Daily Grind - pandemic style

I've been wearing an envo (reusable N95) plus surgical mask since July. The envo seals around my face so not only does it give better protection but also eliminates the glasses fog. Some people looked at me weird when I first started showing up with this (especially the ones who were more concerned about matching their mask to their outfits), but now double-masking is a thing sanctioned by the top professionals. 

When I start to get overwhelmingly down about the state of the world and how stuck I feel, I try to think of the positive sides to this pandemic. There are lots, but so many come with a darker side. For example, we've saved a nice chunk of change from not sending anything to the dry cleaners for the past year. But that probably means that a lot of others did the same and that business went under.

My weight has been going up and down in direct correlation to my mood. At the start of the pandemic I gained. Toward the fall I lost enough to get back to baseline (pre-pregnancy weight). At this point I'm finding myself comfort-eating more often than not and it's showing. I feel my clothes fitting tighter and get surprised when I catch an unexpected angle in the mirror. I try to fight the "what's the point" attitude with "this isn't forever." It takes a lot of mental energy to eat mindfully and I'm not in that mindset. I want to be healthy and strong, with all the right reasons to motivate me, but with so many limits on our lives food is a reliable, easy reward during a time we can all use extra love and comfort. 

I took some time this week for personal grooming and self-care. I encourage my husband to do the same. We're deep in survival mode doing the bare minimum. After an incident left my feelings deeply wounded I needed to reset: I lovingly made a giant vat of chicken soup on Sunday. I had been saving the ingredients the week prior and finally got everything I needed in the last delivery. Since baby boy is currently transitioning from two naps to one, those nap minutes are precious and I used them to chop and clean veg to start the soup. I let it simmer for hours, and the house smelled amazing. I patted myself on a job well done and was so happy to have healthy lunch and dinner options for the next few days. The next morning I woke up literally by sitting straight up in bed: I had forgotten to put the soup in the fridge the night before and the whole pot spoiled. Between teething and the nap situation, I'd been getting less sleep and I was so tired and out of it the night before that I just forgot. I had no one to blame but myself and I was so, so upset. It put me in a funk and I needed something tangible to snap me out of it so I waxed my eyebrows and gave myself a pedicure. I gave a donation to charity to try to offset the sadness I felt by this seemingly minor incident to try to put out some good vibes into the world. [Thinking more about it I realize this was the last straw to something else too. I recently took on the challenge of watching all the Star Wars (yes, 9 movies). I didn't realize it at the time but I was feeding off of the energy of the rebellion who had something to fight for: a unifying goal that they were all working hard toward together. Excitement, adventure, hopping in a ship and taking off. All the things stuck people don't have. I'm thinking the soup was the last straw for me and it sent me down a dark path. I'm still not totally over it but at least better.] 

We've discussed the option of trying to figure out how to schedule the cleaning crew to give our house a scrub since that's something that brings us joy. But with the cold weather making outdoors not an option and no safe indoor options, we literally have nowhere to go for several hours. Something else to push to the back burner for "when this is over." 

I'm trying to think ahead and believe things will get better. There will be a time when we can hang out with friends and hang out with family and feel safe dropping our child off at school. I try not to think too far ahead because then it makes it harder to come back to the present when none of those things are an option. It's like playing the What Would I Do If I Won The Lottery - you imagine all the things you can buy with unlimited funds; how the world would be wide open for you to explore without the burden of debts or a daily job to report to... but then you need to come back to reality and realize you're still stuck to the financial ball and chain that is the daily grind. 

On top of the mental struggle is the cherry on top known as guilt. As challenging as things feel for me, everyone I speak to is going through something. Some are challenged with trying to settle the estates of loved ones who were lost to the virus; others are dealing with struggling with food insecurity and financial instability because they lost their jobs; some are dealing with the crippling anxiety that comes with isolation, loneliness, and fear of what we're all dealing with. It doesn't mean my challenges are real to me, but putting things in perspective is important too. 

