hell.  Do not let this be something that puts you off injectable cycles or IVF.  I do it myself because Adam came at me with a jabbing motion when he asked to do it and I told him to fuck right on off.  I may be odd... but it's the highlight of my day.  I think it's more knowing that we're really doing something productive now than the medical aspect but I'm sure that plays a part.  I really did get into the wrong field of work.

Anyway... to explain the title... when your ovaries are engorged with shit-tons of follies, versus their usual one or two large ones, they get pissed!  I feel them... frequently.  They pinch and pull and stab and let me know that they don't appreciate the extra workload.  Fuck um though... they deserve it.

So... day 5 ultrasound yields a show of 10 follies overall with more to come (hopefully).  Lets hope Saturday's appointment goes even better!

Finally... In Vitro!

Well, kids, I must say, I am much more excited since my last post and I'm in much better spirits overall.  A bit of a break was exactly what I needed and after 58 days worth of screwed up cycle, I finally got AF!  More importantly, I was finally able to start birth control.

"WHAT?" you say... well, it's all part of the protocol.  I shall explain.


Suppression Stage:

First, in order to quiet your ovaries to prepare them for stimulation, reduce/diminish any cysts that Clomid may have triggered and make sure they're able to time your appointments appropriately with their office, you go on birth control for a specific amount of time (you'll also start a baby aspirin regimen that will last throughout your cycle).  Usually, this is 2-4 weeks.  Lucky me, I got in on the 4 week slide.  Regardless, we're three weeks through now and this Friday will be my very first shot of Lupron... but I'm getting ahead of myself.

During this 2-4 week period, you and your dude will both have infectious disease labs drawn and be scheduled for an injection class to teach you both how to handle the meds.  You may sign all of your consents at this app too but that will depend on your RE.  Your man will then repeat his sperm analysis where they'll do a 24 hour test (to see how many survive the day in the lab).  You'll go in for baseline ultrasound where they'll make sure you have no fibroids to be concerned with and that you have no cysts to prevent egg retrieval.  I did but it was a small one and the doc said that the birth control should suppress it completely.  Then, a saline infused sonogram (SIS) or a saline sonohysterogram (same difference) which will be done both to map the uterus and as a mock transfer, to help the doc with a plan of attack since the embryos need to be jostled as little as possible during transfer.  They'll also check for polyps and such here.  This is not the most comfortable thing and, much like the HSG, I cramped like a sonofabitch when he inflated the balloon on the catheter to hold it in place but it was also over quickly.  A bit if an added insult was when he went "all in" with the dildo cam while the catheter was still in place but again, it was over quickly.  The ruling here though was that I had no polyps and everything looked good.  The cyst from earlier had shrunk to the point where it looked more like a follie and he cleared me for starting Lupron.  Adam's sperm analysis also came back very well with 80% survival over the 24 hour term.  He was, as always, proud of himself.

Stimulation Stage:

My new pharmacy sends its regards.

We're currently approaching the stim stage.  This Friday, I'll start with an ovulation supressant called Lupron and continue it through the cycle until just before the egg retrieval.  This will prevent by body from releasing the eggs I'll be working so hard to grow.  A few days later, I'll stop taking the birth control and then go in for another baseline ultrasound to make sure that everything is sufficiently suppressed.  Then, (about I'll start the stims.  I'll be on a Bravelle (300) and Menopur (75) protocol, which will be one shot each night (so two total for now).  This will go on for 10 days (or thereabouts depending on my reaction) and I will be monitored throughout to make sure I'm progressing nicely and don't need my dosage changed.  Ovarian Hyper-Stimulation Syndrome (OHSS) is also a concern during this time.  A very wise friend of mine mentioned shit-tons of water to prevent this so I'm going to try my best.

Once the doc says we have a bunch of follies up and they're of good size and maturity, we'll take the trigger shot, Ovidrel.  This is a pre-filled syringe that has to be refrigerated and I've heard it's best to let this warm up for a bit before injecting to prevent sting.  Now this shot is very important!  It has to be administered at a very precise time as the eggs need to be as ready as they can get for retrieval without being released.  From what I've been told, we're looking at like a half hour window or less to get it right so I'm really hoping I don't' fuck that up.  You'll also take some antibiotics to prepare for the retrieval here as well.

Egg Retrieval


This is, by far, the part that I'm most apprehensive about.  Not only will it likely be painful, but it will also determine how many embies we have to work with and if we can freeze any for the FET if the fresh cycle fails.

