All This? This Is Not Your Fault.

  You've seen the moment in countless movies, particularly of the lifetime channel variety. A previously abused, discriminated, or otherwise oppressed individual is confronted with the reality that the pain they've faced / are facing is not their fault. Their reactions of self doubt and hate are misplaced. This is usually a very emotional scene in which two previously distant characters reach their breakthrough moment. See Good Will Hunting:

  Until today I hadn't really had this moment in this experience. 

  I thought I had. 

  I had created a reasonably strong illusion that I had removed self doubt and blame from my mind. I had become accepting of our path, and was ready for our process. Self doubt though, had remained, hidden.

  My moment came today. 

  Our family's have been amazing during our journey, but we haven't had time with them in person. This weekend we were fortunate to be able to see Shannon's full family as we welcomed back a cousin who had been studying abroad. En-route Shannon and I discussed how excited we were to see everyone. We shared anxiety about our reactions. I stayed positive and logical: 

People respond to your signals, so if you smile, they'll smile. Provide positive data and they will react positively.

  I must not have a computer brain, because when I saw the compassion, love, and heartache for us in everyone's eyes, I wasn't prepared for it. It rocked me. When we openly talked about the situation, our plans, as if we were discussing a new job, I was overwhelmed.

  A thought popped into my head then I didn't know needed reassuring: 

They are not upset with you. They don't blame you. This. Isn't. Your. Fault.

  Emotional overload was reached and I made a quick exit from the room and went outside for some air. Thankfully the men were in the kitchen when I returned, watching the Red Sox game on the smallest TV, at the smallest table, in the house. This is our usual location. We should just build caves in each house. While the rest of the house, including the best lit rooms and most comfortable seats, are filled with the laughter and escalating voices of our better halves, we huddle away.

  The Sox were down 4-1 and not looking good. A few well placed jabs at Saltalamacchia reset my emotional engine temp, and we continued with the day: BBQ, dessert, stories. As we finished up our desserts someone shouted out from the kitchen: 

It's 6-5 with 2 outs and one on!

We all ran into the kitchen. We sat crowded around the table, calling balls and strikes. The Red Sox loaded the bases. The next batter faced a new pitcher, and with a kitchen full of my dear and wonderful family, Jacoby Ellsbury hit the first pitch he saw for a game winning double. My family shouted out together with joy. 

Beat that Matt and Ben.

It Won't Matter One Bit

  When the doctor hands me my son or daughter none of this will matter. When I get to say hello by saying their name out loud and they can hear it for the first time, I won't think of this for an instant. When I can't get any sleep because of the baby crying, when I put on their first shoes, when we walk hand in hand into Fenway for the first time, this will be a distant sad spectacle. If I try to look back at these dark hours or questioning days I'll think:
  What a waste. You were free to go out to dinners, movies, and go on vacations as you wish. You wasted those last moments before you became a dad sulking around or over thinking how you'd feel. You knew all along you'd be in love.
  Today's gift is knowing none of this, the worry, the pain, the thinking, the soul searching, will matter one bit.
  I'm getting my second wind.

The Next Mile

  The next mile is going to be a very rough one. We found out this morning that my Y gene deletion is of the B and C types. With the diagnosis that the deletion is B type this means that I am officially sterile, and I don't have the gene's necessary to produce swimmer proteins. Nothing else medically is wrong or different about me, which is a relief. Having the physical exam so close after being told you can't father was odd, and I am sure will be discussed here later, after the shock has worn off.
   We're both numb right now. I'm just trying to get through the work day without breaking down. That is today's goal.
   Thank you to all those that reached out and have been reading. Days like today are when this matters the most.
   On to the harder/hardest miles.

The Importance Of 11

  The number 11 has special importance to our family. My birthday is 1/1. Shannon's is 11/11. We see signs in very normal places about that number. Over the past few days the signs frequency has steadily increased to the point where we're drowning in it all. The $600M PowerBall last night was 11. The other numbers weren't, so we lost that one.
  It's not just numbers that are connecting in odd ways. Today as I was driving with a friend to play squash in Cambridge he decided to take a route through Newton instead of the Pike. As we drove along in his loudly blue WRX blasting Calvin Harris like 14 year olds, we drove past Newton Wellesley, the site of the start of our journey, and these lyrics were blaring as we flew by.

