The grass is not always greener

Warning: This brings up disturbing issues

I’m listening to coverage of a trial of a woman who killed her three children in a city I know well. She and her family had immigrated to New Zealand only weeks beforehand. She had apparently suffered post-natal depression, and had gone through sixteen IVF procedures to have her daughter, and then four years later twin daughters. She was under severe stress, and apparently texted friends and family regularly about wanting to kill her kids. People dismissed it and thought she was joking. Because they knew she loved her children.

I feel for this woman. Sixteen IVF procedures, with only two successes, would have put enormous physical and emotional and financial stress on her and her husband. She would then have felt enormous pressure to feel grateful, and not complain. Sixteen IVFs! I can’t get over that number, that a clinic would allow her to go through sixteen IVF procedures. That she might not have been given support. Her life is now ruined. Her children are dead. Her husband is back in his homeland. I can only despair for her.

It shows me once again that none of us know what anyone else’s life is like. It may look like the perfect outcome to an infertility survivor – three beautiful daughters after years of infertility. But there is always so much going on. Just as someone going through infertility might look at my life, and decide I have nothing. When I have so much.

It also reconfirms for me that none of this is about worth, about deserving to have children or not. Becoming a mother is a joy to some, a nightmare to others. None of us know what life might have been like for us if we had had children, how we might have responded to stress, whether our children would have been easy or hard, whether we would have coped, or not. Likewise, not being able to be a parent is indeed a loss, but it can also open the world to other opportunities and joys.  The grass is not always greener on the other side. All any of us can do is focus on what we have, seek help when we need it, and give help to others. And above all, I think, we can try not to judge others, so they won’t judge us.

 

Avalanche: A Book Review

Several weeks ago, I was sent a review copy of a new book - I don’t know the author, and have no connections with the publisher, but they’d found my blog. I was under no obligation to write a review, but when I stayed awake to 1 am to finish it, I knew I was going to do so.

Julia Leigh's Avalanche is a small book, split into two sections. The first deals with her marriage and first forays into trying to have a child with her husband. Their relationship was obviously complicated, and I couldn’t really relate to this part of the book at all. Following their divorce, the author then pursued IVF with a donor, and tells her story of the process, the reactions of those around her, and some of her own thoughts.

The author is a novelist and a film director, and she knows how to convey emotions and events. Her writing is often beautifully spare – something I envy, but can only rarely achieve. There is much unsaid in this book, subtly mentioned or only hinted at, events and conversations and observations recounted with no embellishing commentary. Having been around IVF and writing and thinking about the assisted reproduction world for a long time now, I enjoyed these subtle mentions, recognising them immediately, laughing or flinching or rolling my eyes in disgust at a simple sentence that said so much.

But, as Sarah said, there is a “shady abyss that lies between what is obvious to me and what is obvious to everyone else.” So I worry that the average reader – perhaps someone who was reading this to learn about the process, or to find out how to support someone who had been or was going through IVF – might miss these hints completely. I fear that the impact of the beautiful brevity of her words will sadly be lost, because the messages are there.

Still, for me there was a delightful feeling of being in the club, for once I could get the jokes (and weep the tears), and was in the circle.

I started trying to conceive in my mid-late 30s, and so could very much relate to some of the issues the author raised. This one in particular, made me laugh in recognition, and cringe at my naivete:

 “It seemed that every second day a celebrity in her forties was having a baby. I gratefully swallowed the evidence.”

We start to see her recognition that women without children are subject to judgement not empathy:

“In the public imagination – as I perceive it - there’s a qualified sympathy for IVF patients, not unlike that for smokers who get lung cancer. Unspoken: “You signed up for it, so what did you expect …?”

 She touches too on what drives many of us to have children, and why we feel so bereft when it doesn’t work.

“Part of me wanted to have a child just so I could have an inviolable reason for being.”

The loss so many of us feel when we can’t have children, yet which the majority of society don’t see as a loss or grief, is painfully acknowledged in this paragraph:

“I’m an expert at make-believe. Our child was not unreal to me. It was not a real child but also it was not unreal. Maybe a better way to say it is that the unknown unconceived had been an inner presence. A desired and nurtured inner presence. Not real but a singular presence in which I had radical faith.A presence that could not be substituted or replaced.”

I am also sure we could all relate to her gratitude to the doctor who referred to the embryo as “the baby,” even though she herself lists the damning statistics of the likelihood of her embryos ever being born.