This is an outpatient procedure but you are under sedation (and thank fuck for that).  Basicly, they strap a needle onto the dildo cam and proceed to puncture your vag until they get all the mature eggs they can reach.  That sounds like at least the first circle of hell to me so I'm glad I'll be asleep for it.  The good news is (besides the pain meds) that they will be able to tell you as soon as you wake up how many eggs they've retrieved.

Over the next 24 hours, they'll fertilize the eggs either naturally, by introducing sperm and egg, or they'll use the ICSI procedure (IntraCytoplasmic Sperm Injection), depending on your personal circumstances (whether you're dealing with MFI, poor egg quality, etc).  Since we're unexplained, they will be doing half and half for us.  They'll call us with info regarding how many eggs were mature, how many fertilized and how many started to grow over the next few days.  They said I'll get calls daily, letting me know how many cells they've divided into and so forth.  Apparently, our embryologist also sings to the embies.  I found this surprisingly comforting as after all, these are our children... the makings of them at least.

Embryo Transfer


And we've reached magic time!  Assuming I have a decent amount of embies to work with and they seem to be of good quality, we'll go in for a transfer five days after retrieval.  Lower quality/fewer numbers means a day 3 transfer, which we don't want because they're not in the blastocyst stage yet and they aren't developed enough to implant immediately.  However, they'll do this if they worry that we may not have enough eggs to transfer so they have the best chance at survival.  So... fingers crossed for a 5 day!  Anyway, this procedure is very much like an IUI.  You decide how many embies you want to transfer (we chose two if we have that many) and the doc inserts them through a catheter into the top of the uterus.  You hang out for 45 minutes or so and take it easy for a few days.  They generally make the beta appointment for two weeks after retrieval (what they consider ovulation to compare it to a typical cycle), but of course you're free to test at home before then.  And I'm quite sure I will.

Well... there you have it.  IVF in a nutshell.  I'll go into more detail about all this as stuff happens but here's what we'll be doing.  If everything goes according to plan, they'll be doing my retrieval on either the 2nd or 3rd of May.  This means a HEDD (hopeful estimated due date) of either January 1 for twins or January 23rd for a singleton.  I should find out if I'm pregnant mid-May.  April can't go by fast enough!

My Body Hates Me

If I woke up to this scrawled on my panties,
I would not be the slightest bit surprised.

There are oh so many reasons why the title for this entry is fitting.  My body never cooperates, my immune system is attacking me, my uterus works for shit and apparently it's actively plotting against me.  Let me explain.

So... I manage to get out of the funk my last entry described and we made up our minds to go full force with IVF.  My heart monitor never really caught the really scary palpitations, as they seemed to have stopped, but the few episodes it did catch were just extra beats and nothing to worry about.  They've even stopped since then.  We went to the IVF consult with the RE and they let me know exactly what was going to happen with the cycle and gave me more paperwork than I was expecting.  I was close to the end of my cycle so all I had to do is call them on CD 1 and they'd call in the meds and start the calendar (I'll explain all this in more detail in the next entry).  I figured out how I'll be paying for all this so everything is planned and ready.

So all I had to do was wait.  And wait.  And fucking wait some more.  For some reason, my body has decided to embark on the longest cycle it has ever been on to date.  Ever.  I'm currently on CD 52 and my consult was weeks ago.  The one time... seriously the one time I really, really, really want to start my fucking period... nothing.  The RE gave me a prescription for Prometrium, which is essentially Progesterone.  A 7 day treatment will bring AF right along within a few days after the last dose.  They often use this in lieu of Provera to bring on a period during an anovulatory cycle.  My last dose was Tuesday.  It is now Saturday.  Seriously... fuck my body.

What I'm dreading is that tiny bit of EWCM that I discovered on my 1st day of the Prometrium was a sign of ovulation and the meds won't override my own hormones.  This would mean I likely have a few more days to wait; or worse, more than a week.  All I want to do is move on.  I've no patience for limbo.  Yet, here I sit.  No sign of AF... no calendar... no protocol.

No... I'm pretty fucking far from okay.

Are you okay?

