The streets of my city

Although we live in a lively city neighborhood, I’m continually surprised by how quiet it is here; Big City only has a population of 127,579 after all. Please, don’t ever think it’s as if we’re living in Chicago or Seoul. Think Cambridge, not Boston proper. The street we live on is a short (one block) one-way cross street so we get very little unnecessary traffic going past. There is a bus route on the main north-south street about 200 meters from our apartment and sometimes I can hear a bus, but the buses run on electricity or natural gas and they’re not very loud; nothing like the cranky old bus that rumbled up and down 16th Street back in D.C. Surprisingly, we hear less traffic here than we did back in Small Village, because in Small Village our house was right along the main road leading into Big City and here we’re on this quiet little-used side street.

Weekends are especially quiet, and on Saturday evenings and Sunday mornings I hear the bells of the St. Paulus Kirche five blocks away pealing through the neighborhood.



During the week, if the radio is off and the window open, I can hear the church bells chime the hour. In the mornings, when R is taking care of Small Boy and I am writing in bed with a cup of coffee on the table beside me, I can guess at the weather by how muffled the seven o’clock chimes are. I can hear if they are carrying through crisp clear morning air or if they are pushing their way through rain or fog. Some winter mornings, with snow on the ground and fog in the air, I can only hear them if I listen for them.



On an early spring morning, the loudest thing about our city neighborhood, the thing that woke R and me at the crack of dawn throughout April and May, is the constant chattering of the birds in our courtyard. On a pleasant evening, it is the children of our apartment building playing on the playground out back. It’s easy to have a child in this neighborhood; there are nine children in this building alone and one of my neighbors is pregnant with her second. The bakery around the corner has children’s books and high-chairs and balloons; the butcher gives little slices of sausage to the kids when you shop there (they ask the parent if it’s okay first). I never feel as if I have to make the choice, City or suburb? It’s as if I have both at the same time, and it’s something I will miss keenly if we ever leave Switzerland.

Achtung, fertig, los! *

So today is cycle day 3 (CD3) and I started the Progynova. Tomorrow or Tuesday I'll call Dr. L's office to make an appointment for an ultrasound to measure my lining; that appointment will fall on the 8th, 9th, or 10th - the middle to end of next week - and at that point we'll have a better idea of a transfer date. (I really need to find a better pseudonym for Dr. L than Dr. L, but Dr. SocialSkillsAreNotHisStrongSuiteButIReallyLikeHimAnyway is just too long.) And that's it. No blood work, just the one ultrasound (assuming all looks more or less well) before the transfer. We didn't do blood work on the initial IVF, either. We're low-monitoring over here in Switzerland, so between now and the ultrasound there really won't be anything to report in the FET department.

But technically, this attempt has officially begun.

* Ready, set, go!

Strange Swiss street signs

Caution: rollerbladers and airplanes crossing!




Tanks forbidden

CD1

Yep, that's all. Just CD1.

In which I actually make an infertility-related post

In the course of commenting on this post, I feared I was starting to hijack Julie's comments thread and thought that maybe I should continue in my own space.

According to Reuters "medical groups representing U.S. fertility experts, alarmed by rising numbers of multiple births, on Tuesday advised limiting the number of embryos implanted in women undergoing in-vitro fertilization" (link also via Julie). The proposed guidelines for my age range would actually be less restrictive than what I'm dealing with in Switzerland, if I'm correct in assuming that "earlier-stage" embryos means two-day embryos; that is two- to four-celled embryos. (On a side note, fertility patients, especially US-based fertility patients, are the most specific people I know; these are women who can rattle off their E2, progesterone levels, lining thickness and number and size of follicles per ovarie in their sleep. What, exactly, is an "earlier-stage" and a "later-stage" embryo? Please, give us the number of days in the dish or number of cells.) In Switzerland we can transfer a maximum of two, and we do a day two transfer. The maximum of two is precisely toreduce the likelihood of multiples; and the two-day transfer is because at day two you can't really tell which embryos are going to stop dividing so at day two you have just as good a chance of tranferring a doomed embryo as a graced one and anything resembling embryo selection, even just waiting around to see if the embryo up and dies on its own, is strictly verboten. (But you can terminate later if you discover a genetic disorder, which strikes me as an ethically odd set of rules to co-exist, to say the least. No PGD* because we don't want you to be able to discard your genetcially damaged seven-celled embryo, but sure you can terminate at 18 weeks.)

You can see why I thought I might be hijacking the comment thread, considering I've already hijacked my own post twice. Anyway. So Julie posed the questions: what do you think about the guidelines? what did you do? what kind of information did your RE give you? what do you think about all this? And in the course of commenting, I realized that a) I have a fairly strong opinion about not transferring more than two even though b) I have been spared from really having to consider the question. Needless to say that leaves me feeling a little uncomfortable about myself. I never really had to think about the guidelines, and I never had to answer the tough question of How Many to Transfer, because I live in a country with pre-existing guidelines and we were not interested in travelling to do IVF. Certainly not at first until we tried here. So I had to work with the rules my RE works by.