Exhale

I've been needing a mental health day off work and I decided to take it on Wednesday to watch history being made. It was refreshingly nice to see good news for a change. Today is the first day of the Biden Administration and I feel hopeful. I know things won't change overnight, but I'm hoping they will get incrementally better with time. 

I had the opportunity to sign up for the covid vaccine. Part of me felt guilty because not everyone has access to it. My reasoning was that if it doesn't go to me it may end up in the trash because they don't have their act together yet and defrosted doses must be used and cannot be refrozen. As it is, supply is such that I'm not sure they have enough for second doses. I also figured that once it is widely available my arm would be one less in line to delay everyone else. This doesn't change anything for us in our daily life. Masks, social distancing, staying home when we can. I hope we get to phase 2 in Feb and phase 3 by March. 

Once I got vaccinated I stopped nursing. We were down to once a day and he didn't even notice the change. I was hormonal, weepy, and slightly uncomfortable until things started to adjust. There isn't enough data to know what effects it could cause. I believe this vaccine is safe and likely similar to the flu vaccine which is fine for breastfeeding, but again - limited data. It would be a different conversation if he was still an infant or we both wanted to continue. We made it to 15 months and comfortable with that stopping point. 

Unprecedented

I'm watching the news coverage: "House of Representatives evacuated as protesters enter capitol building" while the president eggs the protesters on via twitter. Unscreened protesters got into the capitol toward the house chamber - members of the house were handed gas masks and evacuated from the house floors. There's smoke coming from an undetermined source. Is this real? I thought we left this all behind in 2020. This is complete insanity. 

Unrelated (or maybe related?) my stress level reached a new height and I snapped at my husband. I had to take a webinar for work and once started needed to be completed. It was scheduled between lunch and nap I thought I'd be able to have it on in the background on low while playing on the floor with the boy. Nope. Nothing worked to distract him. He kept climbing on me to get to laptop over my shoulder. I tried distracting him with toys, I tried pointing out birds and trees outside, I tried detaching my keyboard and letting him play with that, I tried putting on a video of puppies on my phone.... nothing worked. As he kept getting rebuffed he went from playful to frustrated to crying as the webinar went on.  He's generally well mannered and doesn't hear "no" very often so he's not used to it. But I hated it. I hated splitting my attention and having to keep it from him with him not understanding at all why. Webinar was finally over and went to play in another area. My husband said he would take over at 1:45 and I was ready for a break. At 1:46 pm I asked where he was and he said, "I thought..." but I didn't let him finish. I put the boy in the crib and went to the bathroom since my bladder was about to burst. He came up a minute later and tried to explain his reasoning and I wasn't having it. I lost it. At this point I don't even remember what I yelled about specifically but the basic gist is that it's just you and me: if you're not watching him, I am. I'm juggling work and daycare and housekeeping and I just snapped. Yelling ended a few minutes later once I ran out of steam, followed by some loud clanking as I washed dishes, and some forceful throwing of laundry into a basket as I collected it for a load. I didn't even realize how wound up I was. I guess 9 months of a pandemic can do that. 

Everyone is struggling. It's not like I can call a friend or family member to complain. In their own way, everyone is going through something right now. We're on edge because the vaccine rollout is going so slowly. There's a new variant or two of the virus that spread faster and are more deadly. The president is actively ruining the country. And we're just over it. OVER. IT. 

The year 2020

 This is the year that historians and scientists and journalists will be talking about for years to come. The things that happened, the words that changed their meaning: pivot, pod, bubble. Even the words that were so overused that meaning started to blur: unprecedented, abundance of caution, mute. It's still 2020. We're still living in that year. 

I'm sure there are lots of articles and news stories and tiktoks summing up the year. I'll leave that to the professionals who will likely do a more comprehensive job than I can. Here's the year I'll remember. This was a very difficult year. We shed all the externals of every day life down the bare skeleton of our existence. What's important? What's essential? 