:/

People spit this question at me constantly, it seems.  Sometimes from well-wishers, sometimes from those genuinely concerned, sometimes from dicks that only want to seem interested so they can talk about themselves for a half-hour.  It's getting fucking old.  Just for a little while, I'd like to talk to someone about my life without apologizing for my misfortune at the end of it.  Moreover, I'd like to just be honest with one of them every once in a while.  I offer the standard, automatic response... I'm fine, thanks.  Mostly because I don't want to get into it all.  People tend to get all weird when you say you think you might be dying soon because your heart is acting like a psychotic homicidal crackhead with multiple personality disorder.  They have no idea what it means when you say you break inside a little bit every time someone talks about their kids because you're slowly coming to the realization that you'll never, ever have any.  These also seem like fantastic reasons to keep my mouth shut and not really tell anyone how I'm feeling.  That said, I'm also grateful for those who actually care and feel more than a little regret for lying to them constantly.  I know I said I was fine; I am not.

I tried to take a break from all this.  The "I'm sorry"s were getting to be too much and because I know I won't be getting a "congratulations" any time soon, I'm going to settle for nothing at all.  I planned on focusing my efforts back onto my weight and my house.  They seem like much better areas to obsess over; certainly areas that I might actually accomplish something real and productive.  Unfortunately, this is the time that my heart decides to lose its fucking mind.  I don't really want to go into it here but the docs have put a hold on TTC for now until they figure out if my irregular heartbeat is benign or something that could actually do some damage.  I was happier when the break was my choice.  It's funny how perspective can cause so much irrational anguish.

Of course, it doesn't help that I've recently had a carrot dangled in front of my face and then jerked away.  My husband knows a woman at work that was looking for adoptive parents for someone in her life.  Unfortunately, the birth mother decided that she'd go to rehab and the judge revoked the order to remove her child from her care at the hospital (she's due in April).  Now I get to think about how much better of a life I could give to this child but won't get the opportunity to do so.  I know it's presumptuous and likely judgmental but I can't help it.  There isn't a single aspect of this that's fair... only situations that solidify the opposite.  Hell, who knows whether or not I would have even been accepted as an adoptive parent.  You still have to do a home study in Missouri, private adoptions included, and the courts hesitate to give a child to a person with an incurable, possibly fatal disease.  Maybe it would work out if I could get my doctors to convince the judge they doubt I'll be dying soon.  Maybe rehab will be just too much and the adoption will be back on.  Maybe one of these days I'll stop wanting to cry every time I see a child.  Maybe I'll wake up tomorrow not wanting to be a mommy after all.  Maybe I'll soon spot a herd of pigs flying out of the asses of random passersby.

Fuck.  Lets talk about something else for a while.

Fuck you world.... just fuck right on off.

My temp tanked this morning.  It's too damn early too if you ask me but at least my body is giving me time to rebound before I have to pretend that I'm not trying to tape my soul back together after this latest in a very long string of disappointments.  Last LP was 15 days... this one is looking like 10.  Whatever.  I'll blame it on the Clomid.

My natural defense mechanism is to turn pain into anger and I'm really fucking pissed off right now.  I can't begin to tell you how much I hate this shit.  All this shit.  I hate temping, I hate worrying about what meds I can take, I hate that my poor vag seems just fucking pissed off all the time because of the shit I put it through, I hate that I can't just make love to my husband without doing some crazy unromantic shit afterward, I hate taking extra pills every day.  I hate it all and I'm not sure how much longer I can do it.

I've been slowly getting myself used to the fact that I will live a childless life.  Honestly, given everything that's happened, maybe it won't be the worst thing in the world.  Anything has to be better than this.  I've gone through a wider gamut of emotion than I thought I was capable of.  When I was 18, married and suddenly being harassed by my biological clock, I was so full of hope.  Even though I had previously lived my life thinking I would never have kids, I thought "surely that's all in my head" and "I'll be pregnant by the end of the month!"  Oh what a series of failures that was.  I was shocked at each negative pregnancy test as I still thought back then that anyone could get pregnant at any time during their cycle... all I had to do was stop taking the pill and I'd be set.  I was so naive, as most women are when they first start trying.  After a year of disappointments, I think most of me gave up.  My marriage was already starting to suck and I was slowly realizing that bringing a baby into that would have been a very bad idea, so I never really tried.  I never went back on the pill and we didn't prevent but it was never something I really strove for.  After 5 years, we divorced and my baby dreams were put aside while I fixed myself.

By the time I started trying the second time, I knew it wasn't going to be easy.  I started educating myself and began charting.  We only managed to try for 6 months before that relationship imploded so I wasn't shocked that I wasn't successful.  At least I made leaps and bounds in my own growth and would be completely prepared when I finally found the right man.

