Call me "Crash"

Everyone knows that the hormone rollercoaster is a given when you are in the thick of your cycle, but what about afterwards, when you get that BFN?

I decided to go back to Dr. F, my famous acupuncturist, who I took a break from for a year. He can help me with hormone stuff that Em, my other acupuncturist, can't, though he is clueless about IVF. After Dr. BloSunMyCha would not monitor my DHEA levels, I asked Dr. F to do it. I had to go off the pregnenolone I had just started taking for a week. I'll get the test on Wednesday. It can't come soon enough.

I think I'm having a hormone crash. I'm getting PMS symptoms and taking no hormone precursors to jump start my system again. I do think I ovulated, but my BBTs have been all over the map. My ovaries are confused.

I read two blog posts today that freaked me out. First was about a C-section incision busting open. I thought, ew, I don't want to do that, but chances are I would have to have a C-section because of my previous myomectomy to remove fibroids. Then, I read a post about a woman's PPD with anxiety. Talk about flashback, but I had that PPD/anxiety when I was pregnant. No one warns you about that. I've made myself sick on chocolate and lack of sleep in the last day and a half. I feel nauseous and panicked. If I didn't know better, I would think I was pregnant.

It seems that my expensive fertility treatment habit is now turning into an expensive car wreck habit too. Yeah, had another car accident last Wednesday. I'm ok, physically. The car isn't. I got a new lesson in trauma reactions, one I could do without. I froze in reaction to being startled while driving. Not good when there are other things moving around you that don't stop.

Seriously, this whole infertility gig sucks.

Phoebe 101

Once upon a time, there was a girl named Phoebe...

Ok, this is no fairy tale, though I wish it were. Here are the basic things you need and want to know about me. My blog is about my baby making journey, cooking, gardening, natural living, and whatever I feel about blogging about. Phoebe is not my real name, but I think it's kind of a cool name.

I am now 43 (updated 8/2009). It took a while for me to find Mr. Magic, and we got married two months shy of my 39th birthday. My first RE visit was just before that 39th birthday. I always knew I would need high tech means to get pregnant with Magic, my husband, but I was very naive about what that meant. I thought, yeah, I'll just do IVF. Little did I know how difficult it would be and how much agony and pain it would bring me.

Magic had a vasectomy 15 years ago after the birth of his second son, thinking he was done with baby making, but saved some of his sperm, just in case. In that 15 years, he was divorced and we were married. A reverse vasectomy now will have little chance of being successful because the amount of time that has lapsed from his original vasectomy directly correlates to the amount of the antibodies that are produced against Magic's sperm.

My baby making journey, which has so far resulted in no baby, has consisted of:

1 IUI
1 IVF converted to IUI
1 IVF
1 FET

I have had my own reproductive problems myself. I had surgery for uterine fibroids, a half a pound's worth, before any RE would touch me. Fortunately, changing my lifestyle and getting serious about taking care of myself have kept anymore fibroids away.

High tech fertility treatments are completely against my own personal philosophies, but since it is the only way I can get pregnant, I suck it up. At this point, it feels like a very expensive hobby.

I did get pregnant from IVF #1 redo (IVF #2?) at age 41. I had serious fucked up problems with my pregnancy that was directly related to doing IVF. I know I would not have had these problems if I got pregnant naturally. One of them was that I had severe prenatal depression and anxiety and was not getting treated for it. I did try taking Pro>zac, but I had a paradoxical reaction to it, meaning it made me more anxious instead of calming me down. In retrospect, I should have been on anti-anxiety medication and a different type of anti-depressant, not an SS.RI type anti-depressant. However, because I was so out of it, I didn't have the energy or will to find the right kind of psychiatrist to treat me, and Magic didn't know what to do. It's difficult when your normally in-control-assertive wife suddenly turns into a withering mass of protoplasm. The doctor who did prescribe me the Pro>ac was my RE, and he did not monitor me. Big mistake when treating someone for mental illness, which is why I could not go back to him, and why I eventually changed fertility clinics and moved my frozen embryos. I probably should have been hospitalized, except on the outside, I was functioning. On the inside, I was falling apart. Even after I eventually got better, I have found it extremely difficult to find psychiatrists and psychologists who treat prenatal depression and anxiety, let alone any doctor or health care professional who understands it. Mental health care is seriously fucked flawed in this country, especially for pregnant women.

