You Know You're Pregnant When...

We all need a little humor in our lives once we finally reach that pregnancy brass ring. Because let's face it...pregnancy may be magical, but it's also a gigantic pain in the tush. So, let's not take ourselves so seriously and make a list of the inevitable pitfalls and problems that will arrive long before our little ones do.

(And PS, if you're still hoping/praying for your pregnancy, I totally understand if you don't want to read further because this might sound whiny, even though it's tongue in cheek. Protect your heart.)


You Know You're Pregnant When:

• Every shirt you own has salsa/ketchup/orange juice/pudding right down the middle of it. And you don't care.

• If one more person says "it's a little hot out to be pregnant, isn't it?" you might be indicted for homicide.

• The number of pounds you've added to your frame is consistent with the number of chins that have also been tacked on to your neck.

• You're basically an indoor plant, growing things on your body that should not be there.

• No, I'm not about to pop. I have 2 months left. Thank you for reminding me, jackass.

• You no longer care if the nursery is done and perfect when baby arrives. You just care that the baby has somewhere to sleep and poop. 

• It takes you a good 10 seconds to realize that the unfortunate person reflected in that store window is you. And you don't look good.

• You went maternity shopping exactly once and wonder why it sees to be a requirement that the sales people weigh exactly 115 pounds and have no wrinkles. Are they trying to remind you how hideous you feel?

• You try and figure out how long you can continue wearing maternity jeans/shorts after the baby is here without people knowing it. Because sweet Jesus they are amazing.

• Your husband has reminded you no less than 249 times that "you asked for this, ya know."

• You have contemplated how to murder your husband no less than 249 times

• Shaving your lady bits is just....nope. I'll just grow a forest.

• It's not that you have cravings. Cravings would mean that you are choosy about what you eat. You're not. Give you all the food.

• Pick one: either your boobs or your ass could easily have its own zip code.

• Doing your hair (or nails) is as likely as running a marathon.

• Is that acne? I haven't had that since 8th grade!

• People ask what you want for your baby shower and you want to answer with, "mostly I just want a nap."

• You start to feel horrible for all those times you judged the pregnant women in your office for being big pregnancy whiners. 

• Sleep? What's sleep? I mostly just pee all night.

• Only one side of you is tan in the summer. It's a little hard to lay on your stomach right now.

• Something as simple as getting a green light will turn you into a blubbering child with legitimate tears of happiness.

• You can no longer watch sappy movies. Your heart can't take it.

• Seriously, how did my keys end up in the refrigerator?

• You count your sick days at work every morning, contemplating how you can take just a few days off before the baby gets here.

• Yeah it's cool when the baby moves, but it kind of freaks you the feck out, too.

• You're more excited than you've ever been for something you can't even fully comprehend yet.

Happy Friday, my friends!

XOXO,

Just Hear Me Out Again: 5 Things Patients Can Do to Improve Their Fertility Clinic Experience

A few days ago I published a post explaining 5 ways that fertility clinics could improve their service to all of us thousands of infertiles. I feel like it was well received and several clinics seemed to even take note of the advice. Yay for being good sports! 

But, my friends, we as the patients are not perfect. While fertility clinics can always improve on their customer experience, we can also strive to make their lives easier, which makes our lives easier which makes life in general easier.

Ya dig?

So here are 6 ways you as a patient/customer can help fertility clinics do their jobs better and keep frustration levels down to a minimum. 

1. Write it down

I don't know about you, but the second a doctor comes into the room, my brain becomes about as useful as my ovaries. It just shuts the hell down. I have all these grand and wonderful questions to ask and they just fly right out my ears. Inevitably I sit there and nod along and smile and realize after I get to my car that I didn't ask one question. 

This is not productive.

Before you go to your appointment, write down anything and everything that is concerning you or you don't understand. This is the time to mention that you read that hot flashes are normal on your current medication, but you feel like yours are super intense, and is that okay? This is not the time to say, "Nah, I'm good. No questions." You do have questions because this is some serious shiz you're doing. I know docs can be intimidating, so if it helps, have your partner be your back up question asker. Have he or she promise not to let you out of that room until you've asked your questions.