Adam and I weren't married yet by the time we started trying.  My bass-ackwards logic said that "I like you enough to be tethered to you for the rest of my life by a child" fell somewhere between "I could be friends with you forever" and "I want to spend the rest of my life sharing the same tiny space with you" in the stages of standard relationships.  Yeah, that's fucked up but I'm being honest here.  In my defense, I was already a bit desperate for a child.  That "trying #2" business up there was when I knew I'd be a single mom and I was okay with that.  I was temping, charting, taking OPK's and monitoring ferning, the whole fucking nine my very first cycle... not that it did any good.  18 cycles later, I was ready to see a RE.  Of course, that was about the time that I got sick and had to go on birth control for 6 months.

After I got better, I hit the ground running yet again and joined a support forum this time.  I was full-on-fucking obsessed with it this go.  I was constantly googling all things TTC, pregnancy and baby related.  I'd look up my hopeful estimated due date every fucking cycle after ovulation and just torturing myself daily.  I think I needed the renewal of hope and knew that would be the only way to get it back.  After three months or so, I got the HSG and thought I cleared up a tube and fixed my problem.  After three failed cycles after that, I saw a RE.  Now I sit, in what I imagine is the final few hours of this cycle, after two failed IUI's.  I'm starting to think that enough is way fucking enough.

Sure, I could get a laparoscopy for possibly no reason other than piece of mind.  I could see if we'd get approved for financing a few rounds of IVF just to say I tried but I have no shred of confidence that it will work.  I've seen too many fail already.  I've experienced too many failures.  I just don't want to do it anymore.  I don't want to find another reason to get my hopes up, just to have them crushed and feel stupid for even thinking it was possible.  I'm tired... fucking exhausted... sick of pretending that I'm okay when I'm not.  Sick of stoic.  So close to fucking done.

Maybe this is why a person shouldn't blog while upset.  This is the blogging equivalent to drunk dialing I think and I'm sure I'm going to regret posting this after a good sleep (and perhaps a good drunk) but for now, I'm sticking to it.  I really do mean, from the bottom of my broken heart, fuck you world!  I hope you get punched in the junk.

It's been too damn long...

Yes... it's December... I know, I'm a wretched slug (more so to try and bring back the Tombstone quotes).  Anyway, a lot has happened and yet nothing has happened.  If that makes no sense, fear not! I shall explain.

I lived in a post-HSG haze for three cycles before seeing a reproductive endocrinologist (RE).  I told myself I'd give it six but I've waited long enough, I think.  Finding a decent RE is one of the most important decisions you can make if you're infertile.  You want someone who has a great track-record and high success rate but also someone that will take your ideas into consideration without copping an I-am-God-and-you-know-nothing 'tude either.  Pricing is also very important if you're paying out of pocket for all this business.  Go over all the costs with them.  Clomid v/s injectables, IUI, IVF, ultrasounds, office visits, everything.  Ask if they have itemized breakdowns of major treatments (IUI and IVF) so you'll know what you're up against ahead of time.  I actually got lucky here.  A BBC friend of mine went to this RE so I piggy-backed her research and have so far been happy with the result.  (Thanks Nic!)

The first cycle was a bust, but I knew it would be, as it was filled with testing; not only fertility testing but also I was back to the cardiologist, rheumatologist and pulmonologist to get the green-light for treatment.  They also made me see a perinatologist, as if I need another fucking 'ologist.  Anyway, I got the "all clear" from the Sarc docs and the fertility tests came back within normal ranges.  In case you're not aware, you'll get an ultrasound to evaluate uterine lining and ovarian health.  They're looking for follicle production, cysts, fibroids and other things that might pose a problem.  You'll also have CD3 blood-work done to determine ovarian reserve and quality and possibly a progesterone test to figure out whether or not you have a deficiency.

Other than a fibroid that they're not terribly concerned with, all things are normal.  All things except for the fact that I still can't get pregnant.  Anyway, I'm officially lumped into the "unexplained infertility" group and they scheduled my IUI for last cycle.  We're doing a medicated IUI cycle with clomid to amp up ovarian production and estradiol to make sure that the uterine lining doesn't thin from the clomid.  They picked a time based on my previous cycles that I might be likely to ovulate and scheduled an ultrasound for a few days before.  They wanted to make sure that the lining didn't thin too badly but also that my ovaries didn't overstimulate and produce too many follicles (which would mean a wasted cycle because they won't proceed with the possibility of too many multiples) but that they produced more than they normally do.  Unfortunately, I did not produce more follicles than usual.  I had one at 17 mm and another at 11 mm.  These were both in my left ovary, as my right was shriveled and useless.  It seems that I only have the use of the one though the doctor still won't fully confirm that after only one cycle.  Regardless, my follicles weren't large enough to trigger me so they sent me home to use OPKs until O day.  When I finally got my +OPK, I called them back and we scheduled the IUI for the next day.

