American healthcare recognizes that I only have one boob.

Thanks to former President Barack Obama, women across this country who are employed by companies of a certain size were entitled to dedicated spaces for pumping breast milk after coming back from maternity leave. On top of that, they were also entitled to having their breast pump covered by insurance, as well as replacement parts, every few months after the initial purchase. I placed my order via insurance for my breast pump back in November, and the company they are going through notified me a week ago that I was ready for replacement parts if I’d like them, so of course, I requested them. What I was not prepared for was that the replacement parts were just for one breast.

This is what the box says:

Spectra Premium Accessory Kit

Contents:

Breast shield

Back-flow protector

Valve

Tubing

Bottle

Bottle Cap

Disk

Bottle Cover

So in case you are not familiar with pumping, the ideal setup, especially if you own a breast pump that allows for double pumping, which means pumping milk from both breasts… is that you WILL double pump for more efficiency. So the above contents are just for one breast, as each piece is singular. So what does this mean — American healthcare via my health insurance recognizes that I only have ONE boob and not two?????

This is truly American healthcare at its finest. This is beyond embarrassing that to call this a SNAFU (situation normal: all fucked up) would genuinely be an understatement.

And if you are pumping exclusively or pumping as much as I do (that’s 6-7 times per day), it’s recommended you replace your parts every month, not every three months as insurance will cover. And you would need to replace them for both boobs. So thanks, American health insurance, for only recognizing half of my boob inventory.

When bad dreams return

It must be my subconscious slowly building its anxiety level, greatly anticipating when I will be back at my parents’ house in San Francisco. That bleak place with an odd, eerie chill and a damp, musty vibe rarely has a positive effect on anyone.

I woke up this morning from an annoying dream. It could be characterized as “bad,” but it’s more annoying because it really encompasses, to me, how frustrating my family can be. I’m here in New York and suddenly my mom calls, and all she says is, “Did you hear that Ed died?”

First of all, assuming that Ed were actually still around, why the hell would anyone ever so casually ask you if you “heard” that your own brother DIED? There is something so wrong about that that I cannot even put it into words. Death is not casual. It is especially not casual when it is the death of an immediate family member.

It is really insane to think that nearly eight years ago, my brother died. Tomorrow will mark eight years since his funeral, since the day I stood up at a podium and gave a eulogy for him that I never wanted to write, a eulogy that gave subtle but pretty obvious hints at what he died from. When I think of going home, I am always reminded first and foremost that he is gone and that I will never see him ever again.

Vivid dreams during early pregnancy

Surges in progesterone and estrogen, as well as the obvious HCG/pregnancy hormone, are to blame for pretty much every pregnancy symptom that exists, from moodiness, sore breasts, nausea, fatigue, dizziness, food aversions, etc. But what I wasn’t quite expecting while reading about pregnancy symptoms is that women also tend to experience more vivid dreams and nightmares as a result of being pregnant, particularly in the first and third trimesters. And this, in somehow and some way, can also be attributed to the surges in progesterone due to pregnancy.

Many women who had never really remembered their dreams prior to becoming pregnant report greater dream recall during pregnancy. They also say that there is an increase in nightmares that feel very, very real. Granted, I’ve always been a vivid dreamer who thinks her dreams are real as she’s experiencing them, but in the last few months, my dream recall has been relatively poor.

The dream I had last night was very much out of the normal range for me. I had a dream I was at the border of two countries… who the heck knows what countries. And we had an endless number of huge crates filled with tropical citrus. I was charged with illegally getting these citrus from one country to the next by smuggling them in and hiding them underneath some other legally recognized cargo. I was working with two other people, and we were mapping out the route we were going to take on the road, the excuses we’d make at the border check-point, what we’d show the border patrol agents, and approximately how much time this would take. It felt like a very high stress, high stakes endeavor, and the pressure was on.

Maybe in some ways, this does make sense for me to dream about from a pregnancy perspective because I have been experiencing cravings for grapefruit that I’ve never really gotten before. While I’ve always enjoyed grapefruit, it’s tasted even more delicious to me in the last couple weeks than ever before. I wonder what I will dream up next.

Excitement vs. fear?

