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Why You Need a Health Coach for Fertility

a blog by Shana Kurz, August 2, 2012

I wish someone had told me this seven years ago. “Shana, you think you are eating healthy, but in actuality you should make some changes. Eating McDonald’s on road trips, drinking skim milk like water, white pasta, white rice, Diet Coke, coffee, Splenda, Cheez-its for breakfast … it’s all making it harder for you to get pregnant. And I have some ideas for gradual changes we can make together.”

But I wasn’t overweight, and I didn’t have any diseases. Even my fertility doctors were stumped. I had unexplained infertility for two years and was told numerous times that I was young (28 to be exact), implying that this just didn’t make any sense. But after I got pregnant through IVF and gave birth to my twin boys, I started to focus on my boys' nutrition and in turn my own diet. Seven months later I’m spontaneously (and surprisingly) pregnant again.

(And it’s not because I wasn’t stressed anymore, because my twin babies were stressful. They were born early and had many follow up appointments because of their small size, a huge worry as a new mom. I also didn’t have a nanny or family close by, and my husband worked so much that he only saw the boys awake in the middle of the night or on weekends.)

So let’s take a look at the changes I made after my boys were born. I started to cook more meals because the option of eating out became close to impossible. In order to cook, I needed to grocery shop, read labels and plan meals. This reduced the amount of processed foods, salt, sugar, saturated fat and trans fat I consumed. It also increased the amount of vegetables, fruit, nuts, whole grains, minerals and nutrients I was consuming. And I was exercising daily. I had a kick-a** double stroller that I pushed around every day, even in the rain. And although my sleep was interrupted often, I was focused on getting enough, which included naps during the day to catch up.

And it’s better late then never, because after another year and a half, I’m spontaneously pregnant again (Boy #4). And that’s when I had my "aha" moment.

In retrospect, I now realize exactly who was missing in my fertility tribe — a Health Coach. A Health Coach guides and supports you while you make healthy diet and lifestyle changes. I could have avoided some of the heartache and medical intervention and have had a support system in place to focus on my fertility and improve my chances of getting pregnant. According to Harvard University, up to 84 percent of ovulatory infertility can be reduced by changes in diet, weight and activity level.

After understanding the impact a Health Coach can have on fertility, I decided to become one. At last, I could use my experience to support others. Take a look around my website to learn more at www.constructivehealth.com, and then contact me for your free consultation.

How James Taylor Put My Infertility into Perspective

a blog by Shana Kurz, July 24, 2012

“There is a feeling like the clenching of the fist
There is a hunger in the center of the chest
There is a passage through the darkness and the mist
Though the body sleeps the heart will never rest”
(Shed A Little Light, James Taylor)

Last night I watched James Taylor perform at Red Rocks in Colorado. A beautiful amphitheater that was originally used by the Native Americans for religious ceremonies and a place that James Taylor said is “unlike any other.” The night was windy and warm, and I sat tight against my husband as we sang along and swayed or held hands lost in thought.

It ended up being an unexpectedly emotional night but started off as usual. I was in a rush to get out of the house, and my husband was pulling together a picnic, and when we got to Red Rocks, we relaxed and enjoyed the view from the trunk of our car and caught up after week of house guests and a sick baby.

Once inside, the beauty of my surroundings and the familiar songs pulled the last seven years into focus. Seven years ago, my husband and I went to see James Taylor at Tanglewood in Massachusetts; we had been married for three months. We spent that Fourth of July weekend and the concert with friends, and had a blissful freedom that most newlyweds do. While I was at the concert, I bought a poster that James Taylor drew himself, a picture of a bus with animals riding inside, all done in pastel colors. I rolled it up and saved it for my baby’s room, thinking someday it will have a place. Little did I know the reminder it would be for the next two years. Had I jinxed myself into thinking I could have a plan around getting pregnant and having children?

Today that poster is hanging in my youngest baby’s room, which he shares with one of his big brothers. It’s hung in three different houses, but it always finds its way onto a wall in my child’s room.

Last night, I was able to enjoy the concert fully and still with some bliss. Just my husband and I again, but this time with our babies sleeping soundly in their beds.

