Wednesday, January 23, 2013

Finding Fitness


To all of you who tweeted about losing years of fitness after one week off earlier this winter:

Thank you for the laughs. 

Let’s make one thing clear: you do not lose fitness, feel for water, gain tons of weight nor undo YEARS of consistent training by taking one week off.  Nor two weeks off.  Nope.  If you think this (or feel this), that’s just fear, vanity or obsession.  Not physiology.  You need at least 4 – 6 weeks of uninterrupted sloth to lose it.  Let me be your living science experiment.  After nearly 8 weeks off – and by off I mean a few walks where my HR maybe pushed 100 bpm, some 30 minute spins at 60-80 watts and some swims where – hey, at this point, I knew better than to even look at the pace clock – my fitness tanked.

And so I’ve spent the past 6 weeks trying to find fitness again.  I’ve been searching for it – hard.  Where do you even begin?  After the first few workouts back I wondered: is it between the couch cushions?  Hiding under the bed?  Posted on Craig’s List? 

Has anyone – ANYONE – seen my fitness? 

MIA

Building fitness is a very slow thing, especially after extended time off.   The process is slow and your pace is slow.  The first few weeks back, this was tough.  In my head, I was still a fast, fit athletic individual but my body was saying: YOU ARE NOT THAT ATHLETE.  What?  WHO SAID THAT?!  LIES!  But I had to listen.  This requires patience.  Patience for the process of rebuilding fitness (or working for any worthwhile) is something we all know we need but day to day it’s really, really hard.  It’s also very, very boring.  Not only that but measuring yourself against the day to day ruler is useless.  You just don’t see progress that fast.  You might feel better but that doesn’t always translate to faster.  It takes time.

The first time I went running while trying to keep my HR low, I averaged a pace 2 minutes per mile SLOWER than my usual easy pace.  But every few times I got out there I got a little faster.  I wish I could tell you a shortcut or quick fix for getting faster, well….faster.  But even if there was one, I wouldn’t take it.  Know why?  Because a few months from now, I’ll be running through Herrick Lake on one of those magical days where the pace is fast, the effort is low and everything feels perfect.  That’s what I run for.  THAT feeling.  It doesn’t happen often but when it does it reminds you of why it’s all worth it.  

And then there’s biking.  Last week, I did a bike test to set a baseline. I pumped myself full of 16 ounces of dark roast, put Gangnam Style on repeat and rode as hard as I could for 20 minutes.  I FELT GREAT.  For the first 5 minutes.  I knew the test wouldn’t be pretty, I just wasn’t sure HOW ugly it would be.  Turns out I’m missing 24 watts from last year.   24 watts!!!  I look to my 2 ½ year old, who can typically be to blame for assorted missing things around our home – Garmin chargers, iPod cords, small appliances.  

Came up empty.  

This past Saturday, it was time to set a run pace baseline.  Believe it or not, I found a 5K in January in Chicago.  It was actually in Burbank, which I didn’t even know existed in Illinois until I found this 5K.  Somewhere south of the city and what felt far too close to Indiana, I went to race.  Paid 25 dollars for it which meant I had to finish under 25 minutes to get my money’s worth (and with the way my runs have been going – 25 minutes felt like a stretch!).   

After a long warm up around beautiful Burbank (hey, how often do you get to run down Harlem Avenue!?), I peeled down to shorts and a tank for the start of the race.  Everyone else was bundled up in lobster gloves and balaclavas.  Folks, it’s 40 degrees in January in Chicago.  Get naked!  Seriously though it was me and one other guy baring our arms today – except that he was shirtless.  

6 months of nursing plus 22 years of running and I knew better than that.

I started up front (fake it ‘til you make it) and immediately was surprised at how many women passed me from the gun.  OUCH!  Not that I expect to go to any 5K and be at the front but I think sometimes we THINK miracles can happen with our fitness (they don’t) so when we are put in our place by other fit people, we learn to better respect and appreciate what it takes to reach a place of great fitness (most do not respect or understand the amount of patience, consistency and focus it takes!). 

The first mile felt awesome.  For the first 2 minutes.  Which is when I looked at my watch and thought: IT’S ONLY BEEN 2 MINUTES!?!  I told myself not to look again and immediately focused on the race in front of me.  There I was in my zone which is really code for being somewhere between WHAT THE HELL IS GOING ON HERE and I HAVE TO HOLD THIS PACE FOR 2 ½ MORE MILES!?  At that moment, someone ran by me. 

Liz?

I thought he was yelling a profanity at me (hey, I was in the ZONE people) as he buzzed by me but then he hovered there and looked at me.  Turns out it was a Facebook friend, who I didn’t recognize because I was focusing on the woman who was falling behind right in front of me.  I might not have fitness but I have PACING!  I passed her and set my sights on the next one.  PASSED.  Ok now, second place was right in front of me.

And let me digress: this is why people should race.  There is an art to racing that cannot be practiced in training.  You’ve got to get out there and test yourself, push yourself and learn to respond in a race situation.  As our sport gets into this nasty habit of only doing long course races, we race less often and we forget how to RACE.  Most athletes are too worried about “finishing” because HOW can you race something so long!  Well, you can’t.  So get out there and race.  Race hard, race short, race often!  Remind yourself what it takes to push, hurt, win and fight for place. 

We turned into the wind – gusting at 30 mph.  Chris told me this morning:  DRAFT!  I found the tallest guy around me and tucked right behind him.  Then he blew up a bit and fell back.  A block later, he surged again, blew up, fell back.  Meanwhile, 2nd place was right there, dangling in front of me.  GET HER!  I was chasing but apparently not hard enough; came up 12 seconds short and finished in 3rd place.

