Tag: Fertility

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Emotional Work Medical Politics

Day 765 and Kobayashi Maru for Women

I woke up to a totally off handed tweet of mine going viral. I had done some googling on the cost of pregnancy surrogacy and learned that it would probably cost $200,000 a pop. I’d never really considered the cost as to be honest as I didn’t think I’d be having children that way. The responses to the tweet left me feeling despondent.

Five years ago I did IVF to freeze embryos (and eggs too) and it kicked off a massive health crisis that I only feel I’ve gotten under control recently. It took everything from me. I was on medical leave, I sold my startup, and my marriage got to learn what “in sickness and in health” really means. It was awful. I am crying just remembering.

It took years to get healthy again. Of course, I first had to get stable at all. I spent years, and a huge chunk of savings, biohacking my way back to a body healthy enough to work. I’m thrilled to be back doing what I love most which is working with early stage companies. But work wasn’t the only goal of getting healthy.

I’ve had a fantasy that if I just kept at my biohacking that one day I’d be off all these medications. That I could truly be healed. That all this trouble and heartache wouldn’t be permanent. That I could heal myself. Unsaid in all of that, is that I cannot be pregnant and on the medications that saved my life. How is that for a kick in the teeth.

I’ve got two embryos and ten eggs and a fleeting dying ember of hope that I could ever carry them. I don’t know if having them via a surrogate is my path forward. Maybe there is still hope I could be healthy enough. I frankly don’t know and I’m not ready to say where my fertility is headed.

All I know is that this feels like a no scenario. That having a child in America is a fraught and expensive endeavor even when everything goes right and you are healthy and young. There is no winning as a woman as any decision around family is going to upset someone.

It’s the Kobayashi Maru for American women. Juggling your partner (or partners), your money, your home, your health and your fertility means balls get dropped. You are going to lose somewhere. And it really hurts.

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Internet Culture Politics

Day 764 and Natalism

There are a number of cultural streams in American life that have all aligned around being natalist. You want your country to have babies because it’s good for the economy. And presumably also good for national security.

This fairly basic insight means everyone from techno-libertarians to Catholic homesteaders believes that Americans should be having more babies. It is not just the Quiver-full types having six babies anymore, so are our wealthiest aristocratic titans of industry.

But this alliance is missing some crucial basics. Like for instance the fundamental civilization level things we need to do to make it desirable and affordable to have children. It’s expensive to be pregnant, it’s expensive to raise children, it’s expensive all around to be parents. I spent $40,000 on IVF and it ruined my health. If I counted lost wages and being forced to sell my startup I’m the total costs is seven figures.

I don’t know if you’ve looked at just the costs around having a baby but it will shock you every time you turn a new corner in the fertility space. I learned today you will spend between $100,000 to $200,000 to hire a surrogate. It’s a person’s salary and a lot of medical care so sure that seems right but damn.

I guess I am interested in the math of Natalism to see if I could afford it. I am one of those “tech elites” that thinks we have to have children to drive the innovation of tomorrow. Our future is based on an optimistic hope that maybe we can push for a better future. Humanity won’t continue without children.

But I don’t have a body that is all that healthy without medical intervention. I live a normal life now and can work full time again because I take some exceptional medicine.

But it’s not medicinal regime that can be combined with pregnancy. So if I want to carry a child I have to go off what amounts to life saving medicine. Without it I’d be on bed rest. You can imagine the math I’m doing in my head? Do I want to pour another million into having a family?

So what’s a girl like me to do? Surrogacy right? But I’ve got 10 eggs and 2 embryos so assuming a third of them make it, that’s nearly half a million dollars in surrogacy fees. To get three kids. That’s a heavy price tag on the future. If more of them take it gets even wilder.

Now ok sure I’d rather we encourage a world where younger healthy folks do things naturally but don’t we want everyone going at maximum effort for a better tomorrow? Shouldn’t we want technology to solve this? Where are my artificial wombs at?

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Biohacking Travel

Day 741 and Physical Safety

The last four days have been a bit messy for me. I flew to Prague for yet another failed effort to secure a visa for a family friend. My second time in a year to have failed to make any progress with our state department. I am not used to losing.

I very much want to give up on fighting this behemoth. Frankly my body has gotten the memo and decided to force a breather. As soon as it was clear my mission has failed, my body felt safe enough to get on with the business of its rhythms and routines.