It took me many years before I could say the words, “infertile” or “infertility,” so I had to laugh in recognition at this:

“Infertile. A slip of the tongue. … I wasn’t infertile I was ‘trying to get pregnant.’”

She makes the usual observations – usual for us, perhaps not for those who have never been infertile or childless by chance/circumstance – about pursuing motherhood in our modern, Western societies. I found her contrast with the Australian Torres Strait Islanders, where she noted that a “clinic on the island would almost certainly go bankrupt” to be interesting, as there was a real similarity with the Maori and Polynesian peoples here in New Zealand. Likewise, adoption seems to be equally difficult in both our countries.

She goes into some details of the process of IVF, and this would be useful for anyone – in particular I think for those who have friends or family going through this.

“An uncharitable thought ... IVF seemed to be a great deal about levels and cut-offs. If number X, then do Y. I wondered if it was the medical equivalent of conveyancing in the legal world, which is to say, largely formulaic, a matter of following protocol.”

“It seemed that only a veil of science shrouded the vast mystery.”

She talks about costs, and how suddenly $5-600 seems like nothing at all, an incidental add-on when, even though some of her costs were recoverable through Australia’s Medicare system, she was spending thousands of dollars every cycle. Then there was this one, simple sentence that says it all:

“In the parking spot reserved for Medical Practitioners Only I noticed a Bentley.”

The emotional impact of doing IVF is clear throughout the book, and she writes about not talking about IVF, and about feeling smaller, less than, “pathetic,” and about the isolation of going through this.

Finally, she acknowledges that there “… was another way out of limbo. The dark and rocky path.”

She doesn’t touch on the dark and rocky path in any detail. But she does touch on the doubt I’m sure we have all felt when first venturing out on that path.

“I tried everything. But did I? Did I really?” 

The book is subtitled A Love Story. There are at least three if not four love stories here – the one with her ex-husband, with the child she hoped to have, the ongoing love story with her nieces, and finally, rediscovering a love story with both herself and the world. I hope this acknowledgement of healing and recovery will give hope to others who may be facing the dark and rocky path – the one that, as I always say, leads up into the sun with expansive, if different, vistas.

Fertility fantasies

Some of us who blog about our No Kidding lives have been highlighting the New York Times article by one of our own, Pamela Tsigdinos, and Miriam Zoll.  We have been delighted that two people have been brave enough to speak out and say, “stop!”  Stop claiming that you can solve our infertility.  Stop claiming that you have everything we need to create our families.  Stop hiding the fact that there are women who will not conceive after fertility treatments.

And yet, not all in the infertility blogging community agree.  It’s as if we read two different articles.

Actually, given that “perception is everything” maybe we did read two entirely different articles.  We come from completely different perspectives. This is another example of the alienation we sometimes find in the wider infertility blogging community, the differences between those who walked away with a baby (or more), and those of us who didn't.  Those who are raising their children after fertility treatments or adoption have reason to be grateful to the fertility/adoption industries.  Completely understandably, of course.  Those of us who didn't end up with our babies after fertility treatments (IVF, IUI, clomid, donor eggs or surrogacy, and any others along the way I might have left out) probably do feel differently when we see something advertising “Everything You Need to Create Your Family.”   It stings, right to our core, as we know, KNOW without doubt that they are not providing “everything we need” because they can't. It might be the “everything” that some people need, but certainly is not enough for all. 

We’re not blaming the industry for that.  We don’t expect 100% success rates.  I was and still am very comfortable with the care I received when pursuing fertility treatments.  (It was being dropped like a hot potato once it was clear I would have no further treatments that rankles.)  But all the advertising, all the media comments, and the common view pervading society is that fertility treatments (and/or adoption) “solve” the problem of infertility.  They are a cure.  An answer.  Therefore we don't really have a problem.  And we deal with this on a daily basis, in a way those who were lucky enough to have successful fertility treatments, lucky enough to have partners who would pursue these treatments, lucky enough to be able to afford them or have health insurance, lucky enough to conceive/have a surrogate conceive/ or adopt, don’t have to.  We are forever told that living without children was our “choice.”  When for many of us, as I've written before, there was no choice at all.

If you think I’m exaggerating, look at the Time cover article about being childfree, dismissing those who faced infertility by implying that “with fertility treatment widely available, not to mention adoption” women without children are largely the child-free.  That’s right, those of us who are involuntarily without children don’t exist.