 So I put my faith in something unknown
 I'm living on such sweet nothing
 but I'm trying to hope, with nothing to hold, 
 I'm living on such sweet nothing

Now the rest of the lyrics are about some passive aggressive jerk who strings the singer along, but these are signs here so they can't jump right out and slap you. We made our way through the backroads and ended up talking about how we met our wives and how we knew they were the one. Just as I was telling the story of our meeting we pulled onto memorial drive by the MIT boat house. When Shannon and I first met we had an hour to kill before a Red Sox game and so I drove us over to that side of the river and we walked along the Charles looking at Boston. It felt exactly like that day as we drove by and I retold the story of knowing right then, and staring at her freaking out mentally the whole time. The water was perfectly glassy as we continued along to squash.

  The fact that my Y gene deletion mutation came as an accident of creation, at my conception, gives me the comfort to know that this was all part of a plan. I was pre-determined to have this condition. These are all signs to me that whatever route we end up having to take to become parents, and whatever we find out tomorrow about our future, there is a plan for us. We are destined for great things.

Shannon's sister Julia has been incredibly helpful in making me see that this journey is a blessing. The growth I am going through mentally, and atheist or not, spiritually will make me a much better husband, father, person.  God has not given us a spirit of fear and timidity, but of power, love and self-discipline, whether he exists or not.

We find out tomorrow at 8:45am where the rest of the plan takes us. We're excited for the next mile of the race.

I Am A Mutant, And My Name Is Nospremo!

  Well it looks like I spoke too soon regarding genetic testing. All day today I have been playing phone tag with the nurses at Newton Wellesley because my results came back for my genetic tests. Normally all these results can be seen through a patient portal online, but for this one the results weren't shown.
   About 3 hours ago I finally got through to the nurse, and as she started to speak I already knew it was bad news:
   I'm a bit out of my element here, and I would prefer the doctor tell you, but the results did come back and they found a Y Gene Deletion
   It is really odd but I didn't get that upset at this news. It could be that I somehow knew this was the case deep in my double helix. I was even able to finish a few things at work before feeling the water works about to start and running out to the parking lot. This afternoon there was only a sprinkle.
  So what does Y Gene Micro-Deletion (YSM) mean? Well it means that I am a mutant. At conception, as the Y chromosome of my dad was copied over, parts of it were left out. This mutation has led to some of the instructions for producing swimmers to be left out. This is a very odd super power to have, the ability to not impregnate naturally. It would have been a great power to know about at another time in life I suppose. I have always wanted to be a mutant, and now I finally am. My X-Men name is Nospermo.
  There is good news though. My FSH and testosterone levels being normal means that I still most likely have swimmers around. The issue at hand now is how severe is my YSM, as the most severe kinds could mean I would pass on this problem to any sons I have. I don't think Nospermo needs a young sidekick with the same powers. We will have to cross that bridge when we get there.
  We are going to run with endurance the rest of the race. This is just another mental wall to blast through. We have our urologist appointment on Monday, we now know what we are fighting, and are going to enjoy the weekend.
   Beware infertility, Nospermo is out there, ready to defeat you.
 

Let Us Run With Endurance The Race That Lies Before Us

   I have a bad habit of falling asleep on the couch on Friday nights. Somewhere during the night before's Colbert Report I nod off. This is not a comfortable sleeping situation. It does however, afford an early morning as the light hits my face just after sun-up. This past weekend, as I woke up to the sunrise I was on a mission to extend my spring obsession. It was time to put plants out on the patio, and that meant a drive to the garden center.

  As I drove through the streets of Waltham I ran through everything that has happened, the process, the people who have reached out and shared their stories and the strength we have gathered from the fertility issue community. This community of people that have been so brave regardless of their sharing level.

