Have you read Love Warrior by Glennon Doyle?  It is the often difficult story of a woman who has been through a heck of a lot of misguided troubles.  I give her a lot of credit for having had the courage to heal through the fog and pain of her own life.

I was particularly interested in her descriptions of the so-called helpers in her life, people who meant well but who hindered her healing.  Their intentions may have been good, but their efforts often turned out to be self-absorbed and, ultimately, unhelpful. Because I hear so many stories about how helpers don’t help during the infertility journey, I offer my homage to Doyle’s Love Warrior.   I respectfully offer what I call “7 Infertility Helpers From Hell.”

1. The Fixer—The Fixer is certain that your terrible situation is a question and they know the answer. In fact, this person has A-L-L the answers to how to heal from your predicament. Note that I called this a predicament, notyour fear and pain. This is just a project to be figured out.  There’s a blueprint. Just do what they recommend, be grateful, and you will be A-OK. Doesn’t that make you feel all warm and fuzzy from your head to your toes? And you better feel better real quick. I remember when The Fixer told my husband and me to make love on the beach under a full moon and we’d get pregnant.  I could make this up.  The answer has been offered. What are you waiting for?  Get to it. And Don’t Worry About It!   Unfortunately, your spouse may be a Fixer.  The Fixer needs you to take the advice and feel good because he or she is already thinking about their own life and it is too difficult to even imagine what you are going through. They can’t even. Better to work on you as a goodwill project than consider the possibility of fear and pain in their own lives.
2. The Comparer—The Comparer knows a person with PCOS who GOT PREGNANT on their FIRST IVF cycle and then they GOT PREGNANT again ON THEIR OWN and they KNOW that you will too!  They don’t know how they know this, but they sure do.  Because The Comparer refuses to accept that your predicament is personal—andyes, (ahem) many vaginal ultrasounds and semen samples are personal—this person needs to deflect your personal pain.  It would be really painful for this person who feel your pain.  This person will not win a gold medal in validation or empathy.  They file you into a category for which they have a reference.  They may also talk about how they are the same as you because something really bad happened to them in their life, like whiplash or they didn’t get that job they really wanted.  And they were very, very sad.  FYI, your pain is about them, too.  The Comparer can’t deal with the intense feelings and situation that you are living in and it is easier to talk about themselves or someone else who also has a really, really, really hard story. Even harder than your own, of course.
3. The Reporter—The Reporter wants all the juicy details. “Oooooh, tell me more”, they say. They have many questions, ranging from the curious to the spicy, and they await your detailed answers. This is a Pulitzer prize winning New York Times reporter with a spiral notebook and a digital recorder. And once The Reporter has the data they just CANNOT keep a secret.  They have to share your big, horrible story with others without your consent.  “Did you hear?  Isn’t that JUST AWFUL?” The Reporter shares with boundaryless abandon in the spirit of transparency because she or he is just so darn worried about you.  Really, it’s easier to tell a story than to feel your pain.
4. The Cricket—*sound of crickets*. (I am whispering.  This person is quiet because they just don’t know what to do, or say, or ask.  They don’t want to do anything that might make you feel worse.  So they do nothing.   But they may say they heard you were doing okay, from The Reporter maybe? And they are hoping against hope that that is true because they don’t know what to do, or say, or ask.)
5. God Reps—Everybody take a breath and please don’t curse me out.  I’m just a messenger here.  The God Rep is here on a gossamer trail of thoughts and prayers, straight from The Big One Upstairs.  This person knows how you should feel.  Isn’t that a relief?  God knows why you are in this predicament, according to the God Rep.  They feel called by the Lord to tell you that God has a plan for you.  The suffering of trying to conceive for years and spending a bucket of money on having children is part of the plan.  Isn’t that simple?  I have seen many good people, devout people, get violently furious about the God Rep’s very important message.  Did you know that you can have a conversation with God directly, without the God Rep’s “help”, and that you can feel however you feel, good or bad?  The Big One can handle all of your feelings.
6. The Cheerleader—Yay! You are going to be okay!  They just know it!  Turn that frown upside down! Rah! You have time! You are young! You are going to beat the odds!  This is gonna work!  You just gotta think positive!  You just need to put on your lipstick and relaxandeatyourvegetablesanddoacupuncture!  The Cheerleader is too uncomfortable to step out of their rosy formation to consider your reality.  They don’t understand that they are dismissing your every feeling and leaving you feeling quite alone.
7. The Victim—The Victim has heard about your terrible news and feels just terrible—wait for it—that you did not share your news directly with them.  They had tohear secondhand.  They are verklempt. They are so emotional about being left out of your big story that they need to breathe a moment.  They thought you were close.  They need to tell you how they feel.  Please note that they have not expressed empathy for YOUR frustration and grief.  Theirs is bigger. Much bigger.