In the end, I achieved the 3 goals I set out for the race:  don’t hurt yourself (it came close, I never run with music but figured I could use EVERY advantage possible so I put on my  iPod for this race and ¼ mile into it, I accidentally ripped the headphones out of my ears then juggled the wires for the next 2 ¾ miles so I’m just glad I didn’t strangle myself out there), don’t embarrass yourself (also close: was changing out of race shorts in my car when guy in next car came back, becoming the 1674th person who’s seen my hoo-ha since October, but who’s counting), and lastly, break a specific time which is 2 minutes slower than my usual 5K time but an honest start in the right direction (nailed this, came in about 20 seconds under goal time). 

At times, I feel like I have the patience of a 2 ½ year old when it comes to finding my fitness again.  I want it and I want it now. In fact, sometimes Max wants things so badly and so immediately that he walks around shouting:

I WANT NOW!  As if NOW was this magical thing that can deliver anything you want right into your lap instantaneously.

So the next time I go running at really slow pace, I’m just going to shout I WANT NOW to make myself feel better. 

And then a few blocks later, get over myself.

I just finished reading Succeed by Heidi Halvorson.  It’s a book that any athlete or coach should read to understand the psychology of setting goals.  The author talks about two different types of goals:  goals to be good and goals to get better. 

When you set goals to be good, you basically are trying to prove yourself how good you are.  The problem with these goals is that they are all or nothing:  you either succeed or fail, you’re good or bad.  Setting “be good” goals can propel you towards a high level of achievement because they are scary.  But this fear can also generate more mistakes.  Furthermore, it can set you up to for disappointment and low self confidence should you fail.  If you fail, you might think of yourself as “not good” and future tasks become a self-fulfilling prophecy.   Not surprisingly, when we choose goals to be good, we might also play it safe.  If you think you might fail at something (or not ‘be good’), you’re less likely to take on a new challenge.  Not only that but these goals get you to settle – if you’re good, then what? 

And then there are goals you set to get better.  These goals allow you to enjoy the process rather than set your sights on an all or nothing outcome.  Getting better is about taking on challenging tasks, learning new skills and growing.  You open yourself up to opportunities with the confidence that you can adapt and change without pressure of being perfect (or good).  It’s all about the journey.  Rather than proving your ability, you focus on developing abilities and mastering skills.  These goals push you out of your comfort zone, they push you to do things that maybe you’re not good at without any risk or judging yourself as good or bad.  You’re a work in progress.

Right now, as I find (or rebuild) my fitness, I’m a work in progress.  For the next few months, I’m not going to be racing to be good.  Or be the best.  Or be better than my old self.  I’m working to get better from where I’m at now.  These are important lessons for anyone coming back from a setback, injury, pregnancy, time off.   Make an effort to get better without worrying about being good. Reflect on your progress, no matter how small, and use it as momentum towards the next goal.

Onward!

Friday, January 18, 2013

Survey Request

I am doing a webinar in March on the pregnant athlete. I need your help. I'm wondering if you can answer the following questions (below).  You can answers these questions (and a few more) by clicking the following link:

Pregnant Athlete Survey

For the purposes of this survey, an "athlete" is defined as anyone who consistently worked out ~ 7 hours per week BEFORE pregnancy. 

1) Age during (each) pregnancy
2) Height
3) Weight BEFORE (each) pregnancy
4) Approximately how much did you workout per week while pregnant (hours)? 
5) If you'd like, describe a normal week of activity.
6) Which activities did you do while pregnant? (ie., swim, bike, run, strength, etc)
7) If you did not workout in pregnancy, why? 
8) How much weight did you gain throughout pregnancy?
9)  Did you have to stop any activity? If so, which activity, at which point & why?
10) Did you follow the rule "keep your HR under 140?" If not, what did you do to monitor/regulate yourself?
11)  Did you have a conversation with your OB/GYN about exercise during pregnancy? If so, what did they say? 
12) How did your family/friends/strangers react to you working out through pregnancy? 
13) How much did your baby weigh?
14) Natural delivery or c-section?
15) How much recovery time did you take after pregnancy (time COMPLETELY off from workouts)?
16) When was your first race post-partum?
17) When did you return to your pre-baby weight?
18) When did you feel like you returned to your pre-pregnancy speed?
19) Did pregnancy change your ability in any sport? 
20) If you nursed, did you train and race while nursing? How did that go?

Feel free to add any additional information about your experiences with exercise during pregnancy.  And, if you had more than one child, please feel free to answer the questions PER pregnancy.

Thank you for your help!

Monday, January 14, 2013

Option 3


This is the last one I'll write on fertility for awhile.  

First, thank you to everyone who contacted me.  Most of us are endurance athletes and on a daily basis put ourselves through “endurance” activities that leave most people thinking wow, you ran how far today?  Yet I’ve realized through this experience that endurance goes much further than that.  As athletes we work and we (generally) get a reward.  In pursuit of fertility, you also work, you sacrifice and sometimes you get no reward.  That said, I am utterly impressed by the emotional and physical endurance some women have with all things fertility.  Stories of women going through cycle upon cycle of IUI, IVF, flying to doctors all around the country, trying anything – diet, vitamins, acupuncture – to reach their goal.  Some were successful.  Many were not.  Some give up.  Fewer press forward.  In either case, I respect everything they’ve gone through to reach their decision.  And I’ve benefitted from hearing about it.

The other day, the nurse called.

Elizabeth, it’s _____, do you have time?

Is it just me or do the most important phone calls always come at the most inopportune times?  Like when you are blow drying your hair after masters with your phone on the counter, waiting for the call, in violation of the sign posted on every wall and mirror that says: USE OF CELL PHONES PROHBITED IN THIS AREA.

Yeah, I’ve got time.

I put myself into the most private place I could find – a bathroom stall.  And quickly realized that when your voice echoes through every other stall, it’s anything but private.

Your pathology report came back.  It was normal.

That’s both good news and bad news.  Normal is good because it means nothing was wrong with the embryos but that's not good because it means something is probably wrong with me.  But everything I've tested for says I'm normal.  