2. Be on the lookout for mess ups

Doctors goof. It happens. They are human beings and they are destined to make mistakes. Don't be naive and think you won't be the one they mess up with. If the protocol they give you looks weird or not in line with what you were understanding, you have to speak up. 

(Keep in mind, I did not say to be an elitist snot while you speak up.)

Be respectful of the doctor and the nurses. I find it's always good to start out with, "Please help me to understand this prescription better. I thought we had discussed that we were going to try XYZ first. Did I misunderstand?" That works a lot better than, "Dude, you quack. This is the third time you've given me the wrong prescription. Do you even have a license?"

3. Know your boundaries

If the doc advises something you aren't comfortable with or glazes over something too quickly, you must tell him. When we went through our orientation at the clinic in Colorado, there was so much paperwork being flung our way that I didn't understand or even remember half of it. At one point, someone in a lab coat asked us if we wanted to dispose of our unused embryos, store them, or donate them. I felt a lot of pressure to answer right then and there (she wasn't the friendliest), but ultimately said I didn't know and could we re-visit that question? I mean, this is a big deal, yo. I didn't want to make that decision all hopped up on hormones and altitude.

There are big choices you are asked to make when undergoing fertility treatments, and they deserve to be taken seriously. Clinics are in the business of getting clients in and out quickly because well, they're a business. So it's on us to pump the brakes and not feel bad about pumping the brakes. Docs will assume you're all good with everything unless you say otherwise. Put on your big girl panties and speak up if you're uncomfortable or confused. That's on you, kiddo.

4. Just throw away your clock

I get it. You're Type A and efficient. Your appointment is at 3:00, and if it hasn't started at 3:02 you start to get twitchy. Sister, get over it and read a Harry Potter book or invent the next Twitter while you wait. 

Remember the advice I gave you at the beginning about writing down questions and clarifying things? If everyone takes that (very good) advice, their appointment is going to get a little lengthier. Can you give the docs and nurses a break? It's not like they're having Tupperware parties in between appointments. They run from patient to patient with little to no downtime. Sometimes they don't even take a drink of water. You want your doc to be on time, but you also want a doctor who's clear headed, yes? You maybe can't have it both ways. 

Think of it this way: you're on an airplane and just about to take off when the pilot announces there's an hour delay. Everyone on the plane immediately loses their shit and starts complaining about how this is the worst airline in the history of ever and they want a refund and blah blah blah. Little do you know, oh snarky one, that the pilot discovered a crack in the windshield and had the plane taken off, the windshield would have ripped off the plane and you all would've been sucked out and died. Now aren't you glad they took a little time to fix the problem?

Remember that the person in the room next to you might have just found out that she will never, ever produce eggs and she's having a complete meltdown. Aren't you glad the doctor took a little extra time to be with her and console her? And besides, you always wanted to read Harry Potter anyway.

5. Don't exaggerate or lie

This seems like a no brainer but it happens a lot. I was told when I first started the infertility process that I should just go see a doc at 6 months and screw waiting for a year. "Just tell them you've been trying for a year," was the advice I was given. This. Is. Stupid. Six months of trying does not an infertile make. If you're giving your doc false information up front, then they can't properly treat you. 

This same philosophy goes for treatment once you get into the nitty gritty. Don't lie and tell your doc you already tried Clomid and it didn't work just because your read in some random thread online that Clomid is worthless. Everyone is different. Your doctor (if he is worth his salt) is going to look at your case objectively and with fresh eyes. It's very possible he'll decide that Clomid won't work for you, but let him in on all the info first. Do you really want a doctor giving you a protocol based on bogus info? This is how bad, bad things happen, people. 

Be straight up with your doctor about everything. Have an STD? Don't hide it. Doctors don't care anyway. Did you have an abortion when you were 17? Spill it. A doctor's treatment is only as good as the information he is given up front. If you give an edited medical history, expect second-rate treatment.

6. Give feedback

This is vital. Fertility clinics can't get better if they don't know they're messing up on something. Many clinics ask for feedback via an online survey or even comment cards. Like I said before, don't be a beeotch about it, but give it to them straight. If they're massively failing at a decent bedside manner, let them know. On the flip side, if they're doing something great, let them know. Everyone who works at a fertility clinic is probably there because they at least have a mild passion for helping people. Let them know if they are helping you and why. Positive reinforcement is contagious. It makes people work harder and smarter. And you ever know, maybe because of your input your next 3:00 appointment will actually start at 3:00.

