Thursday, February 23, 2012

When enough is enough

I got a very kind comment on one of my older posts from someone who is going through one of several failed IVF/ICSI cycles, and thinking about whether to go on or what to do next.  This is a very difficult scenario, and one that we encounter in life many times:  the question of when to stop, compounded with its sister question of what to do next.

Hmmm...  I know.  Give me a call and for a small fee I will tell you what to do :)

But I don't want to be held responsible for the outcome.

Sorry, I am just trying to make light of a very heavy, very serious topic.  I have a couple of thoughts on this topic and I am just going to type them as they come to mind.  Life seems to come to points in the road where you can swear that you have met a fork:  a place where you must make a decision, to go left or to go right, and once you have made this decision, there is no turning back.  However, I think that when it comes to IVF, this isn't necessarily so.  You might decide to stop now, but unless you continue to decide that same thing every day for the rest of your fertile life (and even later, if you are open to gamete donation/embryo adoption), this stop might just be temporary.  Yes, it would be quite a change of heart, and you will need to talk your partner into it again, but say you have decided to stop, and in a few months you feel that you must give it one more try, or ten more tries, who's to say you can't change your mind?  Be flexible.  It's not now or never.

In the same vein, if you absolutely have no clue what to do and have the luxury of time, do nothing for a few months.  Wait.  When you are burned out by depression and hormonal imbalances and unfairness and financial stress (all of which come with failed IVF's), you might go through a stage when you feel NOTHING.  I did.  I felt nothing, including no idea what I wanted to do next.  I go by feel, so if I feel nothing, I am blind.  If that happens, you have two choices:  one is to wait if you can, and realize that eventually you will get a feeling for what you want to do next.  The second one is to try and remember what your old (now comatose) self would have wanted, and to act accordingly.  Presumably you remember some of your old values, and so you could make a decision for yourself the same way you would for a comatose spouse, according to what he/she would have liked to do.

This might sound strange, but when I did not know what to do because I had no feeling for the future, no feeling for the present, and truth be told I really felt nothing at all, I remembered that I am the kind of person that would go on until I die or there is nothing left to try.  Hence, as long as the clinic would continue to treat me, I would keep on going.  So I would just go on in a state of haze and numbness, until either they told me to stop, or I got pregnant and had a baby, or I got the very sharp realization that I can no longer do IVF/ICSI, and that I want to stop.  I never got that though.  I did go through a comatose 10 IUI's until I decided all of a sudden that I wanted to move on to IVF, and at that point I stopped in the middle of a medicated IUI cycle, just suddenly stopped injecting the medications, and made an appointment with the IVF clinic.  Just like that.  Up until then, I had been deathly afraid of IVF (something about the dildocam with the long needle in the wrong place...).  At that point, it was suddenly IVF or nothing else.  Go figure.

If it is time to stop, you will know it.  There will be a voice (either a real one, like that of several doctors telling you so, or an inside voice of your own) telling you in no uncertain terms that the chances of success are too small to be worth the time, money and emotional investment, or that you would rather move your resources to pursue other avenues.  These other avenues are suddenly going to feel like relief, or maybe they will suddenly start to seem more and more appealing.  I remember thinking of surrogacy with great relief at one point, when I thought my incompetent cervix would make it impossible to carry a pregnancy to term.  Before that point, the though of surrogacy felt like a personal failure and loss.  At that point, suddenly surrogacy seemed almost ... chic, if not the greatest invention on earth.  Listen and watch for this change in nuance, it is your brain sending you clues of what it wants you to do next.

So, to sum it up:
1.  realize it is a difficult situation and allow yourself some time to think
2.  most decisions don't have to be final.
3.  it's ok to change your mind
4.  decide based on what you feel that you want to do
5.  if you don't feel anything, decide based on what you think you would have felt if you could feel something
6.  watch for a sudden change of heart towards an alternative (like embryo adoption, gamete donation, surrogacy, adoption, living child free) that you previously thought unacceptable.
7.  if you still don't know what to do, send me a cheque and I'll tell you :)  But I might have to read your energy field first, and visit with your ancestors.
8.  if you have to chose between doing too much or regretting not doing something, always chose doing too much.  Regret is the shittiest thing to live with.

