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An Interactive Q&A with Stirrup Queen Melissa Ford
We're willing to bet that you already know Melissa Ford. Well, you may know her by her moniker, Stirrup Queen, or by her nom-de-type, Lollipop Goldstein, but anyone who's dealt with infertility for a nanosecond has come across Stirrup Queens and Sperm Palace Jesters, Melissa's popular blog.
Melissa's also recently written a book, Navigating the LAND of IF: Understanding Infertility and Exploring Your Options (Seal Press 2009). It's an excellent "how-to" that will help you confront the options (and obstacles) you face when dealing with infertility. We've read it cover-to-cover and have invited Melissa here to discuss it with you.
Throughout this week (Oct. 19 - 23) we'll be presenting a Q & A with Melissa about different topics each day.
You're invited to participate! Post any questions you have for Melissa at the bottom of this page and she will answer you.
Let's get started! Welcome to all of you and welcome Melissa!
Friday, October 23, 2009
Q. It seems like you and your husband Josh have a good thing going. How can couples experiencing infertility/treatment make sure they don't self-destruct their relationship?
- My husband is a fantastic guy — I really lucked out. I couldn’t have had a better person to go through a life crisis with because he is my rock, always grounding us. And yet, he panics when it’s time to panic.
I think that’s the best piece of advice I’ve observed in our relationship that I can pass along to someone else: let the other person see your vulnerability. Let them see that you are scared too. Talk about it, cry if that feels right. I think too many times, emotional people become more upset when they see calm. They can interpret it as a lack of care. And we all know that isn’t the truth.
We all experience fear, we all experience doubt, we all worry about looking weak, and we all have great sadness when we want to become parents and we can’t build our families. Home is not a space to worry about how you appear.
Save your holding back tears for the hours you’re at work. Have a good, long cry in front of your partner tonight.
Q. Let’s end on a positive note! Finally getting pregnant after years of struggle can give ANXIETY a whole new meaning. How can you deal with all your new fears and worries?
- Anxiety is a positive note?! Actually, anxiety is a positive note as I said a few days ago.
I’m a worrier and we all know the negative side of worrying—the unnecessary stress, the bothering of other people. But the positive side is that it’s preparation. You’re thinking through the what ifs and you’re alert, troubleshooting problems.
Convey your emotional state to your doctor, but tell him/her this: “I need you to both reel me in when I’m becoming too wild with my fears and I need you to humour me sometimes for peace of mind. My emotional health is just as important as my physical health and my whole self — mind and body — is tied to this baby.” Hopefully, they’ll see that you’re still well-grounded, even when you’re begging for weekly sonograms.
By the way, I begged for weekly sonograms. Sometimes my doctor gave in. Sometimes he told me a firm no.
Have questions for me about these or other issues? Ask your questions at the bottom of this page.
Thursday, Oct. 22, 2009
Q. Many of our readers have dealt with pregnancy loss. You discuss this in depth in Chapter 7, stating that 10 – 20 percent of all pregnancies end in miscarriage (a number that rises with a woman’s age). Can you talk about ways your book addresses the grieving process that follows a miscarriage?
- Sometimes, people think the earlier the loss, the less painful it must be. And that simply isn’t true. Everyone grieves in their own way, and it can be very difficult to mourn when people don’t know you’re in mourning.
Part of what helps us grieve when someone dies is the ritual surrounding the loss—community and family drawing together, the funeral, the togetherness afterward. Those who experience early loss miss out on that support. If the loss has happened prior to telling people about the pregnancy, it can be very isolating to grieve alone.
Everyone also needs to find their own timeline, after they are cleared by their doctor, if and when they want to try again. I think too many times, those outside the experience try to hurry someone along before they’re ready or hold them back when they want to try again. And those timelines are so personal, my advice is that each person should find their own place of peace and stick with it regardless of what others say. Find the rituals that help you or bring you closure. Connect with others who have gone through a loss and lean on each other for support.
Q. In Chapter 11 you talk about issues that arise with making the decision to live child-free after infertility. What unique challenges does this choice present?
