“So what kind of music do you listen to?” asks the cute, young radiology technician as she lowers me to the entrance of the machine. All the research I did before arriving at 6:45am on a Saturday for a pituitary MRI was failing me. I breezed right past all the other requests — “What year did you get your tattoos?” “When was the first day of your last menstrual cycle?” “Please remove all your clothing and jewelry” — so I’m pretty annoyed that music is what throws me off and makes me start to panic.
Musicals? Too weird. My favorite indie band? Too pretentious. Tegan and Sara? Too gay. C’mon Jennifer get it together!
“What are the options?” I ask, stalling for time.
“Oh, I’m just going to stream YouTube so it’s whatever you want. Most people say classical because they think they have to, but I don’t think that gets loud enough.”
I can tell that she wants to say that it’s too boring. No offense to Mozart, but I’m sure this woman’s day would go by a lot faster if she were pressing buttons to Beyoncé instead.
“How about ’90s?” I say. The tech beams at me. “That is a great choice.”
The music is fitting since my fertility journey began in August 1997 when I got my first period on the morning of my first day at a new school. At 12, I was a year younger than most of my classmates and one of the last (but thankfully not the last) of my friends to ride the crimson wave. I remember feeling relieved that it finally happened and somehow already resigned to this warped, serendipitous relationship with my body because of course it had to start on the first day at a new school. Music in the late ’90s saw the twilight of Top 40 hip-hop/R&B blend into the dawn of bubblegum/boyband pop with the dregs of alternative & grunge flickering like fireflies in between. The internet was picking up speed as a social tool. Life was changing, tastes were changing. It was clear that a big cultural shift was coming with the new millennium so, even though it was scary, I was happy to leave my childhood behind and face high school and the 2000s as a young woman.
“It won’t hurt that much because we use the IVs made for babies.”
I’m standing in a small waiting room, getting the rundown from the tech. Because they’re only looking at the pituitary gland, this scan uses gadolinium contrast to help differentiate between normal tissue and tumors or abnormalities. This requires an IV and I hate needles. The hospital I’m in is currently ranked in the top ten by US News & World Report. They’ve taken extra steps in patient comfort, including warming the hospital blankets, socks, and gown; using the smallest IV possible; and playing music through headphone earplugs to mask the noise of the machine. Despite these accommodations (and the full rundown I received from my mother, a nurse, the night before), I’m still nervous — but the casual “I do this a million times a day; it’s no big deal” tone of the tech is somehow reassuring. We’re the only two people in a five-chamber area: there’s a bathroom; a changing space containing multiple lockers, giving the whole thing a weird gym vibe; a control room with multiple computer monitors and large windows; the MRI room itself, and the waiting area that connects everything to the rest of the hospital.
One small prick later and my head is being placed into a futuristic-looking helmet device at the mouth of the MRI tube. The tech lets me know what will happen, how loud everything will be, and tells me I’ll be able to see her at all times once I am fully inside. She gives me a ball to squeeze in case I need to come out of the machine since I won’t be able to move. I let it rest on my stomach. I’m afraid I’ll absentmindedly grip it if I keep it in my hand. I’m committed to doing this so I tell myself I won’t need it and hope I am right. The last thing she does is put in earplugs that are wired to a microphone so we can communicate and I can listen to music. She does a quick mic check and I give her a thumbs-up as the machine whirls to life in a series of clanks and mild vibrations.
The doors close, the lights dim, and the test begins.
I started having terrible stomach aches in sixth grade. They were attributed to “growing pains.” When they worsened in high school, doctors said it was PMS and I’d just get used to it. The summer before my sophomore year of college, my mother found me deliriously trying to impale myself on the side of our claw foot bathtub because the pain was so bad I needed to cause a different, specific pain to focus on. I wanted to crack myself open. A few weeks later, I was finally diagnosed with severe gallstones. The surgery that followed was three hours longer than normal because the organ was so deteriorated and the stones were so plentiful. I was 19. I’d been actively passing gallstones on and off for eight years. I just got used to it.
