Monday, 30 November 2015

Microblog Mondays: Gratitude

Even though we don’t celebrate Thanksgiving here in New Zealand, online it is almost impossible to miss, as my US friends travel, cook turkeys and share recipes and enthusiasm for pumpkin lattes (whatever they are), or talk about things and people in their lives for which they are thankful. Those of us who are very early in the journey towards a happy life without the children they had hoped for, often struggle to be thankful for anything, but those of us who are many years into this life know how much gratitude can help us in this journey, and it is something I’ve tried to bring into my everyday life. 

So this month,  a blogger and social media friend participated in a month of daily gratitudes, and commented one day that she was “grateful that her hard work paid off,” (referring to a particular achievement). I wonder if she knows how much I appreciated her simple phrasing, her acknowledgement – one that we all know so well – that sometimes, hard work doesn’t pay off? My readers know this, having been through infertility and loss, and my mother knows this, as she sits in a hospital waiting for a place in a care home due to her declining health and memory, and my sister knows this, also sitting in a hospital in another part of the country, with her child who faces health battles every day. None of us are immune from the reality that you can't in fact achieve anything you want, and that hard work doesn't always pay off, and that sometimes accepting this is the hardest and bravest thng you can do.

So even though Thanksgiving has passed, I’m thankful for friends and those who see past stereotypes, who understand the power of words and who use them thoughtfully. And since I have a sentence remaining, I am thankful too for those who care for those in need, whether paid or unpaid, and all those who show kindnesses and consideration to friends and family going through a hard time. 

Monday, 23 November 2015

Nurture yourself

I see so many women being so considerate of others that they allow themselves and their feelings be completely trampled on. This is particularly an issue for the community of women going through infertility, or in the first phases of living a no kidding life, when our self-confidence is often at an all-time low.
I was taught to always consider others, to be polite to them, and for years I have (and still do if I am honest) worried that I might be inadvertently offending them. But what I was actually doing, in many ways, was telling myself, over and over again, that I wasn't worth considering, that I was worthless.

When I finally realised this - it is easier to recognise in others than ourselves, I think - it wasn't a selfish, arrogant, "I'm so wonderful" thought.  I simply realised that, in the interests of fairness, I was just as worthy of my consideration as anyone else.  I didn't build myself up in a self-important way.  But it gave me some contentment, some freedom from self-criticism (that so often feels never-ending), and it allowed me to feel compassion for myself, to like myself, and to accept my flaws without never-ending judgement.  

Saturday, 21 November 2015

Ectopic Pregnancies, including with IVF

Jess mentioned in a previous post that she couldn't understand why she had had an ectopic with IVF. As many of you know, I worked for six years with the Ectopic Pregnancy Trust (and spent many more years on their site informally), answering questions like hers almost daily. I gave her some information in a long comment on her blog, but thought I would edit it a little and reproduce it here, with some additional information. I know this isn't relevant for those of us who are no longer trying to have children, but others might find their way here, and find it useful. Or it might answer questions for some of you who did have ectopics, or know someone who has had one. So I hope none of my readers mind me talking about pregnancies and loss, here where we usually focus on life after we've said good-bye to all this.

Ectopic Pregnancy

Any sexually active woman of childbearing age is at risk of an ectopic pregnancy. 1-3% of all pregnancies are ectopic (ie, not in the uterus), and 95-97% of ectopic pregnancies are in the fallopian tubes.

However, ectopic pregnancies are more likely if you have had:
  • Pelvic Inflammatory Disease - a past infection of the fallopian tubes (for example, chlamydia).
  • Endometriosis - a condition which could cause damage to the tubes
  • Abdominal surgery - any previous pelvic or abdominal operation, such as caesarean section, appendectomy or previous ectopic pregnancy.
  • An operation on the tubes - such as sterilisation
  • A contraceptive coil (IUD) fitted - the coil prevents a pregnancy in the uterus but is less effective in preventing a pregnancy in the tube.
  • Are on the ‘mini-pill’ (progesterone-only pill) or have recently come off it – progesterone only contraception alters motility of the tube
  • Use of the morning after pill with the pregnancy in question
  • Fertility treatment (IVF)
  • A previous ectopic pregnancy, and
  • If you smoke

As you can see, IVF is considered to be a risk factor. In fact, ectopic pregnancy rates through IVF are higher than in the general population. This is often because women who need to seek IVF treatment have an underlying, undiagnosed condition (that has contributed to infertility) that may heighten their risk of ectopic pregnancy. Figures are hard to get however, and of course, clinics are well-motivated to report these differently. A few years ago, we tended to use conservative statistics, stating the risk of ectopic with an IVF pregnancy to be at least 4-6%, or at least twice if not three times the rate in the general populace. But the statistics used in the UK show that the rate of ectopic pregnancy with IVF is around 10%.

When an embryo is transferred into our uterus, it doesn't implant immediately (if, of course, it is going to implant at all), which is why I am always doubly annoyed when the media uses "implants" instead of "transfers." It can float around for a day or two before implantation, and this means it can move from the transfer site. It can therefore travel up into the fallopian tube, and implant there, causing an ectopic pregnancy. Or it can implant at the entrance of the fallopian tube, causing a cornual or interstitial ectopic pregnancy.