I was chatting with my therapist this morning about the transfer earlier this week. She asked me how I was feeling, and I immediately just started crying. I told her I just felt worried… and powerless. There’s nothing, once again, I can do at this point to make anything happen. I also felt a little excited, but all that excitement could easily just die upon getting a negative HCG test next Wednesday, or even worse, getting my period. I hate waiting, I said to her. I’ve done SO MUCH WAITING this entire time. IVF should really be called I FUCKING HATE WAITING VF. So I wasn’t sure how to feel or even how to express myself.

She suggested that I don’t really give myself time to feel, which is likely why I had such an explosion of emotion when being asked by her how I felt. “It’s okay to sit on your emotions, whether they are good or bad or a mix of two opposing feelings,” she said. She said I have a tendency to bury myself in doing things or being efficient to avoid having to feel. That observation is likely true. I mean, I have consciously noted that I pride myself on productivity and “getting shit done,” so those two things kind of go hand in hand.

So then the next question is: how do I let myself feel?

Moral/religious opposition to pre-genetic screening of embryos

In the last two months, I joined a few IVF support groups on Facebook just to see what people were posting and if there was any information I could potentially benefit from. For the most part, over the last week or so, I’ve stopped reading any of the posts in depth, but I did notice a few annoying themes that I immediately ignore when scrolling.

I’m sure decades ago when IVF first became available, a lot of people were “morally” or “religiously” opposed, believing that this interfered with “God” or whatever higher power exists, and felt that pursuing IVF was wrong or “a sin.” I’m sure there are a lot of people who still believe this. Yet, as couples become desperate to start a family of their own, they slowly but surely begin to let their guard down, believing that “God intended for them to pursue this route,” or “God made people discover this possibility to benefit us,” so of course, it would be okay to pursue because God gives these options to people. In other words, when things are convenient for them, they allow what was previously against their beliefs to be acceptable.

The latest war seems to be against pre-genetic screening, which, for women who choose an IVF “freeze-all” cycle instead of a “fresh” cycle, they can also add on (with an additional expense if you are self-pay), as the embryos that make it to blastocyst/Day 5 are biopsied and sent off to a lab for genetic testing to make sure that the embryos are “chromosomal normal” (you cannot do PGS testing for a fresh cycle because the labs need at least 1.5-2 weeks to biopsy and get the result back to you, and fresh-cycle embryo transfers are usually 3-6 days after your egg retrieval). In addition to this, PGS testing also allows for you to know what the sex of the embryo is (it’s usually redacted, but you can request to have it un-redacted). You can also elect for other tests that can evaluate whether the embryo is a dominant carrier of certain diseases if you and your partner overlap for any recessive diseases. So funnily enough, there are many women and couples who think that although “God created IVF for a reason,” doing PGS testing is against God or “messing with God,” and choose “for moral/religious reasons” not to do PGS testing…. even though studies have shown time and time again that transferring a PGS-normal embryo results in a higher live-birth rate, a higher transfer success rate, and a far lower miscarriage rate.

And soon in the future, the people who were morally or religiously opposed to PGS-testing will ween themselves off this thought, and then be against some other new development in science and infertility medicine because it’s convenient for them. I hate it when people use religion or morals as a reason to be opposed to these decisions. You could use “God created X to benefit man/woman” with pretty much every argument!

When someone appears when you need him the most

In the couple of nights leading up to the egg retrieval day, I kept waking up multiple times in the middle of the night. It was likely my subconscious expressing anxiety over the big event that it knew would eventually happen. The last time I had this happen to me, when I would wake up without much explanation or needing to pee, was nearly eight years ago now, when Ed passed away unexpectedly. That continued for about a week or two after I knew he was gone.

The night before our wedding in March 2016, I dreamt of him. Today, I cannot remember what I dreamt, but I do remember seeing him in my dreams. It was as though he wanted to be there with me in my most significant life moments. I woke up feeling miserable that morning and was crying.

This past Friday night, the night before egg retrieval, I saw Ed again. He hasn’t appeared in my dreams in quite a while. He came to my apartment, ready to take me to my egg retrieval. We walked east towards the clinic early Saturday morning, and he dropped me off in front of the office building where the clinic is. I don’t remember any real conversation or words exchanged. All I remember is that he looked at me, smiled, and gave me a big hug before I walked in.