I did question why we could only transfer two, because initially that surprised me, and my RE said simply, Because we don't want triplets. (Let's avoid the whole question of spontaneous division and multiples, by which a two embryo-transfer could yield quads. It does happen, but if we wanted to reduce our risk of multiples to a certain zero we would have to forego IVF altogether. Even a single embryo transfer can yield twins, right?) Another clinic we interviewed but didn't go with will cancel an IUI if you've got too many follicles. The one set of triplets they ever had (so they said) came from a cancelled cycle when the couple went home and had sex against medical advice (so they said). She really wanted to make it clear to us that those triplets were Not Their Fault. Since there was nothing we could do about this rule, we went ahead with our IVF and transferred two embryos - a two-celled and a four-celled (they don't allow embryo grading, either, so don't ask about quality; they looked pretty is all). That cycle -my first and only - resulted in Small Boy and the Hockey Team - ten frozen embryos.

And now we're inching closer to the FET, and we've decided to transfer a single embryo. I think twins (and yes, could still happen) would be unfair to Small Boy. The chance of twins was worth taking when it was the first child we were trying for, but now...I know me, and I know how hard it was with just the Small Boy, and I'm worried already about having an infant on top of my beloved perpetual motion machine and to think of twins. Well. It would be unfair to Small Boy. He'd be pushed to the side in a thousand different ways just due to the sheer physical logistics of twins and I can't face that. We had coffee today, Small Boy and I, at the Beck around the corner from our apartment, sitting on the couch together while he drew circles - he makes the most excellent precise little circles, it's astounding - and I drank my Schale (basically a latte) and we shared a Mandelgipfeli (almond croissant). He's my guy, and my first loyalty is to him. For as long as any subsequent children remain hypothetical, my first loyalty is to him. I'll divide loyalties later, when I have to. And maybe the choice I'm making now will mean that subsequent children will always be just a hypothetical, but I can't make the choice differently. He's here, he's real, the damp sweaty curls at the back of his neck and his outie bellybutton and his nose kisses. He's the reason I'm transferring a single embryo.

But here's the thing. I got pregnant on my first IVF. The pregnancy was uneventful, I went to term, the birth uneventful. And I make these choices going into my FET believing it will succeed. Foolish perhaps, but there it is. I think it'll work. I haven't had to try very hard at this; I feel guilty about that sometimes, about my smooth road. So it's easy for me to say guidelines are a good thing; they worked for me. Or, rather, I had success even within their confines. But if it had all gone wrong, with failed cycle after failed cycle - would I be wondering if we could just transfer a third, or a fourth, wouldn't that help? Hell, yes, I'd be wondering that. I'd be pissed. I'd fly to New York and cycle there. So it's pretty easy for me to have an opinion about guidelines, isn't it, me with my son sleeping face down on my 20-year old teddy bear in the room next door. It's easy for me to move through the guidelines here because our diagnosis - straightforward male factor - is the easiest problem to solve. And I was typing this comment to Julie's post and I realized how dismissive I sounded - not just sounded, was being. Because, granting that infertility sucks, our infertility has been of the least-sucky variety.

And I'm opining about guidelines.

And it has never in my life taken me so many paragraphs to tell myself to just shut up already.

* Even as we speak, the Executive Counsel is supposed to be drafting regulations defining the circumstances under which PGD is to be allowed but Holy Government by Consensus Batman! they're taking their sweet Swiss time about it.

Be afraid. Be very afraid.

You've seen When Babies Attack! But nothing could prepare you for When Toddlers Attack! With a Stick!













(photos taken at Old Faithful Geyser Basin)

The streets of my city

This is my favorite building in my Quartier (neighborhood).



It sits on a busy corner where there is plenty of car and foot traffic and a bus line. The upper floors are residential, but the ground floor is occupied by two local businesses - a cafe/bar and an Italian grocery. On weekends there might be a flower stand in front of the grocery, or sometimes fresh fruits and vegetables.



I think that this building is aesthetically pleasing, lovely really; but I think the reason I am so attached to it is because it has become iconic to me. The architecture of this building, the columns, the statue tucked away in its roof alcove, the colors and especially the two small businesses on the ground floor are a perfect image of what I always imagined life in a European city to look like. I even like that when I look at the building from across the streets the cables for the bus line - so very European - slice across my field of vision. Once upon a time I would mutter at those tram and bus cables for "ruining" my pictures; but they are the essence of European city living and I am learning to incorporate them into my pictures. To use them. To appreciate them. Their presence makes my life on foot, my life lived in close contact with the street, possible.



