Monday, April 30, 2012

Alternative Therapies: Centering Prayer

My name is Sarah, and I am anxious. I've been anxious as long as I can remember. I get anxious before I teach, every single day. I get anxious before I write. I get anxious in social situations. I get anxious before choir practice. I remember telling a couple of friends that I was getting dizzy at work meetings. "Um, Sarah?" they said.  "Those are panic attacks."

I can't take drugs for it, because all SSRIs make me sleep twelve hours a day, or more.

Every alternative-type infertility book I have read waxes expansive about the dreadful effects of stress on the reproductive system. This makes me feel terrible. I can't seem to control my anxiety, and the thought that anxiety is preventing pregnancy makes me even more anxious.

By the time Lent rolled around this year, my anxiety was out of control. TTC + bad test results will do that to you.

I decided I didn't really have any food stuffs to give up for Lent.  As soon as I got my test results I kicked alcohol, sugar, caffeine and most dairy. And I have to eat meat for my kidney yang. I decided instead to recommit to the Centering Prayer. The Centering Prayer is a kind of Christian meditation. Most of the time, when I pray, I talk to God. I talk and talk and talk. The Centering Prayer is a way of praying by intentionally listening to God's voice, rather than talking. I choose a sacred word (mine is Yahweh--and I apologize to Jews who may be reading this, but that's what it is), I invite God to speak to me ("Speak, Lord, your servant is listening). I relax and let my thoughts go. When an interesting thought comes along that commands my attention, I gently repeat my sacred word and let the thought go.

"What if I never get pregnant?" I let it go.
"What if adoption doesn't work out for us?" I let it go.
"What if I ovulate early/late/not at all this month?" I let it go.

God doesn't talk to me in English. In fact, God's voice doesn't usually sound like a voice at all. Sometimes I feel loved and at peace.  Sometimes, I battle my thoughts for my entire prayer time and I don't feel a thing, except a sense of disappointment for failing to meditate properly. I let it go.

I know God is speaking to me because my life becomes easier. I become easier to live with, more patient, less likely to pick fights with DH, more forgiving, less judgmental. I become less anxious (though I suspect that I will have a lifelong battle with anxiety).

Halfway through Lent, my DH said to me, "You haven't told me what you're doing for Lent, but I know that you're working on something, because I've noticed the difference in you and I want to thank you."

It's amazing how twenty minutes a day can change your life.

The Fertility Industrial Complex

I should acknowledge that I am currently under the care of an RE.  The tools and skills of Western doctors have helped diagnose my adenomyoma, diagnose and treat my hypothyroidism, and have reassured me that my tubes are indeed open.

If I were hit by a bus, I would want to go to the ER, not my acupuncturist's office.

However, I remain skeptical that Western reproductive endocrinology will help me have a baby.

I am skeptical of the profit structure of fertility treatments. Going to my RE's office for what is known as a baseline was really cheap: $90 dollars for his-and-her basic fertility workup, including a semen analysis for him, and cycle day 3 blood work and ultrasound for her. From there, however, the cost of treatment only goes up, culminating in $11,000-15,000 per cycle for IVF. Most people need 2-3 cycles of IVF to conceive: that's up to $45,000 for a chance at having a baby. I suspect that my RE's office offers basic diagnostic tests so cheaply because they make the big bucks on IVF.

So far, I like my RE.  I think she is compassionate and good at explaining things.  She never jumps to conclusions before considering all the data. However, I have noticed that if she can't treat something, she's not really all that interested in it.  For example, the adenomyoma: There is hardly any data out there about whether and how adenomyosis affects fertility. Anecdotally, I see people on fertility forums who have healthy pregnancies with adenomyosis, but it seems like every case would be depend on where and how extensive the adenomyosis is. I wanted an RE to look at my uterus and tell me whether I can conceive.

So during my saline sonogram, I asked her if she saw the adenomyoma. "Well, we weren't really looking for that."  What?  It's a lemon-sized area.  How could you miss it?

I think the answer is that she can't treat it, so it doesn't really matter. Similar with my suspected endometriosis.  Laparoscopy can make diminished ovarian reserve worse, so no matter how extensive the endo is, I'm not having it.  I almost wish I could have a lap, just so I could see whether I have endo.  I've always wondered, and given my family history and painful periods, it's likely, but I don't know for sure.

Is she so lackadaisical about diagnostics because she can offer me the ultimate solution: IVF.  IVF can diagnose the quality of eggs by evaluating the quality of embryos.  IVF can circuit a system that's hostile to sperm, whether its due to cervical mucus, endo, or immune-issues.

The only problem is--actually there are a lot of problems with IVF--A BIG FAT HUGE problem is that it's tens of thousands of dollars with no guarantee of success.

Our next appointment with the RE is May 7th.  It's the last big appointment when she looks at all of my test data and makes a recommendation.  I'll keep you updated.