"Extras" like restaurants and concerts and sports and museums get togethers with friends and family were shut down. But are they extras? Or are they the reason that make the daily grind bearable? We got on our screens every day to work, to socialize, to veg out, to shop, to pay bills. We held the people in our household close because they were the only ones we could hold during a time when we needed others the most. We've lost so many people that we've gotten numb to the numbers. But they're not just numbers. 

And it's not over. Just because the calendar year is flipping doesn't mean there's a switch to the virus being turned off. The opposite is true: hospitals are at capacity, health workers are exhausted, the virus mutated and is spreading more rapidly, vaccine rollout is going excruciatingly slow in the US, and another surge is expected post-holidays after millions of Americans traveled against all the experts pleas to stay home. The darkest days of the virus are still ahead.

Beyond that, though, is hopefully a light. A turn. A change. We have to believe there's an end to the darkness. I have to believe there's hope. It's how I'm wired; it's what got me through the miscarriages and RPL and 7 failed IVF cycles. So I'll join the people showing gratitude for some parts of 2020 and what I'm with leaving behind. 

I'm so grateful to have been home with our son. Between maternity leave and the shutdown he was in daycare for all of 11 weeks. I learned something about myself I never would have known without this opportunity: no matter how I envisioned my life I never thought that being a stay at home mom was for me. I didn't know how much I'd enjoy it. I bet I'd enjoy it even more if we could do things like music class and going to the library and the aquarium and the grocery store or playdates with other moms. 

I don't take for granted that our jobs were able to convert to online work. I recognize that so many people didn't have that option and are truly suffering. As bad as my anxiety and financial insecurity felt throughout the year, I know there are people who are struggling to make ends meet and I'm grateful for the programs and organizations that helped when I felt helpless watching the news about people struggling.

There are some things that had accumulated in our pre-pandemic daily lives that we just kept around, similar to that box of stuff you don't feel like sorting and leave packed in storage but bring with you whenever you move to a new house. Here are a few things I'm ok leaving behind.

- office gossip. Gossip in general but I felt like my office was the majority of where I spent time. It felt like the social lubricant that kept people close. That may be true in some ways but when the pandemic hit, we weren't in the office anymore. In the absence of being in close quarters, we naturally limited our interactions to work-related conversations. It felt really freeing. I don't like being part of drama but I like being in the know. I'm rarely in the know now and I'm ok with it. It made me realize what's important to me. It also clarified to me that I'm ready for a new job. Once all the perks were gone I realized that the pieces holding me there were few and not at all worth it. I'm ready for a new challenge and I hope people start hiring in 2021.

- being aloof. I'm cynical and it takes me time to warm up to people. I will continue to work on my trait of making snap judgements about people. While I'm far from becoming the type that offers free hugs to strangers in the park, I think I need to learn to be more open and trusting.

- fomo. I think there will be a lot of opportunities coming up in the months after the pandemic is over. My goal is to say Yes to things I can join and stop feeling left out of life. It's up to me to create my own happiness. Happiness is a choice and takes work but it is within our control.

I'm sure more will come up and I'll add to the list. Regardless of what this year took from us, I want to try to come out of it a better person. 

Best wishes to you and yours for a happy, healthy, and safe 2021.

But wait...

 After several rounds of labs and telehealth appointments, I've been medically cleared from my endocrinologist and pcp. My TSH came back in the 2s even though I haven't been on medication for over a year. If I get pregnant I'll follow up with my endocrinologist to find out if anything needs to be adjusted. My liver enzymes are still slightly elevated but stable so my pcp recommended continued exercise and weight loss but no restrictions otherwise. All bloodwork from my RE came back fine. The next step is to get an ultrasound and biopsy before transferring. But... in true #2020 fashion we were hit some upsetting news. 

Our insurance will not cover any part of treatment. Apparently the company decided to go through PROGYNY for all infertility related treatment and the clinic needs to be in network in order to qualify for benefits. My clinic doesn't participate in PROGYNY which means that absolutely nothing is covered. The real kick in the balls is that my former clinic, the one ran away from after 7 failed IVFs and recurrent losses they chalked up to "unexplained infertility" is in network. 

