For Inktober: Jabba the Trump.
It’s probably been done before, but I had to get it out of my system.
After a long battle with arthritis and kidney disease, Jacob “Jake” Tiberius Dog Hoke-Woodward passed away peacefully on Saturday, July 16, 2016, in his home in Los Angeles, California. He was 13.
Jake was born in Chatham County, NC, in November 2002. Along with three siblings, he was rescued by Chatham County Animal Rescue and foster mom Beate. The only black dog—and fearful of strangers—he was last in the litter to be adopted, but in spring 2003 he joined his forever home with Tory Hoke in Durham, NC.
Jake was distinguished by extremely soft black fur, a round head, square muzzle, triangle ears, and—in later life—a gentlemanly silver Van Dyke beard. He was not that into laps, hugs, or photography, and he was very afraid of lightning, however he enjoyed tennis balls, peanut butter jars, and dogs on TV.
A well-traveled dog, he spent four years in Winston-Salem and visited New York, NY; Franklin, NC; Memphis, TN; and Albuquerque, NM before settling in Los Angeles, CA for his final eight years.
Even-tempered and gentle, he got along with a variety of animal housemates, including Kiwi the German shepherd, Speedo the cat, Grace the cat, Boris and Kona the boxers, and three rescued golden retriever puppies. Reliably, at the dog park, whenever a scuffle would break out, he would be nowhere near it.
He was a good dog. He was a very, very good dog.
Jake is survived by his forever-mother Tory Hoke, adoptive father Jeremy Woodward, and cat-brother Gustopher Blume Hoke-Woodward.
In lieu of flowers, memorials may be made in Jake’s name to Chatham County Animal Rescue.
You can read more about Jake in previous posts on this blog.
I wrote this April 29, 2015, while waiting to learn the results of my first IVF cycle. It is presented without further edit. It has swears.
It’s me—you from a year ago! We’re about to try IVF. Boy, we could not get pregnant naturally! We could not at all.
Well, we did once—after the HSG, which is the exam that can also clear tubes. Maybe you don’t remember what that is? Ha ha ha, just kidding, of course you do. We repeated it 15 months later—plus Clomid/IUI/trigger shot AND acupuncture—as a last-ditch effort to avoid IVF. Didn’t work, but, hey—we tried.
Anyway, we got pregnant once and not long after that we were in a Home Depot and our body decided not to be pregnant anymore. Nobody knows why. Things between us and Home Depot are still pretty weird, and that was 16 months ago. Sixteen months! How time does fly. Except when it doesn’t. Except when you’re waiting… and waiting… and waiting… for news that turns out to be bad.
Boy, we cried in the bathroom a lot! I think we do our best crying there. Probably 80% of all our crying is bathroom-based. The other 20% is random places: the office, the kitchen, the car at a Tove Lo song. It was super fun to cry for an hour in the middle of a Hawaiian vacation. No reason! Just found out we weren’t pregnant… again. It really shouldn’t have been a surprise at that point. But for some reason it really messed us up! It was the day before our husband’s birthday, too. Sorry, husband. Thanks for being there for the crying, no matter what.
We’re truly, deeply grateful that our husband was mellow through the whole thing. We read about depressed husbands, low-libido husbands, indifferent husbands, and we’re so glad he was supportive and gentle. We’re so profoundly grateful that none of this fertility stuff hurt our marriage. Our time together has always been happy. Our time together has always been a comfort.
It’s really our own fault we can’t get pregnant. The problem’s not that we’re so very old, although in reproductive terms we are ancient, we are Bible times, we are Lucy fucking Australopithecus. The problem is that we’re so old AND a woman. That was really dumb, frankly. That was just poor planning. There are a dozen guys in our world having their first kids at 40. We should have looked into that option. Googled it at least.
So much research to be done! We don’t know what people did before YouTube. Drug companies tried to make those self-injections simple, but damn if our hands weren’t shaking every time. The best medication was self-medication—wine, work, sushi, and a really frightening amount of Dragon Age. Did we have a weird dream one time about Commander Cullen? Maybe. Hope our husband can forgive.
The pages of IVF paperwork—35+, just like your age!—made us laugh out loud three times:
We never saw ourselves doing IVF. We’d never admit this to the other women on our TTC-After-Loss forum but… we never wanted kids that much. We didn’t grow up around little kids. We look at babies and feel mild revulsion. We heard that “it’s different when it’s yours,” and we figured that was probably true. We figured nature would take care of everything.
So far nature hasn’t taken care of jack shit.
