Moving Right Along

I wish I had the inspiration to write on a daily basis. More so, that there was actually something to write about on a daily basis. But, the tolls of life are a collection of small change and it takes me a while to fill up the piggy bank. In the meantime, day-to-day life has its ups, downs and detours. Currently we're in the carpool lane driving in cruise control so it's difficult to remember who's following behind.

I suppose the two topics that need to be addressed are surgery and surrogacy.  I'll go about it alphabetically.

I made it through surgery. Not that I was expecting not to. But the fear of "syncope" was greater than the intricacies of the procedure itself. Alas, one month later I am sans limp and slowly working my way through physical therapy to rebuild the muscles around the affected area. Most importantly, I'm back to work. Two small horizontal incision points are transforming themselves into scars. Shaven hair is growing back. I'm at that awkward stage reminiscent of puberty or a competitive swimming (minus the broad shoulder and big chest). In prepping the area, my leg was shaved below the knee, leaving sort of what I would imagine a Franciscan monk look of a haircut on my leg. In an effort to balance out the upper left leg (as well as the whole right one), I took to the razor and did away with it all.

There is more to deal with in my knee recovery and other issues discovered through the scope that poked around. I won't get into it here yet as I need more time to live it before I can put it on paper. This is less of a day-to-day journal and I'm better at writing in hindsight with 20/20 vision and a clear head. So on to the next story line.

Orit is at 14 weeks into the pregnancy and feeling good. The nausea as a blanket feeling is history. There are still moments here and there, but they pass quickly. The belly has popped out a tad and to those that know, it's obvious why. Otherwise I imagine all others in this overly political correct world are quietly thinking she's had one too many burritos.

There have been two ultrasounds since last I wrote. Both done at UCLA  as we've graduated from fertility to the reality of the pregnancy. One scheduled scan at 12 weeks followed by another follow up on the 13th. The later one calmed the previous' slight scare. It's almost like the case of looking for a problem. If you look deep enough, long enough or enough times at anything, things that should not be, can and most likely become apparent. Explains the bliss of ignorance.

Whether you're certain in your faith that all will be good or are certain in your resolve that you'll take what comes along no matter what, you can choose to forgo some of the many tests medicine and technology offer along the path to bringing in a life. For both those reasons, with Little Man we chose this path, along with several other "alternative" ways (funny how natural is modern day alternative, but that's a whole separate discussion) culminating in his birth at home. It was our child. Our lives. Our choices and decisions. Our outcome. And ultimately, our happiness. And though we are able and in the midst of making this happiness possible for R & J, this time it isn't solely our choice to figure out the ways. That is a joint work in progress.

Back to the scare. As we all know, the human body is created on a very precise schedule. What we don't all know is every step along the way. We leave that to the textbooks and professionals. Often scans and other tests along the way, can help us pin point exactly every step of the way and how it relates to where things should be in the schedule. Which is all well and good, if everything is going by the book. The scares come in with the footnotes. The little deviances of human nature. At 8 weeks, the intestines, which are already developed pop out and protrude outside of the fetus to make room for the development of the rest of the organs that later intertwine beneath. By the 12th week, the intestines go back into place.  Or so say the books. The scan at 12 weeks showed something still outside. There is nothing that can be done about this abnormality at this point. If it were to remain this way, it would be handled after the birth. But, regardless it is an abnormality and therefore a source of concern. Another scan soon after can either confirm the problem or a correction back to schedule. Needless to say, the stress level going into the follow up was high. And though I personally could not be present due to work, I was on edge until I heard the results via text - all looks good! Relief. No protrusions other than possibly a little normal one. And though it's not 100%, it looks likely that there's a boy in that oven. We are yet again, where we want to be. And I feel comforted enough to write and share the news.

