Friday, December 31, 2010

Infertile and ringing in the new year: anxious or hopeful?

If you have been grappling with infertility in 2010, and perhaps for months or years before that, ringing in the new year is a time that is symbolically and practically filled with both hope and anxiety. Symbolically you are facing the new year without a baby in your arms, without a healthy pregnancy, and perhaps without much conviction that medical intervention is going to lead to parenthood. On the flip side of this coin, you also may have learned some lessons from your infertility experience and decided in the new year to try some new strategies. This leads to the practical dimensions of how 2011 can be different: can you and your doctor get clearer about medical expectations? Can you find ways to nurture yourself better through the inevitable anxiety of infertility? Can you and your partner discuss timeframes and begin to explore options in case a healthy pregnancy is not in your future?

There's no question that months of medical interventions can take a serious toll on your hopefulness. All too often doctors will continue with the "same old, same old" without re-engaging you in a discussion of possible future steps to consider. So for the new year, why not make an appointment with your physician to discuss a treatment time frame for 2011. This would include future treatment options, for how long to continue them, costs involved and statistics on healthy pregnancies for women of your age and with similar health conditions. Having this conversation will alert your physician to your expectation that you expect ongoing assessments of what treatment options are open after a reasonable time period of trying standard medical interventions. If you are currently being treated by your local ob-gyn, this might be the best time to discuss whether an infertility clinic could offer more comprehensive medical services (and more flexible days of the week for medical procedures and lab tests).

And while you're thinking about timely medical interventions, the new year also is a time to think about whether you are getting enough emotional support, as the months or years of infertility take their inevitable toll. In my just-published book When You're Not Expecting: An Infertility Survival Guide, I offer a number of suggestions for how to access emotional support, ranging from how to communicate differently with your partner to ways of identifying a therapist or a support group. Even if you are not feeling a compelling need for an extra shoulder to lean on, now might be a good time to check out potential resources in your community, since it is best to have this information in advance of being assailed with feelings of desperation. Prevention is what you'll want to aim for in terms of your emotional health, since you will always cope better with your infertility journey if you have the capacity to absorb ongoing news with a resilient emotional perspective.

So what if 2011, like 2010, progresses with no signs of a healthy pregnancy? Here, again from the perspective of your trying to exert some control, is the opportunity to discuss the "what ifs?' with your partner. Would you be open to adoption? Working with a surrogate? Learning about donated eggs, sperm, or embryos (please see my earlier blogs for information on these options). Whereas you might be saying "yes, maybe" now, some more research on your part will let you know how viable these options are. For example, some countries only accept applications from prospective adoptive parents in good health, of certain ages, in first marriages, etc. Some sources of donated eggs/sperm/embryos are highly questionable or ethically inadvisable. Some attorneys specializing in services for infertile individuals and couples have strong professional reputations, where others do not. Rather than wait until you are ready to take the next step towards parenthood, 2011 might be the year to investigate costs, restrictions and waiting lists. You may not be ready immediately to pursue these options, but you'll feel more in control if you begin your initial investigations (both emotioal and practical), so you can be aware of how much time and money you want to invest in current medical procedures.

So, as you ring in the new year, admittedly with both hope and anxiety, perhaps you can take comfort in knowing there are some proactive ways that you can move into 2011 with new and informative resources. The key word for this new year is "resilience," as you strive for the best outcome possible in your quest for parenthood!

Wednesday, December 15, 2010

Infertility and the Holidays: A "Double Dose of Hectic"

December holidays are busy for almost everyone, and those of us who grapple with infertility feel especially challenged at this time of the year. Those challenges are both practical and psychological. So let's see what we can do so as not to become overwhelmed by the "double dose of hectic."

In terms of practical challenges, not only do we face the expectable tightness of our schedules as we shop for presents, wrap gifts, send out cards and holiday letters, attend (or host) various parties and events, bake special goodies and decorate our home for the holidays. In addition to the usual holiday tasks, our infertility may place unique pressures on us at this time of the year. Is our doctor's office going to be open around the clock during the holidays? If not, does that mean missing treatments, being delayed in hearing lab results, or needing to be seen by unfamiliar medical personnel as the clinic copes with absences of key staff during the holidays? If your physician also sees women without infertility concerns, does this mean infants, children and pregnant women in the waiting room, many of them dressed in holiday garb and reminding you of what you'll be missing this year -- sharing the holiday excitement with a wide-eyed child? Perhaps you have the opportunity to be out of town during the holiday period. Does this mean that you need to schedule blood tests in a distant location, feeling all the while that there's no escaping your infertility? Or maybe the costs of infertility are becoming especially apparent at this time of the year, when you have less to spend on holiday celebrations?

These practical challenges are aggravating for some of us and downright depressing for others. At a time when we have so little control over the one thing that matters so much -- our dream of becoming a parent -- it especially hurts to have additional losses of control because of unexpected schedule juggling during the holidays. So what can you do? One thing to consider is to scale down on your expectations for yourself in terms of your productivity or activities related to the holidays. This is probably good advice for anyone at this time of the year, but if you feel extra pressure from infertility concerns, then for sure you need to reduce your stress wherever you can.

