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The Burning Pain of Infertility

April 1, 2013 | By:

Infertility brings with it many kinds of pain.  The pain of an empty uterus could be used as the catch-all category for the pain we infertile folk feel, but really it can and should be broken down into more palatable and discussable categories. I don’t know about you, but I find that whole empty uterus thing to be a bit patronizing (although true).  So let’s explore the burning pains of infertility, those that are momentary and those that haunt us sometimes years after we ended treatment, those that come and go along with our menstrual cycle, and those that blindside us when we have failed to read The Infertility Survival Handbook and obtain a first hand account of whatever procedure you are undergoing.  I mean let’s face, I have been THERE, and I have done THAT.  All of THAT.  And I get the pain.  Even now.

There is the pain of daily injections (momentary) and from transvaginal ultrasound wands (slightly longer than momentary but nonetheless uncomfortable when one’s ovaries are the size of large oranges and someone is poking at them). There is the unbearable pain of a hysterosalpinogram when you have blocked fallopian tubes (or a sadistic doctor who tries to open your fallopian tubes without advance warning — and for what it’s worth the advance warning just would have made it worse).  And the devastating pain which follows a miscarriage.

There is pain, before, during and after fertility treatment and there is no getting around it.  There is no getting around the pain of a miscarriage, but the lessons we learn from it can make the pain more bearable.  (And for what its worth I think “the lessons we learn from it” also is a bit patronizing.  My apologies but I couldn’t find another way of describing what I want to talk about).

Even in the early days of trying to conceive — the pre-IVF days — there is pain.  The pain in the arse of taking your temperature every dang morning (thankfully the pain isn’t actually in your arse now that they have these wonderful digital thermometers which can help chart your basal body temperature).  And of course there is the pain of toilet paper.

What say you?  The pain of toilet paper?  Indeed my friend.  The pain from toilet paper burn, or TPB for short.  TPB is brought on by the obsessive compulsive mentality that we sometimes wander into when our period is due and we are trying to make a baby.  Any color on that toilet paper might be a telltale sign of our impending motherhood so you don’t want to miss it.  There might even be diagnostic value to the color which would help your doctor determine if there is something going on, or going wrong with your menstrual cycle.  So, for those of us who tend to wander into OCD territory (who me??), TPB can become a real hazard.  And as I recently discovered, it can become a hazard even when you aren’t trying to make a baby.

Now, the average woman going to the bathroom does not wipe obsessively, nor does she pay much attention to the process, technique or results involved in use of TP.  Such is not the case for a woman going through infertility treatment.  There is a significant amount of attention paid to the process, there are several different techniques for wiping (all of which are designed to reassure the crazed woman in the loo that she is not getting her period), and the results are quite obviously, critical.  Many a woman has called a friend or perhaps even a nurse to discuss the details of a particular swipe of TP and the medical analysis or conclusion that should be drawn therefrom.  Stop laughing or rolling your eyes.  This is serious.  When you have lost all control over your reproductive capabilities and you are going through emotionally and physically challenging medical procedures, the littlest sign that something has gone wrong (or perhaps gone right if it’s implantation spotting) has tremendous potential impact on your life.  In the absence of HPT’s, TP becomes a valid and useful substitute for self-monitoring during the post ovulatory or post embryo transfer phase of a cycle.

Why are we discussing TPB as one of the many representations of the pain of infertility? Well recently I had the displeasure of being reminded about it, but not under the circumstances you might think.  Rather, I experienced TPB out of fear that I was going into menopause.  Now let’s be clear.  I am not in menopause, nor am I perimenopausal (well I suppose Dr. C might argue otherwise simply by virtue of my advanced maternal age).  But as the window begins to close on my access to fertility treatments, and as I continue to wrestle with thoughts of going back for one last try, the thought of menopause is, well, frightening.  It’s one thing to have lost the ability to independently reproduce and/or carry to term due to infertility (i.e. without Dr. C).  It’s another thing to have my entire reproductive system close up shop and move to Miami.