19 was also around the age I started becoming paranoid about my fertility. It felt like one day I just woke up thoroughly convinced that I wouldn’t be able to have children. I obsessed over this idea to the point of having panic attacks. I told my school psychologist. I told my doctor. I begged to be sent to a fertility specialist. “Are you currently trying to get pregnant?” I was a full-time college student with a part-time job, single, not yet sexually active, my periods were always irregular, and I was desperately trying to convince myself that I wasn’t totally gay.
No, I wasn’t trying to get pregnant, but I wanted to have that option in the future!
Everyone brushed off my concerns. They told me I was being hysterical. They said I had time, told me to relax. So I stopped telling people about the panic attacks. Stopped asking to see doctors. Once again, I just got used to it.
“Alright. Are you ready for your Ultimate ‘90s MRI?!”
The tech is now behind the glass windows. I can see her blurry figure through a series of small, rectangular mirrors but mostly, what I see is my mouth — just lips and teeth — taking up one whole mirror by itself. I immediately think of the opening to Rocky Horror Picture Show and use all my energy to resist singing “Sweet Transvestite.” The image of Tim Curry in fishnets helps distract me from the fact that I’m currently jammed into a tube, being pressed on all sides, with a large cage on my head holding me in place. I’m the opposite of claustrophobic but this is still a bit much. I’m eager for the music to start and for it to all be over. The tech gives me a small countdown and then I hear some distant mouse clicks followed by the slow build of “Zombie” by the Cranberries.
“In your head, what’s in your head?”
In the mirror, I watch my lips stretch into a wide smile as that familiar, ironic, kismet warmth washes over me. Of course this is the song that’s playing as the MRI starts to whirl and explode around me.
My whole menstrual life, I never understood how my friends knew when their period was going to occur. I always felt like I missed a pivotal day of instruction. Some people said every 28 days, others said every 3.5 weeks exactly. I was never good at math and this was no exception; no formula ever gave me the right answer. I would just wake up and either be bleeding or not. I tracked my cycles with red dots in my planner. I watched as whole months went by with nothing, sometimes two in a row. The following year, I’d skip different months. Sometimes they’d start after three weeks, sometimes five. I couldn’t detect a pattern.
I was reassured that somehow this randomness was “normal” despite everyone else having a set schedule. I sought out a gynecologist in my 20s when I skipped six months in a row. No, I wasn’t pregnant. Yes, I was sure. Did I consider losing some weight? Have I thought about exercising more? Perhaps having sex with a man would help!
I went through a handful of doctors until I found one who seemed the right amount of concerned and also not totally perplexed at how someone could be having sex without contraception and not be at risk for pregnancy. I was prescribed progesterone to jump start my cycle when it didn’t happen on its own. I was again reassured that this was fine and “normal” and just something that can happen.
Doctors told me stress was the main factor. I was a full-time grad student working two jobs and volunteering. Stress was my daily operating system. “Once you graduate, your cycle will come back.” No one ever seemed interested in where it went. Since I still wasn’t trying to conceive, I still wasn’t allowed to see a fertility specialist — an appointment I couldn’t get (or pay for through insurance) without a referral. I had my first unassisted period in years during April of 2017, a month after I turned in my thesis. Maybe they were right. Maybe it was stress. I cried from relief. I called my girlfriend and my mom. But the next month, nothing. Nothing again until that October. As of writing, nothing since.
The MRI will be three sets of images: an overall brain scan, then isolations of the pituitary gland with and without contrast. The tech tells me how many minutes each series will take and checks in to see if I’m okay. Her voice sounds distant and tinny through the wires. The first series is the longest at six minutes. The Cranberries bleed into “What’s Up” by 4 Non Blondes. I press my tongue into the roof of my mouth to avoid both laughing and singing.
I have now accepted that this whole experience is going to be one of those moments where you get to feel like the star in the movie of your life. All I can think about is how I should make a playlist later. I’d never have picked this song but it’s kind of perfect. The loud vocals and repetitive chorus do a great job of pulling my attention from the increasingly terrifying clanks of the machine. They tell you MRIs are loud but that is an understatement. I now know what it feels like to be inside a drum. Without the music, it’d be unbearable. I can feel the sound in my bones and I’m only in the machine from the elbows up. If a noise or shift in movement starts to freak me out, I try to focus on the science of it all. They’re taking a picture of my brain! While it’s still in my head!! While I am alive!!! It’s confusing and scary but also kind of cool.