XOXO, lovelies!

Just Hear Me Out: 5 Things Infertility Clinics Can Do to Be SO Much Better

Going through fertility treatments is no fun for anyone. Not for you, not for your partner, not for your family. At it's very best it's stressful and at it's very worst it's damn near impossible to take. So, when infertiles go to a clinic or doctor that specializes in infertility, we expect...well, a lot. 

Hubs and I experienced two separate fertility clinics. One was here in our home city and one was several hundred miles away in Colorado. Both clinics had their weaknesses and their strengths, but I did notice a few of those weaknesses carried over through both clinics.

Now look, I get it. Infertility is a very common issue for couples (if the numbers I read are correct, 1 in 6 couples will be affected), so that means a lot of bodies in and out of the clinic doors. I understand the doctors and nurses are under extreme pressure to perform and get results, and that can be extremely stressful on them, too. So before I proceed, please know I am forever grateful for the work these people do. They are human, they are overworked (though certainly not underpaid) and they are probably never fully properly thanked for what they do.

But that doesn't mean there isn't some work to be done.

All that being said, here are a few pointers I think some infertility practices could use:

1. Just read the chart

You know what? Scratch that. Don't even read it. You can probably get away with just skimming it. Really. Right before you walk in to meet with a client, do a quick 30,000 foot view of her chart and catch yourself up quickly. I know you can't remember every single client that comes through your doors, but it takes literal nanoseconds to glance over the chart and see that the woman you're about to meet with has had a Fallopian Tube removed. 

And you were the doctor that removed it. 

By glancing at her folder and refreshing yourself, it will save you the mountains of awkwardness you would have experienced if you had said, "Now have you had an HSG yet?" The broken woman sitting on that cold, hard, uncomfortable table will love you forever if you come in even remotely up-to-date on her treatment thus far and ready to have a conversation about her current issues, not rehash ones that have already caused physical and emotional scarring. 

Before all of you clinics flip out on me and tell me how busy you are, I want you to remember that we all have jobs. We're all busy. Lawyers have many cases to keep track of. Interior Designers have many clients to advise. You don't get a pass on taking a little bit of time to re-familiarize yourself with a client just because you're a doctor. We all have to do a better job.

2. Smile (when appropriate)

The men and women you are seeing as a doctor or nurse are going through a hell of a lot. They are stressed and scared and sad and more sad. When you are speaking with a patient, a little smile goes a long way. I understand that some doctors are "just the facts, ma'am" kind of people, and maybe that's okay. But we're still all human beings, and a smile conveys care and concern. And that's sort of the business you're in. So try it out. You might be surprised how fast the walls come down and how much less you see eye rolls.

3. Phone calls matter

One of the reasons I left my first clinic was because I couldn't believe the lack of care that went into phone calls. Hubs and I went through two IUI's. Both of them failed. When I got my period each time, I had to call and let the office know that my cycle had started. Both times, this was basically how the convo went:

Me (barely holding it together): Hi, I'm calling to let you know that my cycle has started, so the IUI didn't work this time around.

Nurse: Okay, and so what will you do next? Another IUI or are you moving on to IVF or are you stopping treatment?

Me: Um, I don't really know. That's why I'm calling. I was hoping to talk to the doctor.

Nurse: Okay, I'll let her know and she'll get back to you. Thanks!

That, my friends, is not a good conversation. I'm calling to tell you that my fertility treatment DID NOT WORK and my running tally of failed months of trying to get pregnant has just gone up by one. I am sad and broken and let down and confused. It takes no effort for the person taking the message to immediately say, "I'm so sorry to hear that. I know that's a difficult thing to experience. Let's take a look at your chart and see what our next steps will be."

And if that's hard for you to do, then maybe you should consider another line of work.

4. Your office decor matters

This is probably close to my heart because I'm an interior designer and I think about these things. But really, this should be in the forefront of every doctor's mind when they're opening a practice.

You are dealing with women who may OR MAY NOT ever get pregnant. Is it wise to put a woman who's been through 5 miscarriages and 2 still births in a waiting room for up to 20 minutes where she has to stare at pictures of sonograms and successful pregnancies and babies plastered all over the walls? I'm going with no.