The comparison between a criticism of infertility diagnosis and treatment, and that of cancer diagnosis and treatment, has been made.  The difference with infertility when compared with cancer or other serious diseases (and whilst I haven’t had cancer myself – despite having being suspected of it when my second complicated ectopic pregnancy wouldn’t resolve – I have had two parents who have had cancer, one who died of it) is that the media, society, our friends and family and even those who we thought were our sisters in infertility, all seem to think that fertility treatments will solve everything.  Infertility bloggers (with the exception of a few rare individuals) regularly, still, talk about those who have resolved their infertility (ie with a baby) and those who are “still in the trenches.”  There are only those two groups.  The implication is always that those in the trenches will crawl out of them, clutching their newborns in their arms.  Failure is not considered to be an option.

Yet, when you get a cancer diagnosis, there is the immediate fear that it might be a death sentence.  HIV is a similar diagnosis.  Statistics will bear out that you are more likely to survive and live a long life after a cancer diagnosis (depending on the diagnosis or particular cancer, of course) or thankfully, HIV these days too.  But that’s not the first thought you have, or that anyone has if they hear you have cancer.  You don’t have the world dismissing your problems and telling you that your outcome is essentially “your choice.”  The two diseases – cancer and infertility - are seen totally differently in the eyes of our societies, and are treated thus in the media.

So I for one was pleased to see someone putting a more balanced view on infertility into the media.  One article pointing out that fertility treatments don't always work cannot be called skewed, when 99% of articles I've ever seen about infertility focus on the “happy endings” of pregnancies or adoptions.  Even the negative articles focus on the births of multiples (with the Octomom as an extreme example), never the unsuccessful cycles.  The article too was not anti-treatment.  Far from it.  I am pretty confident in saying that none of us who have tried fertility treatments are against them.  We are thankful for having that opportunity.  I am thankful for friends and family who wouldn’t have children but for fertility treatments (or adoption).  I wish that fertility treatments were more widely available, that in the US insurance covered it, and that restrictions to government funding in many countries weren't so tight.  But against this, we find advertising and media promotion that implies that all you have to do to "create your family" is IVF or another fertility treatment.  And that is simply wrong.  And likewise, it would be irresponsible at worst, misleading at best, for any medical professional to suggest that they had “everything you need” to “cure” a disease, whether it is infertility, or cancer, or heart disease, or HIV.  And yet that is what the Fertility Planit Show is doing.  And it is what many fertility clinics advertise.  (I've never seen a cancer specialist advertise – ever.  It is not done in NZ.  I don’t know if it occurs elsewhere).  And as a result, it is what many people now believe.

There are many hidden issues too.  How many women are told that IVF has a much higher rate of ectopic pregnancies?  And no-one (well, almost no-one) in the infertility community talks about the dangers of fertility drugs, and the high dosages many fertility clinics will give to patients, despite the fact that statistical evidence doesn't show increases in results over a certain maximum.  Yet many women receive treatments at twice that maximum, or more, and at tremendous financial cost.  In my several years of blogging and reading other blogs, I have read only a tiny few blogposts making a passing reference to concern over the effects of the drugs.  But is it talked about?  Do doctors raise it?  I don't know.  I know though that I am very thankful that New Zealand’s industry is regulated, and that – even though it meant the end of my journey – I was not able to demand higher and higher dosages of drugs, in case they might work.  Because I probably would have, if I could have.  Getting off that treadmill isn't easy. It is in many ways easier to stay on it.  And so in an unregulated industry there are dangers, and there can be fly-by-night or unscrupulous operators who will continue to push treatments that are not justified.  And they can argue that they are "doing the best for their patients."  But are they really?

I am as you can see very comfortable describing this as an industry.  And yes, it is an industry, just in the way there is a pharmaceutical industry and a healthcare industry.  These are (with a few exceptions in government-funded systems) businesses run for profit.  I don’t deny that the majority of practitioners are caring and ethical.  And profit is necessary to ensure a service is provided.  But they are businesses, first and foremost.  I know this is different in New Zealand, but I have seen dentists advertise, appearance medicine surgeons advertise, and one or two other medical practitioners advertise.  I've never seen a cancer specialist, heart surgeon, or neurosurgeon advertise.  I have however, even in our heavily regulated fertility industry, had to drive past a huge billboard advertising our local fertility clinic (when there is only one in our city) on a daily basis. Because it is a business. (To add insult to injury, their advertisement included a grammatical error.) 