Theo Progress Report 06/13/11

Ultrasound

Since I just finished speaking of nausea and utter helplessness, the natural transition of topics brings me to the present stage of the surrogacy journey. Last I wrote of the actual pregnancy "catching," as they say. Our elation of the milestone achieved against the odds was high, full of personal pride and hope for the future for the now certain life being nurtured by the giving womb of my beautiful life partner. Blood tests show numbers and numbers reflect scientific certainty. And although we're in the midst of a scientific adventure, we're visual people and naturally the next focus of anticipation is just that visual aspect. Seeing the heart beating. Hearing it. Not just through hormone levels, but on a screen. However vague looking it may seem on an ultrasound it's our first real indication of actual life. And further stepping into the anticipation, the next question to be answered is, how many?

Unfortunately, the morning of the pending appointment that was to answer this question, Orit awoke to the unfamiliar feeling of the negative side effects of pregnancy. Morning sickness. Morning used loosely. Weakness had crept in for a few days prior. My vibrant and strong wife was beginning to feel not as herself and needing the assistance of horizontal moments throughout the day. Little Man spared us any of the ill effects. He developed and grew throughout a picture perfect pregnancy and birth in the comfort of our own home (I may just have to write about that whole experience one of these days). Obviously enjoyable enough an experience she'd want to recreate, otherwise we certainly would not be on this particular course. If not for ourselves, definitely for a couple in need. In come J & R. Who are obviously now members of our extended family and co-pilots of this voyage.

So this first appointment had to be rescheduled at the last minute. With it crept in a sense of disappointment that maybe, although still hopeful, this would not be as smooth a ride as we'd hoped for. Regardless, we would overcome and come out strong. A few days passed. The nausea and fatigue persisted in a manageable enough dose to allow her (us) to make it to our now rescheduled appointment. Armed with pressure point nausea wrist-bands and vitamin b6, we arrive at the familiar waiting room of the fertility center. R, the intended mom, arrived alone this time. J unfortunately is sick. We have a chance to discuss future options of and for the pregnancy. And then the three of us anxiously walk into the ultrasound room and begin the experience.

We have video of the ultrasound. iPhone camera to the rescue. Little Man wanted to be present to see it, but understood that school took precedent for him at this stage. I promised there would be documentation. The computer is turned on and up comes the familiar screen we all know to be an ultrasound. Appears a clear bean shaped, black void. Immediately described by the nurse as the uterus. Go figure, the ultimate bearer of life looks like a bean shaped black void. And in the bean, there’s a seed growing. A little roundish speck of white amongst the darkness. It's the only thing visible in there. So the initial thought following "there it is," is "only one!" Relief. There's a flickering of the rhythmic pulse that's not accompanied by sound yet as the Doppler setting is not yet turned on. So we see one. We see a heartbeat. Emotions are setting in the room amongst the 2 female main players. At the switch of a button, the sound of the Doppler kicks in and we now hear the heartbeat. Rhythmically fast and true.  And the flood gates open as tissues are passed and Orit and R celebrate their joint Mother's Day gift. Orit mentions it's R's first and that thought sets in as they hold hands to cement their bond.

So there you have it. The man made science succeeded as planned defying the odds. Numbers and percentages have told the story thus far. Nature is taking over and the old familiar story of humanity is to be retold through new eyes that are about to be formed.

The fetus is tiny at this point. Only 6.3mm, coincidentally corresponding to the 6 weeks and 4 days of the pregnancy count. A millimeter per week. As we finalize the visit and talk about the next appointment, a still photo print out of the ultrasound is offered as a souvenir. There's an awkward moment where the image is dangled in mid hand off, unsure of who's hands it should land - mom or surrogate? The silence is disrupted by Orit saying to R, "it's your baby, you take the picture." We laugh, and hug and say our goodbyes. Until the next time. The final time for the fertility specialist before he jumps ship and hands off the baton to the next captain of the ship. His job is done. There are other women trying their hand at fertility.