I certainly understand that clinics want to show their successes. After all, that's why they exist...to help us! The doctor wants you to see that there is hope and they can help couples achieve their dream of conception. But those successes are better touted on a website or a pamphlet. By the time a couple comes to your clinic, they've already done the research (hopefully). They know what you do and that you are successful. That's why they are there.

I'm no expert on doctor's offices, but I would imagine it's difficult to have rooms reserved only for women who will ultimately never have kids. You as a doctor aren't a fortune teller so you can't possibly know. So maybe it's better to err on the side of caution and just choose neutral decor that doesn't have the potential to trigger anxiety attacks. I'm certainly not opposed to a picture here and there of a baby, or even a "wall of success". But let's not put it front and center of the waiting room, mmk?


5. All infertiles are not created equal

Like it or not, you as a doctor at an infertility clinic are in the business of exceptions. What does that mean? It means that every couple who comes through your door is going to be different than the couple before. This is not a prescriptive realm you're in. For some doctors, they see patients who have strep throat or the flu or a broken arm. Those patients are likely going to have very similar treatments to cure what ails them.

Not infertility.

The original clinic we visited reviewed our files and the doctor told us on our very first appointment, "what we do here is three months of Clomid, followed by three tries at IUI, and if that fails, we move on to IVF." And that was that. What that doctor didn't take the time to do was first ask me if I'd had an HSG. After months of Clomid treatment, we discovered I had a blocked right tube that was cleared through an HSG. Ovulation through Clomid doesn't do a lot of good if I've got a tube with a traffic jam in it.

In reality, there is no "this is just what we do" when it comes to infertility. Every case is different and every case deserves to be looked at closely. Infertiles pay a lot of money to be treated, and they deserve for their situation to be evaluated. You wouldn't expect a realtor to approach selling your condo in the same way they'd sell an acreage. Period.

*****

I realize it sounds like I'm knocking fertility clinics, and really, I'm not. I know these people literally perform miracles. If it weren't for my clinic, I wouldn't be pregnant right now. But ultimately, we all have to strive to be better and we can't do that without feedback...

...which is why next time I'll blog about what infertiles can do to make their nurses and doctors' lives easier.

Dun dun DUN.

XOXO, lovelies!

Knowing vs. Hoping: A Little Story That Puts Infertility Into Perspective

Below is a little story that I think sums up how infertility is different than other problems people might encounter in life. It's a little bit deep, but I think you all can catch on. ;-)

Here goes:

When I was about 22 years old, my boyfriend called me last minute on a Friday and asked me to join he and his family at the Lake of the Ozarks for a weekend filled with sun, fun, booze and boating. (For those of you not familiar with Missouri, the Lake of the Ozarks is just a humongous lake spread out over 55,000 acres in Missouri. It's a breeding ground for good times and bad decisions.)

Of course when this invite was extended to me, I wanted to go. A whole weekend with my boyfriend while working on my tan? Sign me up! Problem was, I didn't get off of work until 5:00 and boyfriend planned to leave at noon. In order for me to go, I would have to drive down on my own and meet up with them later. No biggie, this is what maps and directions were for, right?

I agreed and he hastily gave me the name of the condo in which they were staying and mentioned something about getting on a highway and driving for 3 or so hours. He would give me further details when I got off work. Done and done!

5:00 hit and I ran out the door and into my car, loaded up with gas and speed dialed boyfriend for more concrete directions. Straight to voicemail. Not a big deal, I had a 3 hour drive in front of me and could connect with him at some point down the road.

Fast forward 2.5 hours. I'd called boyfriend 392 times. All straight to voicemail.

I started to get a little worried.

There comes a point on the way down to the Ozarks when your phone will no longer work. We're talking "Deliverance" type territory. All that's around you are cows and people in overalls. Other than my phone having sketchy service, I also realized my battery was rapidly dying. I didn't have a car charger.

I knew I was getting close to the spot where I would need to turn off to find boyfriend's condo, so I couldn't just keep on driving willy nilly. The sun was setting and I was running out of gas. I pulled into a Walmart and charged my phone in a bathroom enough to hear my phone if boyfriend's call did manage to come through. I called boyfriend again and again. Voicemail voicemail voicemail.