Now the rational part of my brain understands that the last several months of my personal life have been subject to profound and extreme stress.  I have always prided myself on the fact that my menstrual cycle is regular to a fault.  The only time I have ever been late, I was pregnant.   But there is always a first time for everything, and so a couple of months ago I missed a month.  Then another month.  I didn’t need to take an HPT because I knew I hadn’t ovulated (let’s just say that after TTC for 7 years some habits die hard, especially if you are a fan of Toni Weschler).  My sane brain was telling me that the reason I hadn’t ovulated was from stress.  My OCD, however, kicked-in into high gear and I was rapidly becoming obsessed by the fear that my days being of “reproductive age” were dwindling. And the longer I went without a visit from Aunt Flow, the more the OCD took over.  How ironic. TPB brought on not by the fear that I wasn’t pregnant (and the hope that I was) but rather that I was in menopause.  Despite repeated attempts at convincing myself I was overreacting, I kept making trips to the loo and quite quickly (haven forgotten good TP technique) I had a significant case of TPB.

I finally decided I needed to decompress and meditate.  So I did. I meditated, I did yoga, I slept, and I paid more attention to eating things other than Snicker’s bars.  And I ovulated.  Or so I thought.  Going by the fertility bible written by Toni Weschler the signs were clear.  But I wasn’t 100% sure.  And so, 11 days after my suspected ovulation I was back rolling through TP, making extra trips to CVS to buy an emergency six pack of TP, and this time relearning my TP technique.  And yet I still felt the burn.  And finally, when I could stand the TPB no more, she arrived.  Precisely 14 days after the day that I thought I had ovulated (and let me extend my never ending thanks to Toni Weschler for teaching me so much about my ovulatory cycle).

I write this neither because this experience with TPB has led me to once again revisit the status of my own family building and a continued longing for another child, nor because I am working through my fears of the inevitability of menopause and that one day my reproductive years will come to a close (although technically the fact that the NOvary has put a “closed-gone fishin’ sign” on the front door does not mean I wouldn’t be able to get pregnant with some medical assistance), but because I was so struck by the way infertility and the quirky little habits and tricks we use to cope with it — TPB — endure.  TPB also is symbolic of the loss of control and fear that we live with when we are infertile.

In the end, I am grateful for that recent opportunity to experience TPB.  It is helping me work through those last remaining “what-if” thoughts which linger after you move on, after you stop treatment without a baby in your belly.  But it also reminded me of how many women are out there running the race to the loo and counting the days until they can take an HPT or get their blood drawn for their beta.  I am glad I had my little TPB encounter because it has once again helped me connect with my clients and understand what they are going through.

For everything unwanted (a negative pregnancy test), there is something wanted (a positive pregnancy test).  For every swipe of TP that remains spotless we need to remember to focus on the spotlessness in front of us and even glory in it, be excited by it, by the expectation of it; and not give in to the fear of the appearance of a spot on another swipe of TP and/or the end of a dream whether for that month or longer.  In the face of a spotted or soaked piece of TP we need to try and remind ourselves to stay focused on the day when we find out we will go months without worrying about TPB or better yet, no longer care.  My somewhat random fear of menopause has served to remind me that all of this, including menopause, is meaningless. Instead of looking at the burning pains of infertility as a negative, at TPB as a negative, I am instead looking for all the positives they reveal.  Without all those trips to the loo, I wouldn’t be here today, with the career I have, the family I have, and without the intense sense of inner peace that my recent bought of TPB has brought to my my life.  Yes the pain of infertility burns.  But through the ashes left behind after the burning subsides, there is birth, or in my case, a rebirth.

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How art imitates and informs our life as prospective parents.

May 26, 2011 | By:

I have periodically blogged about how Hollywood portrays infertility, but I have never really focused on how Hollywood or television portrays parenthood.  There are tons of great movies and t.v. shows about parenting, but there isn’t a ton that really addresses the transition people go through when they become parents: The Leap from Infertility to Parenthood.  Granted there are fantastic movies like Juno that really capture aspects of adoption, but until now I haven’t really seen a movie or t.v. show that helped me understand (even as Monday Morning QB) what the transition — the Leap — is like.  I  am always “warning” my clients to be prepared for life with baby, but I previously have not had anything I could tell them to watch which accurately represented or characterized the Leap.