Friday, April 27, 2012

Current Alternative and Western Treatments

Here is a current list of my alternative and mainstream treatments:

Vitamins and Supplements
B-complex (overall health and energy, plus additional folic acid)
Cod Liver Oil (immune health, plus post-colonial children swear by it)
Vitamin D (diagnosed with low vitamin D 12/11)
Selenium (thyroid function)
Zinc (thyroid function and PMS)
Evening Primose Oil - only until ovulation (endometriosis and PMS)
Vitamin E (endometriosis) Discontinued post-surgery.
Pyncnogenol (endometriosis) Discontinued post-surgery.
Fish Oil Supplement (endometriosis) Discontinued post-surgery.
CoQ10 (egg quality)
Royal Jelly (egg quality) Discontinued 1/13.
L-arginine (egg quality) Discontinued 1/13.
Chlorella (egg quality) Discontinued 1/13.
Iron (iron deficiency, diagnosed 12/11)
Calcium (bone health)
Magnesium (cramps and PMS)
Wheat Grass (egg quality and FSH) 

Traditional Chinese Medicine
Weekly acupuncture (started 4/2004)
Prescription Chinese Herbal Formula

Spirituality and Psychological Health
Centering Prayer (1-2x/day)
Yoga for Fertility (Aiming for 1x/day)

Western Medicine
Synthyroid (hypothyroid, diagnosed 4/12)

But I did everything right!

In When Bad Things Happen to Good People (a book you'll be hearing about a lot on this blog), Rabbi Harold Kushner tells the story of a couple who lost a child in a tragic accident.  When he goes to visit them, the couple looks at him and says, "Rabbi, we didn't fast on Yom Kippur this year." It takes Kushner a second to realize what they are saying: they think that God took their child as a punishment for not fasting on the day of atonement.

The idea that God punishes wrongdoing by killing children, giving people cancer, and causing various fatal accidents is called the theory of just retribution. With the exception of a few fundamentalist Christians (Michele Bachman, I'm looking at you), most people reject this idea.  We know that God didn't give our aunt breast cancer as punishment for her sins. We know that the tornado that struck the high school prom wasn't punishment for the kids sleeping together on prom night.

I reject the just retribution explanation for my fertility struggles. It's not because I slept with my husband before we were married.  Or because I used contraception. If you think it is, look at all those teenagers who get knocked-up without any problem at all!

But despite the fact I reject the theory of just retribution, I do have my own version of it.  It goes like this:  But I've lived a very healthy life!  I don't drink or eat to excess.  I barely eat sugar.  I have never smoked. I don't eat processed food. I eat ridiculous amounts of vegetables. I exercise regularly, but moderately. I don't even drink coffee, for God's sake!

I did everything right.  This shouldn't be happening to me.

The theory of just retribution is so hard-wired into all of us that we can't quite reject it.  Instead, we have merely substituted health for morality. Healthy food (whether it's vegan or Paleo or gluten-free) is the new kosher. Unhealthy people are punished with infertility.

This attitude is common among the fertile as well.  In this egregious example, a blogger thinks that she got pregnant so quickly because she worked so hard, "reading books, changing eating habits, exercising, not smoking, not drinking, doing tests, taking care of health problems, doing dental work, taking prenatals etc," in short, "doing more" than other people who are trying to conceive.

Um, no. She got pregnant quickly because she was lucky. Some people are just more fertile than others. While some things do adversely impact fertility (smoking, sugar, caffeine, alcohol, etc.) many people who live healthy lives are infertile, while many sugar-gobbling, coffee-guzzling lushes get pregnant with no trouble at all.

Why do we hang on to the theory of just retribution, despite all the evidence that this is not how the world works?

My theory is that it's comforting to this that if we work hard and do everything right, we will be protected from infertility. Conversely, it's frightening to think that infertility (or for that matter cancer)  could strike any of us, for no reason, despite all our efforts and healthy habits.

I've been on enough fertility forums to know that some people get pregnant after making a bunch of lifestyle modifications: diet, exercise, Chinese medicine, herbs, vitamins and supplements. Still others go the Western medicine route to get pregnant. But some people, despite all of their efforts, despite tens of thousands of dollars in fertility treatments, never do get pregnant.

The frightening truth is that we have limited control on whether we ever get pregnant.

The frightening truth is that a lot of really big things in our lives are ultimately beyond our control.

The frightening truth is that this is the human condition.

Thursday, April 26, 2012

Enter Sarah

First things first:  At the time of this writing, I haven't actually been trying to conceive all that long--only nine months, to be exact.  I have several complicating factors, including periods so painful they make me vomit every single month.  My pelvic pain specialist advised me to go to see the RE if I wasn't pregnant after six months of trying.  My cycle day 3 blood test and ultrasound suggest diminished ovarian reserve, my pain suggests endometriosis in addition to a lemon-sized adenomyoma in my uterus.

So even though I don't have an official diagnosis of infertility, I am terrified.  Terrified that I won't be able to have children without a cascade of intervention that I don't want.  Terrified that I won't be strong enough to opt out.  Terrified that adoption will end in dead ends.  I write in the hopes of quelling the terror.  I write for courage to face the unknown.  I write to find companions on the journey.

I am not an optimistic person by nature, (just ask my DH).  I am like Sarah, cynical, doubting, needing to control things.  One day, God made her a promise, and such was her cynicism that she laughed in God's face.

I write praying that one day, I will laugh too.  But unlike Sarah, I will laugh at God's goodness and generosity to me.  One day.