Much of my neighborhood is mixed-use; businesses on the ground floor and apartments above. I'm a big proponent of mixed-use zoning. As Jane Jacobs illustrated long ago, mixed-use neighborhood are lively and interesting; they have varied foot traffic at most hours of the day and night (thus providing not only interest but safety); and they're convenient for the residents. I live within a ten minute walk of a bakery, a grocery store, an organic food store, a butcher, two wine shops, multiple restaurants and cafes, an ATM, a post office, a papeterie (stationary and card store), an art supply store, two bookstores, two florists, two apotheks (drug stores), a branch library, a park, and the bus stop. Small Boy and I live our lives on foot, out on the streets of our neighborhood, strolling here, popping into this store and that, recognizing faces on the streets, contributing to this lively neighborhood. Our neighborhood is designed to be lived in, not merely inhabited.

I love the buildings, the businesses, the streets of my city.

Moose at Willow Flats, Grand Teton National Park, Wyoming

Oxbow Bend (Snake River), Grand Teton National Park, Wyoming

Oxbow Bend (Snake River), Grand Teton National Park, Wyoming

Poetry Thursday

This week's idea - to spend some time with poetry that we usually avoid, that makes us uncomfortable, or that we don't like (or think we don't like) - was hard for me if only for purely logistical reasons. I've said before that I drifted away from both the reading and the writing of poetry about ten years ago. Since then I have moved four times, once internationally. Any poetry that I wasn't truely fond of didn't survive all those different packings, and my collection was none to stellar to begin with. Getting my hands on English-language poetry over here isn't easy; there is none at the library and the collection at the book store is small and tends to the tried and true, and is often prohibitively expensive. And I'll confess that I wasn't willing to spend money on poetry I didn't think I was going to like.

So I took a different tact. I decided to avail myself of the library after all - the German collection. In many ways I am fond of the German language. I find it bitingly precise; efficient; and as cleverly constructed as a three-dimensional puzzle. What it do not find it is poetic. Of all the words that come to mind when I think of German, poetic is not one of them. Of all the ways in which I might be able to express myself in German, poetry is not one of them. I will go to my grave without ever attempting to write a poem in German, I know that much; the language of my heart is certainly English. But there is no reason to go to my grave without reading a poem in German. So I am reading Goethe (how predictable! how stereotypical!) in German.

Congratulate me or console me as you see fit.

See what other people are reading here.

Family traditions

I seem to be unable to upload pictures in the blogger post page; I've been posting pictures by importing them via the Hello program. But when I do that, I can't intersperse pictures and text, and each picture appears as a separate post. The four pictures below are meant to be read as part of a single post. If you read the captions, you'll see that Small Boy and I returned to some old family haunts on this vacation - in fact, Small Boy is the fourth generation of my family, going back to my maternal grandfather in the 1950s, to vacation in Ketchum/Sun Valley, Idaho. He's also the fourth generation to visit West Yellowstone and Yellowstone National Park, though I suspect that is a less unusual family destination than Ketchum, Idaho.

I have to confess that I expected some sort of epiphany upon seeing my son on the banks of his grandfather's beloved Madison River. I expected some sensation, as if by squinting and looking into the sun at just the right angle I would see my father on the far shore. I didn't. And much to my surprise, I didn't feel the loss of it. I was too caught up in watching my son throw rocks and occasionally point up to the sky and say "bihr" (bird). I was too caught up in the moment to think about the past. That's a good change in me, and a much needed one. My son is, of course, my parents' grandchild. But he's my son and R's. And above all, he is his own self. We will make our own traditions and find our own special places. I will always circle back to the Rocky Mountain West, to those sage flats, to the cottonwoods, dragging Small Boy in my wake; I can't stay away for too long. But I won't weigh those trips down with emotional baggage anymore - I carried it out with me in September, but like Small Boy throwing rocks I threw it in the river and left it there.

The trip home was lighter.

Small Boy on the banks of the Madison River 2006

My father, on the banks of the Madison River circa 1966

Me and Small Boy, Warm Springs Creek, Ketchum Idaho 2006

My mother and brother, Warm Springs Creek, Ketchum Idaho circa 1967

Buying produce the Swiss way

In comments to this post, Junebee asked how the Swiss buy produce, and since I'm still having jetlag-induced fuzzy brain, I thought I'd make a post out of my answer to break up the flood of pictures I'm posting, for those of you who are interested.