I know, it makes absolutely no sense to me either.  

I told the nurse I had my appointment with the doctor in a month.  She insisted on sooner and fit me in on Saturday.  So I went.  Still with a post bike test hacking cough (more on that in another post), equipped with 2 magazines and a book.  I’ve never waited less than an hour for this doctor and by the looks of the office when I walked in I was thinking I should have packed pajamas.  It was jammed.  

To my surprise, 30 minutes later, we were in his office, waiting.

The doctor walked in - with Chris fondling the plastic uterus (those are polyps, and those are cysts……so now all of a sudden you’re a reproductive endocrinologist!?)  The doctor is a nice guy, sharp looking, tan, with an easy going matter furthered by the warmly casual way he calls you “kiddo” before answering any question. When you’re in an office because you might have a bunch old eggs, any reference to youth is greatly appreciated.  The last time I met with him, his response was hilarious: you keep getting pregnant but what the hell?  Did I mention it was also very scientific?  This time around, he approached us with sympathy and then – no answers. He had several theories (bad genetics in the eggs, you’re a bad implanter, you’re missing a uterine protein) but nothing definitive. 

A wall full of medical degrees and awards but he had nothing for me.  

Regardless, he made a plan.  Option 1 is to hit the nail harder.  In case you haven’t been following, I am the nail and a bunch of fertility drugs are the hammer.  This gives whole new meaning to the phrase drop the hammer.  When it starts to involve a mutt mix of hormones that includes androgens (male hormones), I get scared.  I mean, I know difficult things in life tend to build character or put hair on your chest but really, folks, I do not want hair on my chest.  He lists out the doses of about 6 different drugs meant to stimulate me to make more and better eggs.  People your size shouldn’t need this much.  People my size probably shouldn’t eat as much as I do but there are outliers to everything, right?  Honestly, the thought of putting all of that into my body scares me.  One of the biggest things I struggled with through IVF was the cost to me – my body, my spirit, my long-term health.  This is my body, not a science experiment. 

And then, there was option 2.

Option 2 is something we decided we might consider if we had to.  And let me start by saying, it makes me feel uncomfortable, almost bad to be able to consider any of this.  All of this fertility stuff is a first world, modern society problem.  Which means it’s not really a problem, it’s just something we have the privilege of worrying about.  My mom told me about my Auntie Ann who had endometriosis and because of that she could only have one child.  Circa late 1940s.  Aside from the fact that Auntie Ann had every single piece of furniture in her house covered in plastic (as well as plastic runners on the carpet), she seemed like a pretty normal person.  A person who at some point got over the fact that she couldn’t have another child and moved on with her life, played cards with the ladies and preserved her house in plastic.   

But now, we’ve got science.  Which means we have lots of choices.  Choices give us the illusion that we have some control.  And control – illusion or not - is a dangerous drug.  At what point do we quit even though there is always that tiny glimmer of hope from the many, MANY choices out there?  We can go any number of routes to grow our family – more IVF, more IUI, more drugs, different doctors, the naturopathic approach.  How many do we explore?  When do we consider them all exhausted?  Or, would we be better served by an answer, a final answer that says the door is closed?  Would we be better able to accept it and move on? 

Most of the women I’ve talked to have eventually given up for two reasons: fatigue or the feeling that they’ve done everything possible.  Fatigue tends to come after so many failures - you just give up because you’re out of energy or even out of money.  Doing everything possible seems to come after checking off a list in your head of all the things you can try to get pregnant – for many women this includes giving up a lot of things (exercise, dairy, gluten) or trying new things (weekly acupuncture, meditation, yoga) while mixing it with science.  But I’m not even sure either decision can be called giving up because when you’ve done everything and gotten nothing, sometimes for years, haven’t you given enough already?

So here it is, option 2.  Gestational carrier.  This means taking our embryo and putting it into someone else’s body.  We would basically rent someone’s uterus.  And let me tell you – a uterus is not cheap!  It carries a price tag of $60-80,000 dollars.  It also carries many complicated health, legal, financial and ethical issues.  Even if we wanted to consider this, the price tag alone eliminates this as an option for us. 

So there’s really only that first option.

After about 15 minutes, the doctor stood up.  It wasn’t clear that we were done asking him questions but it was clear that he was done answering.  He grabbed our files and said “so that’s our plan.”  Chris and I looked at each other, confused.  Did he just end our meeting?  I couldn't help but feel that to these doctors, numbers are everything.  Statistics are collected for clinics around the country and people choose or refuse clinics based on them.  What doctors want are good statistics.  When he stood up, I felt like he was saying I would never be a good statistic.  My first cycle was already a failure and without any conclusive results on what is wrong with me – I would never add to his success.  He walked out of the office to leave Chris and I standing there. 

On the drive home, I mulled over the options.  I look for guidance or an answer from Chris but he tells me I need to draw my own line in the sand. When we talk about this, which isn’t often because how do you talk about this, he tells me matter-of-factly that it’s my uterus.  My decision.  At first I got angry by the lack of shared support I felt in making any of these decisions.  But then I realized he’s right.  For as much as he’s told me his wishes (to have more children), he can’t tell me what to do with my body.  He tells me to draw the line that I won’t go beyond.  I need to decide how far I will go. 

And the answer is: I don’t know.  I don’t even know how to arrive at that decision.  These are not the kinds of decisions you make in a hurry.  They take time.  But in fertility, time is everything.  This makes the situation, well….difficult.

Which brings me to my next point.  At times, this quest feels odd and desperate.  A sense of time urgency pressing upon something that is really emotionally and ethically complicated.  Not surprisingly, at times, it just doesn’t feel right.  Like we’re trying to force something that perhaps isn’t meant to happen.  I don’t have any answers on why it’s not meant to be but the more we fail, the more I wonder – maybe we just need to accept it and move on?