Well that has all changed.  Last weekend I was watching a movie with my DH (Dear Husband).  He had rented the film and I had agreed to watch it (despite an initial lack of interest) because the main character was played by Katherine Heigl, who is as we know, an adoptive mom.  Not only do I love her films in general but I always am willing to watch a movie where the actor is in real life a parent through ART (assisted reproductive technologies) or adoption.  And I am especially interested if the film involves parenting or the formation of a family.  Putting aside a desire to escape my life and enjoy the movie, I always wonder whether the actor’s personal experiences with infertility, ART or adoption will influence his or her choices as an actor.

To be honest, when DH proposed watching this film I had no idea what it was about.  I was inclined to pass as I had a vague recollection that the film had not been a tremendous success at the box office.  But when I heard that Katherine Heigl (who ranks #2 behind J.A. as one of my favorite female actresses) was one of the lead actors, I caved.  And what a good decision that turned out to be!

The movie in question is “Life as We Know It” starring KH and Josh Duhamel (JD).  You can check out a trailer at http://lifeasweknowitmovie.warnerbros.com/dvd/

In this movie KH and JD play the close friends of a couple who pass away, and who name KH/JD as their baby’s legal guardians.  Romantic comedy aside, the movie is a fantastic and very realistic portrayal of the Leap, and how the relationship between the parents can change.  As I was watching this movie, both my DH and I were struck by how much the movie reminded us of what it was like to suddenly go from being wanna-be parents to BOOM being parents.

I think the movie really resonated for me because I am an adoptive parent who had very little notice of our pending adoption and I had never really focused on what it would be like to be a parent (let’s face it I spent the entire time wanting a baby and never realistically envisioned what it would be like to have the baby and be a mom).  Once the movie really gets past the characters’ acceptance that they are now parents, there are some very insightful moments about the reality of being a parent and how different that reality is from your expectations.  Whether or not you take a baby care class as part of your adoption plan, I highly recommend this film because I think that it really shows you — and in a humorous, light-hearted manner — what you are in for when someone hands you that baby!  From changing that first poopy diaper, to installing baby gates and midnight runs to the pediatrician, I think that Life as We Know It is a great primer for prospective parents through adoption or assisted reproductive technologies like gestational surrogacy.

Most people who have gone through infertility tend to have blinders on about the reality of parenting.  Whether you only have 24 hours notice or ten months to prepare for your baby’s arrival, this film has some very poignant moments about what the transition feels like and what surprising issues parenting can present us with.  Best of all it’s fun to watch.  It is a surprisingly good romantic comedy, Josh Duhamel is total eye candy (and I won’t hold it against my DH that he thinks Katherine is eye candy too), and it’s sweet, has a happy ending and all that stuff.  So if you are on your way to parenthood after experiencing medical or social infertility, I think this movie is a Must See.

And not to totally discredit my intelligence, my DS (Dear Son) has turned me on to SpongeBob SqaurePants.  I had the unexpected pleasure this week (while cleaning up a child’s puke) of watching an episode of SpongeBob involving a baby scallop and SpongeBob’s experiences as a new parent.  This episode of SpongeBob presents a similarly hysterical and informative perspective of what the Leap is like to being a full time SAHM.  I can’t remember the title of the episode off the top of my head (I will check the DVR and post the name of the episode if I can find it), but suffice it to say that I could relate to SpongeBob’s adjustment to caring for a baby all day and all night while Patrick (his best friend) goes off to work every day as they simulate and satirize what its like to be new parents.

I totally and completely remember that in the beginning of my “maternity leave” I had a rough time.  By Wednesday night when DH walked through the door, I was an exhausted mess.  Thursday night, when DH returned from work and walked-in the door, I handed over DS and went upstairs to have a good exhausted-woman-cry-in-the-shower.  By Friday night, I was prepared for the hand-off at the door, and upon hand-off I bolted out of the house to have coffee at Starbucks (decaf of course b/c I was breastfeeding).