My period has been a bit late but it’s here with a vengeance today. I appreciated it if I’m honest. Today I am wrecked with cramps and bloating. I had already caved to a emergency dose of steroids for an allergic reaction over the weekend. So why not add cranks to the experience.

Bodies are pretty smart about figuring out when you can afford a physical issue. They keep you safe through hormone boosts like cortisol and adrenaline. But they are not permanent states you can maintain forever. And now that I’ve been through the gauntlet of the embassy and failed there is no point is holding it all together.

I’ll rest and work today. Any ambition I had to see Prague is probably gone for the time being. I’d hoped to do some tourism before the American work hours in the late afternoon and evening. But I’ll be on my laptop in the Airbnb working and taking Midol instead. My body wants physical safety so I’ll give it to her.

Categories
Medical Politics

Day 656 and Genetic Material Storage

What feels like a lifetime ago, my husband and I pursued fertility treatments. I didn’t have any known issues but we wanted to freeze eggs and embryos while I was still young. At the time we didn’t feel stable or wealthy enough to predict when having children would be feasible. It seemed like the responsible choice to have a backup plan. Everyone we knew was doing it too.

I remember a gynecologist telling me off for considering freezing eggs as she managed medical school with a toddler so surely an easier career like startup CEO would have no trouble with resources for becoming a mother. I never saw her again after that incident. But knowing me the shame I felt from her judgement simply cemented my decision to free my eggs.

But I was equally poorly served by the fancy fertility clinic that glossed over risks and side effects. In hindsight I wish I’d been more concerned about ramifications. I also which I’d listened to my gut which was screaming that this felt more like a luxury shopping experience than a major life decision. The ease with which I was being sold a life where I could buy an insurance policy about a decision that I was ambivalent is almost shocking.

Now I’m faced with another choice. The genetic material needs to be moved to a safe state. In the wake of Roe v Wade being overturned, there is concern that fertilized eggs (embryos) might not be fully under our control as red states pursue stricter and stricter control policies. No one is quite sure how embryos will be treated. And frankly no one wants to find out.

Embryos that were stored in states like Texas and Florida are on the move. Clinics and storage facilities cannot guarantee their safety and usage as too much is still uncertain. Of the storage options we have, only two are in safe states unlikely to be impacted. Minnesota and Connecticut.

We picked Connecticut. Even if Republicans take it over we are banking they will be of the WASPy moderate types who see value in family planning for nice white married couples. Our privilege is at maximum there and that’s worth a premium.

I am so conflicted on even addressing the issue of what we are supposed to do with our generic material. Is this the moment we give up and admit it’s not a life path that we want? The chances of Alex and I have children together are getting slimmer. It’s not impossible but it’s also not looking likely.

My health is stable but I use several pharmaceuticals that shouldn’t be used during a pregnancy. I’d need to be on bed rest and dosed off everything to proceed with a pregnancy. I’ve been warned I could lose my progress on controlling my autoimmune disorder, the worst case scenario is I’d have to repeat the last four years of stabilizing treatment. I would be in a lot pain that couldn’t be treated for the duration.

Needless to say I’d not be able to work during the pregnancy and possibly for an extended time after. It feels perilously close to a choice between living my life and organizing my entire life and healthcare for a child I don’t even know if I want. It might be a permanent off ramp from work as the recovery would be significant. Everyone says you will regret not having children but I’ve only ever met people who regret having children.

At which point I have to admit to myself I don’t want children so badly that I am willing to be physically debilitated for another five years. I am so excited to be living a semi-normal life where I can pursue my personal and professional goals. The last few were hard. Perhaps we could pursue surrogacy but that suggests a level of wanting children that I just don’t think either Alex or I have. Because neither one of us strongly desires children this additional effort and cost simply to preserve our own genetic material isn’t under consideration. If later on in life we find our preferences changed we are both comfortable adopting or raising children not related to us genetically.

Perhaps the problem was that we never strongly wanted children in the first place. Maybe that shitty gynecologist was right. If we’d wanted kids we would have found a way. Instead we bought an insurance policy. And now that insurance policy is a scary liability with an uncertain political future.

With the way America is headed if we don’t move the embryos to a safe state now it’s entirely possible the government will decide we actually already have children. Unborn children. Who might have more right to life than I do. To be honest that’s an ethical question I don’t have an answer to. All I know is that I am absolutely not willing to let the government decide if it is my life or the embryos. That’s between Alex, myself and God.