Following the ultrasound appointment we got back home armed with the good news and right away hit a rough patch. Over a long almost 2 weeks of nausea beyond the morning, throughout the day and night. No vomiting. Maybe that would have helped, but it wouldn't come. Weak, helpless, apetiteless and f****** miserable. The world continued to spin around her. And she picked up a sinus cold to top it off. It hurt seeing her so uncomfortable. Nothing helped. Just time and shut eye. Positively the most time I've ever seen her spend in bed in all our twelve years. Orit is usually the opposite of sedentary. She was worn out from feeling worn out. Down and out. Finally, we discovered a homeopathic formula that has taken care of the bulk of it the majority of the time. We believe she's reaching the tail end of this cycle and see it’s end. Back to being a functional super mom, though still with little bad moments.

We're currently looking for the next captain for our freelance crew. The doctor of our collective choice to take the reins for the prenatal care and birth. Which brings in another decision to be made given our alternative choices in life. Doctor or Midwife? Hospital or birthing facility? We knew going into this thing that a home birth would not be much of an option. Not our baby and not our choice to make. There is the matter of the other couple involved. All we can do is let our minds and hearts be known and hope that we can all be on the same page along the way. Home birth is beyond the comfort level for R as she mentioned. But she is still open to alternative ways. A midwife, natural birth is within our scope. The research for options is being done. So that's where we're at and where we're heading.

Syncope

I am about to go under the knife. I first started writing in this blog (which was originally set up as a photoblog for the Theo Progress Reports) as a way of getting through the one and only other surgery that has touched my life.  Last August, Little Man had his tonsils and adenoids removed in what after the fact proved to be a very wise decision, though it certainly didn't feel like that in the midst of recovery. The positive results of his breathing were immediate. The healing from the procedure, THAT was difficult. And yet, if under the same circumstances someone were to ask my recommendation on the procedure, I'd definitely say yes. Easy to say in hindsight and I'm thankful for being there. While in it, I channeled my feelings towards documentation and story telling. The only way I'd like to ever re-live those moments is by going back and reading my posts of the time. Otherwise, I hope to never have to see my son through any such experience.

Now it's my time. My turn. I've written of my knee problems before. More with the hope of avoiding any sort of invasive procedure. With the somewhat comical twist of my spiritual shaman sister's new age techniques of transatlantically healing me with the power of her focused mind. Yes, I'm a bit of a skeptic to this realm, but I love my sister and was and always am happy to open myself up to giving her a chance. I had nothing to loose. In her mental travels of visualizing the internal workings of my torn meniscus, she was led to see a monkey jumping out from within my knee. I know, I know. A monkey? Yes, a monkey that claimed to be my inspiration. He had been trapped in my knee and was now out and free. You'll just have to look far enough back in my writing and seek the corresponding post to satisfy your curiosity should the itch need be scratched. And still, do so with an open mind. The bottom line of this inspiration monkey turned out to be quite a prolific period of my artistic flow. Thus, inspiration came freely and led to more and more writing, woodworking, and the ever-continuing polaroiding and life of art in all it’s formats. Inspiration continues as the words find their way to this page and the stories I tell find their way to your eyes. So for that, I thank my sister (and the monkey).

Unfortunately, the pain in my bad, left knee has persisted and gradually worsened. My right knee, which has no tear, over compensates for the other's shortcomings and is heading in the degenerative path, occasionally acting up. So, I have finally taken the step (intended pun) to do something about it. All of you millions of people (wishful thinking of my readership) out there that have had arthroscopic knee surgery have been telling me of how simple and common this procedure is. It has been perfected over 30+ years as the technologies advanced. Should calm my nerves and make me feel at ease. But regardless of how small the incision may be, the idea of having anything protrude through my skin and beyond makes me nervous. Not for the obvious reason. Unlike a tattoo where the needles quickly go in and out of the top layers of the dermis, just beneath the epidermis, and more like a consistent scratching beyond one certain spot, injections and surgeries (both of which I am not a fan of) go further, deeper in. And more disturbingly, stay in longer.

My zero hour of May 24th is nearing faster than anticipated and the nerves are beginning to make their way into my consciousness. Less of the actual surgery itself. More from the two upcoming needle occurrences that are to happen prior to the deed. Routine pre-op blood work to determine my body as surgically fit a week before the procedure, followed by the anesthesia on the day of. It may seem odd that those are the two things I fear most. More than the actual procedure and its recovery.