“No one can tell me that I'm doing wrong today, whenever I see you smile at me”
(Your Smiling Face, James Taylor)

Where Does Infertility Fit Into My Life?

a blog by Shana Kurz, July 19, 2012

I look back at my life and can see its phases. Infancy through high school blur together, a flurry of changes coupled with the belief the world revolved around me. College offered a breath of fresh air through its choices, a chance to choose my friends, classes I was interested in, parties to attend and who to date. After college, I steamrolled into the corporate world, I believed in myself and did not have anything to lose. With that determination I went to business school and then back into the corporate world still full of drive.

Then when I wasn’t looking I met my match and entered the next phase. He was a hard worker who had pushed himself for the sake of getting to the next step. A “work hard, play hard” guy who pulled all-nighters while only coming home so we could go for a run together. We both knew how to move ahead, and when we met, we quickly realized our next step was to be together. Within a year and a half of meeting, we were married and gave little debate to having children. We expected to have children; they would be an additional layer to our lives. A challenge we were excited about.

And then I entered the phase I named the “Baby March” (March of the Penguins had come out recently, and the name stuck). One step in front of the other, with trips, falls and collapses throughout. Walking through quicksand, while everyone else has wings. I lived my life in two-week increments, and each day I wanted to hurry to the next so I could either find out if I was pregnant or get to the day when I could start trying to get pregnant.

The Baby March gave me a period in my life when I didn’t know what was next. It didn’t fit with my plans, it wasn’t solved through hard work; it was ugly and not an easy topic of conversation. I knew it was a phase; somehow I was going to have children, but I wouldn’t let myself think that far ahead.

When I look back at the Baby March, I have sympathy for myself, I feel bad that I had to go through that time. But I can also draw so much from my march, and I can apply my march to other’s marches. We are all marching, for different reasons and at different speeds. Some are being dragged along, while others are the grand masters of a parade. But what I realize is it can always change, my parade ended with the start of the Baby March, but afterwards I was able to get back in and this time I joined the band.

A Story of Friendship

a blog by Shana Kurz, June 30, 2012

I believe as you move into adulthood, each of your friends serve a purpose. Some are there to make you laugh, others for support, some you share common interests with and then there are one or two that are the complete package. I also believe there are cycles that friendships move through, the ups and downs similar to all relationships, but compared to the crazy boyfriend from college, the curve on a graph would be smooth with gentle slopes.

When I started trying to have a baby, my husband and I moved to the perfect suburban town. This town had a beautiful downtown area with a coffee shop, bakery, restaurants and two Ralph Lauren stores. The train took half of the town into New York City each morning while the other half took care of their children. It was an amazing place to live, with amazing people, places to go and activities for involvement. But only if you had children.

It was a strange place to be when you didn’t have a child. I didn’t have any use for the playgrounds, the parades and the top public schools. But I joined the Young Women’s League anyway. I was so excited about the town in general that I wanted to be as involved as possible with or without children. During my first meeting for new members, I spoke with a women who didn’t have any children either. We moved quickly from pleasantries to the down and dirty of infertility. She was a friend in an instant.

We spent all of our free time together. Lunches, dinners with our spouses, phone calls after each doctor’s appointment, car-pooling to events and Pilates classes. We even shared the same reproductive endocrinologist. And as we progressed through our individual fertility treatments, we had to face the probability that one of us was going to get pregnant first. It was easy to say I’d be excited for her, but in actuality I knew it was going to be devastating. Not only would I lose my support, I’d have to watch her move to the inside of all that our town had to offer.

I had my second round of in vitro fertilization (IVF) scheduled the same month as her fifth round of IVF, same office and with the same doctor. And our cycles synced up, so our embryo transfers were a day apart. I was full of mixed feelings. What if this doesn’t work again, but what if it does? And what if it doesn’t work and hers does?

We each had a positive blood test and spent a nail biting couple of weeks as our blood levels doubled every 48 hours. Her blood levels were so sky high, we had a suspicion she was carrying twins. We had our ultrasounds scheduled back to back, and hers was first. But the night before my appointment I started bleeding, a lot. And I had been through this before. My husband and I curled up on the couch as I sobbed.