Wednesday, February 22, 2012

the man's role

Just a brief post about the man's role in infertility/pregnancy loss.  We need our men to do a lot of things:  to be strong for us, to share our grief, to express their grief in a way that we understand, to understand our grief in the way that we express it, to take out the garbage and clean the house when we can't, to give us flowers and a back rub and be our best friend when we hurt, and above all to hang in there.

Except girls, we can't drive them crazy, you know.  To be able to go on and try to conceive again, or try for another pregnancy, or try for adoption, or whatever plan we are hoping for next, we need them to be on board.  If a man is run off his feet with crazy demands, like read my mind, and make me happy, and make this pain go away, he might think twice about going down that road again.  I'm just sayin'.

I realize this post might sound harsh, but please, take care of your wingman.  No nagging.  Don't expect too much either.  He will give you what he can, and no amount of nagging will make him give you more, 'cause if he could, he would have.  If your man loves you, he will give his pinkie finger to see you happy.  Believe me, if he could, he would have, whatever it is that he didn't.  And if he doesn't love you, what are you doing trying to have babies with him anyway?  Get an anonymous donor, much less hassle.

I am writing this post because I remember a time when I wanted my husband to feel my misery and hence I would unconsciously/carelessly try to make him feel it.  Don't.  Let the man be happy if he can be.  Even if you are not.  Let him have his alone time, his time with his buddies, his gym time, whatever, let him be happy without you.  You are the one who will benefit from it.  He will find that living with infertility or recurrent pregnancy loss or whatever is not such a hard life, and it can be done, and he will want to go on.  The last thing you want is for a man who loves you to leave your life because he can't breathe in it.

I am not talking on my soapbox.  OK, maybe I am a little, but I am both on the soapbox and in the audience.  These are things I need to remember often, and apply often, and so far I got good results, so I am sharing.  MrH is wanting to go for another IVF, despite the absence of any urge to procreate on his side, so I must be doing something right.  We all know he is special, but being allowed to live has helped.

acceptance as gradual process

I used to think before I would write.  I used to have time to think.  Now, I barely have time to write.  This is why a lot of my blogging is about mundane things, rather than well thought-out topics.  If I were to wait until I actually had something well articulated and well formulated to write, there would be no blog at this point.  So, instead, I just decide to write, I wait until Emma falls asleep, then sneak out like a bandit with my laptop and just write, whatever, hoping that my brain will stumble upon something wise, but mostly just taking snapshots.  My blogging has become snapshots of my life, whatever goes through my mind at a particular time, with very little synthesis involved, and mostly painting the picture-of-the-moment.  If I am smart at that time, something smart comes out.  If I am my usual sleep deprived and not particularly intelligent self, get the drift.

Today, I was thinking about how acceptance is a state that comes and goes.  I was trying to breastfeed Emma and, like so many times before, I had no milk, or I had too little to interest her.  I got her a bottle of formula, and fed her, as I lay next to her, as my useless breasts kind of sat there, doing nothing.  I felt useless myself.  As much as I have embraced the concept of having semi-barren breasts, I still have moments where I am not accepting the truth about my lack of milk, and try to breastfeed her, sometimes succeeding in pacifying her, but mostly not.  I am thankful about all the formula available to us, and I am impressed and thankful for all the donated breast milk that we have received over the past six months, but I am still in pain about not being able to feed her myself.  Most of the time, I suppress that pain so well, that I forget all about it.  Have I really accepted the situation?  Partially, yes.  But I still have work to do.

I don't know that we ever really accept something.  Particularly something big.  I think that a very primitive part of our brain responds first to things like being infertile, having a baby die, or even small things like having no breast milk.  The acceptance part is the work that we do to quiet or disarm that primitive voice that starts the "why me, I'm no good, I'm damaged, what's wrong with me" chorus.  With time and practice, the wiser self gets faster and better at quieting this voice, to the point at which we don't even have to work at it, it happens almost automatically, and perhaps we are not aware of it.

Acceptance is a process.  It takes work.  Initially, the response time is slower, then we get better and faster at it.  Eventually, it becomes automatic, and we forget that we are doing it, until the day when we are tired or upset and the acceptance part takes more time and effort, or maybe doesn't happen at all.  That is the day when the old chorus starts again, and the useless/damaged/wrong feeling comes back.  A day like today, when I realize that I wish my stupid breasts would do their job.