Think about what could be dropped from your "to do" list; enlist your partner or friends to do tasks that can be shared; hire some help; alert family and friends that you're striving for a restful holiday this year. Next, in the spirit of being restful, think about how you can psychologically take some time out from holiday pressure. A good book? a funny DVD? some time on the treadmill? tea or eggnog with a few close friends? a nap? Undoubtedly you can think of what works for you -- and your challenge then becomes putting yourself first at a time of the year when it is easy to get caught up meeting others' expectations. Just remember, you're experiencing the "double dose of hectic," so you, especially, are entitled to take some quiet time to regain your perspective.

Now, remembering that I also mentioned the psychological challenges of this time of the year, let's see what that might mean for you. Since several of the December holidays have a major focus on children, there's no escaping their excited presence -- whether enjoying school vacations, playing in the snow, sitting on Santa's lap at the mall, or being wheeled everywhere in carriages and strollers. This, often combined with harried parents' complaints, can set our teeth on edge. It is such an emotional reminder that we don't yet have a child and, when and if we do, that we will be accepting, not resentful, of the inevitable stress of parenthood. So, whether you encounter the excited children head on when you venture out to malls and restaurants, or whether you consciously choose to avoid those locations as much as possible over the holidays, be purposeful about how many doses of childhood excitement you can psychologically absorb. When you are reaching your limit, try to find a quiet place to regroup, consider postponing your tasks for another day, and head for a peaceful place where you can focus on more calm thoughts.

But what if leaving the scene isn't an option? Here I am thinking of family gatherings, holiday meals, and traditions where your presence is expected. Here is where some anticipatory planning can provide a safety net. You and your partner are probably aware of what is likely to occur at these various family events and how those occurrences may push your buttons. Make a plan, and clue your host in, that if it all begins to feel "too much," you will retire to a quiet bedroom, or for a short (or not so short) drive, or excuse yourself with a headache (yes, I know it's really a heartache...), and head for home, or your hotel room, or a peaceful place you've identified in advance as emotionally safe. Once there pull out a book, listen to music, light a fire in the fireplace, meditate, or do whatever you can to feel more calm and relaxed.

Holidays are a mixed blessing, and infertility makes them even more mixed, as holidays often mark another year that has passed without a baby. You are entitled to feel the sadness that accompanies these yearnings, and you also are entitled to make whatever conscious efforts you can to soften the impact of your infertility at an emotionally vulnerable time in the calendar year.

Even as you are feeing vulnerable, remember that you also are loved and that your loved ones deserve the opportunity to support you through this season. Clue them in. Let them help.

Friday, December 3, 2010

Infertility: How to Brighten the Holidays

Many of us find our struggles with infertility are especially difficult during the winter holidays. Perhaps our medical specialists have curtailed their office hours; perhaps we are overwhelmed at the mall with the numbers of children sitting on Santa's lap or the number of parents pushing strollers; perhaps last year we had looked forward to being pregnant by this holiday season, and we're not; and very likely it is hard to get excited about holiday gifts and celebrations when the only rejoicing we could imagine would be to revel in a positive pregnancy test or having our own baby to cuddle under the holiday lights.

So with this acute awareness that the holiday lights seem dimmer this year, I'd like to offer some thoughts on ways that you can turn up the wattage. Of course, being infertile does not make you the only person feeling some disappointment in the holiday hecticness. We all tend to have inflated expectations of family togetherness and spreading joy at this time of the year. But infertility does present itself as a reminder of reproductive sadness to couples, and it also is an unresolved issue that keeps tugging at your heartstrings. So how can you get beyond this emotional disappointment at a time of the year when others seem so effortlessly to be celebrating the joys of the season?

Perhaps one thing to consider is to decide with your partner how you want to acknowledge the holidays this year. Would you like to host a party or to go to lots of holiday gatherings? Would it be soothing to spend some peaceful time together before the fireplace or hiking outdoors? Would it bring you satisfaction to do some volunteer work in health care facilities or soup kitchens where regular staff would appreciate having time off during the holiday season? Do you enjoy baking holiday goodies to share with friends and family? If the local shopping scene is stressful, might you consider home made gifts or ordering from catalogues instead of braving the crowds? Rather than getting swept up in the hectic pre-holiday rush, think purposefully about what will bring you pleasure among the many choices available and then indulge yourself in these activities.

Another aspect of the holidays to consider is which rituals have meaning for you. You may decide that you no longer want to participate in familiar family rituals, like watching nieces and nephews open their presents, if this now feels more obligatory than joyful. Now is the time to absent yourself from rituals that no longer are satisfying and to invent or participate in new rituals that are more uplifting. How about a midnight walk in the snow, or a nighttime stroll to enjoy the holiday lights, or a peaceful cup of eggnog before a crackling fire? Or maybe a try at ice skating after many years off the rink or a visit to a local nursing home or watching some favorite DVDs with loved ones? There's nothing magical about inventing rituals -- just an opportunity to let your imagination travel in creative directions!

So what if your family objects that your new holiday rituals prevent you from participating in their favorite familiar ones? Every family is different, and you know best how to counter their objections, but keep in mind that you have every right to assert your belief that change can be good, new rituals will bring you happiness, and you would appreciate family support as you move forward in seeking happiness during the holidays.

Since we're in the midst of the holiday season, now is a good time to rethink what can make this time of year more uplifting for you. Let your imagination soar, let your creativity flow, and get in a holiday spirit that offers a chance for your infertility to co-exist with love, with embracing unique rituals, and with discovering new aspects of yourself as you move forward into the new year!