Playing the role of a Damsel

First let me explain something. I think I’m not a normal female. I actually like to carry heavy things. In college, I once carried a small refrigerator up a couple flights of stairs by myself. A muscular male student offered to help me and I refused, even though I just about had a heart attack because that thing probably weighed almost as much as I did. I’ve been called petite, but I’m not a weakling. Since we live in New York City and we are proud to not own a car (so green!), I often carry lots of groceries for blocks and I think it’s good for me.

In my 3 prior IVF attempts, I was told not to lift anything over ten pounds after the transfer and to avoid high impact activities. I didn’t think too much about it. I pretty much went on living normally, but just a little more carefully… well, maybe not. I do recall one time when my husband actually carried my purse for me, but I know that most days I probably wasn’t quite as careful as I should have been. This is our fourth IVF. Again I was simply told to avoid lifting anything over ten pounds and to avoid high impact activities. Perhaps I am getting desperate. Perhaps I am getting wiser (I wish!). Perhaps the difference is that I have a very emphatic, persuasive acupuncturist who pleaded with me to "Rest. Rest. Rest. Don’t do any shopping. Anytime you feel tired, lie down. Don’t exercise at all because I have a patient who lost her baby when she exercised." I said I don’t exercise, but I walk and that’s okay. Then she said, "Don’t go anywhere." I know this is extreme advice and almost impossible to follow. However, I deeply respect her for some reason and I actually am trying to listen.

Since the transfer on Friday, my husband has done all the grocery shopping. He opens and closes windows for me. He transferred milk from our big gallon jug into a small, glass pitcher so I don’t have to lift the big jug. He doesn’t seem annoyed. I have a hunch he even likes being the strong one. Well, he’s always been the strong one but now he gets to prove it every day. So we’ve been weighing a few things around the house to find out what is really over ten pounds. The actual weight of some items surprises me.

9.5 inch diameter cast iron skillet: 4.5 pounds
full 2 Liter Brita water pitcher: 5 pounds
full gallon of milk: 8 pounds
stepping stool in kitchen: 13 pounds (whoops! I had been lifting this!)

Of course full laundry bags, chairs, and big fans are out of the question. I think my muscles are going to atrophy. Then I really will be a weakling! I’m starting to get used to this.

Agave nectar and the 2 week wait

Rachael Ray has been talking about agave nectar and how it doesn’t spike blood sugar like other sweeteners. A couple of weeks ago I went to a supermarket that I don’t usually frequent and some agave nectar caught my eye. It was organic, natural… why not try it? I fell in love with the taste! I’ve been using it in my decaf coffee each morning and in my yogurt. (I buy huge tubs of plain yogurt so I can add in whatever I fancy at the moment.)

I’m currently in my two week wait. I had my transfer four days ago. This morning I decided that I really should do a google search to see if agave nectar is safe during pregnancy. Wouldn’t you know…it’s not. IS ANYTHING??? Supposedly, it causes uterine contractions, brings on menstruation, weakens the uterine lining and causes miscarriage! HOW CAN THEY NOT PUT A WARNING ON THE BOTTLE? I once read that herbal supplements are like the wild west- there’s not enough regulation… but this is a FOOD product sold in supermarkets!

Am I going all neurotic because of where I am in my cycle? I have been having some serious cramping. Sunday night the cramping was super strong (woke me up out of a sound sleep) and that was after I had the most agave nectar- like two and a half big spoonfuls in a giant bowl of yogurt. Prior to googling about this sweetener, I had convinced myself that I was experiencing implantation cramping. Now I’m worried that after spending thousands of dollars on this cycle and jeopardizing my future health with all the drugs I’m putting in my system, I may have erased all chances with something small that costs less than four dollars. No more agave nectar for me. At least I’m not bleeding yet, but with all the uterine contractions I’ve experienced, it’s hard to imagine that the embryos are nestling in. This time I was determined to do everything right (I’m being very careful about keeping my activity level low). I have already failed.

Many people say that we shouldn’t google during the two week wait. Maybe. But if I didn’t do a search on this, I’d still be ingesting something that could be harmful. Ugh. Can someone please create a special haven for women during the two week wait/1st trimester where everything is controlled down to the ions in the air we breathe? Where someone else is responsible for all the details and for helping us to relax? Please. Then we could at least blame someone else when something goes wrong!

And they found something else…

Turns out being almost bled dry at the lab was good for something. They took about 16 vials of blood about a month ago to check for blood clotting problems. Yesterday I got the results. There were two indications that I "have a tendency to throw clots" my nurse said. Hmmm. So of course I googled everything. Some web sites even suggest people with my condition wear Medical Alert bracelets, because if they need emergency surgery or end up having to lie around in a hospital bed for a while, the doctors need to put them on blood thinners.