The next morning I went to the fertility doctor's office so he could confirm what I already knew. As my husband and I walked in, I saw my friend at the desk making her next appointment. She smiled and held up two fingers — she was having twins. We didn’t even speak, knowing the delicacy of what lied between us. I entered my appointment braced for the worst news.

What I believe about friends is they are in your life for a reason, and it takes the full cycle to find out why. Stick with them through the ups and downs.

I was having twins also.

An Apology to a Friend

a blog by Shana Kurz, June 19, 2012

Dear Friend,

There was a time in my life when I hadn’t experienced any failure. My heart didn’t know sorrow or shame. My ego was in control and my life was easy. So easy in fact, I was fearful of what awful experience I was going to have, it was bound to happen, where was it hiding? Was I going to be in a car accident, was I going to be raped at a house party, was my apartment going to be burglarized? I watched others go through tough times and had no way of reaching out to help them. I felt useless and scared when faced with others' misfortunes. What could I say to someone who experienced something tragic or sad? Nothing that would ever seem genuine and surely they could see through me; they would know I wasn’t sincere, that I didn’t have any idea what I was talking about.

And then your father got sick and quickly passed away. Your father who was so similar to my father. Your experience so easily could have been my experience. I felt consumed by what happened, but, at the same time, had no idea how you could have been feeling. I was one of your closest friends but had no way of supporting you. And I was a coward. Rather then dealing with my own emotions and being honest with you, I didn’t do anything. And it’s been hanging over my head for years.

A few years later, my easy life caught up to me and I endured two years of miscarriages, surgeries and medical intervention. Infertility became the awful experience I was waiting for. I cried at inappropriate times, hated others for their bundles of joy and felt that nobody understood what I was going through. But I also realized I wanted support from others. I could feel people pull away, that they didn’t know what to say, and, therefore, they didn’t say anything. I craved for someone to just honestly tell me what they thought of my experience and for them to give me space to open up and talk. I needed a friend who called to see how I was doing and just let me cry.

I now understand how I could have been a good friend to you. How I could’ve stopped by with two beers and a hug. How I should’ve pushed myself into your sad world and insisted on staying awhile. How I should have trusted you would eventually feel better.

I’m sorry I wasn’t able to support you during your toughest time. I promise to be there for you as we continue through our lives, which include all that is good and bad. I have context now, and I’m not scared. And I’m humbled that we are still friends.

Love,
Shana

Stop Rationalizing a Miscarriage

a blog by Shana Kurz, June 12, 2012

When I suffered a miscarriage, I was always able to use the rationalization that the baby “wasn’t meant to be.” Early miscarriages are most likely because of chromosomal abnormalities, so I was able to use research, medical terms and comments from well-intended friends and families to explain away each miscarriage I had. The fetus wasn’t developing properly and therefore stopped growing, “it wasn’t meant to be.”

The days between a positive blood test and a blood test with a falling hCG level were always full of hope, signals between the embryo and myself through exhaustion and nausea. I would think about the time of year I would give birth and how my life would change. I would enjoy the secret I had inside me, invisible to all others while so important.

And in one phone call, from a nurse named Alexia, those thoughts and hopes would be slashed. My body was carrying a chromosomal mistake that would be explained away with the words “it wasn’t meant to be.” And although I believed those words, I now realize that they were not true. It wasn’t up to me or anyone else to determine what is meant to be — it was my body and an experience. If someone loses their watch, a loved one or a race, we don’t say “it wasn’t meant to be.” Instead, we say “bummer," or “I’m so sorry to hear about your loss” or “better luck next time.”

Nobody tries to take away your experience in any other situation, except when there is a miscarriage. Why did I believe those words? What was on the other side if I took away these words and stared at the hole that was left? I would have admitted there was a huge loss that would shape my life in every way, ways I will never understand. I will never know what would have happened if I hadn’t miscarried, and, therefore, my life is different now. There was grief, but as that faded, I would have admitted that a miscarriage isn’t a mistake or a small hurdle. Instead it’s a sharp turn in the road, a u-turn in fact. It’s a shift for your body and mind, a shift for you, your partner and your families. I should have screamed, “Life just changed forever! Is anyone listening?”