Unfortunately, my pregnancy had an unhappy ending, and I do not talk about the details of my loss on my public blog. I was traumatized by the whole experience, and the less I have that trauma out there in the world, the better it is for me. I know that my story could probably help someone, but I get nothing from retelling my story except re-traumatization. I do have a private blog that has my story that I created as an outlet for myself and my healing. I only let longtime readers/commenters access. You have to get to know me first before I will allow you access. If you request access to my private blog first to get to know me, I will have to respectfully decline your request.

I love receiving comments and I love the support I get and give by conversing with other bloggers. I do moderate all my comments. I usually publish all the comments I receive. On rare occasions, I will remove any comments that I deem nosey, mean-spirited, or unsupportive. If you return to my blog and see your comment gone (really, why are you coming back to check on your comment?), that should probably be your clue that I thought your comment was nosey, mean-spirited, or unsupportive. Rather than write another comment that is nosey, mean-spirited, or unsupportive that I will also remove, please simply click away from my blog.

Most of what you really need to know is here on my public blog. Thanks for joining me on this crazy ride.

Shrink Shop

Let's review the checklist of things I need to complete before getting pregnant:

1. Buy a Car
2. Shop for a Shrink: I predicted this would take longer than buying a car. I am so far correct.
3. Finish 2008 taxes: I so loathe having to do this. Isn't there another blog I need to catch up on?

I did buy the car, which should be the topic of a future post, as I learned a lot of interesting things about car safety along the way. Basically, reader's choice won out!

On my mind now is the search for a new psychiatrist. I really wanted to find someone who specializes in treating pre-natal depression and anxiety and have it set up before my FET. I'm finding out a lot of good reasons for this.

1. It took me 3 weeks to do the research and make an appointment.
2. Once I did make the appointment today, it will be another four weeks before I could actually get in to see this specialist. I don't even know yet if this doctor will work for me.

The lesson is that this process takes a long time, which I already knew. If you have any inkling that you think you will have a problem with mental health during your pregnancy, you do want to find your psychiatrist before getting pregnant. If you are like me and thought that once you got pregnant that all your depression about not having children would vanish in a wave of euphoria, then you are going to be in big trouble. Once my mental health took a turn for the worse after the euphoria of initially finding out I was pregnant passed, I did not have the capacity to go through the search for a psychiatrist. I did try, but gave up after a few discouraging phone calls. Now that I am sane again, I can handle what seemed, when I was pregnant, an overwhelming task. I truly was sick at the time and needed help right away, not two months later. It's a sad story, but this is the reality of our ailing healthcare system.

Let's review the crap process I've already gone through in my search. First, I asked my RE for recommendations for psychiatrists in my area that specialize in prenatal depression. It took him a week to find those and get back to me. Of the two, one woman psychiatrist said that prenatal depression was not her specialty, but she could see me. She also gave me an off comment like, sounds like you just want medication management and not therapy, and that's not what I do. I didn't like how she misinterpreted my questions, so she was scratched off the list. Plus she is out of network with my insurance. With the next psychiatrist, I first had to get through the misinformation from his newly hired receptionist to find out that he does have some patients with prenatal depression he is currently treating, though it is not specifically his specialty. The problem with this guy is that he is out of network with my insurance and insanely expensive, $150 for half an hour. I'm always amazed that out of network shrinks won't work with you on their price. Scratched off the list. Next, take on the in network list of psychiatrist.

First, I called my insurance company to get a list of psychiatrists in my area. I had to endure the, "are you contemplating suicide?" before I could even ask my question. I was then given a bunch of misinformation and sent a list of psychologists, not psychiatrists that I had asked for. I decided just to do the search myself than frustrate myself with incompetent "mental health specialists" at my insurance company.

I printed off a list of all the psychiatrists within 25 miles of my house who are covered by my insurance and narrowed the list of 54 down to 6 women psychiatrists in my town or adjacent towns. Of the six, one had closed her practice, and four worked with other specialties. I did find one psychiatrist who does specialize in treating prenatal depression and anxiety, but only after talking with another male psychiatrist's office. I called her office four times in a week and did not get a response. I was a bit frustrated, but decided if I didn't get through this week, then forget it. Maybe they were on vacation last week, I don't know. I would have given up on this female psychiatrist, but I was going to make an appointment with another male psychiatrist who I was told specializes in prenatal depression by his receptionist. However, I had to call yet another person to actually make the appointment. When I talked to the appointment lady, she referred me to this other female psychiatrist instead.