A couple of years ago I saw those glamourous compression stockings at our local drug store. They were marked way down. I’m not one to ignore a bargain, so I picked up a pair… thinking they’d be a good idea for long airplane trips. My husband looked at me like I was crazy (which I am, of course). Now it seems the compression stockings were a prudent buy, since I am prone to deep vein thrombosis, especially during air travel. We like to go to far away places… the kind of trips where you are on the plane for more than 20 hours at a time.

So now I have one more daily injection to add to my IVF protocol: lovenox. What a sultry name, except it’s not pronounced the way you would think. I’m thinking LOVE + NOX. Noxious means "harmful to health or physical well-being or morally harmful; corrupting". Sounds like fodder for the lyrics of a country song, but I’m not a fan of country. I’ve read that the lovenox shots tend to cause lots of bruising and they sting. I’ll be doing them out of love… love for my husband and love for my future children (I hope). Anything for a baby…

Yellow Light…Green Light!

Update:

In 2009, we went through four IUI treatments and three IVF treatments. All failed. Since two of the IUI treatment cycles were with injectible medications, I’ve now done five cycles with the shots. It’s definitely taken a toll on my body. I still have ongoing discomfort in my midsection, even though my last cycle was in December.

January 2010 found us switching to a new Reproductive Endocrinologist, doing more blood tests, and a hysteroscopy with an endometrial biopsy. That’s when we got the yellow light. They found abnormal cells in my uterus. My Reproductive Endocrinologist referred me to a Gyn-oncologist. Yesterday I finally saw the oncologist (waiting seems to take forever when you think you might have cancer!). He gave me the green light to continue fertility treatment! He sees nothing to worry about and said the cells they found were NOT precancerous. Whew! We’re hoping to do our fourth IVF treatment in May at SIRM in Manhattan.

Emotionally, I’m feeling resignation. I feel like I’m beginning to accept our childless life. I have moments when I still feel wistful, especially since I find every baby and every toddler that I see downright adorable. My motherly instincts are still there. When I hear a baby crying nearby, I long to take it in my arms and comfort it, rocking it gently. However, after going through so many failed treatments and learning about multiple causes for our infertility (we just keep on racking up the possible causes!), I’m no longer planning on being a mother. I’m beginning to look for other sources of fulfillment.

We have the green light from the doctor and we will keep on trying. I’m putting my foot back on the accelerator – Here we go! (Just hope our car isn’t a Toyota with a gas pedal that sticks… we’ll have to hit a red light at some point). I’m not sure exactly what our destination will be (parenthood or child-free living), but we are grateful for the chance to at least try… so grateful that I don’t need a hysterectomy (gasp!) at age 35 and that we have insurance coverage for these treatments when so many do not.

Oh, and in case you can’t tell… my winter blahs are gone! Spring is here tomorrow! I am so ready for Spring!

Have you seen “Next to Normal” on Broadway?

We stood near the box office, waiting, while the rain drenched the sidewalk. A bubbly girl next to us asked, "Have you seen it before? It’s sooooo good! This will be my third time. A friend of mine has seen it seven times! It’ll make you cry. I hope you brought some tissues."

That the musical would be tear-jerker was a surprise to me. I guess I shouldn’t have been surprised. It’s a musical about living with bipolar disorder, after all. It also focuses strongly on grieving a loss, so I suppose it would affect most infertile women deeply. It also made me laugh. The song about pills, pills, pills was hilarious to me. I didn’t hear so many people around me laughing, but maybe they haven’t taken as many pills as I have.

I loved the ending where the daughter decides that a life that is "next to normal" is not so bad. I need to remember that. My verdict: Go see it! And oh…uh…bring your tissues!

Winter Blahs

Lately I’ve been feeling lonely and unmotivated many days. The apartment feels empty, quiet and dark. I’m grappling with the very real possibility that we may never become parents yet I soldier on in another IVF cycle. The shots are no longer a novelty. I wish I could exercise rigorously to shake off this ugly mood, but I’m not supposed to exercise too hard while I do IVF treatments. One bright spot in my day is that my husband walks home from work, and I walk to meet him, so I get about 45 minutes of walking. Does walking produce enough endorphins? I’m sure it’s not as much as I got from aerobics. And now with winter brewing, there isn’t any sunlight to benefit from in the evening. Maybe I need to do two walks a day so that I get the sunlight in the morning and produce a little more of those "feel good" chemicals.