Who is a Real Helper when you feel vulnerable and afraid?

It’s the person who just listens.  Who gives you a hug without offering advice.  The Real Helper goes to the clinic with you, just because.  They cry with you, because infertility is unfair and they know you hurt.  It’s the person who offers understanding, not judgment.  They ask and understand when you can’t talk about it today.  They hold hope for you and your future when you feel hopeless.  They don’t offer to give you one of their children.  They give what they can give in the hope that it is helpful to you somehow, maybe now, maybe later.  And this person keeps checking in, offering a smile or an open ear.

Sometimes you have to be very clear with people about what you need. Like me, East Coast Debbie.  In the words of the immortal Spice Girls, “I’ll tell you what I want, what I really, really want.” What most people are desperate for is E-M-P-A-T-H-Y.  The Real Helpers do exist.  Please take the risk to open your heart to them.  And invest in www.Resolve.org and www.FruitfulFertility.org.

You know I love your stories.  Please feel free to share with me and others.  It really does help to talk with others about fertility struggles.

Hey, there’s a person over there who looks like they are suffering. They look like they are in pain and they are upset.

Go punch them in the head.

What? Do what? Are you serious?

I am absolutely serious. Go punch them in the head. While they’re down, kick them, too. And please tell them that they are a failure.

You look appalled by what I’m saying. Why is that?

Isn’t that what you do to yourself every day? Hating on yourself about infertility?

Every day I meet with women who hate on themselves for the medical problem of infertility.  Unfair, I say, so unfair!   Why are you treating a human being whom I care about in this terrible way?

STOP.

Flip the script and stop hating on yourself about infertility. Please.

Here’s how you do it. You have the same amount of compassion for yourself that you have for other people.

Can I tell you how many times people tell me that they don’t know how to do that? Maybe you are one of those people. I certainly had to learn it for myself. I come from a family that regularly serves up a shame buffet. A shame fest. I had to learn to have compassion for myself and not load my plate up with shame.

You can too.

Here are a couple of ideas. I love the book The Four Agreements by Don Miguel Ruiz. It was one of Oprah’s Super Soul Sunday book recommendations that was wildly popular several years ago. It is deceptively simple. Here are the four steps:

Be impeccable with your word.

Don’t make assumptions.

Don’t take things personally.

Always do your best.

Here’s my interpretation.

• Be impeccable with your word. In short, you don’t say ugly things to other people. You also don’t say ugly things to yourself. And if some of those slip out of your mouth or float around in your mind, you question them. A typical one is “I am a failure.” Is that true, you with a medical problem of infertility? Let me ask you this: would you tell a person with cancer that they are a failure? I don’t think so.
• Don’t make assumptions. Most people struggle with this one. In my experience, people do not make positive assumptions, as a rule. In the infertility treatment world, I hear more about assuming that a cycle will not work than people who assume that it will. Assumptions are often wrong or irrelevant, but when you go into them, your mind and body will react negatively. This is why people are often surprised and relieved when their negative assumptions are not true.
• Don’t take things personally. You see pregnant women and new babies and you become infuriated. I feel you. I have been there. I also know that those other women did not get pregnant or have a baby to be harmful personally to me or to you. Here is a picture that can tell the story.