- It’s the only path out of infertility that asks you to let go of all the dreams you’ve been carrying, not just some of them. It’s also the only path that is undo-able—which in some respects makes it a harder path to walk. Meaning, you can’t unring the bell once you’ve adopted a child, or used a surrogate, or given birth. But you can actively live child-free and decide years down the road that you want a different path and it’s possible, depending on outside factors, to switch to a different path out of infertility. And that can make it more difficult to commit to and it can make it more difficult to convey the finality of your decision to others.
I think what separates living child-free from taking a break is ownership of the decision. Living child-free is a choice just as adoption is a choice and just as treatments are a choice.
There is a big difference between “I didn’t choose this” and “I didn’t want this” and I always get worried when someone tells me they want to live child-free and uses the phrase “I didn’t choose this.” They may not have wanted to be infertile, but that shouldn’t be mixed up with the idea of not wanting to live child-free.
If it doesn’t feel like the right choice, it’s probably not the right choice—at least not right now. It may become the right choice somewhere down the line. And if you didn’t feel like you made a choice, you aren’t actually living child-free. Living child-free is a concrete decision—one that comes with sadness, grief, happiness, anger, relief: just like all roads out of infertility (peace with a decision does not mean emotion-free).
Deciding to live child-free is about wresting back control from infertility just as much as doing treatments is about wresting back control (your body says no, so you over-ride it and try to tell it yes through injections and procedures). Living child-free is not about “giving up” or “throwing in the towel.” No one should be entering living child-free because they’re frustrated with infertility.
And I say all these things to keep it as a choice rather than a default position. People need to give it respect as a path out of infertility both by recognizing it as an option and by treating it as a choice.
Wednesday, Oct. 21, 2009
Q. Patients are always telling us that doctors lack bedside manner. What level of care should you expect from your RE? When is it time to move on to a new doctor?
- I lucked out and had a great doctor. He would include us in decision-making when there were two good options and took the reins when a doctor needed to be in charge. He didn’t give in to our whims, but he understood we were stressed and upset and acted accordingly. He didn’t sugarcoat test results, but he also didn’t let me run directly to my worst fears (remember: I’m a worrier).
Now, does every doctor need to do that in order to be considered a “good” doctor? No, but respect should be flowing both ways between doctor and patient. The doctor should listen to the patient and include them as much as possible whether it’s explaining test results or giving them options. And patients need to be open with their doctors, follow instructions, and be forthcoming.
I think you should listen to your gut and ask yourself if you’re remaining with your doctor because it’s easier than switching, or if there is actual trust flowing in both directions. It’s hard to switch doctors or clinics, but sometimes it has to happen because personalities will not always mesh well with one another.
Q. You recommend couples approach decision making about family building by using a “Choice Web,” taking a deductive approach. Can you elaborate for our audience? How does a Choice Web help?
- Using a Choice Web helps because it takes all the possibilities that you’re currently juggling inside your head and places them on paper so that you can look at them with your full attention and you can share them with another person. Sometimes, if you follow all the possibilities through their “what ifs,” it takes some of the fear of the unknown out of the situation as well.
Q. Chapter 8, “A Walking Tour of Treatments,” is filled with helpful tips about making taking shots more bearable. What are some of the secrets you’ve learned? Can you share a few helpful tips?
- > Letting injectable medications get to room temperature before injecting.
> Icing your stomach with an ice cube right before the injection to numb it.
> Lying down for 10 minutes after inserting your Prometrium will help allow the peanut oil (the stuff that is dripping out on your pantiliner) to get absorbed along with the progesterone. It doesn’t make the drug more effective, but it keeps your panties neater.
Tuesday, Oct. 20, 2009
Q. One big challenge infertile women face is responding to ignorant questions from (possibly) well-intentioned third parties. You address these issues in Chapter 5 of your book, “The Road to Hell is Paved in ‘Just Relax.’” What's the best way to deal with unwanted (and frequently uneducated) comments from others?
- Grit your teeth! What’s the old saying, “You catch more flies with honey?” No one is going to hear you if you immediately snap at them when they believe they are being well-intentioned.
If it’s a first or second transgression, you can gently correct and then distract (take them far far away from the topic of infertility).