You see, I recently found out the name to a condition that I've suffered from since childhood. Vaso Vagal Syncope. It's not rare. It’s actually quite common. Maybe one of you live with it too. It's not anything I've ever been ashamed of, even prior to now in discovering it's name. Basically, I'm a fainter. Not for nothing.  My trigger is needles. Those that go in deep and stay in for a period. I've had no control over it in my life thus far and have learned to live with it, through it and despite it. Luckily, I don't have to face a needle too often. Or maybe not. Maybe regularly facing it is the answer to overcoming. At this point, I'd rather find another way.

It doesn't always happen at every instance, which has made it more difficult to identify over the years.  The path of symptoms, though are always the same when it does. Through my numerous experiences I learned to recognize them and prepare for all they bring. To make sure I'm lying down and make it be known as a possibility. When it does happen, it's not the physical act of the faint that scares me. The sudden hot flash, sweats, paleness, loss of vision and the tingling sensation as the black out begins to set in. The loss of speech and hearing followed lastly by the dark void. Dreams. Then on the other side, a slow, disorienting return to consciousness that starts with hearing while the eyes still see black. Fuzzy vision slowly refocuses to normalcy. I'm used to it. I recognize the feeling as it's about to happen, during and after. If this were the only part of the whole process I'd be a relatively happy camper. It's the side affects thereafter that hit me hard.

Just as I make my way back into this realm and finish assuring whoever it is, lucky enough to be in my presence, that I'm ok, it happens, it's happened and I'll be fine... that's when my body takes me on the wild ride along it's painfully familiar way of dealing with the next phase of the now dreaded process. Like a 24hr bug, I'm stricken with immobilizing nausea and vomiting. And just like a 24hr bug, it's gone at the end of its cycle. But in the midst of that day and night, I'm as miserable as I could possible be. Utter helplessness. The current healthy mind doesn't let me formulate the words to describe my hatred for that moment. Bottom line is it just absolutely sucks. And it's this post-faint period more than anything else, I fear and wish to avoid. Which may perpetuate the anxiety deep within the mind that causes the trigger in the first place.

Over the years, this fear of the after life of my meetings with a needle, have much surpassed the actual fear of the needle itself. It's not the physical prick or conscious pain. It's not at all about pain. My threshold for that is high in all other realms. As I've been told over and over again, it's all in the head. When that needle is in for long enough for the mind to decide if today is the day, somewhere in my psyche, the emotional trigger kick starts what's called the Vaso Vagal response. The part of the nervous system that regulates heart rate and blood pressure malfunctions. A message is sent by the brain for the heart rate to slow and the blood vessels in the legs to widen, allowing blood to pool down there. Which in turn lowers blood pressure suddenly. Blood flow to the brain quickly diminishes and thus we have syncope, or in layman's terms, the faint. In most cases, such as mine, the most dangerous part of this condition can occur from physically falling and injuring the head or other body parts during the faint. Thus, the lying down. Otherwise, there are no other health implications. It just happens. Shit happens.

Finally now, at 39, armed with a definition and knowledge of the condition, I may just be able to find a way of not just recognizing and living with it, as it’s been, but actually avoiding it. There are techniques that can be applied to try to avoid the response. I used to think simply lying down, turning away and trying to distract myself was all I could do. I know now that's not enough in my case. Raising the legs allows gravity to discourage the misguided message the ventricular system receives from the mind. If the darkness begins to creep in still, a critical window of 2 to 3 seconds exists as the symptoms leading into the black out take hold. Rhythmically flexing or pumping the leg muscles can help the blood push back upwards (actually downwards, when the legs are up) and return the flow back to the brain. Simple techniques that theoretically make perfect sense. Seems almost too simple. They’ll soon be tested. But it obviously took my lifetime of experience in recognizing my body's way of coping to get to this understanding.