I'm not sure what we'll do. We need to figure things out. The FET and medication can cost about $10,000. But money shouldn't be a reason people don't have kids right? I would sell my house before giving up because of money. Or maybe slightly less responsible things like putting it on a cc or dipping into retirement. I guess things are on hold while we process this. 

#2?

We started the conversation about considering trying again. In a nutshell, there is a lot to consider and I'll try to unpack it here. 

Financial

Having a baby is expensive. Doing treatment to have a baby is very expensive before the baby even arrives. I estimated that between the hospital bills, celebration, setting up the nursery, and getting all the gear we spent nearly ten grand. That doesn't even include all the money spent trying. Obviously a lot of items will not need to be bought again (stroller, furniture, etc) and any celebration will be a much smaller affair, if not entirely on zoom. Even so, we still need to factor in potential hospital bills and fertility medication costs. This is before we factor in the monstrosity that is daycare costs for infants under two or the debt we're paying down for replacing the roof last year. 

Medical

My weight is back to where it was before we transferred. I gained 27 lbs during the pregnancy, lost 20 by 6 weeks pp. During the early months of the pandemic I gained an additional 15 lbs - I can blame it on nursing or stress or lack of sleep but it was probably a combination of all of them . I'd like to continue losing weight and focus on healthy eating and exercising. Over the summer I got some labwork done with my pcp for my annual physical that was nearly a year overdue and got some results we're monitoring. One of the liver numbers was high. She said fatty liver can be caused by pregnancy and breastfeeding so she wanted me to retest several months after stopping to breastfeed. I was originally planning to stop breastfeeding around the one year mark but weening has been going slow. I just don't think we were both ready. We're down to twice a day for a few minutes and slowly decreasing. Either way, I messaged my pcp asking about following up and the recommendation was to get blood work and see where the numbers are at. 

Nearly a year ago I stopped taking thyroid medication per my endocrinologist's recommendation. I was about 8 weeks post partum when I realized my refill was out and I hadn't been on the medication for nearly a month. My levels were tested and since they came back within the normal range she recommended staying off of the meds until we can reevaluate at my March appointment. Then covid happened and that appointment never did. The fertility clinic used to recommend seeing a TSH under 2 for pregnancy but now that level has been updated to under 4.5. 

Emotional/mental

Fertility treatment is a roller coaster. It's an exhausting and draining process. Even assuming best case scenario of successfully getting pregnant, the first weeks are rough and we have no support in terms of childcare or cleaning or whatever. It would be all on the two of us so we really have to be prepared for it mentally. 

Covid

There's so much unknown about this. We don't know if covid causes or increases risk of miscarriage or birth defects if someone gets it while pregnant. We don't know if someone who had covid or is vaccinated prior to pregnancy is immune or has increased risk of defects. We're still not really clear on how safe it is to be indoors with masks, even though we know it reduces the risk significantly. So what does this mean for doctors appointments? Potential hospital stays? 

We do know that pregnant people are in a higher risk category. We know that pregnancy can potentially exacerbate covid symptoms. There is no safe daycare option before everyone is vaccinated. Hospital stays are very different than before - you may be allowed one visitor and they may or may not be able to leave. Even if everything goes smoothly with labor and delivery and we all get home safely, there are still so many appointments within the first few months, for baby and mom, and each one can increase risk of exposure - we just don't know where this pandemic is headed or where we'll be a year from now.

Each of these considerations is very serious individually. All together they seem insurmountable. A rational person may say that it's definitely the time to wait. Some may argue that a "vaccine is on the way" and if we hang tight for a bit then the whole covid situation will resolve and a lot of these considerations will become moot. 

All that may be true, but I've been burned before for waiting and I don't want to repeat that mistake. Before trying for our first we waited several years while trying to get our finances in order. We wanted to finish school and buy a house and pay down debt before taking on the challenge of parenting. How did that turn out? Not only did we never fully get to where I'd like financially (thanks, 2008 recession) but we ended up needing multiple years of fertility treatment before being successful. Trying doesn't guarantee success. If we end up needing another IVF to keep trying then we're up against the clock.