Still, 90% of women who have ectopics go on to conceive again successfully (ie, in the right place). 50% of women who have ectopics have none of the risk factors, and will never know what caused their ectopics. So women who are looking for an answer, like me, struggle to find one.
Conditions that can lead to tubal or interstitial (at the connection of the tube to the uterus) ectopic pregnancies with IVF (or otherwise) can include:
  • tubes that are blocked or semi-blocked (so if an egg floated up, it might not get back to the uterus),
  • balding of the cilia (these little hairs that waft the egg down to uterus can gradually disappear, and so can't do their job), and
  • the fallopian tube contractions that help push the egg downwards can, on occasion, reverse. (I was told this by my own specialist, when he was trying to figure out why I had two (one, tubal, one, interstitial, neither IVF) ectopics. I don’t have any data, and he said that they could monitor me for hours, and not see one of these reverse contractions, so I cannot 100% stand behind back this last point.
  • Jess was told her cilia were pointing or directing the wrong way. I've never heard of this, and wonder how they knew, as the cilia are so tiny infertility tests can't see them. Perhaps they conducted investigations on her removed tube, or it could simply be a case of a doctor surmising, hoping to give an answer to a patient who is hungry for them.
Many of these conditions are almost impossible to diagnose. Hopefully, further research will provide further information.

For more information on ectopic pregnancies, go to The Ectopic Pregnancy Trust website
Previous posts where I talk about my own experience of ectopic pregnancies can be found here, and here.

Thursday, 19 November 2015

The Fraud Syndrome

Every so often, after I’ve been posting about how I have managed to get through grief and loss, and especially after I get kind and generous comments, I start feeling like a fraud. (I’ve talked about this here and in other places, I know.) 

Here on No Kidding, I’ve tried to live up to the name of my blog. I have been brutally honest about my feelings about living without children, and the issues around it. But I do worry a little that, in my efforts to show that we have a good life after infertility, it might give the impression that my life is perfect, and that I’ve solved all the problems of living a No Kidding life. 

Of course, life is not that easy. So, because I don't want to be exposed as a fraud, I have to confess, all is not well in Mali-land. (Though of course, when is it ever?) So I thought I should be honest about that too. (To an extent, anyway. Perhaps my blog should be called “No Kidding Within Reason?”)

These are some (most?) of the issues bothering me:
  • I need to be more proactive in certain parts of my life (though that’s nothing new).
  • I’ve neglected friendships – or one in particular perhaps – that has been damaged for some years.
  • I’ve allowed my more natural shyness to influence parts of my life, though oddly, I am able to completely ignore it in other parts of my life.
  • I complain a lot (too much?) about my in-laws.
  • The house isn’t as clean as I would like.
  • My office is messy – really messy (though better than it was a week or so ago).
  • And I have several projects on the go, when I really need to finish one! (Though I am finally getting very close to finishing one of these, so I’m thrilled about that! More will be revealed in due course.)
These aren’t major issues, any of them, but I can say I’ve observed a gradual deterioration in my approach. I think there’s a reason though. Stress levels are reasonably high, for several other reasons.
  • This year I’ve been looking for a job. I’ve been applying for positions, attended several interviews, and have got really close to getting jobs, but just not close enough. Inevitably, I have been thinking about what I would really like to do. (Yes, I’m still trying to decide what I’d like to be when I grow up!) My husband was without work last year too, so I’ve been fretting about retirement savings, worrying about what sort of a lifestyle we’ll be able to live when we’re old. (And of course, that becomes a little more pointed when there are no children to take up any slack, in the way that I could for my mother.) I feel as if I’m running out of time. It’s a bit of a flashback to trying to conceive, when I knew I was running out of time there too.
  • My mother’s conditions are deteriorating, and decisions will need to be made sooner rather than later. But they're not solely up to us. Anyway, I’m leaving in a few days to help her post-op, and at this stage, can’t book a return ticket.
  • We have a major maintenance issue with our driveway, and we have just received the quotes for the work to repair it. We knew it would cost us a fortune, but the quotes have come in about twice what we expected. We have no choice but to deal with it.
  • My weight is an issue, and it can suffer when I’m under stress, so I’m a bit worried about that. I might talk about this some more in the future, if I can pluck up courage.
The one thing that isn’t really a huge issue in my life at the moment (even with the retirement savings issue) is the fact we couldn't have children. I'm not kidding about that.

Monday, 16 November 2015

Healing with art

I occasionally talk about mindfulness, and how noticing the small things in life helped pull me out of grief, gave fleeting pleasure, and reassured me that I would feel joy again.  This renewed attention to detail - to a beautiful sight, or the warmth of the sun on my back, or the thrill of seeing a tui in my tree - made me want to reproduce what I was seeing or the things that carried fond memories, and so I took up painting. I had never been artistic, though I enjoy and appreciate the visual arts, architecture, interior design, and photography, so was keen to see what I could do.

It turned out that I really enjoyed it, not so much for what I managed to produce (which was far from skilful!), but the way I could totally focus on it, how quickly time would pass, and how my mind would quiet, and troubles temporarily disappear. Having read some of the research on adult colouring books, meditation, and mindfulness, I can see why it helped me at the time.

Recently, I've found myself experimenting with colouring (read my #Microblog Mondays post over on A Separate Life to learn how, and to see an example). It's easier and less pressured than painting, as all I have to do is colour between the lines, yet it has the same beneficial results. Five years ago I would never have believed I'd be suggesting this, but if you're feeling stressed or overwhelmed, or just needs something calming in your day, you should give it a try.