Categories
Biohacking

Day 652 and Startled Awake

There are few things more disorienting than waking up without realizing where, or even when, you’ve fallen asleep.

The first few moments of regaining consciousness are the stuff of genuine terror. As your senses do their best to bring their data to your brain, there are a few agonizingly slow beats where you genuinely have no idea what the fuck is going on.

I imagine this phenomenon is where our vocabulary of phrases like “startled awake” get their origin. Perhaps you weren’t awoken by anything surprising, or particularly startling, but the small gap in processing between sense and mind is such a chasm in that singular moment that it all feels startling.

I had lay down to wait for a Midol to kick in to ease my first day of menstruation cramps at around 1:30pm. I remember asking my husband if he could find a heating blanket. I don’t remember much past that except a few hazy details of wrapping my entire lower torso with a heating blanket.

I had not turned off any lights. Nor had I thought to put on a sleeping mask. I thought I was simply waiting for the sweet relief of caffeine, Tylenol and diuretics. I had even told my girlfriend Ellie who had been expecting me to come up upstairs to hang out that I just needed a quick lie down. Turns out the lie part was true. It was not quick however. Which is some fun wordplay.

When I regained consciousness I had no sense of how much time had passed. As I fumbled about for my cell phone I swear I felt my neurons firing off rapidly in an attempt to gain data points for my poor addled mind to do some damned interpreting.

I was wrapped in something hot with a cord. Did that mean I wasn’t in my own bed? I didn’t generally sleep with anything electronic. I briefly panicked as I felt trapped in what was previously providing my body with comfort. I’d forgotten about the electric heating blanket, leaving the cord with no other function but to panic my hind brain with a fear of being strangled.

As all my lights were on, the various lamps were washing out any indication of the hour. I could hear noises above me so perhaps someone was awake. Did that mean it was the afternoon? What was with all the stomping above. It felt like it must be day.

I simply wasn’t getting enough orientation information from my initial position and I couldn’t seem to find my phone. I doubt more than a second or two has passed as I went through my startled awake process.

As I attempted to make sense of all these inputs I finally realized that I had passed out on top of my phone and I’d let it slip under my pillow. It was a bit past 3pm. I texted Ellie to let her know I’d accidentally passed out. The brief pumping of adrenaline and cortisol was easing back. I was at home in bed quite safe and a bit overly warm. But I certainly felt a new appreciation for the limits and frailty of my human mind.

Categories
Politics

Day 565 and Mommy Issues

I just want to scream into the void about how disappointed I am in American men right now. I probably shouldn’t but this is my own little space so I may vent briefly and without a lot of citations. I’m angry and sad and I’m pretty convinced we’ve got a bad case of mommy issues with the way we are treating women’s rights this summer.

I’m surprisingly steamed that gay marriage is being protected via legislation before bodily sovereignty. It is just so American to protect the fucking tax regime. Like I get it. We organize all our property around monogamous two person households. Everyone should have equal access if we have it.

Also maybe we could not have the government involved instead. But nope we’ve chosen to get the government involved in social organization and now we’ve got to fight for equal access. And sure the liberals in America are scrambling in this particular summer to front run the Supreme Court being open to overturning settled precedent on all kinds of shit. I get it. I swear. I get it. I’m glad something is being done.

But like in what fucking world is bodily sovereignty for half the population the sort of problem you don’t bother to codify into rights first. Or at all! Why is it easier to protect marriage than my body. What message does it send we protected gay marriage before the right to manage your own body.

We are able to pass legislation on protecting equal access to some dippy tax scheme but we couldn’t figure out how to have control control over your own body if you can get pregnant. White gay men have more sway than brown women. I get it. I get it. I’m just so fucking disappointed.

Categories
Politics

Day 543 and Complicated Country

America has always been a complicated country. We’ve perpetrated some of history’s great evils. And at the same time we’ve achieved the greatest set of freedom ever known. Dickins didn’t fucking know best and worst of times. That’s always been the great American novel’s thing. The remix is better sometimes.

And I am feeling this tension in my body this week. To have always believed in the forward progress of this nation. Even when one grew up, perhaps most uniquely among generations, aware of the sins. We had Adbuster’s and Zinn’s People’s History and every politically aware piece of Hollywood awards bait.