Did I lose you yet? Yes, it was complicated and I'm going into all the detail to show how much research one has to do to find the right person. When you are in the throwes of serious depression and trauma, you can't deal with this overwhelming task. My other support fell apart too, because people, including my husband, were not used to seeing me my normal assertive-take-charge-in-control-self fall apart to a whimpering mass of protoplasm. I related this whole shrink shopping story to my husband, and he said he would have given up after the 4th psychiatrist. I called a total of NINE psychiatrists before finding the one, and I have not even interviewed her yet to find out if she will be a good match!!

Don't depend on your fertility clinic to help you out either. While my new RE did try to get me the proper referrals, which is more than I can say for my old RE who just pawned me off on their clinic psychologist who I didn't care for, the referrals were not psychiatrists who specialize in prenatal depression or postpartum depression! If a fertility clinic has their own psychologists, they specialize in treating the stress and depression that comes with infertility, not after you get pregnant. I believe the assumption, which was mine also, is that all would be well after getting pregnant. There are women like me, who have problems with all the hormones of pregnancy and it affects their mental health. As far as I can tell, it's similar to post-partum depression, though the actual mechanism in the brain is probably a bit different.

When I was pregnant and depressed and anxious, the doctors I was seeing either 1) ignored my depression or 2) judged me for not taking the Prozac I was prescribed. When an anti-depressant makes you more anxious, you don't have much motivation to take it! Hence the reason I am insisting on seeing a specialist in the area of prenatal depression and anxiety. If a doctor had said to me, "here is the specialist you should see that is covered by my insurance" that would have helped a lot. But out of three doctors who saw the state I was in, none of them gave me any recommendations for a psychiatrist. You truly have to be your own mental health advocate, and when you are mentally unhealthy, all you want to do is crawl under the covers and stay there. I did the best I could at the time, and I really wasn't seeing the right people. I hope I don't go through the same thing again, but I'm going to be prepared this go around.

Ed note: Upon proofreading this for the 10th time, I finally noticed that I started off with "before getting pregnant" not "before my FET". I was going to change it, but then I thought, how cool is that?

A Beautiful Mind

"Michi's on the front page of the Sunday paper," declared Magic the other day.

"You're kidding." I say. She's been dead for two years, I'm thinking.

Michi was a brilliant colleague of Magic's who tragically committed suicide two years ago, almost to the day. However, her suicide was no ordinary one. She committed suicide while on 24 suicide watch in a hospital. Never leave a brilliant suicidal person alone in a room with her glasses. Michi really wanted to die, so she found a way to do it. She broke her glasses and cut herself to use her blood to leave a message to her loved ones. She figured out when she was being watched, which was about every 15 minutes. When she wasn't being watched, she set up something to make it look like she had her head down on the desk in the room that was in view of the camera. Then, she used the broken glass to shred her gown and hang herself off-view of the camera. I normally wouldn't talk about something so personal to someone else's life, but all of this was in the newspaper article. Michi made the news because her parents are suing the hospital that majorly screwed up. The hospital is going to lose this one, but who wins?

I remember being upset by Michi's suicide. We all knew Michi, Magic the kids and I. We liked her, but we knew she was a troubled soul. I'm always impacted when someone I know commits suicide. I know that it could have been me. I hate seeing how suicide affects those who are left behind as they grapple with the questions of "why?", the anger, and the grief. I've been on the receiving end of the fallout as a good friend of mine from high school committed suicide at age 20. I take it upon myself to tell the spouses, parents, sisters, and friends left behind how mental illness took their life, not the person they loved. I can say this as someone who has been to the edge of the abyss, but backed away. I don't enjoy being able to speak from experience, but I think it does help those left behind to know that it was mental illness. When you feel that depressed, you are not aware of the love others have for you. It's like being in the hell of a black hole that you can't get out of. So you might as well be dead.

Michi's boss, a prominent professor at our local university said in the newspaper article that he did not notice any outward signs of depression. Michi apparently hid it pretty well. I also know how this works. I wondered while I was pregnant if I fooled people by appearing functional, when in reality, I was falling apart inside. I have a long list of health care practitioners who dropped the ball on me while I was pregnant. All of them either didn't notice that I was depressed, or didn't care. Their apathy took the form of assuming someone else was taking care of me, or assuming I would "be alright". One doctor boldly wrote me off in her notes of my visit with her. I was so angry about that. It's not like I didn't tell them, I did. I don't know if they just didn't take me seriously because they were so used to seeing me be so competent and functional, or they didn't have the time to deal with me. I asked Magic if he thought I was fooling people, and he said, no, I was not in my right mind when I was pregnant.

No wonder I had no trust of doctors to help me when I was pregnant and depressed. The system had failed Michi. People are so clueless about mental illness, even health care professionals. It wasn't only doctors who failed me. It was doulas and acupuncturists as well. I'm glad her parents are suing. If it saves another life in the future, I guess it's worth it.