  Some people have struggled to understand why we are sharing our experience, or have reacted oddly to it. One friend said that it was difficult to discuss because it was so personal of a situation. It is between you and your wife, they said. Well frankly so is cancer, or a genetic issue or a developmental issue with a child. So would being gay. If it was something people felt was difficult to discuss or overly personal that makes it feel taboo in my mind, and if it is taboo, then it feels wrong. This is not something to be ashamed of or to feel the need to not share, or to not be asked about. Now again, each person or couple going through this is entitled to whatever decision about sharing they want to make. This is about respecting everyone's process.

 A few people have said I was brave in writing this blog, in sharing in this way. The odd thing, I couldn't do this any other way. I need to be open about this, I need to talk about this, I need to write about this. If I don't, if I was forced to hold this all in, I would have some serious freudian situations popping up somewhere right now.

 To continue with the openness, we found out Friday that the SA and urine sample came back zero again. With this second zero test, I officially have azoospermia. Azoospermia is the medical term for no swimmers in the batter. There are a number of causes for my condition, and approaches to resolve:

• Pre-Testicular - This is when the cause is hormone related, where there is a low level of FSH or testosterone, and it can be resolved with hormone therapy. That would be great!

• Testicular - In this situation the FSH levels are high because the feedback loop is not working. Your body knows you aren't making swimmers and is pumping out FSH to get them going. In these circumstances they can sometimes find a few, but it usually means that through genetics or organ failure there won't be enough to extract

• Post-Testicular - In these situations the hormone levels are normal, the genetics clean. This is usually caused by a blockage or a missing connection. This is the best possible situation as it is most likely that there are fellas in there, they just need some help getting out.

  With the hormones level normal, we are in the post-testicular zone and have been dancing around with hope. Most likely I have no vas deferens and I am a cistic fybrosis carrier, or I got in some accident as a kid and screwed up the area and just am finding out now. On the CF front, Shannon isn't a carrier so we are ok from that perspective. Knock on wood, we will end up doing IVF and ICSI when they find some bannermen in vesicals or in a testicular biopsy. For those not familiar with these procedures here is a brief intro:

• IVF, or in vitro fertilisation is a where eggs and sperm are harvested and the egg is fertilized outside the body and then inserted as a zygote. To make this work the woman needs to be pumped full of hormones to produce eggs, they are extracted, and then she needs to get pumped full again to get the body into pregnant mode for the zygote to take and everything to proceed as normal.

• ICSI, or intracytoplasmic sperm injection, is where a single sperm cell is injected into the egg. This procedure was first successful in 1992. 

  
We are going to engineer a baby. So cool.

  As I walked around the garden center looking at plants I marveled at how lucky we are, how everything has lined up for us. We are blessed in so many ways. We have so many people to talk to. We have some much love being brought to us. We have examples of life throwing unreal horror at people, who react with courage. The survivors and first responders in Boston are helping us understand the most powerful way to react to challenges in life: to adapt, to grieve, to stay on.

  However, this isn't easy. There are dark days, hours, moments. I've been thinking a lot about a line from The Old Testament at those moments.  I'm keeping it very old school lately. I first heard the line from Obama's speech at the interfaith vigil after the marathon bombing. If you haven't watched it please do.

Therefore, since we also have such a large cloud of witnesses surrounding us, let us lay aside every weight and the sin that so easily ensnares us. Let us run with endurance the race that lies before us. 

  That is my goal in this journey. To not let this situation stop a single moment of happiness in our lives, and to push on. I'm hoping to reject self doubt and pity, and share this with the crowd of witnesses around us, and run with endurance.

 Another moment from Obama's speech has me thinking about the wonderful team we have around us and the fertility challenge community that is supporting us.

Scripture teaches us God has not given us a spirit of fear and timidity, but of power, love and self-discipline. Even when our heart aches, we summon the strength that maybe we didn't even know we had, and we carry on; we finish the race. We finish the race, and we do that because of who we are, and we do that because we know that somewhere around the bend, a stranger has a cup of water. Around the bend, somebody's there to boost our spirits. On that toughest mile, just when we think that we've hit a wall, someone will be there to cheer us on and pick us up if we fall. We know that. 