Saturday, February 18, 2012

I am a bad babyloss mama...or am I

I am a bad babyloss mother.  I admire with all my heart the tenacity with which the other babyloss mothers write on their blog about their lost babies, even after they have had the rainbow baby to distract from the topic and to cut their writing time available into shreds.  I have not written about Adrian in a long time.  On January 2 of this year, I almost forgot that it was his anniversary.  I write this with great shame, and I am afraid of being judged and scolded by the other babyloss mothers, just as I am also afraid of being dismissed as not deserving of being part of the babyloss mama group.  In fact, I have been removed off a couple of other women's blogs because, I guess, I don't really write a lot about my grief, and hey, I honestly don't become aware about my grief all that often.

Except you know what? I carry this grief in my own way.  And my way might involve not bringing the pain to consciousness all that often.  My way might be different.  My baby has died.  I have another one, and that brings me immense joy, and fills up a void that would otherwise suck my life in, and leave me devoid of energy, just like it did for one and a half years.  But my first baby, Adrian, is dead, and his death is there, in my mind, forever.  It comes up at times, often without much pain, but occasionally with heart-stabbing soreness.  I suppress a lot of it, I know that.  I become aware at how much I suppress at times like that.  But maybe that is what I need to do.  There is no telling of what is right and wrong, and I have felt a bit let down by the community when the links to my blog disappeared after I had Emma and stopped blogging so much about the loss of Adrian.  I guess I felt less "accepted".  That is not what matters the most, though.  What matters the most is that I accepted myself less.  As if I must be conforming to a certain pattern of behaviour, of blogging, of feeling, of remembering.

Yo, I do things my own way.  I am saying this for my critical self, the one that chides me for being an inferior babyloss mama.  I love Adrian with all my heart, even if sometimes I forget to dust his urn.  I wish for him to be here just as much as always, even though I am so profoundly happy that Emma is, that I sometimes forget to be sad about the fact that he is not.  And, if on the anniversary of his death I nearly forgot to light a candle and say a prayer, it is because I was to busy being happy and living my life, the way he would have wanted me to, the way I would have wanted him to.  It is a fine balance between living on and remembering, and sometimes we do one better than the other, but nobody (lest of all ourselves) should be critical of how we handle this fine balance.  It changes daily anyway.  There will be days full of living in the present, and days of waddling in the past.  We do the best we can.  And we all deserve love, understanding, and the space to be who we are.

Now if only my critical self would listen and learn...

working mom advice

I would like to write a post full of helpful advice for working moms...but I am not the guru of the topic, and in fact struggle quite often, so I will rather write a post with what I found that works for me.  Pick and choose what might seem helpful.

I went to work when Emma was 5 months old.  I work in the afternoons only, from 1 pm to about 4:30 pm.  Sometimes I run late and stay until 5 pm, and sometimes I get called out during the night, but that is no more than once every 1-2 weeks, for a few hours at a time.

The best thing that I did was to get Emma on a schedule.  We had no schedule before, we would sleep in late, stay up late, and nap together whenever the urge struck us.  Having a regular sleep-wake-nap schedule is extremely important, as it is the backbone of any activity done with a baby.  Everything we do has to fit in between 10:30-1 pm or between 4-6 pm, her awake times.  Evenings are off limits, as she is very cranky and needs to have me give her attention non stop, preferably at home.

The second thing that we needed was to have her take a bottle regularly.  She does take the bottle and the breast with equal ease.  At work she has one full bottle, and some baby mum-mum crackers.  I breastfeed at 11 and then at 5 pm, with a six hour break, and this hasn't affected my production at all.  Probably because she feeds every 2-3 hours all night long at the breast, so I only get one long break from breastfeeding in the span of 24 hours.

The third thing was to decide what to do about diapering.  We use cloth diapers at home, but to carry the cloth diapers to work is sometimes difficult.  So far, we had a couple of the hybrid G diapers inserts, which are disposable biodegradable flushable inserts that go in the G pants (the G pants are basically a cover and a waterproof layer, forming the outside shell of the diaper.  The inserts go inside, and for G diapers the inserts can be cloth, which is what we have used so far, or this biodegradable flushable gel-filled inserts).  I don't know if I should continue with that, or try to convince the nanny that carrying stinky poo-stained cloth diapers in the diaper bag is chic after all.