And that’s what I’m struggling with.  I know there are women who exhibit freakish endurance for growing or starting a family.  They put their body through marathons of IVF cycles, interventions, testing.  And they NEVER regret it.  But right now – I can’t imagine going that far.  Like the first time you realized you were signed up for an Ironman...I have to run HOW far after a 112 mile bike?  Right now I can’t see how it’s going to happen.  I can't imagine that I will ever have that kind of emotional or physical fitness.
There are times I have felt comfortable with just accepting what my body is saying to me (we can’t do this, stop forcing it) and other times I found the competitive athlete inside of me fired up to do whatever it takes (never, ever give up!).  One of my good friends went through this a few years ago and I stood on the sidelines watching her process test results and weekly doctor’s visits.  Though they could have pursued any avenue to grow their family, at some point, they just gave up.  My never-say-never attitude couldn’t understand that until I went through it myself.  At what point do you accept that there is another path for you that doesn’t include a bigger family.  At what point do you say, it’s time to walk a different path?

Through months of keeping quiet about his feelings over this, last week my husband finally said something: my midlife crisis is that I want more kids

My heart broke. 

When I heard this, I felt really selfish for thinking about giving up.  And I felt like everything was my fault.  There he was totally healthy, beaming with swimmers with excellent motility, heck, swimming fly no breath for 4K straight and I can’t do anything with them.  So many times through all of this I have felt like an absolute failure.  I’ve been successful at so many things in life – sports, business, keeping my house really, really clean – but in what matters most….I am one child away from a complete DNF.  I’m so used to working hard, getting results, pushing, expecting excellence that it’s been frustrating to find no answers for this.  But while sport is a metaphor for life but it is not real life.  Sometimes even with hard work you don’t end up with your desired result.  We can’t forget what every personal best requires: a little bit of luck and a lot of patience.

And so for now, I’m taking option 3:  give it time.  That’s right, I’m not going to do anything except wait until things settle, wait for clarity.  It might take a week or maybe a few months.  The one thing I don’t have right now is a lot of time but oddly enough – time is what I need.  According to the latest tests, I still have over 400 units of HCG in my body.  Until that number falls below 25, for all technical purposes, I am still pregnant!  Because of that, I feel like I’m at a dangerous junction of still being very emotionally connected to all of this and at risk of making a decision I might regret.  Right now, I need to step back and find some clarity and peace in my body.  No interventions, no drugs, no protocols.  Just let things settle until a solution becomes clear.  

So for now, my story ends here.  I was very tentative to open up about something that’s kept so private.  But once I did, I was surprised by how many others stepped out of the darkness.  Thanks for that.  It’s really meant a lot to me and I’ve learned from everyone.  I’ll pass on something that one woman shared with me:

I just read an article in the NY Times about writing from the most personal place in your heart - that when we share the deepest, most private stories when we write, we connect with readers/friends in a way that can't be accomplished if we only focus on the surface issues in our lives and share only the happy parts of what we face.  When you have the courage to really open the door to share something so personal, you also create an environment where others feel less alone in their own hurt.  Healing can be facilitated by sharing the wounds we carry with others.

Women need to talk more with each other about this.  We don’t need to feel comfortable with talking about it because honestly nothing about these experiences is comfortable – we just need to see the value in sharing it – for others and for ourselves.

Thank you for reading.  Now, let’s get back to talking triathlon.  Did I mention I did a bike test…?

Monday, January 07, 2013

From Behind The Paper Gown


The last post was a huge relief.  An outpouring of everything I had been thinking and feeling.  And, hiding for some reason.  Maybe it was through secrecy or shame.  But what I want to say and what many of you have been saying to me is – that’s not right.  It shouldn’t be that way.  We need to talk about this.

I’m writing this for all the women who have gone through it.  And, as one of them reminded me, you don’t have to get over any of this, you just have to get through it.  I’ve also found that it helps to have a sense of humor.  As strange as that seems, humor has been my medication for many obstacles in life.  Laugh at me and with me.  Because if we just sit around being sad and pitying each other, where does that get us?

Probably at an AA meeting or on SSRI medication.

Fear not, I won’t make this blog a diary for all things fertility.  But for at least this post, I’ve got some things I want to get off my chest.  Actually, out of my uterus.  Remember, ladies, it’s one uterus, two ovaries.  There will be a quiz at the end.  I’ll soon return to more exciting stories about triathloning – in other words, the runs where I’m poking along trying to keep my heart rate under 150, fearing that right around the next corner that nasty headwind will send me straight up to 153.  And then what. 

THEN WHAT! 

Sharing my last post was like opening up my legs and letting yet one more person look inside.  And if you’re keeping track, you are the 1,693rd person to see between my legs in the past year.  That’s right, my vagina has gotten more face time than apparently a certain professional runner out there who led a secret life as an escort.  Except my vagina has been leading a secret life as in infertile.  And it’s seen more action from an ultrasound wand than my husband.

Did I go too far?

I’m trying to keep that sense of humor about all of this.  But it might get messy.  Consider yourself warned.

So let’s start at the beginning.

I finally found something more expensive than triathlon: IVF.  We hesitated to talk about IVF because it’s a loaded topic; emotionally, politically, financially, spiritually.  We went through this process for a few reasons.  But the biggest one is: I am old.  I know in the land of real life that 37 is the new 17 but in the world of fertility, 37 is old.  Once you hit age 34, or your 35th year, you are considered of advanced maternal age.

You’ll have a geriatric pregnancy.  It's like full on Golden Girls every time you go to the OB/GYN. 

Unfortunately, after age 35, your fertility takes a huge nose dive off a cliff of egg quality.  Girls, let’s be honest.  Many of us have been getting our periods since we were 12.  Nearly 25 years later, you can’t expect that you have a fully operational death star machine in there anymore.  Things are rusty.  Squeaky.  Old. 