You know how weird it feels to be optimistic about capitalism and the mess of democracy when you know it’s fucking blood magic that bought its riches? Everything has a cost. But who am I to know the cost. And would I bear it myself if I thought I could enjoy it’s fruits only? I doubt it. Everyone loves a fucking deal. And white people love the meritocracy. Because it means we’ve got merit by being winners. Whatever your ego needs.

It’s no wonder we love horror movies in America. We like a nightmare on Elm Street. And we love our monsters. What if racism was the monster all along we laugh. Our art has always recognized the victims in the system. It was only very occasionally that our laws did anything to protect anyone though. Amendments were hard fought and fiercely opposed. Reconstruction of what exactly? Did we even try?

So I’m not surprised that my body is on the line. Because someone in my lineage knew the cost. They came to America willingly. The freedoms we bought for ourselves as immigrants. We knew they weren’t free. But maybe we misunderstood the cost. Didn’t pay the bill in full.

But if the promise isn’t worth it. If the dream cannot be attained? Then what happens. Who pulls back from contributing our best. Who gives up a little on working harder. And how do we slowly decay just a little bit over time. Slowly at first. And how does that compound. What little failures add up to the final cynical calculation that anyone who has lived under an authoritarian can smell.

It dawns on me that we should have been fighting my entire lifetime to secure every inch of freedoms we could. That every single instance would matter because we’d be losing ground the moment we stopped. Because shame is unrelenting. And we must hold our ground against it every day. Ever vigilant.

Categories
Politics

Day 488 and Life

I woke up today feeling betrayed. I’ve never been concerned that my reproductive health would be decided by anyone but me. It’s been a luxury not to fear my own body knowing I had a right to chose for myself. It was my belief my family would do it’s own planning.

And we did plan. We did fertility treatments and it went catastrophically badly. Four years later I’m just barely stabilized from the attempt to extract eggs and freeze eggs and embryos. The vast majority of people have to cope with our reproductive health in some capacity. Having a family is pretty standard issue. Mine just happened to be a little more dramatic than average. But I never had to worry if it was my life or my unborn child. Or who would get to chose. I never got that far and now I’m a bit afraid I never will. I’m afraid to be pregnant in a world where my health decisions are not my own.

In case you missed the news, last night someone decided to leak a draft opinion from Justice Alito (supported by the conservative justices but without any indication where Roberts stands) that would overturn Roe vs Wade. Abortion would no longer be a federal question but devolve to state authority if Roe is overturned. After 49 years it looks like a major reversal is possible. To be clear it is a draft and while Chief Justice Roberts confirmed it’s authenticity, he said it’s not final or representative of any current justices or the courts final authority.

But it didn’t fucking matter what anyone intended. Chaos has absolutely ensued as various parties look to assign blame for such a massive breach of judicial norms. Everyone is jockeying for position and speculation is rampant. A topic like when life begins is guaranteed to generate strong emotional response. Who gets to decide is a big question. But I’ve generally fallen onto the side that the woman has autonomy over her own body. A fuck ton of other people felt about the same as I did. I’ve seen social media erupt in fear and hurt.

I’ve got very complex feelings on abortion. I’m against it in principle (and I’m deeply grateful I’ve never been faced with that choice) but I am not convinced a fetus is a person. Lord knows if an embryo is a person I know I’d have a very different opinion. I’m not even sure I would have been comfortable doing IVF if I thought an embryo was a person.

This is all complicated by the fact that I don’t think any of society’s crucial issues should be legislated by courts. They enforce laws they don’t make them. We have a legislative body for a reason. Why won’t we try passing federal legislation for anything? Like honestly I’m sick of the courts having to be a backstop. I think most people are. I just don’t get it.

I don’t fully understand how we build out laws to enumerate natural rights but I’m pretty sure it’s meant to be an amendment. We have sucked at this amendment thing traditionally and I don’t really grasp why.

I failed Constitutional Law so my opinion maybe doesn’t count. In my defense, I took it with Will Baude as a fellow classmate as an undergraduate and well now he is is famously a world class constitutional scholar. He absolutely wrecked the curve for my class of twenty. But maybe I understand the issue marginally better than I imagine. Just not as well as say someone tapped to regularly review how the court operates. I don’t know! But at a certain point the contentious shit is going to be an amendment right?