Simplicity, I hope will win over my little battle with the condition. I will take my new techniques with me and utilize them this week at the next needle face off. And I will overcome. No fainting means no followed misery, and thus a personal victory.

Oh yeah, and the knee surgery. It's almost a secondary thing. I'm certain that will go smoothly. And all I've heard and read will ring true as recovery speeds along and the pain will be a memory of past. I look forward to that day when I can say to Little Man - "YES let's do that, cause my knee DOESN'T hurt."

Theo Progress Report - Israel 04/2011

Notes From A Cafe

Pistachios are being cracked with salty fingers. Scooby and Shaggy are once again cowardly hiding from some ghostly-evil-not-so-genius-after-all-demagogue, looking to rid of the gang of teenagers in a last push towards world domination.

And that's all I managed to write on the flight before being distracted by the uncomfortable muscle aches of immobility that kick in the minute you hear that click of the seatbelt. We made it through the first domestic and later transatlantic flights. We crossed a continent , an ocean and a sea. We watched movies, did math, tossed and turned in sleep attempts (Little Man being much more successful) and comically climbed over the guy that slept through it all while blocking the isle seat. It took a couple of pseudo attempts to gather the courage for climbing over a sleeping stranger. Then, that too became normal. And we made it to the other side. Out through the automated doors that spill out to the main reception hall for arrivals, Little Man ran into the awaiting arms of Saba and Safta. And so, our Israel 2011 visit begins.

A few days later, I sit in an Israeli sidewalk cafe, sipping on my upside down coffee (the practical Hebrew translation for cafe au lait) and amongst the many ponderings that roam my inner thoughts are; what makes ice so American that nowhere else is it typical to serve it with a Coke? Little things that seem insignificant like this add up to the more substantial reasons of why I am no longer a resident of this country. There are many. There is a tension and aggressiveness that looms over the relaxed atmosphere of the full to capacity sidewalk cafes, frequented by the wide spectrum of the population. News on a radio, tv or spoken of in person is heard in the background of any given time and place. There is a love hate relationship to this way of life that is typical to all immersed in it. On the one hand it's emotionally and aggressively defended towards those who chose to attack it from the outside. On the other, it's battered from within by it's insiders like a no holds barred cage fight. It's like a racial joke that can only be told by the same culture that's being joked about. Only insiders can take the piss out of the inside. Anyway, I'm not gonna get into the passionate inner struggle of who I am or where I belong. Not in this post. Probably, mostly because it's not much of a struggle anymore with every year passing. I am in a good place. regardless of where I physically reside. I am settled and satisfied. With life, my life and myself. Not to say there's not a need to aspire for more - always. There is work to be done and roads ahead to travel. My hope for the future is to continue as I have thus far - with pride and without regret. In the meantime, I take pictures, make art, write, live, give and get.

So I sit here a continent, an ocean and sea apart from my wife, with pride and hope for the journey that I spoke of two entries ago. The surrogacy journey. The one that has been all on paper and talk thus far, has officially begun in it's actual manifestation. It's been a long theoretical journey of which we are now stepping over the threshold of reality.

As I begin to type these words into my iphone for the first draft of this piece, there is a chance that currently existing cells will continue to multiply to the point of a human creation. A day prior to this father/son family visit Little Man and I are on, was the "transfer" of two healthy embryos that belong to our hopeful couple, the Intended Parents. It's a very clinical way to speak of them. And as they're warm, loving people I will give them the respect they deserve by naming them without naming them. J & R are each their first initial and from so forth will be regarded as such.