I feel very sad for those who might try different fertility treatments over and over again at the encouragement of a doctor (perhaps well-intentioned, wanting to see their clients go home with a baby, feeling their pain), and who aren't counselled about the odds, and whether they should stop.  A friend of a family member, in another country, talks about her million dollar baby who arrived after up to 20 fertility treatments.  Whilst I'm happy for her, I think of those others who did that many cycles and didn't walk away with a son.  After all, even cancer specialists will tell a patient when they can’t do anything more.  How often, I wonder, (and this is a genuine question, not a sarcastic comment) does this happen in an unregulated industry? Maybe less than it should?

I also want to acknowledge those who don't appear in anyone’s statistics of success or failure, simply because they couldn't afford even a basic fertility treatment, let alone the “2-3 IVF cycles” that might be necessary to conceive.  I have known plenty of people who can only afford one cycle, in New Zealand, in the UK and the US, or can’t afford any.  Even when free treatments are available in a government-funded system, there are other costs – travel to and from clinics, time off work, for example - that prevent women/couples attempting even one fertility treatment cycle.  That gets us into a much wider issue, of course, but I can say I don’t know of anyone in the UK or New Zealand who would be denied basic cancer treatment or a heart bypass simply because they couldn't afford it.

Pamela and Miriam are not condemning this industry. Far from it.  But they are saying that some balance is necessary.  They make the very valid point that fertility treatments don’t work for everyone, and that bears talking about - in the industry, the support community, bloggers, friends and family.  I wonder, does the fertility industry and the wider infertility community just want those of us who are childless to go away and be quiet, and pretend it never happened to us?  I fear so.  We are after all bad advertising to potential clients of fertility treatments (or adoption), letting them know that treatments (or adoption efforts) aren't always successful.  We are the worst nightmares of the women deep in the trenches, and we unwittingly provoke "survivor's guilt" amongst many of the women who have their prized children with them now.  We know that.  We understand that.  We accept that, albeit sadly.  But we won't go away.  We need to speak out, and be recognised.  

As a woman who could not have children after loss, infertility, and fertility treatments, I personally was very pleased to see my perspective put out there.  For a change.  Maybe this publicity will help those of us who don’t walk away with a baby.  Maybe it will help raise awareness that it happens, and maybe that will reduce the pressure on us and others (to try IVF as if it is a golden bullet, or to “just adopt”).  Maybe too it will help others decide whether and when and how many treatments are right for them.  Maybe, just maybe, speaking out like this will help society begin to realise that infertility is a real disease, and just like cancer (or heart disease, or a myriad other conditions) some get a cure, and others have to live with the consequences for the rest of their lives.  And that this isn't “our choice.”  But that we still matter.

Oh, and an afterthought.  If the Fertility Planit show really does have  “Everything you need to create your family” I'm assuming they have a well-stocked bank, ready for all those women who can’t afford treatments, to make withdrawals.  Or have directions to a leprechaun with a pot of gold.

Nature/nurture and general ignorance

Mel's post prompted me to think about how other people view adoption.  On the one hand, we are barraged with comments along the lines of "just adopt."  On the other hand, we have people who make judgements and view children and relationships differently if they know they are adopted.  I suspect there are family members who feel that way about donor eggs too.  I wrote this post in 2009, and think it's worth repeating here.  I'll have more to say at the end.  Here it is:

Over the last few months, I’ve found myself frustrated over comments from people about members of their family. They have used family with quotation marks – “family” because they have included people in it who have been adopted. (Spouses were also not included as “family” but that in itself has not bothered me). Every conversation about the wider family has included a variation on the phrase “but of course don’t forget that J and D are adopted.”   I know that these people have strong feelings about this, and have included provision in their will for grandchildren “of natural issue” only.

It brought me to that age old question, what makes a family? Is it the years spent together, the shared experiences, love, arguments, traditions? Remembering the Christmases when Uncle Robin drank too much, or Auntie Evelyn’s beautifully-iced Christmas cake, or Yvonne and James wrestling, or the games of French Cricket on the lawn? Or is it simply the shared blood, the shared DNA, that ties us? The fact that we can look around and see that we share the Rose hips, or the R noses, or that I see my mouth on my nieces’ faces.