So what am I getting at?  “Life as we know it” as parents is very different from life as we know it while waiting for the Stork.  I don’t really care whether or not you are taking baby care classes or infant CPR (although I think both are excellent ideas) because the reality of life as a new parent is vastly different than anything we can ever learn in school.  As infertile prospective parents we tend to be so focused on our goal of becoming parents that we lose sight of what we are in for when we are parents.  It is a transition the likes of which you just can’t understand until you are living it and why I call it the Leap.  Life As we Know It and even (surprisingly) Master SpongeBob, have nailed it on the head and I highly recommend watching them (when I find out the title of that SpongeBob episode, I will post it and maybe you can find it somewhere and watch it).  Both are totally and completely worth watching.

p.s. please note that I am not complaining about being a parent.  I love every minute of this crazy, full-catastrophe life I am living! I want more kids and my attitude now is much more about enjoying and being mindful of the joy in this experience.  I am just saying that these movies can help prepare you for the full-catastrophe aspect of parenting.

p.p.s.  If you have any other movies that you think are good to watch as prospective parents, post them here.  Maybe we can start a list of “Movies to Watch During the Wait”!!

 

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Why does Jennifer Aniston’s quest to be a mother inspire me so?

August 19, 2010 | By:

Everyone knows that I am fan of Jennifer’s.  I actually probably wouldn’t be married to my DH if it wasn’t for some advice her mom gave me a long time ago.  But seriously, Jennifer is an extraordinary woman in all respects, and from my perspective even more so for the way she is approaching her quest to be a mom.

At 41, most of know that Jennifer is likely to be facing some fertility issues (although with her health conscious lifestyle and yoga-bod maybe she’s found the way to turn back time, she sure looks it anyway!).  While most of us would be doing a little freak-out dance now, and panicking about the ticking time bomb that are our ovaries, Ms. Aniston seems anything but panicked.  In fact, she seems rather Zen about it all.  And that is exactly my point and what inspires me.

First, the woman KNOWS she is going to be a mom.  One way or another the woman has total and complete faith that she will become a mom.  Rather than spiraling into depression (as I did and many of us do), Jennifer has seemed to have found a way to let go and TRUST.  This is, I think, the gateway to success.

I really truly believe that it is when you completely accept and embrace the concept that you will be a mother, no matter what and no matter how (IUI, IVF, IVF donor egg, gestational surrogacy, adoption, whatever is your path), that fertility treatments have the highest success rates.  Study after study shows that the mind-body connection cannot and should not be ignored.  Women who are able to be in the place that Jennifer Aniston seems to be in, are the women who are more likely to succeed with fertility treatments.  It’s fact not fiction.  I know — as does JA — that she’s got an edge on success that I wish more of my friends and clients had: The inner-knowingness of the inevitability of their impending state of motherhood.

Another thing that I think sets her apart from many of us (and I include myself in this group when I was in the first 4 or 5 years of treatment), is that by all media accounts, she seems fairly open to many different paths to parenthood.  I am not privy to her conversations with her BFF’s but I am guessing that there isn’t much she isn’t considering about how she’s going to become a mom.  That too puts her on the fast track to “mommydom”.  Not all of us can be as enlightened and confident as she is, and I am not saying that she doesn’t have her moments of . . . doubt  . . . but I really think that the confidence and openness that Jennifer Aniston is talking about whenever she is interviewed about becoming a mom is something that tells me it ain’t gonna be long before she’s announcing the arrival or the impending arrival of a little baby Aniston.

And for what its worth, I think she’s a fantastic role model for every woman, single or married, over the age of 35 who’s trying to become a mom.

ASSUME IT IS GOING TO HAPPEN, AND IT WILL.

p.s. and when you can’t totally assume it will happen, fake it, fake it until you make-it  . . . because that’s another sure fire way to get your mommy-Zen fire burning.

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