Last Thursday was a day that started like all others in this normal, mortal world. A small window of that morning, was not. Orit was told to drink a lot of water prior to coming in. More correctly, she was told to come with a full bladder. Those of you who know her, know that she does as she feels. In altruism as well as basic physical needs. So when the girl has got to pee, she's got to pee. She's gotten quite creative in the past with this topic. Like the one time with a diaper... They picked the perfect internal organ to fill up completely for this procedure. She's told that it would not be the first time should the valium relaxed muscles give into the urge of peeing right there and then on the medical table. We all would understand, but no one wants to see it. Apparently, the bladder being full pushes down on the uterus and makes it easier for the fertility specialist to see what he's doing on the ultrasound. Which in turn makes it easier for the rest of the peanut gallery to follow along as well. Those of us in the grand stands are yours truly and J & R. R, who's gone through this procedure twice herself (now you know which one is the intended mother), is knowledgable in more than just this procedure but in the whole fertility medical world. She's an RN and besides her personal experience and journey, has also worked in the fertility field. I suppose every case is different and every couple and surrogate has a different relationship. Ours is such that when they asked if they could be present, Orit (and I) didn't hesitate. It's their baby and so long as they're comfortable being in the room and following along, we are. I'm not the one who's vulnerable, legs up in stirrups. And Orit is certainly not shy. Once she's positioned and prepared under a blanket, they come in and the fertility party commences. Music and all (a little background ambiance believe it or not. I think it was Buena Vista Social Club). Orit, a little loopy from the valium given her to relax her body, is laying down in position. Me at her side. J & R behind us. All anxiously glued to the ultrasound screen like patrons at a sports bar waiting for the kick-off. Don't ask me why I chose this metaphor as none of us are neither bar patrons nor sports fans. The doctor and his assistant are on the working side of the blanket. Activity begins on the screen. A catheter is inserted and is immediately and clearly visible on the ultrasound screen. A window reminiscent of a dumbwaiter opens from the adjoining room where the embryologist passes the two embryos in a syringe with a long tube. Kind of like what we see on tv when the doctor asks for a tool and it's handed over with two hands in a sterile and procedural manner. There is a formality to the hand off. The long thin tube is inserted into the catheter and the syringe is pushed in. And poof, two little specs are seen as white dots on the screen being pushed out of the tube and into the abyss of the uterus. And that's that. Two minutes and it's over. The most uncomfortable part is the full bladder. She is now free to pee. But "please don't get up just quite yet... I'll bring a bed pan," the nurse said, as we all exited the room. I then come back into the room for a quiet, intimate wait of 20 minutes as she dozes off into a sleep. I believe it's the first time Orit has ever taken any kind of medication such as Valium, so it's natural that it knocked her out. And then we are finished. As a souvenir, we're given a 4"x6" photo of the two embryos (as seen through a microscope and by this time multiplied into 8 cells) that have just been placed in her womb. And off we went for lunch at the Nickel Diner. Back to normalcy just like that. Just another day in everyone else's world.

The chances of a pregnancy "catching" as they say, are less than what you'd imagine. Around 30 percent. These were embryos that have been frozen for several years after all. But we're hopeful that the host body and her determination to make this happen will defy the odds. If anyone can make it happen, it's Orit. There was a chance that they'd not survive the thawing. But both did. There is a smaller chance that they will both "catch" and there will be twins. Right now we hope for one. For the deed to be done. That's the gift we signed up for. The reality of carrying twins is not what Orit would chose given absolutes. Though she will deal with the realities of the science and nature, and take the chances as they come. In the meantime rest is the prescription. It's why Little man and I are here in Israel alone. School dictates our schedule these days and spring break is here. There are only so many windows. As Orit remains a world apart, we are still very much connected. Technology facilitates it. The heart and soul make it real.

Ten days following the transfer, a blood test is taken to determine results in absolute terms. Since a week has past, in a few days we shall all know where we stand. Maybe before, the body will give it's own signs. None thus far. For now we wait and cross our fingers. Nature is taking it's course.

And so on then 10th day, I am expecting and awaken by a video chat, an email and a call -"Congratulations! You are going to be a surrogate daddy!!!" And so it is. Coincidentally falling on our 12th Anniversary (which will be celebrated together upon my return). Looks like I'll be making some trips to Whole Foods for that particular flourless chocolate cake she craved with Little Man. Or maybe this time it will be something else. Either way, I'll be happy to go. Welcome to my life.

Theo Progress Report 03/30/11