And how important is that blood? It is only important in consciousness. If you know that someone doesn’t share your DNA, do you look at them differently, in that awareness? If you are not aware of the lack of any genetic connections, wouldn’t you love them as deeply? Don’t people manage to find or imagine physical or emotional similarities to ensure they’re included in the family? Aren’t family trees full of children who don’t have the fathers that are recorded or assumed, coming from different blood? Or these days, family trees will include children from donor eggs or sperm, whose genetic links are to another family tree entirely, but who have been loved and raised through this one, whether the wider family is aware or not that they don’t share DNA? Aren’t, too, family trees empty of those who should be there, the children who are lost to that branch, unacknowledged because of indiscretions, shame and stigma, or simply lack of knowledge of their existence?  So why should these blood connections seem to be so important? And why do I mind so much that they are?

I suspect that this has hit me hard on a personal level, because our particular branch of the family tree ends with us. Adoption or other alternatives were always a possibility for us, not having any children of “natural issue.” I am furious at the thought that if I had adopted, people would view my children differently to those of my sisters, or of my husband’s brothers. The fact that they would be seen as second class citizens, not true members of the family. Would they feel the difference? Would it scar them? It makes me wonder whether child J and D, mentioned in the first paragraph, are aware of how some members of their family see them. I hope upon hope that they are not.

So why is it that I still flinch when I think of the bare, lonely branch on a family tree that ends with my husband and I? Why should it matter? Whilst I mostly feel accepting of my life without children, of my death and beyond, it does annoy me that this still has emotional power over me. Is it the desire for some form of immortality that makes blood so important? And isn’t that based on a deep-seated fear of being forgotten, a fear of ending? And isn’t that based on a feeling that you have not been enough in this life? Done enough? Been loved enough and loved enough right back? Is it based on a fear that we have not made a difference in someone’s life? Or that we have not changed the world after all?

Perhaps I just need to get over myself. We all need to get over ourselves. Simply being here has changed the world, and made it a better place. A kind word can make all the difference to the right person on the right day. Delight in someone’s writing, their work, their smile, their garden. Loving and being loved, whether by family or friends, near or far. These are not unimportant things. They should be, and are, enough.

The person I referred to in that post is my father-in-law.  Yes, I obviously harbour a deep resentment towards him as a result of these comments!  The ridiculous thing is that he is so ignorant of reproductive technologies that there are some grandchildren who could easily be the wonderful result of IVF or donor egg/sperm.  I don't know, and as I said here, it's not my business.  He loves them (as do I) - they are good students, very active, athletically-talented, and fun kids.  Everything he wants in grandchildren.  And that's all that matters.

Oops

It was July 2003. My first IVF cycle had been cancelled when I produced only one egg. A 3% chance of a take home baby, my fertility specialist said. Try again, he said, this might have just been a one-off bad result. So we booked a holiday for August, to help pass the compulsory six week gap before we could try again in September.

I emailed my sister-in-law, to chat, and to tell her about the holiday to Vanuatu. She knew about my ectopic pregnancy seven months earlier, but didn’t know about IVF. We weren't telling any family members. And she wasn't the most sensitive of people. I had earlier emailed friends in the UK, internet friends, who knew all about the details of my efforts to conceive. I told them about our holiday. I said, “so hopefully we will be all relaxed and ready to try IVF again.”

I forgot to proof-read the message to my sister-in-law, as I copied and pasted. I left the bit about IVF in. She responded. “Are you trying IVF?” she wrote, her excitement oozing out of every word. She continued. I can’t remember her exact words, but she implied that IVF was the answer, that it would work. But I was wounded already. I knew it didn’t work for everyone. I knew that it hadn’t worked for me once already – in fact, I hadn’t even had the chance of getting to any In Vitro Fertilisation. No eggs meant nothing to fertilise. So I fudged my response. “Oh no,” I said, a wee white lie not bothering my conscience at all. “I made a copy/paste mistake with a friend who’s doing it. Besides,” I said, this time being truthful. “It isn’t right for everyone.”

I didn’t want to say we’d tried and the odds of it working again weren’t good. I didn’t want to say I was too old, that I should have tried earlier. I didn’t want the judgement, the sympathy, the feelings of inferiority. I didn’t want to deal with someone else’s emotions, someone who was so casual about getting pregnant that she’d said to me a month earlier that being pregnant whilst visiting us was the worst possible holiday (I pointed out that it wasn’t), and who then said, “I don’t care if I miscarry this baby, I can get pregnant again.” And so I never mentioned IVF again. To give her credit, neither has she.