The fourth thing:  get the baby used to the nanny.  I was lucky to have my mom help so far, as Emma loves my mom.  In fact, there are many days when I doubt she is clear on the fact that I am her mother, not her.  Luckily, I have the boobs, so I still present some interest to the little lady, otherwise she would ditch me for my mother :)  In two weeks, however, my mom has to go home and I need to introduce Emma to the new nanny.  She cried the first time she saw her, and could only be in her arms for a second.  I have a lot of work to do I'm afraid.

Fifth (in no particular order):  decide on about four dishes that are easy to cook and keep in the fridge for up to four days (if they don't then get another fridge, most food should keep that long in a well functioning fridge).  For us, they are:  moroccan chickpeas (with coconut milk, yum!), salmon (steamed, a portion every day), beans with vegetables, and lamb or bison curry.   I rotate through these every few days, having two at a time in the fridge, and eating one every second day (like this:  cook chickpeas on Sunday, eat them, cook fish on Monday, eat it, cook fish again on Tuesday, as I like the fish fairly fresh, eat it, eat chickpeas again on Wednesday, then cook beans on Thursday but eat any leftovers from either fish or chickpeas, and eat the beans on Friday, cook the lamb on Saturday and eat it, beans on Sunday, lamb on Monday, cook something else on Tuesday but eat leftovers.

I guess what I am trying to say about the food is:  eat leftovers.   You can make a quick salad to go with it.  Even if you cook a dish one night, cook it after your child is in bed and eat it tomorrow.  Do not expect to come home from work and cook dinner and then eat it.  It is too much for the child.  He or she wants you to give him/her attention after you come home, not to cook dinner.  That is just my experience.  Do the cooking while child is in bed for the night, i.e. after 8 pm.  My leftovers are just as good or better the next day.  The only exception is the fish, which I just plonk in the steamer and eat freshly cooked, as I am not a big fan of leftover steamed salmon.  The second exception is the weekend, when I have time to cook during the day and we can eat right away.

Other miscellaneous advice involves:  get someone to help clean the house.  This is precious time you have to spend with your child, and it is worth paying for.  I am going to add to my usual 3 hours of housekeeping a week a further 1-2 hours on the weekend.  I used to think it is an indulgence, but I think it is worth the sacrifice.  I just don't have time to clean, my life is really regimented and Emma hates it if I do anything that doesn't involve her.  I barely have time to water the plants and change the pets' water.  With all this housekeeping, you'd think you could eat off my floors, but actually there is still cat hair on the couch, dust on the carpets, and crumbles on the linoleum on a regular basis.  (Part of the problem is that my housekeeper is old and really slow, hopefully she never reads this blog...).

Also on the miscellaneous list:  get some kitchen gadget like the Thermomix that cooks for you so you don't have to sit there and stir the food.  I just throw all the ingredients in and set the timer, after which it is all done.  A crock pot might do the trick, I just don't use it so I can't give advice as to what to do with it.

I hope I haven't left out anything important, but if I did I am sure somebody can point it out in the comments section :)

Thursday, February 16, 2012

on sleep, and hope, and fear

I am practicing a form of attachment parenting I guess, not because I care to follow rules to parent by, but because I have recently discovered a book that described attachment parenting and became aware that, hey, that's what I am doing.  It just came naturally.  When you have a child that you have struggled for years and years to have, you naturally don't want to separate from him/her, so you carry the child everywhere, preferably on your body, and sleep with him or her, and breathe with that child, and do everything you can short of seeing clients at work with Emma in the baby Bjorn.