But instead I suffered in silence, rationalizing and burying my feelings in an effort to have hope again. Could I have suffered five miscarriages and faced my true feelings each time? Did I have the strength to stand up to friends and family when I heard them utter those same words “it wasn’t meant to be?” I wish I could have, just like I wish I could have the baby that was lost each time.

My Great Fertility Doctor

a blog by Shana Kurz, June 6, 2012

I’ve had plenty of doctors in my life; primary, dermatologist, dentist, ophthalmologist and gynecologist. Each of those doctors I saw once a year for a standard appointment so I could spend another year feeling healthy.

Then I had two miscarriages in three months, and after hearing that the genetic test from my second miscarriage came back “normal” I asked my Ob-Gyn: “Should I be seeing a specialist?” I was distraught and wasn’t getting any information that explained what was happening. The only advice I received from my Ob-Gyn was “Refrain from trying again for a month, since you’ve just had a D&C.” Right, thanks. I was looking for more, someone to tell me what was wrong.

My reproductive endocrinologist (RE) was a gentle and calm man who took time to speak with my husband and I at length. He would sit cross-legged in his scrubs on the other side of his desk and explain our options, next steps, costs and statistics. He easily handled our business-like focus, even going so far as to hold conference calls with my husband when he couldn’t attend an appointment.

When you search for a fertility doctor, you are looking at “live birth rates” and “top docs,” but equally important is how you feel in their office, how comfortable you are talking to your doctor. This is the doctor you will spend more time with then any other. My "one and done" appointments were traded for something similar to training for a marathon: I now faced numerous appointments that required endurance. Early morning blood work, repeated ultrasounds and procedures — all taking place in the same office. In a given month I would visit my RE’s office 10 to 15 times.

And after all the care, we crossed the finish line. I remember fondly the little brick building, the parking lot across the street, the elevator ride upstairs, the moody receptionist who remembered my name last week, but oddly not today. But what I miss the most is my RE. When I found out I was pregnant I wanted to send flowers to the office. My husband thought maybe they should send me flowers, since we did pay a hefty price. So I opted for muffins to bring along to my last appointment. When I found out we were having boys, I asked my husband, can we name one of them Spencer after my RE. (None of my sons are named Spencer but it’s a name still dear to me).

There is a unique relationship that is created in a fertility doctor's office; there is so much trust, energy and emotion being used during each visit. Both your and your RE need to have a great relationship with each other to endure the marathon — or I hope for others, the sprint — of infertility.

The Dreaded Injection

a blog by Shana Kurz, May 31, 2012

When I was 12 years old I had a minor surgery scheduled in the morning. My mom accompanied me, and as part of the pre-op workup, I needed a finger prick test. The next time I saw my mom, I was in recovery, not because I had surgery, but because I passed out during the finger prick. The last thing I remember before passing out is the nurse calling for help, yelling “anybody!”

Fast-forward 15 years, and I’m faced, once again, with needles. The first ones start out small, as if that makes a difference. The needle may have been small, but facing my fear was not. I attended a class to learn how to draw up the medications, how to pinch my skin and inject. I also learned about the importance of timing these needles. So when the nurse says you need to do your injection tonight between 6 and 8 p.m., I had to comply.

I had a job that required a lot of travel, a different city each night. The first time I needed to inject myself, I was in a hotel room with a queen size bed, a sofa and kitchenette. I tried sitting on the bed, pacing the room, walking into the bathroom, but the needle will not make its way into the pinched fold of my stomach. No amount of hopping around, breathing, lying down and back up again worked. Injections are mind torture. You are willing your hand to plunge the needle into your body, telling your mind to get over it, while being so frightened at the same time. I wish I could tell you how I did it, but I just don’t know. There was a split second where my hand was just listening more then my head.

As I progressed through fertility treatments, the needles moved from small to large and from my stomach to my backside. My husband was usually the one to inject these, but he traveled as well, and there came a time when he wasn’t going to be able to do it. So in steps my mother-in-law, a sweet and caring woman who was desperate for grandchildren. She drove an hour each night to inject medication into my backside, a bonding moment to say the least.