So here we are, financially committed to a cycle of IVF and feeling… nothing. I don’t have any hope for it. The doctor says the odds of me conceiving as a result of this cycle are 50/50. I don’t think I have the financial or emotional will to go through the whole monitoring/medication/X-Files harvest again. I sure would have liked having two kids. I sure would have liked a lot of things.
By the time you read this, one year in the future, you’ll already know. You’ll know how many usable embryos you ended up with. You’ll know if any stayed alive. You’ll know if they made it past the magical 13-week gestation mark, the point at which it’s reasonable to tell other people you’re pregnant, because your miscarriage chances are now below 1 in 5.
There’s a 1 in 3 chance you’ll find out what a C-section is like, because advanced maternal age + increased chance of multiples + IVF = well…
You’ll know if you carried to term. You’ll know if a baby was born healthy. You’ll know if it made it out of those fragile first three months. You’ll have weathered that all without God to lean on, because infertility and miscarriage killed your belief in a God with a plan.
I’m so jealous of you. I hope you beat a lot of odds. Over here, we haven’t beaten any odds at all.
But I know we agree on one thing. We’re really, really jealous of us in forty years.
Because in forty years ww’ll know what our family turned out to be.
And in forty years we’ll know more or less whether all these reproductive stunts we’re pulling—the IVF, the ICSI, the general oldness—affected the reproductive chances of our kids.
Lately we’re not that composed at the best of times, but when we think of taking that phone call from a kid… if we have one at all… by biology or by adoption… when we think of that phone call that says, “Guess what, Mom? We’re pregnant!” or “Mom, this fertility stuff isn’t going so great”… we really cannot handle our shit at all.
We are crying in the office right now.
We are glad our office-mate stepped out.
I hope things are well for you on your end. I hope you’re reconnecting with all those friends with small children. I hope you’re replenishing your savings account. I hope you found a way to deal with all this, because I’m not dealing with it so great.
I hope the Dragon Age: Inquisition DLC was fun.
I hope you’re still wearing soft leggings to work all the time, ‘cos that shit is comfy.
You From a Year Ago
Dear infertile people, you are rad as hell.
I’m not here to tell you it’s going to be OK. I have no idea where your journey goes. That’s kind of the reason your journey is so difficult.
I’m not here to tell you how to get pregnant. Although if you haven’t been to /r/shittyfertilityadvice you should go there immediately.
I’m going to tell you my 5 Steps to Being Slightly More OK With Shit. Will they work for you? I have no idea. I had to get to a certain place before I was ready to do any of them. But my second IVF cycle didn’t rough me up near as bad as the first one did.* So here they are, if they help.
(If they don’t help, print them and rip them up and stuff them in a cat box.)
All these people out there giving you advice and not one of them’s gonna congratulate you on what you’re doing right. You’re doing a CRAP TON of things right. Let me tell you some things you maybe did:
li>You balanced infertility treatment and career and home life.
And that’s not even scratching the surface. Looks kinda badass to me.
This is easier said than done. For me, there was a real mental block to get over before I could join an infertility support community. It was like joining in made it real. No more keeping quiet because “next month might be good news.”
It wasn’t until after the first IVF failed and knocked me on my ass emotionally, mentally, and spiritually that I realized I had to do something different.
Finding people who had been through it, who were still going through it, and had worked out a general code of conduct for letting people share their truth in peace and understanding–no “baby dust”–brought me the sanity I was missing. I didn’t know how bad I needed it until I found it.
Uh, and therapy, too. Therapy is good.
For what it’s worth, over at /r/ttcafterloss and /r/infertility are some of the most beautiful supportive non-judgmental anonymous strangers on the planet. Struggling to conceive for 6 months? Welcome. Early pregnancy loss? They’ll never call it a “chemical.” Secondary infertility? Bring that kid. They’re like seven-foot drag glamazons of inclusion. Heal, diva.
Like #2, this took getting over a mental block. Saying it out loud makes it real. But after that failed first IVF, slowly, one at a time, I started letting people know. As I’ve mentioned, reactions really varied. But some people poured out pure love and compassion to a degree that was really quite confusing. It was that love and compassion, with its waves of goodfeels and understanding, that let me know this “telling people” thing was the right track. You deserve that, too. I hope you find it.
It’s true that, along the way, I also had to mend fences with friends and family–friends I kept at arm’s length because I resented this or that; family I kept out of the loop because I was embarrassed to bring up the subject… or afraid of being hurt by their reaction. There was a certain amount of butthurt I had to get over, and resentment that it was my job–on top of treating infertility and not crying at work–to get over my butthurt. But maybe I grew up a little as a result.