I don’t have a tidy summary to any of this except to say I know this is hard for everyone. I wrote this post because I’m scared and hurting. I can now imagine a world where if I’m faced with crisis like an ectopic pregnancy it’s not clear that the choice to terminate to save the geriatric mother would be in my hands. And I don’t think that’s right.

Categories
Internet Culture Politics Preparedness

289 and Apocalyptic Aging

Millennials are aging, but that doesn’t seem to have kicked off the midlife crisis handwringing of popular culture yesteryears. The first millennial are edging towards 40 but it feels like no one is a day over thirty on social media. Maybe because it’s hard to feel like you’ve hit midlife when the traditional markers of stability like children and mortgages feel more like luxury status symbols.

Maybe no one is craving red sports cars and the open road because no one has the security of a home life from which to break free. A midlife crisis seems like an almost comically indulgent thing that our boomer parents did. Imagine having kids and a home and thinking that you wanted to go back to the insecurity of your twenties? And boomers have the balls to call millennials spoiled. You had to have have stability to throw it away first.

I’m an elder millennial and a reasonably comfortable even wealthy one at that. But I don’t have kids or own a house. I frozen my eggs when it seemed like having kids wasn’t financially feasible. My husband and I lived in Manhattan at the time and we both had early stage startups. It seemed like a wise idea to put off the decision at the time. And we never even considered buying an apartment. Tying up all that wealth into a one bedroom apartment was for trust funders not the professional class.

Now it’s clear we can afford children and a mortgage on a house, but it seems crazy to commit to either. No one has a clue what life is going to be like in ten years so why would you anchor yourself and innocent progeny? It almost feels immoral to consider.

I don’t really understand how one can age gracefully when so much of life feels casually apocalyptic. Maybe millennials aren’t acknowledging aging because we live in the stasis of the long now. If there is no future then we aren’t moving into it. Each passing year is just a lucky bonus when nothing builds towards stability.

Not being able to afford children and houses is a blessing if you don’t believe in the future will be better. We’ve rationalized that the basics of the American are luxuries only for the wealthy. The wealthy can afford to live with rising tides and six figure college tuitions. Everyone else is thrilled to have enough cash to buy prepper supplies and pay their health insurance deductible.

And in some horrifying sense it is rational. I don’t trust the political system in America. Which means I don’t trust we can solve pressing issues like climate change or rising debt. So when new and exciting issues like the pandemic destabilize life even further it makes committing to a future even less appealing. There is absolutely a part of me that stopped believing in the future sometime in 2016. Everything went Hobbesian. Millennials are aging but we aren’t growing into a future.

Categories
Chronic Disease Politics

Day 142 and Optimism

The pandemic has done more to improve my life than to it has hurt it. I have a little survivors guilt as I am not far from family and friends that have suffered but I was lucky. Part of my luck has been tied to my privileged place in society. I was able to enjoy housing flexibility and leave behind an expensive city apartment for a townhouse in my hometown. I was always able to work from home with little fear my income would be impacted by disease or even negative secondary effects. Nevertheless I haven’t felt much optimism until recently.

Part of my lack of optimism has been tied to my health challenges. It’s been two years of working to get a diagnosis, stabilize my spine, and get the secondary symptoms controlled. There were low points when drug regimens didn’t work. Or when it seemed like the fatigue or pain would keep my life away even when primary concerns were improving. I was genuinely terrified going into the pandemic as it did cut off my access to typical doctors visits and more hospital setting delivered care.

But I’ve found significant improvement over the past six months thanks to excellent remote care I was able to receive from functional medicine doctors. It’s almost as if with the operational and physical logistics of care removed the actual outcome of my care improved. I was able to get to the heart of a diagnosis and hone in on effective treatment protocols more quickly. Thanks to this improvement I’ve come to find my optimism again.

Not that I think the world is getting better. If anything I’m far more worried about the many axis of American failure. Our politics has become authoritarian. Our economy increasingly serves only the entrenched and already wealthy. Our interest in mitigating climate change remains low. It’s so bad the best we can do is chuckle at why millennials don’t have kids. It’s because they are selfish right? Nothing to do with how hard it is to trust that the system will ever work for you so why bother investing in the future?

But I am intrigued by the opportunities afforded by the chaos. There is money to be made adjusting us to new realities. Maybe by dint of accidental or unexpected changes we find innovations that change our world. Maybe those will be for the better. And maybe I can help nudge along the better outcomes. And for the first time in a while o believe my body will be up for the challenge. It’s nice to be optimistic.