When I woke up yesterday morning from this dream, I thought of this as a sign. Maybe this dream is a sign that he knows this is happening, and he’s been looking down at me this whole time, sending his hopes and prayers that this all works out for us. Maybe his appearance is a sign that all of this anxiety and frustration and anger and sadness and turmoil will actually have a happy ending. Maybe he’s trying to give me the head’s up that we will finally experience some success.

I can only hope that will be the case.

Oocyte retrieval day

Today was the day when I got sedated, had eggs sucked out of my developing follicles, and got told how many eggs my body had produced during the stimulation period. It was kind of a weird day in that all these experiences were new, and it was on the one hand a little exciting, and on the other hand, completely and utterly terrifying.

After signing some forms and undressing, I was given a pink gown to wear. I had to confirm my identity a few times, was given a bracelet with ID/procedure name, and led into a waiting room to wait for the doctor to greet me briefly before the procedure. The doctor, whose official title is reproductive endocrinologist (RE) and who would perform the procedure, came out. He’s actually new to this practice as the third RE onsite. Meeting him was pretty boring and useless. He cited a few stats that did not help me or make me feel better (it’s not really the doctor’s job to make you feel better, but it IS the doctor’s job to have some damn empathy), gave me some generic pieces of advice that I could have Googled (and DID Google prior to the day). My own RE, who I have met fewer times than I can count on one hand despite coming to this clinic dozens and dozens of times, “does not work on the weekends,” the nurse let me know a few days before. Well, how glorious for him. Gotta love the empathy here. As you can tell, we have a tight connection.

Then, I got led by a nurse into the operating room, which has one tiny window that appeared to look into a laboratory. I was set up on a chair to lie down, and the nurse strapped my legs and feet on. Everyone was masked (duh), and through the tiny window peering into the lab, I could see multiple people in lab coats, one of whom was looking right at me. The man introduced himself to me as my embryologist, who would be working with me. He asked me to confirm my name, date of birth, my partner’s name and date of birth, and to confirm verbally what procedure I was there for today. Then, the anesthesiologist stuck an IV into a vein in my arm, and when the RE came in, closed the door, and confirmed that we were ready to begin, the anesthesiologist let me know he would activate the IV, and I’d immediately feel a metallic taste in my mouth and within 10 seconds, fall asleep.

“You should taste it now,” the anesthesiologist said.

Yep, I did. “Whoa, I can definitely taste it,” were the last words out of my mouth before I passed out. They worked on me for about 30 minutes. During the time when I was asleep, this is basically what happened:

The RE, guided by an ultrasound, sticks a long needle through my vaginal wall into one ovary and then the other. As he views each follicle on the ultrasound screen (from what I could see before I passed out, there were three large screens they were all viewing), he sticks the needle, which has an aspirator at its tip, into each follicle, sucking out the liquid inside, which hopefully will have an egg in it. He removes the needle after sucking out liquid for each follicle, and then each follicle gets one tiny vial. The RE hands this over to the nurse, who then walks the vial over to that tiny window where the embryologist is sitting and waiting. The embryologist takes the test tube, and using a high powered microscope, examines the contents of the vial to confirm whether there’s an oocyte. He says “confirm” if there is an oocyte/egg. If nothing, he says “none,” or something similar, and they continue the process until the RE extracts liquid from every visible follicle. This is why and how, before you leave for the day, the RE will tell you how many eggs were retrieved. Whether they were mature or not will not be shared until the next day, when you get your fertilization update. As you can probably guess, the more follicles you have, the longer this procedure will take. Once this is done, the IV is removed, and within seconds, I regain consciousness, and two nurses tap me lightly to wake me up, unstrap me and help me out of the chair, and guide me into the recovery room, where I continue to sleep and rest until I’m deemed okay for going home. That takes anywhere from 30 minutes to over an hour.

And during this time, when I’m in my deep sleep, my partner is in a tiny, sterile room, masturbating to provide his “sample” into a small, sterile cup that we hope will then be used to fertilize my oocytes. What a truly memorable day it was.

Hair extremes

Over the years, I’ve gotten all kinds of compliments (and passive aggressive comments) about my hair. I’ve had countless friends, colleagues, classmates, and acquaintances marvel over how low-maintenance my hair is, how “you probably wake up with your hair looking like that, huh?”, how envious they are that I don’t have to straighten my hair or use any type of texturing cream or gel to get it to look the way it does every day. Up until recently, I have been lucky enough to “wake up like this.” My hair is naturally straight and fine, though with fine hair comes issues like flatness and lack of volume.