• Always do your best. This does not mean being perfect. After you have an egg retrieval, your best will be to walk down the hall at home and get into bed without falling. On a day when you have had enough sleep and you are feeling relatively well, your best will be very, very different. They are both your best. Best is relative.

So, stop it. Stop hating on yourself. Infertility is hard enough without treating yourself terribly. Hug yourself instead. (I’m sending you a hug too! ?) Really, use The Four Agreements every day. It really helps. And thank yourself for doing your best to get through each day. Just your best. I am there with you in spirit.

#FliptheScript

#NIAW

During this National Infertility Awareness Week, write yourself a love letter.  A loving, compassionate, kind letter, telling you that you are wonderful. That the world is blessed by your presence.  That you are doing your best with a very challenging situation.  And most of all that you will get through this.

xoxoxoxoxo,

Dr. Deborah Simmons

#NIAW  #ListenUp

I read an article recently entitled “­Mother who spent £20,000 on FOUR rounds of IVF says she was made to feel ‘selfish’ because she already had a child – and reveals her battle to conceive felt like a ‘shameful secret.’ (www.DailyMail.com, March 30, 2017).  Note the “FOUR”, as if that’s SOOOO much.  It’s not.  Most of my patients do whatever they need to do to build their family.  If a doctor told them to stand on their heads and cluck like a chicken, they would do it.  And they are often judged negatively for it.

Secondary infertility is the red-headed stepchild of the reproductive world. Secondary infertility gets no love at all.  It is confusing and maddening.  This is an ache.  Yearning. There is nothing logical about wanting a child or children.  We just want it.  The pain and obsessiveness of the chase is very similar to primary infertility with one big difference: people are fresh out of empathy for you.  Even people who are trying to make their first child don’t quite understand your distress.

I’m learning to live without you now

But I miss you sometimes

The more I know, the less I understand

All the things I thought I knew, I’m learning again…

“The Heart of the Matter”

By Don Henley

Let’s say your first child was conceived in the bed with some pleasure or in a doctor’s office.  Great! That went well enough.  Let’s repeat a successful process.  Wait. Things aren’t working.  Time is passing.  Things are getting more confusing.  It can be a crushing blow when attempts at the second child go flat.  There is a sense of panic because you are trying to make sense of something that makes no sense.

WHAT THE HECK IS GOING ON HERE!?

Inseminations worked before.  Why aren’t they working now?

IVF worked for us.  Why can’t we get good embryos again?

Nobody ever told me that I might not be able to get pregnant again!

Why am I having miscarriage after miscarriage?

When did my AMH (Anti-Mullerian Hormone) level plummeting?

Unfortunately, there are seldom answers to these important questions.  Urgency and anxiety grow in the absence of data and certainty.

This is when the questions and “helpful” comments start from others.  Let’s list them, shall we?

• What’s your problem? At least you have a child.
• You’ve got what you wanted. Why can’t you just be grateful that you have a child?
• Aren’t I enough? (This one seems to be is a specialty of the male species.  She loves you a lot but she needs something more.  Read my earlier blog post “No Fellas, She Needs a Child, Too.”)
• Maybe it’s meant to be. Move on. Get over it.
• It’s not the end of the world if you have one child.
• This is God’s way of saying (________).
• Why would you spend money to have another child? (Hint to the helpers: why wouldn’t you?)

Exhausting, all this “helpful” advice.

I understand your pain.

I wish other people did, as well.

It is hard to explain to your child that he or she may or may not get the sibling they ask for.  You are trying.  So hard.  It’s not your fault.  You are a good person.