But as I said to a friend, also at age 37, who when I said let’s get wine, she said I’m going dry for 2013, I said menopause is coming soon enough, let’s not rush it.

Are you laughing yet?  No?  Read on.

Being too “old” to do something I’ve been waiting my whole life to do was hard to hear.  We’ve lived for years pursuing our careers, taking the time to meet Mr. Right, finding ourselves - thinking that fertility was something we could just turn on or off.  A matter of stopping a pill and deciding it’s time to make the baby!  Not as easy as that.  And those girls who get pregnant by just looking at a penis?  The only reason that happens is because they are young.  Mostly under 30.  For the rest of us geriatrics, it’s not as easy.

And I know that sounds depressing.  But it’s the truth.  And one thing I've realized we've been lacking all along – through years of sex “education” or health “education” - is the TRUTH.  Many women have a poor understanding of what’s going on in their bodies.  Myself included.  And I feel like if only the gynecologist had handed me a manual of uterus maintenance and fertility at my yearly PAP exam: I would have been in a position to make more educated decisions.  I’m not blaming anyone, I’m just saying there’s something missing out there.    

The good news is that now countless late night hours reading fertility forums and googling scholarly articles has given me an honorary degree in reproductive endocrinology. 

The bad news is that I’m way beyond the age where any of this information is actually useful.

My journey began in October.  To prepare, I gave up coffee, exercise and wine. Like a friend said to me, so pretty much I should send someone for you to kill every morning. 

YES.

If I had to give title to the month, I would call it Track Marks On My Thighs.  I took a variety of injectibles to first suppress my ovaries and then wake them from the hormonally dead.  Reading through the risks and side effects sheets, I got as far as medication #1 (of many). I told Chris that I might just glow in the dark after going through all of this.  I learned that some fertility meds are actually abused by body builders.  Apparently shutting down certain hormone receptors puts production of other hormones into high drive.  I didn’t race when I went through this but I can assure you these injections did nothing to enhance the performance of my ass sitting on the couch. 

All they did to me was make me fat and give me headaches. 

My first obstacle in the process was getting my ovaries to shut down.  They would not be suppressed!  Nurse called:  this is weird.  Well, if you knew me, it’s not.  I don’t back down easy to a challenge and it’s safe to say my ovaries are just as stubborn.  Finally, they quieted down and we could begin the process.  Up to 4 injections a day!  

Along with lots of medications, I made many, many trips to the doctor.  You actually never see the doctor – you see his technicians and nurses.  They take blood, do ultrasounds.  You sit in the waiting room with a lot of other women.  Many doctors cycle women at the same time so you see the same women, over and over again.  Yet you’re all sitting there in silence, scrolling through your smart phones. 

After a few visits, I just wanted to get up and say: YOU, over there, I know you’re looking at Just Mommies trying to find more information on IVF success rates.  And YOU, you’re symptom checking in the Fertile Thoughts forum.  And YOU, you’re looking up success rates of someone your age going through this while wondering if you’ll be the next success.  And YOU, the only male in the room who is hiding behind a Food and Wine magazine, we all know why you’re here so don’t try to brush it off, we know the man in the gray coat is coming to get you and we know you are here to touch yourself.  And ME, you see, I’m just like the rest of you, nervous, anxious, googling what my numbers mean, afraid to call the nurse YET AGAIN because I don’t understand what’s going on with me, alone, pumped full of hormones, desperate to talk to someone, anyone about my experience so much that I just want to stand on one of these stupid beige chairs with the Today show blaring in the background and shout to all of you:

CAN WE JUST TALK ABOUT IT ALREADY!?

And then your name is called.  Your appointment was 30 minutes ago but it’s not as if since starting this process you haven’t noticed the ticking of every freakin’ second.  To add insult to injury, the appointment takes 3 minutes.  Forget that you’ve spent about 90 minutes arranging your life to get here.  After the appointment, you plan to check the voicemail box where the nurse leaves the results from your bloodwork or ultrasound.  They tell you to call after 3 pm.  Which means you start calling around 2 pm. 

Nevermind the nurse never called until after 3 pm.

And at 3:01 pm, I was on google searching for the meaning of everything.  And I’ve found the meaning of everything

Except secondary infertility.  I’m still not sure why it happens.

Then, it’s time.  The magical union of the stars, moons, planets, your follicle size and estrogen level.  The doctor calls: it’s time for your trigger shot.

Next you wait.  Exactly 35½ hours until you go in for egg retrieval.  It’s a procedure done under full anesthesia, in my case, very early in the morning.  Chris went with me because, of course, he had to give a sample.

Now, let’s talk about the husbands of infertiles.  What you don’t know is that 30 percent of fertility problems are actually male factor.  Mine not being one of them.  He’s got perfect swimmers.  The first time he went in to give a sample to make sure his swimmers were swimming on AT LEAST a 1:30 base, he reported back to me.  You see, I envisioned some dark room with mood lighting, black velour curtains, a leather couch and some stacks of magazines.  Yes, I just described to you my husband’s bedroom while we were dating.  Imagine my shock (pity?) when he tells me that they put him in an examining room.  Bright fluorescent lights.  With nothing.

ARE YOU KIDDING ME?  HELP A BROTHER OUT!

Knowing this, I almost felt sympathy when I told Chris that we had to be at the doctor’s office at 6:30 am and he would have to come with me to give a sample.

Isn’t that a little early in the morning?

I suppose.  But excuse me: I have shown my vagina to at least 20 different people in the past week while wearing nothing but one of the paper gowns that might as well be the size of a cocktail napkin and all you have to do is sit in a room with a door closed, ALONE and have a party with yourself.  I want to know how to get that lucky.

6:30 am, got it.