“…get it all out, what’s in my head
And I, I am feeling a little peculiar.”
Follicle-stimulating Hormone (FSH) and Lutenizing hormone (LH) are secreted by the pituitary gland to control ovulation. At the beginning of a cycle, most adult levels range between 5-20 mlU/ml. Mine tested at 1.4 and 1.2 respectively, levels that are considered “prepubertal.” As someone who went through puberty in all its awkward glory, I resent that term.
I learned about my pre-teen levels after going to a fertility clinic with my girlfriend to do some diagnostic work into having a baby. We want to have a baby. I, on paper at least, am trying to conceive so the keys to the fertility kingdom I had been denied for so long were finally dropped into my lap. It’s both momentous and anticlimactic, which is exactly how the first visit to our first fertility clinic felt. While the LGBTQ supports were in place, the rest of the experience was… not great. No one explained anything in detail, no one gave us any procedural outlines or expectations. I asked if I’d need to give blood on my first visit and was told no over the phone but when I arrived, they took 13 (!) tubes which is standard for a consultation.
Because of my disappearing periods, I’d need a four-part diagnostic treatment: give a lot of blood, give more blood on day one of my next period, get a trans-vaginal ultrasound on day three, and do an HSG test somewhere between days five and seven. I already survived giving blood so my anxiety settled on the transvaginal ultrasound. Doctors attempted to give me one in my teen years but I took one look at the massive device and shut that whole thing down. But this is different. I’m a grown-up now and I’m guessing childbirth will be way worse so I take a breath and began searching for any/all information I could get on what to expect.
It turns out that, for once, my fears were misguided: the ultrasound they attempted before was a 3D ultrasound which has a much larger wand with a significantly more bulbous end. The regular ultrasound lasted maybe three minutes and was completely painless; it felt no different than putting in a tampon, except there were more people involved and I was lying on a table.
Whatever relief I got from the ultrasound, however, was destroyed by the HSG test. The HSG — or hysterosalpingogram — is an x-ray of the uterus. That is all I was told by the fertility clinic beforehand. My ultrasound nurse mentioned that the HSG would be a speculum exam, as well, which took me by surprise. I was thinking it’d be x-ray-like CAT scan or what happens at an annual dentist visit. I was very, very wrong.
An HSG test uses a fluoroscope to take images of the uterus and fallopian tubes by injecting iodine via a catheter through the cervix. Absolutely none of this was ever communicated to me by any clinic staff. I raged around my apartment, phone in hand, shouting each horrible new discovery until my girlfriend banned me from Google for a few days.
“Don’t tell me ‘cause it hurts”
None of the sites I saw spelled it out plainly, so I will: IT HURTS. The speculum is larger than normal and, since the table you’re on is flat, it’s really painful. The catheter insertion felt like a more extreme and longer PAP smear. The speculum does get removed once everything is in place so that offered some relief and having the dye inserted was more awkward than anything (it feels like you’re peeing all over yourself, but colder). The cramps that followed days after were the worst I’ve ever experienced, requiring me to miss a day of work. The doctor who performed my HSG test was very kind and really angry that no one told me what to expect. She walked me through everything and, despite all the pain, I could tell she worked hard to keep my discomfort at a minimum. But it was still horrible. Every time I’ve had cramps since, my breath catches in remembrance.
Why is this level of bodily trauma continually expected from women who seek treatment?
The next song that plays during my MRI was No Doubt’s “Don’t Speak.” Crammed in that machine, I listen to the anguish in Gwen Stefani’s voice and feel gratitude that at least the MRI isn’t so bad. I wonder what else I won’t adequately be informed of until it’s already happening to me.