Was it IVF?

A friend, in response to my Let Me Be post, wrote an interesting collection of thoughts on having children.  She noted that when she learned her cousin was pregnant with twins, her first thought was whether it was IVF.  Then she asked herself, “why do I care?”

That’s a really good question, and I don’t know the answer.  But it does seem to be the kind of question we all ask.  At the same time as I fiercely protected my own privacy (you may laugh about this given the intimate details I now willingly divulge here online, albeit under a pseudonym), I remember discussing with my husband whether his brother’s twins were conceived via IVF.  The twins are now 11 years old, and we still don’t know.  We have an opinion on it, but what business is it of ours?  None, I know, and that is why we have never asked, and never will.  I was not prepared to be open about our own IVF efforts, and we never told my husband’s parents or brothers (although we probably would now if the subject came up).  So I have to respect their right to privacy too.

I’ve seen a variety of opinions on this, though.  Some people find it appalling not to tell.  “There’s nothing to be ashamed of!” they cry.  (And they are right.)  They share details with their families, friends, colleagues at work, people at the bus-stop, as if they are on an awareness raising crusade – and maybe they are.  If it works for them, that’s good.  They are horrified that some of us make a different decision. 

But just because we’re not ashamed of something, doesn’t mean that we want everyone to know.  I’m not ashamed of spending all morning in bed this morning (just because I can), but it doesn’t mean I wanted my next door neighbour to know when he knocked on the door at about 11 am.  I’m not ashamed of the way I vote, but it isn’t something I ever really discuss with anyone.  So IVF, a process that is so intimate, that brings up so many emotions, and can be such a stressful experience, is hardly something I was ever going to shout about from the rooftops.  Many of us who go through this don’t want to expose ourselves to judgement, or insensitive questions, or simply the knowledge that other people know what we’re going through.  Let’s face it, many people will not understand – either the decision, or the mechanics themselves of IVF.  People think it’s an instant fix, guaranteed to work.  Others have very strong views on it based on religious beliefs. 

Besides, who goes around telling everyone exactly how their children were conceived (or not conceived as the case may be)?  Why should we expect couples who go through IVF to be any different?

A shoulder to lean on?

 In infertility circles, there’s always the question.  Who do we tell?  I started spotting (and my temperature dipped) on Christmas Day with my second ectopic when I was with all my family.  I knew things were not going well.  And I remember thinking "I just want to get out of here."  I knew that I wouldn't get the support I needed with my family.  I just wanted to be alone.

This isn’t an indictment on my family.  They’re not selfish or any more insensitive than anyone else (including me!), but they wouldn't know how to react, and that would have been hard for all of us.  I could see myself having to spend all my energy worrying about my mother, for example.  I might be selling her short.  But I wasn’t prepared to test it.  Besides, I was 40.  I stopped relying on my family for emotional support when I was 17.  I wasn’t going to start again at this.  I wouldn't have known how, and neither would they.

As my ectopic dragged on, proving complicated to treat and resolve, as I was in and out of hospital, I got support from my husband and from on-line friends who knew what I was going through, having been through similar times themselves. One of my sisters was concerned, and would ring regularly to show support.  I appreciated that, but I found it hard to talk.  So in the end I asked her to email, not phone.  In the midst of grief, having that control, being able to choose when I spoke (or wrote) to someone, was important.  I didn’t have to pretend I was cheerful, or to sound upbeat.  The words could do it for me if I needed, and I could type with tears streaming down my face. 

So when I tried IVF, I didn't tell anyone in my family.  There were dozens of women on the support group who knew I was injecting myself daily with drug, but only one real life friend.  I knew I couldn’t cope with the expectations, the questions to see how it was going, how I was coping, why I wasn’t feeling optimistic, or getting “over it” etc.  I’d seen others under enormous stress from their friends and family, expecting positive results, and I didn’t want to deal with that.  So I blocked everyone off, and I did that to protect myself.  I needed to be selfish, and concentrate on what I was going through at the time.  It worked for me.  It doesn't work for everyone, I know.  A lot of women would be shocked that I didn’t involve my family.  But it was right for me, and really, that's what was important at the time.  And to be honest, almost eight years later, I don't actually know if my family know.  I can't remember if I told them in the end, and we've moved on.  I guess if they read this, they know now!