The produce is all set out the way you'd expect it in a grocery store in the US, except that next to each pile of fruit is a number. For whatever reason, bananas are always number 1. Apples might be 2, carrots 23. You get a plastic bag and fill it up with your fruit or veggies and then take it over to a scale. The scale has been programmed with the price of all the fruits and veggies - so if you're buying bananas, you put them on the scale and press number one. The scale prints out a price label and you slap it on your bag; then at check-out the cashier scans this label same as any other label*. One major advantage to this, from my oh-so-un-Swiss perspective, is that once you've weighed your fruit you can feed as much of it as you want to your child as you finish your shopping without ripping off the grocery store. I once weighed three apricots and by the time I reached check-out handed over a bag with three apricot stones and a label!

Some things are sold by the unit - mangos and avocados, for example - but most things you weigh yourself and the cashier just scans them. It just makes so much sense to me; but I guess anything that you get used to over time becomes the most logical way to do anything.

* Actually when I buy bananas I don't use a bag, I just slap the price label on the banana. If I buy Small Boy one apple, same thing. And if I buy two carrots and two zucchini I use one bag and stick both price labels on it. I try to reduce my plastic produce bag consumption as much as possible.

Gros Ventre River, Grand Teton National Park

Gros Ventre River, Grand Teton National Park

The Gros Ventre River, Grand Teton National Park

Small Boy at Jenny Lake, Grand Teton National Park

Small Boy at Jenny Lake, Grand Teton National Park

Near Jenny Lake, Grand Teton National Park

Grand Teton National Park, Wyoming

Grand Teton National Park, Wyoming

The ghost of posts future

Well, my body seems more or less to have recovered from the jetlag (and Small Boy is getting there, and doing so much better than he did after our Thanksgiving trip that I can't believe it's the same boy!), but my brain still feels like it's swimming through mud. I can almost see the fog I feel like I'm walking through, and to try to write anything interesting in this condition would be folly. But here's a list I made up while in the States of some things that struck me as strange, or things I miss about the US, or things that annoyed me about the US. At some point I hope to turn a few of these bullet points into actual posts, but we all know about good intentions, don't we?

• Highway exit and entry ramps are strange - I can't put my finger on it, but it's scary to merge here.
• American toilets are shorter than Swiss ones.
• I miss friendly/chatty service workers - the cashier at Old Navy who told us about her trip to Finland.
• Portions are huge. HUGE.
• Too many commercials and they're loud and in your face.
• There were 3 school shootings in the 6 days we were in West Yellowstone. WHAT is that all about?
• International coverage on TV news non-existent (really - I made lists while watching the news).
• Plastic grocery bags are stupid, and they're so small you wind up with 8 of them no matter how little you buy. There is zero attempt to conserve.
• People in the US are so friendly - the woman outside the Pioneer in Ketchum with her dog Token.
• Coffee shops in the US sell newspapers rather than simply make them available to their customers.
• Why do the cashiers weigh your fruit at checkout? The Swiss way seems so much easier for everybody.

Those are some profound insights, no? I bet you can't wait to see that list expanded into actual posts. Just. can't. wait.

Maybe I should just stick with journal excerpts.

Travel journal from Wednesday 27 September

"The Tetons.

Picture a high plateau, high sagebrush desert, flat and dusty and colored uninterupted with sage. High desert. In the fall, like now, a band of yellowing aspens and cottonwoods lines the banks of the Snake River twisting through the tawny landscape. The trees extend perhaps 20 meters on either side of the Snake, then the dominant sagebrush returns. The flat plateau continues and suddenly crashes into the Teton Range. There are no preliminaries, no foothills, just a sudden 6,000 foot rise to the craggy Grand Teton. The peaks are snow capped, or snow-dusted, for lines of rocks like spines run grey and graninte down the range.

I live in the shadow of the Swiss Alps, but these are the landscapes that swell my lungs and square my shoulders, these sudden changing landscapes blending together on this high plateau. It is the contrasts that capture my heart. Or perhaps it is simply that we love best the things that we loved first."

Planes, trains, and automobiles

We're back. After driving the rental car to the Jackson Hole, Wyoming, airport, we boarded the flight to Denver. In Denver we connected to Frankfurt, Germany. In Frankfort we transferred to Zürich. In Zürich we caught the train to Big City. Through it all, Small Boy was a trooper. Or is that a trouper? He rocked, I tell you. He slept. He played. He sucked his thumb during take off and landing like we told him to. What he didn't do was cry. Over a 20-hour travel day. I almost cried, but Small Boy hung in there.

We've got jetlag and woke up at noon. It's Small Boy's fault - you can force yourself through jetlag but when the 20-month old Boy is wide awake and wants to play at 1 am because he thinks it's 4 in the afternoon, well, what are you going to do? Explain time zones to him and send him back to bed? So we played. And slept 'till noon.

Look for updates at the most random of hours, and pictures once we get them from R's computer to mine.

It'll take me forever to catch up on everybody's blogs, but I'll try.

Off to restock our empty fridge.