I’ve been delaying getting a job outside the home until after we move on from trying to conceive. I know that if I started a new job, the stress might necessitate an increase in my bipolar medications and I’m really trying to avoid that right now. But I need a reason to get up in the morning and to get out of the house more. On the days that I have to go for morning monitoring at the clinic, I am forced to get up and get out. I probably need to begin using the public library as my "office" again. I did that in the past when I worked on writing projects. It helped me feel more like a productive person.

I guess I’m a real housewife. I’m not at all like the women on the TV shows called "the Real Housewives of _________" (fill in location). I’ve never watched any of those shows, but the glimpses I’ve seen about them tell me they are probably filled with glamour, juicy gossip, and lots of pampering. My real housewife life is often PJs until 3 or 4 pm, unbrushed hair, and too much time being a couch potato.

I’m starting to really get down on myself about not working. Yesterday I saw a young, handicapped man who works in our local Rite Aid leaving the store after work. I knew he was handicapped, but I didn’t know how much effort it takes him to walk. I saw him dragging his lame leg awkwardly with every step. I silently admired him for choosing to go to work everyday, even if it isn’t a job to brag about. Then, inwardly I called myself a lazy bum. I have a different kind of handicap (bipolar disorder), but I still should work. The infertility treatments may make working 9-5 difficult, but there are other possibilities. I think I would definitely feel better about myself if I were earning something, even if it was only one hundred dollars a week. It’s wonderful that my husband is such a great provider. I’m so blessed. But I still need to find a way to feel like I am contributing more- for myself, for society.

My prescription for myself:
two walks a day- brisk enough to produce endorphins
15 minutes of sunlight or more a day
one hour of writing in the public library each weekday
no PJs after 9:30 am
brainstorm about a way to make some money without getting stressed out

Marriage Matters

Today is our 5-year wedding anniversary! Woo hoo! Of course, I never thought we would hit 5 years without having any children. At times, I have gotten so caught up in battling infertility that I have somewhat neglected my hero, my husband. In fact, the last 2 days I was focused on recovering from embryo retrieval, not on planning our anniversary celebration. Though we WILL go out tonight to a fancy restaurant and we’ll try to be romantic, I cannot deny that some of my thoughts might wander to our embryo transfer which will happen, God willing, tomorrow morning.

How can we work on fanning the flame in spite of everything we’re going through? Right now we do 3 simple things to stay affectionate and connected.
1. We go out on a "date" once a week. We try not to argue or discuss stressful things during that time.
2. We hold hands and walk together at every possible opportunity. It has become almost automatic. Somehow it just feels good all
over to be holding my husband’s hand. I think God made a hand to be the perfect shape to grasp another hand.
3. We have 10-20 minutes of pillow talk every night before we sleep. We wind down together.

My mother always said a husband must come before children in our priorities. Daddy always comes first. As a child, I resented it a little (because I thought the whole world should revolve around me me me) but now I see that my mother is blessed with rare wisdom. I didn’t doubt that their marriage was going to make it. Our home was always a place of safety, security, and unconditional love. Although my mother loved my father the most, it was clear that she had plenty to go around for all of us. They are still married after 40 years! Their marriage is an easily accessible example for so many. Like my mother, today I need to choose to put my husband first. When (if) we have kids, it will probably take even more effort to carve out prime time for him. Hubby is first and we’re going to be unabashedly romantic tonight. Take that, infertility!

Preventing Urinary Tract Infections

Okay. So this doesn’t strongly relate to having bipolar disorder, but who needs one more thing to make us tired or irritable? Urinary tract infections (U.T.I.s) make me wiped out and cranky. When the frequency of intercourse is increased (pretty much a given during the trying to conceive period), it’s common to have U.T.I.s.

Since I’ve had lots of these pesky infections, here are my tips on preventing them:
1. Drink 1-2 cups of cranberry juice daily. Try to never miss a day. Drink extra cranberry around the time of ovulation when you’re having the most intercourse. The juice seems to be more effective than the capsules, no matter what the vitamin companies claim.
2. Eat yogurt with active cultures daily. My current favorite is Stonyfield Farms yogurt. The full-fat version is better for fertility in case you haven’t heard that yet (read more info. in the book The Fertility Diet). The probiotics in the yogurt help to prevent infections.
3. Do kegel exercises. (Don’t ask me how this helps, but they say it helps prevent U.T.I. and it can’t hurt anything.)
4. Urinate 15 minutes after sex even around the time of ovulation. The latest info. says lying there longer will not make you pregnant. I know from experience if I lie there 20 minutes or longer, I’ll have a U.T.I.
5. Go when you gotta go. Don’t hold it for 2 hours because you’re busy at work.
6. Drink approximately 8 cups of liquid daily. Sometimes we get so busy we don’t keep ourselves hydrated. It doesn’t have to be water.
7. The pink scum that accumulates on shower curtains can cause U.T.I. and pink eye if it splashes just right. Keep your tub and shower curtain clean.
8. Wear only cotton undies and don’t wear any undies while you sleep.
9. No baths or jacuzzis. (You’re not supposed to during IVF treatment anyway.)
10. Get plenty of Vit. C rich fruit to promote healing. I try to eat one orange a day. The cranberry juice usually also contains Vit. C.
11. Bars of soap can harbor bacteria, too. Use your own soap. Don’t have one bar of soap for the whole family in the shower. You can always share the liquid soap.
12. Avoid excess sugar. (Always a good idea.)