All the pamphlets and financing options and NIH reports define success as pregnancy (specifically one that makes it 8 weeks and to a detectable heartbeat.)
That’s a damn narrow target to hit. If after all the time, money, and emotional stamina of a treated cycle the only measure of “success” is getting pregnant, no wonder infertile people feel like failures.
What helped me was celebrating when a cycle phase was done.
Had well-timed intercourse? That’s one week of waiting and one week of keeping romance alive on a schedule. That deserves a night out.
Weathered a two-week wait? That’s fourteen days of sweating and hoping and spotting a thousand pregnancy symptoms and yet not going insane. Sushi at least.
Had an IUI? That’s about two weeks, six appointments–including two mornings back-to-back getting up ass-early to perform against the clock and then hurry the specimen to the clinic–and two procedures on a full bladder. Couple scratcher tickets might be fun.
Retrieval complete? That’s at least two weeks, five appointments, three trips to pharmacies, twenty injections, and a surgical procedure. That shit deserves a pancake brunch.
Transfer complete? That’s about two weeks, four appointments, two trips to pharmacies, and an outpatient procedure on a full bladder. You’re not supposed to drink, have sex, have sex goodfeels, watch horror movies, or exercise, so… Dragon Age?
Reward every victory. Demonstrate that you deserve it.
I would have rather had the kid than the lesson, but I did learn a lot.
Now when someone tells me they’re struggling with something severe–loss of a loved one, divorce, chronic illness, any of the brutal stuff that happens for no reason–I’m more likely to rush in instead of run away. I can listen without trying to fix. I can be a better friend.
Not that I always will, but now I know a little better how to go about it.
Empathy is transferable.
Hope this helps.
* My third IVF cycle SUCKED ASS. Just so you know I’m a huge hypocrite.
It’s National Infertility Awareness Week! Count me in.
Been trying to have a kid for over three years, gotten treatment for two. Two HSGs, 4 IUIs, 3 failed IVFs, one hysteroscopy. Got pregnant once. Didn’t last. That was two years ago.
Not ready to quit, but close.
I’m infertile. Infertility means not being able to get pregnant after 1 year of trying (if you’re under 35) or after 6 months (if you’re over 35, as doctors advise against risking more fleeting fertile time), OR conceiving but being unable to carry to term. I’m in numerous company; about 10% of women will have trouble getting or staying pregnant. About one-third of couples in which the woman is over 35 will have fertility problems.
Haven’t been telling many people. Keeping it secret is wearing me out. “Do you want kids?” and “enjoy this [childless] time while you have it” are pissing me off. And I’m already worn out and pissed off. My injection sites are itchy and my patient demeanor sucks. Infertility treatment has been, as one forum-poster said, “the second job that takes my money.”
But telling people is a grab bag. Some people are beautifully compassionate and kind and generous and loving. Other people say the first thing that pops in their head.
Dear fertile people, I’m all out of smile and nod.
So here’s what you can do for me, if you choose to speak to me on this subject:
Suffering is frightening. I get it. We hear about someone else suffering from something beyond their control–disease, natural disaster, loss of a loved one–and we instinctively look for the reasons it won’t happen to us. It’s how we make sense of the world.
Sometimes the search for reasons makes us eager to blame the person it’s happening to. This can lead to thoughts like:
I get it. I do this basically every time I read the news. It’s how we as a thinking species help ourselves feel safe. I also get that it’s frightening to feel your deeply-held beliefs are being called into question. When we see someone do something other than what we think we’d do in that situation, we may feel threatened. This can lead to a desire to convert others to the belief that:
This is human nature and I have absolutely done both of these in the face of someone else’s suffering. I have also said Absolutely Nothing. Absolutely Nothing is not great, either, but I realize that’s a rock and a hard place if you don’t know what to say so if you really don’t know what to say then Nothing is cool.
Looking for reasons and looking for converts both come from a place of fear. They don’t come from a place of compassion. Compassion would help a lot.
But compassion ain’t cheap! Where does it come from?
Imagine this scenario:
Now imagine what you’d want to hear.
Until someone holds their child in their arms, they have to live with the reality that it might never happen.
In the face of uncertainty, other people’s certainty is not comforting. It’s isolating. For me, it makes me feel unheard and unseen and it summons my Hate Librarian that carefully logs every hurtful moment and I really do not like the Hate Librarian and I wish she did not work here.
Advice in general is pretty isolating. Got enough. Really all stocked up on advice here. You could fill four sharps containers with all the advice I got. FWIW, I already secretly believe this is all my fault. Don’t need anyone else telling me what they think I’m doing wrong.