Your very real medical problem is being dismissed by others who cannot understand that your family is not yet complete.  Ask yourself how many children you have wanted.  I’ll bet that the number comes to you right away.  I don’t know of any research that explains that instant number that everyone seems to know.  I know that you are setting the table for another person.  You have invited them but they are not here yet.  And they may not be coming after all.

This is when empathy from others would go a long way.   It’s National Infertility Awareness Week from April 23-29, 2017.  If you have the energy, teach the people around you about your pain.  Because it’s real. I’m doing my best to do the same.

Please hang in there.  Hold on to the dream, if there are different paths to take that might make the dream come true.  And if you are at the end of the journey, your grief is real and true.  Your tears speak to what might have been, and who you are now.  Give yourself the time and grace to heal. Because you will.  And new dreams will form…

#ListenUp #NIAW

Infertility turns your life on its head. This is especially true of people who label themselves as planners or control freaks. Unfortunately, there seem to be a lot of control freaks and planners in the world of infertility treatment.

I really am not sure why this is so. There is nothing about the world that we can control, really. We can’t control the weather but maybe we can control the type of clothing that we put on. We can maybe control the type of food we put in our mouths. We can control how fast or slow we drive. You can control which clinic you work with. But when it comes to the big stuff, like a medical problem like infertility, we cannot control it at all. We can only control our approach to it.

Infertility treatment is physically, emotionally, socially, and financially challenging, as you well know. One of my patients called infertility, “controlled chaos. It is a lot of juggling.” All of the required medical appointments wreck your work life. The timing of an IUI or IVF cycle wreck your personal life. So what you do? You try to control other things. You go to the gym to work off the anxiety and try to control your body, because the hormones you are adding weight to your adorable body. You go to acupuncture and maybe take herbs. You quit caffeine and alcohol. You figure out how to eat “right” or perfectly.  I have wondered if planners take on the strict regimens of infertility treatment as a good thing or not so good thing. After all, it is something that can actually be planned. Another patient said, “Infertility feels like one too many things. It is so much to take track of.  Which times to take medicines. Which doses. Which days to be at the clinic.”

Control freaks are trying to control anything and everything, as a way to tamp down anxiety. In my experience this is the case prior to a diagnosis of infertility. The codes words “I am a worrier” are often my clue that I am working with someone who calls themselves a planner. Often this goes back to childhood. It is code for anxiety. The uncertainty of infertility sets up all kinds of “what if’s” that are beyond our control.  What if I get pregnant just in time for the family cruise to South America? What if I lose the baby? What if my boss doesn’t appreciate my working less? What if I drink too much coffee? What if I never get pregnant? And then there are always the coulda/woulda/shoulda’s.  Control freaks look for something—or someone—to control.  But control is a myth.  You can make as many plans as you want. Life has a way of happening right under our nose.

I feel for you. I really do. Humans look for answers and certainty. Medical problems like infertility offer question marks and uncertainty. I have learned over the course of my life that I don’t know nothin’ about nothin’ and that flowing works better than controlling or planning.  What I know, in truth, is that the only thing we can control is ourselves. Yeah, that sucks but it’s real.

Let me share something with you that is very helpful during anxious times. Break down time into 15 minute blocks. Most of us can control our lives in 15 minute blocks. When you get to the end of that time block, start the next 15 minute block.

You can plan, perhaps, for the next 30 minutes or hour or day, but don’t get too far out ahead of yourself, because anxiety is waiting to say hello and kick you in the behind. Meditation can help, too, but I think that moving meditation maybe works better for somebody who is anxious. Walking slowly, and I mean slowly, while you just observe your thoughts or physical sensations without judgment can be very helpful. Step by step.  Just like life.  Another way of moving meditation can just be to sway slowly back and forth and just letting things be.