What was I going to do? I was in the middle of nowhere with no directions where to go. I was literally stranded. I pulled my car to the farthest section of the Walmart and tried to rest until my phone rang.  It didn't go well. I saw one homeless man pee on a dumpster and I'm pretty sure I also watched a drug deal or two go down. For a 22 year old girl, this was just too much.

And so I cried. I cried because I was scared and alone in a strange place. My parents were on vacation and had no idea I had decided to come here. Literally no one knew where I was. I cried because I was pissed at boyfriend for clearly abandoning me in my time of need. I cried until the tears wouldn't come anymore. Was I going to die out here in a friggin' Walmart parking lot? Was this what was to be my life?

It was the lowest I remember feeling prior to my experiences with infertility. I just felt like I was stuck with nowhere to go and no one to help me. And then I had a thought that cheered me up. This wasn't going to be the end for me. I had no need to be so dramatic. Eventually my boyfriend would call. And eventually I would find where I needed to be. At the very worst, I could turn my car around go the hell home. This was not going to change my life for the better or the worst.

And right then, a light bulb went off.

I remembered that the name of the town where boyfriend was staying was named after a woman. Leila? Leslie? Laurie? Leanne? I couldn't remember. With new life breathed into me, as a last ditch effort, I drove to a sketchy gas station and asked the woman with two teeth behind the counter if I was near any towns that had a girl's name. Jackpot. I was 15 minutes outside of Laurie, MO. That had to be it!

Huzzah!

I got directions from two-teeth girl and headed toward Laurie. I remembered something about turning off on the second street once I got to Laurie and the condo having a steep driveway. And so, I drove through Laurie with only vague memories to guide me. I must have passed 15 different condo complexes with steep driveways. But I kept going. What else was I going to do?

And then suddenly, it was there. Boyfriend's dad's Tahoe. It was even right underneath a lamp post so light shone on it like it was delivered from heaven itself. I had made it.

Ironically, as I pulled up to the Tahoe, I also noticed two figures approaching the vehicle. Two young guys, freshly wet from swimming in the lake all evening and slightly buzzed from one too many Natural Lights. Boyfriend and his friend. Boyfriend's mouth hit the ground when he saw me. He launched into a huge story about how he thought his phone was lost but he had just realized it was in the Tahoe and was on his way to call me right then. (I constantly thank my lucky stars this is not the man I ended up with.)

But it didn't matter his excuses. I had done it. I had gotten to this god forsaken place by myself, and I hadn't given up. And no one could take that from me.

*****

Okay, so you can probably see some parallels here and maybe you can even see where I'm going with all of this. It may have taken 4 hours longer than it should have, and I may have had six mental breakdowns in the process, but I made it to my destination in the Ozarks and I made it there with nothing but pure determination (and maybe some rage).

My point is this...infertility was a lot like that ridiculous car ride down to Hickville for me. There were so, so many times where I just felt alone and scared and stuck, afraid to turn down the wrong road, end up in the wrong place. The difference, however, is that in my journey to the Ozarks, I had that moment of clarity where I knew that things would eventually be okay. This was all just a longer than expected chapter of my life, and someday I would be able to laugh about it. And that feeling was comfort enough to keep on trying.

With infertility, there is no comforting feeling or knowing that it's all going to work out. Ever. The best you can do is hope it all turns out okay. You never know if there's an end to the road. It could just go on for infinity with no no two-tooth Sally to help you choose the right path, because there is no right path. And that feeling of hopelessness? It never leaves. Even when you get good news that lifts you up, there's still that little devil with a pitchfork telling you "this might not work". There are no safety nets with infertility. You really might end up in that Walmart parking lot for years and years...and your only option might ultimately be to give up and just head home.

I was lucky in that my path did end with a pregnancy, and I am one of the fortunate ones. So many women and men dealing with infertility don't get the good news I got. They don't get that positive on the pregnancy test. Yet they still have to hear from friends and family and co-workers, "oh, it will all be okay eventually."

BUT IT MIGHT NOT BE OKAY EVENTUALLY. I wish everyone could understand that, and I think we'd all be better off.

Here's to an infertility journey that ends you safe at the condo, my friends.

XOXO,