If this is an on-going problem, address it head-on. If it’s still an on-going problem, well, you need to do what you need to do to get through the day. If it means not interacting with that person, so be it. Because it boils down to a lack of respect and support if you are clearly stating your needs and they’re not being met.
Now, the problem becomes bigger if you’re bumping heads with someone who you need to still interact with, such as a partner, sibling or parent. In those cases, if you are explaining how hurtful those types of statements are for you and they aren’t hearing your words, therapists can help mediate.
As much as we laugh with chapter five because we’ve all had random people offer that advice to us, it isn’t funny when it’s someone close stating those ideas as fact.
Q. What do you recommend telling the “pry-ers” who really want to probe into why you don’t have kids?
- It all has to do with tone. If I think they’re asking it because they’re genuinely curious, I’ll tell them the truth. If I get the sense that they’re judging, well, then I go through that three tiered list: kind, firm, and a free-for-all.
- Why don’t I have kids?
Kind: We just don’t. Actually, I had a question I wanted to ask you and I’ve forgotten it now…wait…give me a second.
Firm: It’s not something I really like to talk about.
Free-for-All: We thought they might turn out like you so…yikes…
Q. As was painfully evident in the commentary to the recent New York Times article, “The Gift of Life and Its Price,” many people cannot possibly fathom why women put so much blood, sweat, tears and dollars into IVF. They think adoption is the universal answer. How do you respond to the people who say, “Why don’t you just adopt?”
- Well, first my head explodes. And then, once I have it back on my shoulders again, I respond like this: There is no “just” in adoption.
That adoption isn’t a cure for infertility, and while it is a wonderful family building option, it needs to be considered on its own, without tying it into infertility. There are very real people with very real feelings involved in the triad — which is why there is no “just” in adoption. That is a term better applied to situations that do not contain such enormous emotion.
People don’t adopt because they’re infertile. People adopt because they want to build their family, become a parent, and raise a child. And that is the method they chose to enter that situation.
I'll be back with more Q&A tomorrow, but if you have any questions for me, please post them below and I'll answer them!
Monday, Oct. 19, 2009
Q. You start by talking about how to make the difficult choices about the course of treatment. How can women and their partners make the process as smoothly as possible? Don't these early stages set the tone for everything that follows?
- Yes and No. I don’t think it’s ever too late to put the brakes on the path you’re on and say “stop, I need to pause and think about this for a second.” Infertility is so incredibly painful and if people are acting quickly, it’s for good reason. You’re doing everything in your power to move through the situation to the other side.
No one wants to linger in the Land of If. But plotting out your comfort zone beforehand will help you make decisions that you’re at peace with later down the road.
Q. One of the reasons your book has legitimacy is that you have been down this road. Looking back on your experiences with decision-making, what would you do differently if you were TTC today?
Well, we are still family building, so a lot of this is still relevant to me, but I think I would have taken my own advice sooner.
I would have stopped trying to be someone else and work with what I have. I’m a worrier—which doesn’t sound like a desirable trait and certainly, I think everyone can guess the negative side of being a worrier. I spent so much time early on trying not to be a worrier that I just built up more stress because now I was infertile and not myself.
Once I embraced the fact that I am a worrier, I looked at ways to use my foible for good. Worriers are also great at thinking through what ifs and coming up with questions. See, not a terrible thing to be.
Q. Can you talk a bit about what you call “Exit Plans?” Why are they important?
- Exit plans lead somewhere, whereas walls are simply obstacles keeping you from a new road. So I’d start by stating that everyone should know their exit plan just in case the path they’re on isn’t working.
Walls have “nevers” built into them: as in, “I’d never consider adoption” or “I’d never do another IUI, this is our last cycle.” Exit plans follow an “if…then” format: as in, “if I try three IUIs and they’re not working, then we’ll sit down and talk about whether we want to do more IUIs or move to IVF.”
They aren't rigid plans because those tend to build more unhappiness and fear than bring peace. Think about it this way, there’s a reason why people want to live on cul-de-sac streets: They’re safer. Possibilities fan out around you and it offers some protection. Walking a straight line towards an end point is difficult and each step towards that end creates fear (“what if this cycle doesn’t work? Then I only have two more chances.”).