So be aware of what you can actually can and cannot control.  Make plans as long as you know that plans are just a thing, not something that may come to pass. I’ll tell you personally that when you let go of the need to control your world, things ease up. It may seem counterintuitive but it’s true. And the 15 minute time block idea may change your world for the better…

#NAIW #ListenUp

I have noticed that fertility clinics are not chatty places.  I also hear many of my patients talking about why they don’t talk about infertility with others.  Why is that?

I think it’s infertility shame.

Maybe you already know what I’m talking about. Suffering in silence. Keeping your head down. Not telling other people in your life about the fertility struggles you are having because you are embarrassed. Feeling that there is something wrong with you. Learning through others’ stupid comments that it’s not worth trying to talk about it.  Infertility shame tells you that you are a failure because getting and staying pregnant are not happening in the way that you were promised.  That you are different. You are living in a bait and switch world.  We have all been told that you get pregnant any and every time you have intercourse.  Well, that story happens for some people, I suppose.  But if that was true of everybody all the time, the Earth would be groaning with the weight of trillions of people.

I’ve been there.

I never understood my reproductive “stuff” because doctors told me that everything was normal. Before I really even understood what intuition was, I knew that my reproductive stuff was NOT working correctly. Getting a period and bleeding for weeks and then nothing; repeat. Terrible cramps. Menstrual migraines.  You get the picture. It didn’t make any sense at all. And then…I tried to get pregnant.

My husband and I were told to use a basal body temperature thermometer and chart my cycle. Let’s cut to the chase, shall we: there was no obvious ovulation. Ovulation kits were expensive and the 14^th day of my cycle was as crazy as any other day. I detested BBT thermometers. I remember my ritual with my husband of cursing them and throwing them in the garbage. By some miracle we were able to get pregnant, even with wonky ovaries.  And then… I tried to stay pregnant.

What I found out ultimately was that the bottom segment of my uterus doesn’t work when it has too much baby in it. My uterus was not meant to be pregnant, not really. Aha, maybe that was what my intuition was about!  I felt like a failure for not having a body that would make things easy and for putting a baby at risk unintentionally. It took me some therapy and some compassion for myself to learn that my wacko uterus and wonky ovaries were beyond my control. I have learned that my uterus may have been “defective”, but I sure as hell am not.

And you are not defective or a failure either. You have some intuition about your body, too. Something isn’t working, or maybe something isn’t working for your partner. That is nothing to be ashamed of. It is beyond your control. It is something to work on, or work through, or work with. That may be with a fertility clinic or an adoption agency.

Shame is personal. It’s the shitty things we tell ourselves about ourselves. You sure wouldn’t say shitty things about your neighbor’s body, right? For other people you have a sense of conscience and compassion. You are kind and empathetic (hopefully) and you offer to listen.

Here’s the thing: for you to listen, somebody has to speak. Now let’s turn that around so that you can start to beat down your infertility shame.

For other people to listen, you’ve gotta talk.  You’ve gotta let it out into the sunshine. Shame is the shadow in our lives. You have to talk back to your infertility shame and beat it by letting it out. Sometimes that is talking with family or friends or colleagues at work. Unfortunately, that may or may not end up being a good idea, depending on the often dumb responses from other people from other people. Going to a Resolve meeting near you or online can be a lifesaver. Facebook groups, Twitter, Instagram, and Pinterest are great places to talk with other people, too.

www.bigstockphoto.com

You are not alone! One in eight couples in the United States struggle with infertility. In Canada, it is one in six couples.

It’s time to work with your Self. Please stop saying shitty things about yourself and your body. Stop apologizing, or explaining, or justifying the fact that you are struggling with infertility. This is a physical, medical problem, just like cancer or thyroid disease. You did not bring this on. With help and compassion, you may be able to beat it.

So listen up. The best way to beat infertility shame is to do it together. You and your Self.  You and me. You and Resolve. During this National Infertility Awareness Week, April 23-29, 2017, let’s work together.

Let’s. Beat. Infertility. Shame. Together.  #NIAW #ListenUp