The photo at the top is a picture of Michi's art that she won an award for. Michi had a flair for photographing liquid crystals under a microscope. Don't they look like colorful snowflakes?

Let Me Tell You About My Mother

This is a private post. If you have access, click here:

The Grumpy Grandma

Doubt

I had just seen my Wizard, The Shrink, and I was in our local groovy pharmacy today getting another prescription filled for anti-depressants. I decided to kill some time by perusing the store's book selection, and found this: "The Zen Path through Depression". The irony of me finding this book on Zen while waiting for my anti-depressants was not lost on me. I didn't know whether to chuckle at myself or to burst out in tears on how hopeless it all was.

When I first started taking anti-depressants three weeks ago, I was started out on Well.butrin. I felt the effects immediately. I went from 0 to 60 in a couple of days. I felt like the Energizer Bunny compared to how down in the dumps I was feeling before. Magic told me that he looked at the chemical structure of Well.butrin, being a wiz in this type of thing, and that basically, it's very similar to metham.phetamine. I needed to function, so the extra boost was welcome as I had a lot of catching up to do from the down time of my IVF cycle and pregnancy. That lasted for about a week, until the depression started creeping in again, but that may have been situational. My Shrink put the medicines in perspective for me. "We are just trying to get you to the shore," he said. "We aren't going to give you a speed boat, you'll still have to swim." I liked this analogy, and it made me think of Sharah's brilliant post on "Infertility Island". If you haven't read it yet, go read it now, or this next part won't make sense! I feel like I've been drifting in the current ever since my ferry capsized and haven't know which shore to swim to. I still have a lot of inner work to do, so I better get swimming, as that shore looks kinda far away!

I was prescribed another anti-depressant today, to cover all the neurotransmitter bases. The Well.butrin increases dopamine and norepinephrine. Too much norepinephrine can cause side effects, like interfering with sleep. I now have Cel.exa, an SSRI drug to increase serotonin, to mellow out the speed like effect of the Well.butrin, and hopefully make me sleep more.

As I was waiting for the Cel.exa prescription to be filled, I browsed through the contents of "The Zen Path through Depression". I gravitated towards the Chapter titled "Doubt".

"...in depression [my note: feel free to substitute with infertility here] all the reassuring and comfortable touchstones we had, or thought we had, in our lives are gone. We feel adrift, with nothing to believe in. The doubt within us sits heavily in the pits of our stomachs. We can't seem to get rid of it no matter how hard we try."

I have doubt about a lot of things. Doubt if we will try again. Doubt about my ability to be a good mother. Doubt about whether I really want to have children or that I want to live childfree. Doubt that I really know what I want in life, or that I really know who I am, for that matter of fact. Doubt that God or the Universe cares about me, that maybe I'm just the butt of a cruel cosmic joke. Doubt that I should have ever gone down this road of IVF with all the agony it's brought me. Doubt that I know what to do with my life next.

"We must be willing to reside in the midst of this enormous doubt and let it be all right. In fact, we must accept that it may never be resolved and that this will still be all right.

This means that we continually question; we never simply accept the answers others give us. It means that we do not hold on to the answers even when we have discovered them for ourselves.

If we can live with this doubt, we can then be continually ready to be surprised - by life, by ourselves, by our answers, by our experience."

The author describes how Zen koans, which are like riddles to meditate on that have no answer ("what is the sound of one hand clapping?"), are used to increase doubt. I feel that I have been given a koan to meditate on. I wanted to have children all my life and went to great lengths to achieve that goal. Yet, I had a lot of contradictory thoughts when I was pregnant. Was that prenatal depression? One book I have on depression and anxiety says this:

"Pregnancy does not protect women from depression. In fact, at no other time is a woman at greater risk for the onset or relapse of a psychiatric disorder than during pregnancy and the post partum period...For women who have Post Traumatic Stress Disorder, pregnancy and labor and delivery can also trigger flashbacks, nightmares, and intrusive thoughts about prior traumatic events."

What trauma was I reliving? I've already worked on my childhood issues a lot, so I was completely unprepared to deal with the intensity of emotions that surfaced around this during my pregnancy.

I know I need to find some answers about what happened to me while I was pregnant. I want resolution, though I know that it may never be resolved. For now, these questions, these koans keep me up at night.

References:
Healing Anxiety and Depression, by Daniel G. Amen, M.D. 2003.

The Zen Path through Depression, by Philip Martin. 1999.