And I am enjoying it immensely.  She is such a sweet, good natured child, talkative and full of life, with inquisitive dark eyes that seem so soft and velvety at the same time.  I love her with all I have.  And I adore sleeping with her at night, in our family bed.  The only issue I have is that I would like her to start learning to fall asleep by herself.  It is an important life skill, the ability to be quiet and put oneself to sleep.  It also gives me a bit of a break to do my nails, and that is important ;)

I just have to decide how to do it.  Should I let her cry?  I put her in bed, and give her some boob, then she gets drowsy and often falls half asleep, after which I usually leave her in the room and go in the living room space just outside the door.  If she wakes up, I don't go back in there unless she cries heart-fully, if she just whimpers then I leave her.   She usually talks to herself, and plays with the pillows and bedspreads, until she falls asleep, when I go in and cover her up.  She has fallen asleep quite a few times like this, and I know she doesn't like it, but she doesn't dislike it terribly either.  She would rather just have me there, with the boob in her mouth, preferably the entire night.  If I do go in and stay, then she plays with me and doesn't sleep, so I leave after five minutes of soothing, and try again.

This usually happens around 8 pm, and the whole process of her falling asleep takes about half an hour.  Sometimes more, sometimes less.  I go to bed at ten, so I have about one hour to myself, if I am lucky.  I often fall asleep earlier than my usual bedtime though, because I am still quite tired, with the 7 am wake up call that Emma gives me.  I am not a lark, by any means.  I wish the world would stay in bed until eight, which is, as far as I am concerned, the only civilized wake up time there is.  (If you guys have to get up at five or six to go to work, you have my heartfelt sympathy.  I had to do it for one month when I was working on a surgical ward, and I gained 7 lb because of constant eating in order to stay awake).  But I digress.  There is lots written on sleep, both for infants and adults, and I am fascinated by all the reading material, however I still don't know if letting her cry is helpful, and to what extent.  So far, I guess I am doing a graduated extinction method, but if anyone out there has tried something different and it worked, let me know.

I have recently seen a few clients at work with infertility issues, and it makes me review my feelings about the topic, now that I have a child that is, thank God, alive and well.  As time went on, I started to believe more and more that Emma is here to stay, and the fear of SIDS and other dangers has passed almost entirely.  With that, I also have a deep contentment, that of having a child.  She seems pretty solidly lodged in my life at the moment, and I have high hopes of having that oh-I-want-so-much ending of dying before she does.  You know, that ending that we all deserve, of being outlived by our children.

My feelings about infertility right now are indeed still the same that I had before, namely isolation, inferiority, defectiveness, anger, unfairness, struggle, and also reverence, and awe, lots of awe, at how much is possible nowadays compared to 100 years ago for women like me.   And gratitude for these possibilities that give us hope.  I think that is the big difference, I focus on the hope instead of on the fear that "it won't work".  Sure, it's easy for me to do that now, compared to before I had tried my first IVF, or before I had my term pregnancy.  It's infinitely easier to hope now that I will be able to do it again, then it was back in time, four years ago, when I was getting negative after negative pregnancy test.  If I could go back in time and talk to the me that was peeing on yet another stick with a single red line on it, I would tell myself to rather focus on the hope than on the hopelessness.  I felt hopeless and that made me lose enjoyment in life, for months and years.  Why?  What for?  Sure, I might have not succeeded.  But then I would have had to deal with that reality at the end of a few hope-filled years, and yes, it would have been final and hard and sad for a long time, but being so scared for so long led to difficult times.

On the other hand, I was not completely hopeless, since I persisted with the treatments despite so many obstacles.  I must have had somewhere in my mind the possibility that it would work.  However, I can honestly say that I was on very familiar terms with future-childless-MrsH, while this mommy-MrsH is a foreign lady.  She suits me just fine all the same though :)

I guess what I mean to say is that I have not forgotten the issue.  I have graduated from the school of hard knock-ups, and learned too much to ignore.  But other than the advice of clinging on to hope, I have nothing else to give to people.  Cling on to hope.  In the absence of guarantees, it's all there is.  It is a gift you can give to yourself (and only you can choose to accept it).  Accept it.  It will make months and years of your life easier.  In the end, you will be able to deal with the final outcome just as well regardless of whether you have hoped or feared.  Fear does not help fill the emptiness that childlessness brings.  Fear does nothing necessary, I am afraid (pun intended).  It is safe to let go of it as often as you can, allowing for as much hope as you can muster.

I am sorry about rambling, I am aware that I don't make much sense when I am tired, but I am writing this anyway because I will be able to make sense of it when I need to re-read it.  Which is going to be sometime soon in the future, when I am going back for more.