We parted ways, he to the sample room, myself to the surgical room where the last thing I remember is the large clock ticking on the wall.  Time ticks so obviously when going through IVF.  Every second.  Every day.  And then, I woke up being wheeled into recovery.  Where I found Chris who told me that after weeks of injections they retrieved (drumroll please….wait for it...):

One egg.

Huh?

Let’s try that again……..

ONE FREAKIN’ EGG.

Fact: Women are born with 1 to 2 million eggs.  Yet I went through all of this to woo my eggs out of me and only ONE egg shows?  

ONE EGG!?

No, actually it was 3 eggs.  Two were immature.  One was ready. 

The doctor comes in. 

I’m disappointed.

That makes two of us.  Do I get a refund?  A sympathy card?  At least a freakin’ lollipop?  He tells us they were expecting 6 to 7 eggs (most women get 7 – 15 eggs).  They got one.  All we could do was wait.

The next 3 days are the longest wait of your life.  Until you’re in the two week wait.  That is absolutely the longest wait.  The embryologist calls with an update on our one little egg that could.  It fertilized!   And then, that’s it.  You wait until transfer day.

Transfer day is 3 days later. Again, you show up at the office early in the morning.  The nurse hands you the usual paper and cloth gown.  And this time also hands one to your husband.

This thing doesn’t close in the back.

Husband gets that on the first try.  You’d think the medical field would have picked up on this by now?

Embryo transfer takes place in another surgical room.  The nurse seats you in a chair which she then quickly inverts until you are nearly hanging upside.  Like a bat.  While wearing nothing but a paper gown on your lower half which she quickly removes.  It goes without saying that my you-know-what was out for all the world to see.

Meanwhile, my husband, in scrubs, is spinning around on the doctor’s stool like it’s his first time at the playground. 

The doctor walks in.  He extends his hand.  My husband stands up to shake it.  The doctor then proceeds to have a conversation with my husband about the origin of his last name.  All of this is taking place over my vagina.  Which, again, is completely uncovered.  But apparently very much part of this conversation.  And if it could talk, at that moment it would have screamed: DOES HE LOOK DUTCH!?

The doctor gets to work, telling us we have one nearly perfect embryo to transfer.  A pipette is inserted and the embryo moves to the top of the uterus like a little shining light of hope on the ultrasound screen.  You hang upside for another 15 minutes.  As if women haven’t contended with gravity for thousands of years, god forbid you go vertical too soon and the embryo falls out.  The hardest part of this day?  Going home to do nothing but lay on the couch. 

People live like this?

Next up?  The two week wait.  In my case, the 18 day wait.  During which I took a series of HCG booster shots to trick my body into thinking it was pregnant.  But after about 9 days, I knew I was.  You can easily tell.  The first thing you notice when pregnant is bizarre, vivid dreams.  You start waking up to use the bathroom in the middle of the night, several times.  Your chest tingles.  Your mouth gets a strange metallic taste.  You just know

Then, I had the dream: the dream that I took a home pregnancy test and it was positive.

The next day, while giving myself a progesterone shot, Max pointed at me. 

Mommy, baby.

What the …?  How soon until all of us in the house start seeing dead people? 

At 18 days, I went in for my beta and it was positive.  Very positive.  1200.  The nurse tells me these numbers are great.  Two days later, my beta has tripled to 3600.  My progesterone is over 100.  Everything is much higher than expected.    

A few days later, in between restless sleep and trips to the bathroom, I had another dream: a dream of two bright shining perfect pennies, heads up, sitting next to each other.  I woke up the next morning and told Chris:

We’re having twins.

Call me clairvoyant (and send me 20 bucks to predict your race season), but a few days later twins was what the ultrasound confirmed.  Funny how a woman just knows.  They tell me in the entire history of the office, only one other person has had one embryo that split.  Identical twins are nature’s mystery.  A fluke.  I felt like the lucky one.   

In between then and what sadly was the end, I had more odd dreams.  And then, all of a sudden, the odd dreams stopped.  As did the nightly trips to the bathroom.  And I knew something was wrong.  I started having night sweats.  Soon after, sitting at my desk, I confirmed it was all over – my head spins, what always happens when my hormones start dropping.  

But wait – our infertile journey does not end here.  It actually ends in the hospital.  I’ve always chosen a D and C per the recommendation of the doctor so they could gather evidence for testing to determine what went wrong.  In each case, after 6 weeks of waiting, they’ve reported back to me that nothing was wrong.  That’s not reassuring.  But maybe this time it would be different.

The worst part about surgery?  Not the gown that doesn’t close in the back.  Not the pity that every nurse gives you.  Not when they weigh you so you can say to yourself so THAT’S how much weight I actually gained.  It’s no eating or drinking after midnight.  And when your surgery isn’t scheduled until 3 pm, this is borderline disastrous.  Mostly for your husband who has to listen to you all day saying I AM SO HUNGRY.

Apparently my doctor was overbooked which means I got to wait, starving, for 3 hours beyond my scheduled surgery.  Meanwhile, I listened to what should have been very private conversations in all of the other surgical waiting rooms (would it kill them to close a door?).  The woman across from me who apologized for having trouble coming out of anesthesia (I’m warning you, I’m a puker).  The foreign man across from me who was having his knee scoped (I want to bring my cell phone into the surgery).  Were you planning to tweet about it?  Better yet, the older woman who was having her leg amputated.  When the surgeon, for the third time said, can you confirm that it’s your left leg, she barked back – YOU BETTER NOT TAKE MY GOOD LEG.  At that point, I was so hungry, I texted my husband:

If they don’t get me out of here soon, I’m going to eat her good leg.

And then it’s my turn.  I never had surgery until I tried to make babies.  I never realized how risky all of this could be.  Surgery is an ephemeral experience.  You lose time in your life with absolutely no recollection.  And in my case, you wake up in mesh panties with no idea how they got on to you.  It’s like waking up from a night of crazy drinking without the fun memories.