NOTE: Lucky gals like me with a tipped uterus have to be especially careful to urinate after sex and to not withhold urine.

What if you think you already have an infection?
I rely heavily on AZO urine test strips that I buy at the drug store to test my own urine. I drink corn silk tea which helps immensely when the symptoms are very painful. I tell the doctor if there is any chance that I might be pregnant so that I am only prescribed the safer antibiotics. Usually I’m prescribed Macrobid.

Coping with a Big Fat Negative

Here are some possibilities:

EXPRESSING ANGER AND FRUSTRATION

Tear up some paper.

Scream underwater at a pool or scream in your

car with the windows rolled up.

Punch a pillow.

Go to one of those plate smashing places.

Scrub your sinks till they gleam.

Throw a ball against a wall at the park.

Bake some bread (and knead the dough heavily.)

 

FINDING A SOURCE OF PLEASURE

Eat chocolate.

Get a makeover.

Buy a new outfit.

Buy some unusual foods like lychee juice.

Drink a CAFFEINATED beverage.

Eat sushi.

Give yourself a foot massage (or bribe someone

 into doing it.)

Make plans for a WILD, care-free childless life.

Settle down and read a good book all day.

Bake some decadent cookies.

Imagine the smell of dirty diapers and be happy.

Sit out in the sun to boost your mood.

Eat your favorite comfort foods (mine are grilled

 cheese sandwiches and tomato soup.)

 

REFLECTING

Journal.

Take a mental health day and go to a beautiful

 spot in nature or to an art museum.  Even in a

bustling city there are unexpected quiet nooks of

beauty (sometimes near fountains) just waiting to

be discovered.

Tell yourself it’s not your fault and you did your best.

Milk all those emotions… write a poem or a song.

 

ACKNOWLEDGING THE PAIN AND HURT

Ask someone to hold you… just hold you.  Repeat

as often as necessary. 

Realize your feelings may be intense right now- you

can always blame the hormones.

Go out with your “best empathetic listener” buddy

to a coffee shop and talk it out till you have nothing

left.  Take tissues.  (If you cry, let people stare!

As they say- everybody hurts sometime.)

Note:  If you don’t have this kind of friend, you need

one.  Start looking!  I call mine my MELBA (most

empathetic listener buddy always).

Compile a “go to” folder (or create a beautiful box)

of letters, song lyrics, speeches, blurbs that lift

your spirits.

Be kind to yourself- hide some notes and money in

jacket pockets and you’ll be surprised by them one day.

 

CONFRONTING FEAR/ANXIETY/UNCERTAINTY

Write out your fears.  Sometimes it helps me to see

how illogical they are.

Take back your life by writing a nasty letter

starting “Dear Infertility…”

 

BANISHING GUILT AND SHAME

Create some morning affirmations like “My

infertility is not my fault.”  “I didn’t make this

cycle fail.” “I am doing my best.”

I’m still working on ideas for getting rid of

false guilt and shame so let me know what you

think of.

Calming Mantras

Last week was a particularly stressful week. We were in the middle of an in vitro fertilization cycle. Extended family arrived in town and stayed overnight for a few days. They came the day after my very first embryo transfer. In the midst of a heat wave, I was cooking, cleaning, and entertaining. I thought I might have a breakdown, but I got through it by trying to manage my thoughts. I wrote down some calming phrases on an index card and repeated them to myself.

Here are some of the calming mantras I use:

“Messy and cheerful is better than perfect and bitchy.”
“Just do what you can.”
“What will be, will be.”
“I am relaxed.” (and I imagine floating on my back in water) “This is not life or death.”
“There’s plenty of time.”
“This too shall pass.”
“Let go and let God.”
“Oh well, next time I’ll do better.”
“Let it be.”
“Worse things can happen. At least it’s not…”
“In this moment, I am grateful for…”
“Do your best and let God do the rest.”
“Little by little I’ll get things done.”

What mantras calm you? Care to share?