I know people with advice are coming from a good place. People just want to make things OK. But when people try to put a happy face on me it just encourages me to keep hiding the sad one. And for me hiding is no bueno.
I don’t compartmentalize emotions like I used to. I keep ’em close to the surface, and that’s actually better for me. So if I speak honestly, you might see tears (not a crying jag, but tears) or hear a raised voice (not attacking, but raised). Maybe not! Hard to say.
But I’ve noticed, when people get surprised by other people’s strong emotions, sometimes they try to make those emotions go away with either a bright side (“you can always adopt”) or a hand-wave (“it’s not like it was a real baby.”)
That feels bad.
Let me be more specific.
For me, getting dismissed or minimized is like setting a 24-hour rage timer. In the moment, I smile and think, “This is going to piss me off later.” And, lo, 24 hours hence I find myself in a deep black mood of raw-edged hate until I do the work to get rid of the resentment.
I can’t take any more resentment homework. I am all booked up. I know a lot of that’s on me to be more vigilant about protecting my boundaries.
But you can help.
Please, if you can’t do the three items above…
If you really, really want to tell me what your friend tried that worked, please give me a chance to decide whether I’m comfortable hearing it. Show me that you understand the words you speak stay with me after we part.
Basic ways to do this:
(If you want to tell me your personal infertility or loss story, I am all ears. I promise not to give advice.)
If you need another infertile POV questions:
Nobody’s perfect, and nobody knows the perfect thing to say. But knowing you care enough to try helps a lot.
Some states mandate health insurance covering infertility treatment. Some states don’t. It would be neat-O if infertile couples didn’t have to choose between their nest egg and an egg in their nest.
There are lots of ways to volunteer and spread the word. Write. Tweet. Talk. Every little bit makes a difference.
Hope this helps. It helps me, anyway. Hope that’s OK.
A doctor in the family reached out to ask if I could put together some kind of printable poster for Zika travel awareness—something printable for her office to spread the word about the mosquito-borne Zika virus and the threat it poses to babies of infected mothers.
Apparently the CDC has distributed a printable poster for general audiences about avoiding mosquitoes when traveling, but there wasn’t something available that targeted women who are or may become pregnant.
So I put together the image below. Health care providers, community organizers, anybody, anywhere, please feel free to use/print/distribute these any way you see fit.
If you’d like another version, or you can provide translations, please reach out via my contact form.
If you get the chance to send them, I’d love to see your photos or screencaps of how you put this to use. No matter what, thank you, and best of luck. Let’s get the word out.
2016/02/05 UPDATE: City of Chicago is using it!
I wrote a suite of scripts to help you background check your doctor.
The Primary Care Provider Investigator imports a list of health care providers and then scrapes multiple review sites (e.g. Yelp, UCompareHealthCare) to aggregate their reviews: PCPInvestigator.
This project was born of frustration with my health insurer’s “search for a doctor” function, which listed the doctors my insurance covered but didn’t give me any sense of whether a doctor was any good.
Now I have a database of doctors and a snapshot of their reviews across multiple sites, plus a local webpage that displays the results and lets me sort by the categories I care about. (Click any image to view full-size.)
Y’see, doctor reviews became important to me when I visited Dr. Norma C. Salceda back in 2009 and had such a bad experience that I complained to my insurer (then Blue Shield) and was told just go find another doctor.
If I’d had the PCPInvestigator at the time, I would have been able to see this before I ever made an appointment:
That’s 38% positive reviews for Dr. Norma C. Salceda with over 150 reviews to examine. That’s bad.
In the summary report, I would have seen such quotables as “WORST experience that I’ve ever had with a doctor,” “worst medical experience I’ve ever had,” and “LADIES BEWARE SHE IS AN ANIMAL!!!”:
Sure, any doctor can have dissatisfied patients and a few complaints, but the intensity and the sheer number here is pretty special.
If you want to try the PCPInvestigator out yourself, it’s on github. You’ll have to be comfortable with the command line, and it’s useful to have some familiarity with python and mongoDB. You may also have to massage the doctors’ information input parsing to get it to match whatever list you can get from your health insurer. There’s more detail in the README. And you should know…
Even with these issues, if you want to find the best, closest primary care provider covered by your insurance, this is the only way I’ve found.
Hope this helps. Enjoy!
Back and now mobile-friendly for your Halloween enjoyment! Evil is at the door.
DEAD WEEK (Remastered): the week before final exams, college roommates face a horror they may not survive.
“Dead Week” is an interactive horror webtoon with audio, playable in English or Korean. Headphones and a modern browser on a desktop computer are recommended for the best experience.