  I know that. Shannon knows that. Our family knows that, and for that, we thank all of you.

What Exactly Did You Mean By "I Screwed Up The Sample, Frowny Face"?

   With 20 minutes till my appointment at MGH, I was just getting on the Mass Pike in Weston. For those that aren't from the area, that is not enough time to make the journey. I had moved my appointment from Friday to today, and from 1pm to 10am. I had not reflected the time change in my calendar, so when I called to confirm the appointment at 9:25am, and they told me it was at 10am, I ran down to the parking lot screaming at Siri to give me directions to MGH. We have valet parking at work due to overflow, and the attendants looked at me in horror as I ran by screaming into my phone.

  It wasn't until I pulled into the garage, 10 minutes late already, that I realized I had left my wallet at the office in my haste. I thankfully was able to prove my identity at the fertility clinic through the following:

• I do know my birth date and social security number
• I successfully argued that it would be rather odd for someone to give bodily fluid samples in someone else's place under the circumstances. This isn't a test that cheating on will get us pregnant.

  Let me pause here to warn readers that I am not going to hold back on details of anything on this blog. That would defeat the whole purpose. This process is going to include the discussion of the human body and all its wonders and weirdness. That said, I will do my best to keep everything SFW (safe for work).

  After "confirming" my identity, I was given two cups, and instructed to place the baby batter in one, followed by a urine sample in the other. The urine sample cup was rather small, and was half filled with an alkaline solution to balance the pH in hopes that any soldiers in there would survive. The lab tech told me I should empty my bladder "about halfway" before beginning as they would want me to empty it for the test.

  Entering the bathroom with my two cups, I estimated how full the tank was, how much I would need to remove to get halfway, and prepared myself for the challenge of stopping the removal mid-stream. The first physical pain of the experience occurred today.

  Next I entered the "sample production room". This was the second of these rooms I have entered, and this one was a bit more extreme than the first. If you haven't had the need to enter one of these rooms before, it really is troubling. There is a couch or a chair for your use. I'm not sure why anyone would sit on this thing given the room's purpose. There is a collection of magazines and videos of various levels of depravity to assist in the process. Once again, not something that I am going to physically touch, let alone use. This sample room's video and magazine collection was much more extensive than at Newton-Wellesley. Several rather specific sub-genres were represented that I wouldn't expect. City vs. suburbs I suppose.

  During the "process" it is extremely important to get the timing right. One needs to have some sense of when it's time to reach for the cup. I misjudged, and resulted in only about 20% capture. Full on panic commenced. I half contemplated waiting around for a bit and trying again, but thinking better of it, closed the cap, took the pen and wrote  I screwed up this sample :-( on the cap and sent the sample through the revolving door to the lab. The frowny face, I thought, will create empathy.

  On to stage two of the process. As soon as I started filling the second cup I realized I had misjudged the volume it would take to fill the container. Overflow occurred, and had to be dealt with. I was now in a complete and total shame spiral. I'm that guy who screws up his samples.

  As I exited the bathroom, now fully ashamed of my performances and about to have a breakdown, an early 20's female lab tech was waiting outside with an odd look on her face. She is obviously prepared for an awkward conversation, and asks as tactfully as she can: What exactly did you mean by "I screwed up this sample, frowny face?". I walked her through my mistakes in both samples, she laughed and reassured me that the samples will be fine. As I told Shannon later, they are seeing if anyone is at the club, not whether they have reached capacity.

  I headed to the car and scrambled around for loose change to pay for parking. While searching, I thought about my emotional readiness for my samples coming back Zero from today. I would say I have reached the acceptance stage of my processing this whole thing, and I am pretty confident I will be fine with the results.

  As I pulled out of the garage Shannon called and told me the first good test results of the experience: My hormone results came back and they are all normal! This means that most likely I do not have full testicular failure. Unless I have a rare genetic issue, there should be bannermen in the keep.

  What a great way to end another step in the journey.