Friday, February 3, 2012

obsessed with sleep

I have become very interested in sleep over the past two weeks.  My own sleep deprivation might be an incentive to think about this captivating subject, but I think the main appeal for me to read extensively about sleep issues is Emma's previous problem: the frequent, frequent awakenings that were so uncharacteristic for her.

Well, I am happy to report that life is a lot better over the past few days.  I started reading a book (GASP! I read a book) on child sleep issues (double gasp!! I read a book about baby stuff...I thought I could make it through parenting without ever reading a book on parenting/child rearing advice, but hey, I succumbed to the movement).  Anyway, the book finally shed some light into how long babies should sleep for, and at Emma's age it seems that around 15 hours is the appropriate answer.  The other thing I learned is that her sleep should be divided as follows: morning nap, afternoon nap, and a third brief nap before final bedtime that should be at seven pm.  This gave me some structure on how to divide the day.

The problem was that I have to be at the office at 1 pm.  She would sometimes want to sleep around 12:30, which would be a problem, since she comes to the office with me and my mom looks after her there.  This was a big deal.  Before, we had no schedule, and we would just sleep whenever the fancy struck us, but with the start of work, I began to make her nap at regular hours, and this has helped so much, I cannot recommend it enough.  She is a much better sleeper now, not overtired, and she is so happy and smiley when awake.  I can tell immediately that she is tired when she starts to fuss.

So, we wake up at 8:30 am or so, and she is fairly reliable in waking me up so I don't even have to set an alarm clock.  We then stay awake for about an hour, me having coffee, her having some apple juice, and playing on the kitchen floor with books, blocks, and spoons.  At about 9:30 I start to get her ready for the morning nap, and by 10 am she is asleep again, for one hour.  This is the time when I can do my makeup, shower, empty the dishwasher, make phone calls, do my hair and get dressed for work.  At around 11:15 am she wakes up, and we go for a half-hour walk outside in the sun.  Even when it is cold and windy!  she hates the wind, but I find that without some exposure to the elements, it is hard to get her to nap again in the early afternoon, and that makes it hard for her to be sociable when we get home from work, which is our best family time.  Anyway, after the walk, we go to work, and at work my mom makes her sleep for two hours, usually 2-4 pm.  At 4:30 I am done, and we go home, sometimes stopping to get groceries on the way, but usually not because I am in a hurry to get her latched to my bursting boobs.  I still don't have much milk, but man, if I don't get that little bit drained, it hurts!  So we go home, and spend 5:5:45 pm in bed, sucking on the boob, and then either having a brief nap or a cuddle.  At 6 pm daddy comes home and we have dinner at 6:30, after which we play with her.  At 7:45 pm we have a bath in the big tub (I find that bathing with her is so much fun, and it helps the eczema on her cheeks improve), and then we go to sleep at 8 pm.  At exactly 8:45 pm she wakes up again, and takes another 15-30 minutes to fall asleep.  This is the bizarre waking moment, but it makes sense being after one sleep cycle, and then she goes to sleep for the night.

Overall, I spend about two hours of my time during the day with the boob in her mouth putting her to sleep.  But it is worth it.  I have complete peace of mind knowing that she is at least very well rested, that  I know when fairly well whether she is tired or not, and also knowing that I can leave the house at specific hours and she will take it well.

I used to think that schedules are restricting, but in this case my devoted observance of this schedule is what lets me do all the mothering tasks (feeding, changing, washing), all the household chores, and work at the same time.  I feel pretty confident at this point in how I have things going.  The only thing that I wish for is that she stay asleep when she goes down for the night, but that will probably come in time.  She has achieved so much in just two weeks that I am shocked at how regular and trainable her brain is.

Please make suggestions for games to play with her.  She will be six months old in about one week.

PS.  We even went out to Boston Pizza tonight, and she had half a slice!  she smells like cheese and tomato sauce, that is so cute.  It was not my idea to feed her pizza, MrH did it, but I don't think he had a choice, given that she grabbed his hand with great urgency and started smacking her lips and salivating while looking at it.  The healthy avocado/egg yolk/cottage cheese puree sat there, untouched, while my child ate pizza.  I think my next reading will be on child nutrition.

If one can also tell me of good child-rearing books, I am in.  I am sold.  The wheel has already been invented, might as well use it.