I spoke to our RE to catch up. I love her, she's the best. Her recommendation was that it's a personal choice but that she wouldn't put her life on hold due to covid. With regard to our treatment, she would want to do a saline ultrasound and biopsy to see where things are. If all comes back normal then the transfer would be the following cycle. If anything needs to be addressed, then we would treat and take it from there. Before even doing that, I need to address the liver and thyroid issues first. 

So that's the timeline. I'll use December to follow up with my pcp and endocrinologist. In January I'll verify our new benefits and see what, if anything, insurance will cover for a FET and the medication associated with it. Maybe by February we'll know more about a vaccine and we'll be ready to do the u/s+biopsy in the spring. In the meantime we'll continue to try to save money, pay down debt, continue to lose weight, and get in the mindset of gearing up mentally. 

Thanksgiving 2020

Thanksgiving this year was different. Like millions of others, we stayed home. In the past we celebrated with the entire family. I would make the bird and stuffing and rolls. Others made apps and sides and desserts and brought drinks and paper goods and decorations and entertainment. There would be a fun, festive feeling and a warm atmosphere of togetherness. Eventually the kids would get cranky, politics would undoubtedly come up, loud disagreements about mundane things would be discussed, and we'd all remember how grateful we are to not live under the same roof. It would swing back up with singing and dancing and laughter. At the end of the evening, with full bellies and some last chuckles, everyone would gather their coats and head out. Memories made with the photos to remember them. 

This year there was none of that. I didn't feel like being in the kitchen all day on my one day off to make a turkey we wouldn't eat half of. We had an awkward zoom call around lunch to celebrate a family birthday. We went outside to enjoy some of the beautiful unseasonably warm weather, but mainly spent the day trading "shifts" so that each other can feel some freedom of time off for a change.  I missed the traditions, I missed the togetherness. I even missed the eye-roll of the conversations we had a thousand times before and had no interest in hearing anymore about who went gluten free by choice. 

After we put baby to bed I scrolled through social media and ate my heart out even more watching stories of people who actually did gather with family and had those traditions. Maybe they quarantined 2 weeks before and got tested and were all negative. Maybe. I want to believe that the dire predictions are just an exaggeration. But considering how many people are traveling and how many people are not being as careful anymore makes me very worried. It makes me want to gather the people I love and head into a bunker until this is all over. 

Being alone for the holiday isn't new to us. We spent Pesach alone, still reeling from the shock of losing my father-in-law to covid. We spent Shavuot alone. Months later we spent the Jewish new year, Rosh Hashanah alone. But Thanksgiving hit harder. Maybe because we didn't think it would still be a thing in November. Maybe because things are getting worse, not better. Maybe because the novelty and panic have been replaced by anger over how mismanaged this pandemic has been. Maybe because there are still people resisting wearing a mask. Maybe because we're 9 months into a pandemic and some people still don't believe it exists, even as they're dying from it in the hospital. 

I think people have gotten weirder in isolation. Myself included. I'm not even talking about re-learning how to wear normal pants. I mean being able to have a conversation with someone without navigating away from their face to multi-task something else online while they talk, like I do now on Zoom. 

I know I'm missing social interaction but I don't know what I want. Between the masks and distance, being with people feels exhausting. Phone conversations these days feel exhausting. I prefer texting and even then sometimes the effort of coming up with a response feels like an accomplishment. I want a change of scenery but nowhere feels safe. Even if we had a location to go to, packing up everything we'd need for an overnight trip feels like a monumental effort. 

My response to this is to try to check in with friends. If they're not checking in on me maybe it means they're in the same funk. I try not to take it personally and instead start up a conversation, regardless of how much mental energy it costs. We wear masks to protect each other physically. I think checking in is a way to check in on each other's mental health. 

Stay strong. Stay healthy.