Although each shot was painful (and in the case of my mother-in-law, embarrassing), it was always followed with a surge of pride. I had faced my fear, and I could congratulate myself because I was doing exactly what I needed to do to have a baby. It did not make the next needle any easier, but I’m still amazed with myself. It’s a moment in my life when I can say to my former self “I don’t know how you do it. You are so strong and courageous, I don’t know how you do it.”

Asking for Help

a blog by Shana Kurz, May 24, 2012

I am part of a family of doers. We work hard, don’t complain and push on with enormous amounts of strength. So, when I approached the doors of the fertility clinic, I approached it like a job. I would be on time, wear professional clothing, study up on my meds and cycles. I would take notes and keep track of my hormone levels, egg maturation and learn all of the statistics. I would not cry.

After each day, I would summarize my “fertility for today” when I talked with my husband at night. He is strong, works hard, is fully supportive and interested, but just wanted to talk about other things too. So over those first six months of tests, meds and ultrasounds, I realized that even though I was focused on the details of my doctor’s appointment and procedures, my husband needed his wife and friend. So I took the next step and asked for help.

I was referred to the therapist who worked out of my fertility doctor’s office. She was kind and thoughtful, a great listener and above all else was able to help me put words around the feelings I was having. I resented my pregnant friends and my pregnant sister-in-law, I didn’t like to be around babies and overall had a negative view of my body since it was failing me. I didn’t like what I was going through, how it impacted my corporate job, my relationships, my sleep, my body. And what I learned was that this was all normal, protection in fact. I wasn’t mean or being negative, I was taking care of myself. It was OK to complain.

She helped me through all of my fertility treatments and ultimately had to tell me that we had come to our final session. I was still on her couch at 10 weeks pregnant and wasn’t planning to make a change. The week before, my doctors had finally convinced me to see an OB, and now it was my therapist’s turn to set me free. I had come to a point where I was going to be OK and could turn back to my husband, family and friends for support.

When I think about all I benefited from that one hour a week, I get goosebumps. It was an hour of strength, and a time to admit what I was really feeling and to ask for help. This was so different from how I grew up that it became a pivotal point in my life. I still don’t feel comfortable asking for help, but I now know that it’s courageous and a reflection of strength … and something I need to practice my entire life.

Infertility's Lasting Impression

a blog by Shana Kurz, May 22, 2012

When I was going through fertility treatments, I had a friend’s bachelorette party one weekend. Leading up to the weekend there were a flurry of emails about our plans and excitement, but one email knocked the wind out of me. It was from one of my closest friends remarking how she couldn’t make the party because she was pregnant so “have a drink for me!”

How I wished I could sit home pregnant and not drink. I wanted to be in her shoes more than anything, and it was crippling to feel those words. It turned that weekend into another chore I had to endure because I wasn’t able to get pregnant. I would dream about a time when I couldn’t drink, or when I’m early in my pregnancy and drinking grape juice instead of wine because I didn’t want anyone to suspect I was pregnant yet. Wanting so badly to be on the inside of pregnancy jokes, like my friend’s, rather then offended.

I wanted to be just like my friend, pregnant and funny, with a twist of “wish I could drink.” But when I finally got pregnant, I couldn’t be that pregnant women, I had been through too much. I wasn’t naïve and cute. I had endured surgeries and fear. And then within 20 weeks of my pregnancy I became a high-risk patient because of pre-term labor. Not only did I need the help of many doctors to become pregnant, I also needed many doctors to stay pregnant, to deliver my twin boys — and then more doctors to help keep them alive.

But my infertility made me strong, a confident women who knows tough times. It made me compassionate when I talk with someone who is struggling. I may not know everyone else’s pain, but I understand pain. I don’t pity people, or think “poor soul." I think of all of the unique experiences, outpourings of love and support that will come their way. I learned to push through hard times, focus on what is important and enjoy life when it does go my way. I also have learned the feeling of peace that comes from good health for my family and me.

Infertility has changed the type of parent and person I have become and will continue to be. I didn’t dream about my son being a baseball star or learning to ski before his peers. I dreamt about my family, a baby in my arms. A happy baby because he has loving parents who spent years trying to have him. The experience of infertility stays a part of you, and can miraculously be called upon when you need perspective for yourself and others. I can still get mad and downright cranky, but I also know how to see my way through to the next moment with hope and determination, because I’ve overcome.