Seeking fertility help is daunting for everyone, but those issues are compounded for same-sex couples. Reproductive health in the U.S. is already a poorly taught, rarely-discussed subject so when you toss in the safety and comfort concerns of being lesbians, the whole thing feels extremely intimidating. Even though this is happening in 2018, there aren’t many resources discussing the gritty details of lesbian conception. I spent weeks scouring the internet and asking trusted queer spaces about where to go and what to expect.
According to most findings, when a person with a uterus loves another person with a uterus and they decide to have a baby, they just skip down to the fertility center, select some sperm from a catalog, and voilà: nine months later, there is a baby. I knew it wouldn’t be that easy for us but even ignoring the lesbian factor and just looking for information on the assisted conception process yielded little to nothing.
“Ain’t nothin’ but a heartache (tell me why)
Ain’t nothin’ but a mistake (tell me why)
… Yes I know it’s too late, but I want it that way”
There are thousands of Mommy Blogs™ but where are the “I am interested in the idea of being a Mommy but we have to run some tests first” blogs? Even the limited material that is geared toward lesbians (who almost always need some type of medical intervention to procreate) assumes that all parties are perfectly fertile and without issue. What if they’re not? I found pieces relating to the trauma and grief of miscarriage. I read and read about the depression and isolation of infertility in all its shades, but nothing that showed a roadmap on how one got to that diagnosis. Everything seemed to occur either before or after where I was. Why is no one talking about during?
All of this rattles around in my head and I start to get overwhelmed. The tech announces that we’re on the second series and that she’s going to turn the music up for this part. There’s a brief moment of silence followed by a smooth “yeeeaaah” as the Backstreet Boys start to croon in my ears. I’m more of an *NSYNC girl myself but this song feels like a balm to my magnetized brain. I nearly tear up from the comfort. Yes, these issues are momentous and formidable but my frustrations are much easier to swallow when they’re sung in sweet five-part harmony. Bubblegum pop indeed.
We are now living in the future predicted in the ’90s (where you can download a pizza for the most part) but women’s health is still the Wild West. It’s bad for fat women. It’s worse for older women. It’s fatal for black women and trans women. Our symptoms and pain are dismissed by our peers, caretakers, and often ourselves — mostly due to the engrained patriarchal social constructs fed to us from conception. These numbers are even worse when it comes to maternal health where the U.S. ranks 47th in maternal mortality rate globally — the highest percentage of maternal deaths for any developed nation. This is especially stark given that maternal mortality is declining almost everywhere else in the world. So why am I doing this?
The technician announces that my exam is almost over and that she will be introducing the contrast now. A cold sensation will run down my arm like water but that is standard and nothing is leaking. She reminds me not to move. “People tend to freak out at this part. Just remember that you’re fine and this will just be another little weird thing.”
REM’s “Losing My Religion” is playing as I feel the icy gadolinium fingers stretch through my arm and across my body. Lying there, it feels as though I’m hearing this song for the first time. Perhaps it’s because I am choosing my confessions: I am an American woman and a lesbian and I am taking steps to have a baby, despite all the terrifying baggage that comes with it. I hope that in the grand-scheme of my life, this will just be another weird thing that got me from one point to another.
The exam ends and the tech helps me sit up. She explains the follow-up process, reminds me to hydrate, and lets me collect my things. As I’m leaving, she stops and asks me if I have trouble sleeping.
“I let the melody shine, let it cleanse my mind, I feel free now”
“Sometimes, but I think it’s mostly due to the stress and because my apartment is so dry. I didn’t sleep well last night but I assume that’s nerves.” I gesture to the viewing screens: “Can you see that somehow?”
“No, but I did see that you have a deviated septum. Most people mention it and it doesn’t look like your nose has been broken so I just wanted to be sure that you knew.”
We both laugh and lightness washed over me. I can see over her shoulders that the music is still on and the song playing is “Bittersweet Symphony” by the Verve. I smile warmly and thank her again. As I exit the hospital, the sun is shining and the song hums in my mind even though I didn’t actually hear it. Somehow it feels like the perfect ending — not quite the same as Reese Witherspoon driving off in a vintage jaguar in Cruel Intentions but it’s close enough. 🎈
edited by Heather.