Well, once I started highlighting my hair in the middle of 2017, that changed a bit. Highlighting or bleaching fine hair never really does anything good for you, and if anything, it tends to result in easier breakage, more split ends, and thus, a larger need for more careful maintenance. The amazing thing that has happened since dyeing my hair is that I actually need to shampoo LESS. Once upon a time, with daily weekday morning gym workouts, I washed my hair five times a week straight. I hated that process but didn’t want to go to work smelling like sweat and oil, so I sucked it up. Then, I reduced it to every other day with just a rinse after a sweaty workout every other day after my friend insisted a rinse would get rid of the funk. But finally, I realized my hair wasn’t as oily and was getting drier. Since late last year, I wash my hair only twice a week, which has been a dream because I truly hate the process of washing my hair and combing it out.

That has come with some hair extremes. I wash my hair, even with moisturizing shampoo or an all-natural shampoo bar, and it’s a bit dry right after. Three days later, it becomes extremely oily and looks as though I’ve added oil to my hair. It hasn’t been fun, but it’s what I have dealt with. I even have to use a hair mask or deep conditioner every other week now to keep my hair from breaking so much and feeling so brittle.

This is what it’s like to have “haircare,” huh?

Teeth shifting?

One of the recurring nightmares I’ve had pretty much my entire life is that my teeth are shifting, breaking, or falling out. I’m not sure what gives me this much subconscious anxiety about my teeth. Perhaps it’s because I’ve had two oral surgeries, two coats of braces, and two different sets of retainers in my life. Perhaps it’s because my mom constantly told me how grateful I should be to have had the privilege of having dental care at all growing up since she came from Vietnam to this country with teeth so rotten that every single one of them needed to be pulled out and replaced with fake implants. Or perhaps this is just my internalized anxiety about life, just culminating into terrorizing dreams about my teeth being destroyed?

I’ve been grinding my teeth during the night ever since high school. I can’t really control what I do with my teeth when I am sleeping, so I wasn’t even really aware of it until multiple dentists called it out, not to mention I started developing sensitivities everywhere in my mouth. And stupidly, it wasn’t until maybe six years ago when I finally started wearing a mouth guard at night to prevent grinding during my sleep. But the problem with wearing a mouth guard (which goes on my upper set of teeth) at night is that this prevents me from wearing my top retainer, which then means… uh oh. My top teeth are more likely to shift.

I’ve tended to neglect my retainer in favor of my mouth guard, and when I looked in the mirror this morning, I was annoyed to see that in reality, one of my top front teeth appears to have shifted, and this teeny tiny gap has formed between two of my teeth. I immediately felt frustrated and realized I need to start wearing my top retainer more. I popped it in, and felt right away that it felt snug and tight in that area of my mouth.

Need to wear retainer to retain smile. No more teeth shifting. No more braces. No more retainers made for me. Need to wear retainer to retain smile. Need to wear retainer to be grateful to my mom for providing me dental care until age 22. Need to wear retainer.

Travel envy but anger

On Instagram and Facebook, I can see friends and colleagues who are traveling in Europe, and I cannot help but have massive envy that their countries are seemingly doing the right thing and getting their virus rates down, and I am still stuck here in a total mess. Colleagues of mine in England are traveling to Italy. Friends from The Netherlands are traveling to Portugal or Spain. They are posting their videos and photos of their hikes and museum visits. On the one hand, I am envious, but on the other hand, I’m not sure if they really should be traveling at all. Is it even responsible for anyone to travel to other countries now? Are they being selfish? I personally think that here within the U.S., to cross state lines is pretty selfish. I’ve read and heard that national parks across the country have been overcrowded, primarily from out-of-state visitors who think that since they are outdoors, they must be safe. But what inevitably happens is that the most popular trails still remain the most popular trails, which means they become overcrowded, and there goes any chance of social distancing, right? Now, if you were to leave New York state and come back, you’d be required to quarantine yourself for 14 days. I don’t want to be part of the problem. So outside of the U.S., every time I see these pictures and videos, I wonder if these people are part of the problem or are they actually being responsible at all? My default is to think that they, too, are being selfish, just like the people here who are crossing state lines.