As soon as I wake up, I’ve always wanted out of there immediately.  The golden ticket?  Producing urine.  Me (asking the nurse): how can I get out of here.  She:  you have to go to the bathroom.  I’ve never been one to back down from a challenge.  And after nearly 20 hours of not eating or drinking, going to the bathroom proved to be a big one.  Imagine my disappointment when I missed the measuring container. 

I’m going to need more water please.

And then?  You go home.  In all of my cases, the recovery was quite painless.  I’ve never taken any pain medications in the recovery process, not even after the c-section.  So many people spend so much time trying to avoid or escape pain.  As an athlete, I’ve never understood this.  Same reason I don’t use an iPod when I run.  If it’s going to hurt, I want to feel it, hear it.  That way I know to appreciate painless effortless when it happens.  

So here we are at today.  I’ve got my WTF appointment in early February.  That’s where I go into the doctor’s office and ask WHAT THE F*CK, I paid how much to get my period (which I still haven’t gotten – lost in the mail!).  I’m thinking about bringing Max with me since last time that went so well.  He threw a plastic uterus across the room.  Yeah, they’re a lot easier to deal with when their embryos, aren’t they, doctor.  I’ve compiled a list of about 1000 things to ask.  I’ve done my research.  And, like I said, I’m google certified which means I know a little about a lot but just enough to ask all of the right questions. 

So that’s where I’m at. 

I’ve really appreciated the emails and suggestions I’ve received.  I’m interested in hearing about anything – send me your success stories, your naturopathic experiences.  At this point, I’ve decided that if someone told me to eat my dog’s sh*t to have another baby, I would do that.  Seriously, I was on a run the other day and thought to myself – would you eat Boss’ sh*t?  Yes, yes, I would. 

But I would probably hold my nose while swallowing. 

I’ve tried to find the bright side of what we’ve gone through.  The side of “that which doesn’t kill me makes me stronger” or “it builds character.”  Maybe it’s like Dorrance said, this type of stuff doesn’t build character but reveals it.  If that’s the case, maybe my character still has room to grow.  Because while I’ve never given up on much in life, there are times I’ve felt like giving up on growing our family through my own body.  There’s only so many times you can walk into the same brick wall and think to yourself this feel good, I want to keep doing it. 

Yet at the same time, I realize we’ve chosen this path.  I know we don’t need to do any of this.  We chose this.  We knew the rewards and consequences.  We, and our doctor, felt after going through several other losses, this would be our best shot.  Now that it’s failed, in part I feel guilty about being upset – we have a child, he is perfect and both my husband and I are healthy.  What’s there to complain about?  Absolutely nothing.  And we know that.  Yet it’s going to take some time to come to terms with the idea that what we want for our family may not be something that we’re going to have.  And though we realize there are other options for growing our family, we’re not ready to explore those yet.  

In my next post, I’ll talk more about rebuilding my fitness after all of this.  Which is where the real fun begins.  Let’s just say that I’ve learned to slowly grab my Fuel Belt bottle while running because that movement alone brings my HR up.  Opening a gel?  Shoots that puppy straight up into the high 150s.  Embarrassing?  Or hilariously funny?  Ah, humility.

As always, thank you for reading. 

Tuesday, January 01, 2013

Starting Over


It’s been a long time since I’ve talked about my personal life for many reasons.  It’s not that I don’t have material.  Trust me, I’ve got a 2 ½ year old, a husband who hangs pictures with a laser level and a 9.4 pound Chihuahua (he lost weight!).  I got material.  Lots.  But even now, I’m not sure I want to share what I’ve been up to simply because it’s private and emotional – the messiness of life that many of us like to hide.  Yet I know there will be value in sharing – for someone else to feel less alone or confused.

A few weeks ago, I went through my third miscarriage in 12 months.  All in all, in my journey of trying to have babies, I’ve lost five.  Each time, it doesn’t get any easier.  It hurts – bad – if not worse because each time it becomes more and more inconceivable to understand how (or why) it keeps happening. 

Miscarriage is terribly common but that fact alone is not comforting.  Some reports say that every 1 in 5 pregnancies will end in loss, most in the first trimester.  Human reproduction is very inefficient and risky.  And now that many of us have waited until we’re older – the risks are even higher.  Age is not on the side of fertility.

More confusing is secondary fertility.  You see, I know my body can do this.  It’s done it before and if you’ve seen my son (often, on Facebook!), you know I can do it quite well!  He’s utterly adorable and perfect!  The pain of not being able to do that again is baffling.  Yet like most women in my position, I keep quiet.  How can someone talk about the pain of infertility if they already have a child?  Why can’t we just be happy with that?  I’m not sure I owe anyone else but myself and my husband answers.  It’s complicated but the pain in our hearts is very real. 

Like many women’s issues, miscarriage gets swept under the rug under a strange veil of secrecy.  As a society, we encourage women not to even announce they are pregnant until 13 weeks has gone by.  Once you’ve made it through the first trimester you’re much less likely to suffer a loss.  If it happens before then, keeping it secret tells women that if they do go through a loss – it’s theirs alone to bear.  Those of us who have gone through it feel uncomfortable talking about it because how can you mourn something that didn’t exist in the outside world?  How you can get understanding and support from people who know nothing of what you are going through?  And why is this ok? 

Like much of this experience, I have no answers.  Just mysteries. 

Since October, I’ve done everything I could to create the best possible home inside of myself for new life.  I played by the rules:  I gained weight.  I gave up coffee.  I ate full fat everything.  I did not exercise.  I took everything the specialist told me to take; sometimes 4 injections a day!  I did everything at the right time.  I was monitored.  I tried acupuncture, yoga, even meditation!  When I found out we were successful, I was overjoyed but cautious.  Cautiously optimistic, I said.  Recurrent loss robs you of the innocence and joy you should feel with pregnancy.  You become hypervigilant and worried.  I didn’t sleep through the night for weeks.  I was too anxious.

