Having given up on getting pregnant, MJ and I turn to trying to fix my own health, which has nosedived precariously in our blind pursuit of parenthood. It is no secret that the best way to avoid the pain of endometriosis as well as its worsening is to no longer be cycling, so at thirty-five I can be found at the pharmacy filing a prescription for birth control. It could be projection, but I sense a smirk from the pharmacist as she looks at the bottle and asks me to confirm my birth date for the second time. I could be one of those women whose unbridled fertility and incomparable sex life has resulted in a brood of children her husband and her love but are still drowning among. “We simply can’t afford another mouth to feed,” I can imagine MJ saying in a sad but pragmatic voice. We would consider abstinence, but our passions would be too great to deny and he with his plentiful sperm and me with my hearty eggs would realize we simply had no choice but to just shut things down until the “change” finally came to me, most likely some time in my late seventies when I finally stopped being a pinnacle of woman’s reproductive health. But the pharmacist who has also filled my prescriptions for clomid, and letrizole and progesterone and a host of vitamins, and supplements probably does not consider that. I get the distinct impression as she asks if I have any questions that she just thinks I’m a disaster. Since she’s already there, I add some Ben and Jerry’s pints to the bill and let all self-esteem float away down the aisles of Walgreens.
I find it particularly cruel and of poor humor that the side-effects of starting birth control mirror almost exactly those early first trimester signs of pregnancy which I searched for so relentlessly over the past three years. I am nauseated on a regular basis. I feel queasy in the mornings, I feel queasy in the afternoons, and god help me if I have not had anything to eat in awhile. On more than one occasion I find myself in the bathroom, hunched over our toilet anxiously heaving up whatever I managed to eat that day, and wondering in what universe is it fair to give an infertile woman morning sickness.
But even that is not comparable to my breasts which have transformed over the past three weeks into mounds of heavy bloated flesh, as if a heartier version of me had flung large bags of flour over my shoulders in an effort to carry them the day’s walk from the feed store back to the ranch two towns over. They are larger too. I notice one day looking up from a book and catching myself in the mirror that out of the neckline of a dress I’ve worn for years without issue has spilled enough cleavage to frighten pastors and small children. It is far too indecent even for being at home, completely alone, with no intention of seeing anyone the rest of the day. I quickly change clothes and attempt to push the wayward beasts into a more restrictive bra, which later that evening, when it is removed, will feel much like releasing the Hoover Dam.
The birth control pills come in this idiot proof packaging, where they have not only lined the pills up by week but labeled each day so that you know exactly when to take them, in case the general instruction on the label “take one daily” was too unclear. When I read through the lengthy small print of the instructional packet, I find that the largest section by far, more than side-effects or studies done, is the Instructions for Use, which includes at least eight different suggestions for ways to remind yourself to take the pill each day, and at least four repetitions of the same information on what to do when you do, inevitably, miss one. I find it initially offensive, and condescending, but then I think about all my pregnant seventeen year old clients, and all of the people I know who have accidentally gotten pregnant while on the pill (including my own mother) and realize that I have literally aged out of the birth control target audience.
At thirty-five this will mark the fourth time in my life that I have actively been on birth control. Quite humorously and counter to Conservative nit-wits, only one such time was for the actual purpose of having sex. Having never been a pinnacle of reproductive health, I was first put on birth control in eighth grade in an effort to fix a host of cycle problems I’d developed. I like to tell people I started birth control at twelve without adding any of the medical background just to get a reaction. Sometimes I say it matter of factly, like didn’t you? Didn’t everyone? Other times I like to imply how advanced I was in my sexuality and independence, but no one buys that for long. You only have to look at me to understand that I was not losing my virginity at an early age, or even really a middle age. Whether it’s the cardigan sweaters or tickets to GenCon that give it away, I’m not sure, but no one ever gasps or accepts the idea of me having sexual moxie. Most just pause for a second, then tilt their heads and smile sadly asking if it was a tumor or some other problem. Even MJ when we first met was pretty sure I was frigid and sexually repressed.
A week before I broke down and asked our doctor for the prescription while declaring through tears that we had decided to stop trying, I found myself in the ER with intense abdominal pain. A scan reveled a mass on top of my ovary. I don’t blame the ER, but they were far too free with their descriptions: “unknown mass” they kept saying. “Radiology can’t decipher it,” and “you need to follow up soon.” I drove myself home, the morphine wearing off already, the scripts for pain and nausea meds in my hand, and tried not to panic. A few days later, my own doctor declared the mass gone, attributing it and the constant pain since to a ruptured cyst of some sort. I have yet to get better. Nearly a month later I still ache with abdominal and stomach pain, I have trouble eating, and even more trouble getting around. I see other doctors, I schedule appointments, get tests done, but no one can figure out why I am getting worse. Why I can’t move or eat or live a normal pain-free life. I schedule a consult with a surgeon and on Monday I tearily submit FMLA paperwork to my boss.
I cry daily, but that swing of emotions I cannot blame on the birth control, though their change of hormones could no doubt create that other similar early pregnancy sign. I cry because I am in pain. Not just pain from endometriosis, a new pain, something more central, higher up, something wreaking havoc, but not something that has been identified yet. My mother agrees to come out for a week to help out and go to appointments with me. MJ feels distant, working late night after night, exhausted with having to carry my load at home and much of it at work as well. I panic about finances, my student loans looming over me as no new paycheck enters my bank account. For three years I have dealt with constant pain. I have risked my job and my health and my relationships in the hope of someday being a mom. And now that hope is loss, now that it has been sent out the window, tossed into the recycling bin, hidden in the dirt of the backyard, now things are only getting worse.
I try to get through the day as best I can. I call doctors and make appointments, I try to not overly rely on the pain medications which I know can equally damage my stomach. I try to put my health first for once. And at night when I try to get comfortable before bed I take that birth control pill with water and think about how much I hate it. How I hate that tiny white pill and all it represents in my life, and how despite that, I am terrified I waited too long to start taking it.