Adam's appointment was scheduled for an hour before mine in order to give them time to wash the sample.  Washing is when they take your significant other's sperm sample and remove the dead sperm and the seminal fluid.  After regular intercourse, the sperm shed the fluid before entering the cervix anyway and getting any of it into the uterus would cause severe infection.  So, about an hour after Adam made his deposit, we got to business.  The room was set up like a normal exam, sans all the normal equipment.  I'm not sure why I hoped for some candles, maybe a nice water feature, but for something so intimate, it was certainly clinical.  Once you get to this point, I highly suggest that you take all delusions of romance and "the natural order of things" and throw them out the window.  I promise it will make your life easier.

So... feet in the stirrups, the nurse practitioner came in and had me verify the sample.  I thought this was odd at first but I'm fairly happy they did it.  She told me that his count was around 193 million, which is apparently awesome-sauce, and then she showed me the catheter and made sure I was cool with what was about to happen.  Long and short of it is, they insert the catheter through your cervix and into your uterus so they can deposit your man's swimmers right next to the tubes.  This bypasses the vagina and cervix, which is where most of the sperm are killed enroute.  She set up like any other exam and like a Pap, it was a smidge uncomfortable but nothing too painful.  I bled a bit more than I expected but she said that happened sometimes.  They had me lay there for ten minutes or so and then I paid the bill and showed myself out.  The whole thing was pretty impersonal considering I was making a baby but we do what we have to do.

This two week wait was in-fucking-sane!  Despite my better judgement, I could not contain my new-found excitement.  I was researching, and googling and pinning baby shit left and right!  I started thinking like I did when I was 19 and newly married... thinking like it might actually happen.  Thinking like a fucking idiot.

Then, it happened.  I was 11 DPO, typically the day before AF would show, and my temp jumps through the roof.  I was giddy!  Laughing and crying a bit at 6 AM, trying to contain myself so as not to wake Adam that early on a weekend.  I wasn't supposed to test until the next day and managed to wait a few hours until I lost all willpower and tested with a cheap pregnancy test from Amazon.  Much to my dismay, like it always has been, the test was negative.  I thought maybe it was too early and the test wasn't sensitive enough.  I continued to think this for a few more days, even after several more BFN's, because AF hadn't started yet.  I was around 3 days "late" before my temp tanked.  It was another two days until I'd get my period.  You see, for me at least, one of the dirty little secrets of clomid is that it can lengthen your LP.  This is information that would have been fantastic while I was thinking "I'm not out till she shows" so I'm letting you know now.  Before starting a medicated cycle, take everything you know about your body and forget it.  You can ovulate later (or not) and you can have a longer LP (or not), you never know how it will affect you until you're on it.

So, after all that, the end of this story is that my first IUI failed.  I'm supposed to accept this, do exactly what my doctor says and move forward knowing that most IUI's fail the first time.  I realize this.  However, what I've been doing is losing any ounce of hope I might have gained with the IUI and all of what I had before that.  At this point, I'm fairly positive that I will never get pregnant.  Don't get me wrong, I haven't given up, but I have no hope left.  No delusions.  No fantasies.  I'll go ahead with this IUI (I'm on CD4) and I'll run through the motions but I do not think it will work.  After AF arrives this cycle, I'll go ahead with the next IUI but I doubt I'll think that one will work either.  Once both IUI's fail, we will take a deep breath and toss in the towel.  IVF is an option if we finance but I don't care.  Kudo's to all the women who have the energy to go through all this shit and more, only to do an IVF round and a few transfers as well but I don't.  I waited too long.  I should have seen a RE more than a year ago.  I'm glad I didn't have a child with my first husband but that time didn't help either.  I've always known I wouldn't be able to have kids.  I've always known I'd never know what it felt like to bring life to something other than myself.  It's been a long decade and have no fight left in me.  Childlessness can't be too bad right?  I have a feeling I'll be finding out.