Not surprisingly, when I went to my 6-week appointment, I was already convinced I was having a miscarriage.  I was spotting.  I just didn’t feel pregnant.  Imagine my surprise when the ultrasound technician said, well, I see two heartbeat!  There on the screen were the tiny hearts fluttering of two babies; identical twins.  We had been blessed.

The next few weeks I was in a delicate place, caught between fear of what could happen and the joy of what was happening.  Some days I felt utterly pregnant.  Other days I felt normal but wired.  I spotted on and off.  I found no solace in the phone calls from the nurse informing me that the numbers looked great.  In part, I feared that things were going wrong because it made the risk of a loss much easier.  I expected things wouldn’t go well because for the past few times they didn’t go well.  Depressing, yes.  But in fearful situations like this, I think we do what it takes to protect ourselves. 

At my 8 week visit, after seeing a strong heart beat in both twins twice before, the technician’s silence when she stared at the ultrasound was enough.  At that moment, I knew they were gone.  She didn’t even have to say anything.  The worst part: no one knows why. There on the screen were two perfectly developed babies – with no heartbeats. 

Each time it happens, I have a road map of where the pain goes.  At first you feel a helpless, this can’t be happening to me pain.  Then, it moves into deep grief.  You feel mostly alone in the darkness of night uncomforted by the outpouring of your own tears.  Then, you have quiet acceptance.  And from there, you move on.   It doesn’t happen that fast but it happens. You just have to hang on through the darkness – the light will eventually come.  It just takes time for things to settle. 

Meanwhile, I have searched everywhere I can think for answers.  The doctors, tests, the internet.  I’ve searched my heart, my gut and even God.  There is nothing wrong with me.  No test has pointed a finger at anything that can be fixed.  Specialists don’t have answers.  I’m just an inexplicable statistic.  About 20 percent of the women with recurrent pregnancy loss never find out why.  It just keeps happening. 

Why share this?  I realize it’s raw, it’s awkward and depressing.  Sometimes life is messy like that.  But there is value in sharing this experience. Because out there I know there is a woman wide awake in the middle of the night who will be wondering what she did to cause it.  Or why it keeps happening.  These are deep questions that often don’t have answers.  But she needs to know she is not alone.  It is ok to grieve, to feel anger and to be frustrated.  I have felt these things and more.  I have hated myself.  I have looked woefully at my son wondering why I can’t give him a sibling.  I have endured quarrels and then silence with my husband because neither of us knows what to say.  We expect to go through many difficult things in marriage but we simply do not have a language for how to deal with infertility.  Even more, I have wondered how I could be so close to family and friends yet felt so utterly alone.   For none of this could I find an answer.  It is an unfortunate part of the experience – no one talks about it which doesn’t make it any better.  But for anyone going through it – what you’re feeling is real.  Talk about it, cry about it and let yourself feel it.  You deserve that.

Why share this?  Not for sympathy or feel good comments.  But for shared understanding that we all have tough times – yet that’s not what defines us.  It’s how we choose to bounce back.  We’ve all had loss and setbacks.  We’ve had obstacles, disappointments and difficulties – maybe an injury, maybe an end to a relationship, a job loss, an illness.   Through life, I’ve encountered many obstacles.  And the only way I know to deal with them is to pick myself up and move forward.  Prove others wrong.  When you are at your lowest, set your sights on your highest point and then bust your ass to get there.  Maybe it’s called a comeback.  Maybe displacement of anger and sadness you can’t find a place to put anywhere else.  Or maybe this is the stuff that makes champions. 

About 2 weeks ago, I got back into training.  After nearly a 10 week hiatus.  I put together a training plan.  It started by stepping on the scale.  121 pounds.  I race under 110.  The first time I hopped on my bike, I was putting out 87 watts with my HR in the 150s.  That’s nearly a zone 3 heart rate for me.  My second run back was a 45 minute out and back on one of my favorite paths.  I hit the first mile in 9:15 – well over a minute slower than my Ironman marathon pace.  By 30 minutes into it, my ITB hurt and the remaining 15 minutes might as well have been straight up a mountain.  I wanted to stop, cry and walk but you know what – I didn’t let myself.  This is where I’m at right now.  I trust my body enough to know that with patience and consistency it will only get better. 

That following Monday, I went back to masters.  I could easily have left when the coach announced we would be doing a 10 x 100 test set.  Instead, when my lanemate said, you lead, I said gladly.  When she passed me 300 yards later, I swam with my heart in my throat to limit the gap.  When I felt like the world was sitting on my back at number 6, I said to myself only 4 to go, you’ve got this.  And when I saw my old lanemate, Tom, standing in the next lane over, proud to have averaged 1:12s, I accepted my 1:21s and said to him my new goal is to be able to swim with you again.  His response:

You can do it.

There’s a lot of things all of us can do but you have to make the choices.  You have to take the first steps.  It’s so much easier to make excuses for yourself and play it safe.  Feeling sorry for yourself gives you the illusion that you’re doing something but it gets you nowhere.  Overcoming your setback or even yourself is part of the healing process.  Move on, move forward.  Make things better for yourself. 

It won’t be easy but it will be worth it.  I have faith in that.

So here’s to starting over.  To new beginnings with hope and promise.  Take the first steps towards who you want to be this year.  No matter what’s behind you.  It starts with YOU.  Ask yourself what it will take to make it happen.  Then go there.  At a time of the year when we are so filled with promises to ourselves, understand that to improve it takes patience through small, persistent daily actions.  It is not a quick process.  And at times it’s boring, frustrating, even repetitive!  But it’s worth it.  Trust in that.     

Wishing you all a new year filled with joy, health and success!  

I’m closing comments on this one.  If you have gone through or are going through infertility or miscarriage, please do not hesitate contact me any time through my email address.