Posts from — February 2009

This is the 30th installment of Barren Advice. You can ask questions that are fertility or non-fertility related.

Barren Advice is posted each Tuesday-ish. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you’re addressing if there are multiple questions in the post.

Dear Mel:

At what point do you stop trying to repair a relationship, and just move on? What if this relationship is with someone you’ve hired to care for your child?

The situation in brief is: my babysitter e-mailed me that she was quitting, because she disagrees with how we’re putting V. to sleep. She’s been trying to do it our way but has been very frustrated. We’ve been e-mailing back and forth about it since Friday. I’m waiting to hear from her whether she’s willing to give it another shot, making some compromises but not doing it her way (15-min CIO), but at the same time I’m wondering whether the relationship will be sustainable in the long run if we have such philosophical differences.

It’s like, do you quit the RE who proposes a plan you don’t feel right about?

—Elizabeth

I always believe in listening to others; especially if they’re adamant. Who knows–they may make a really good point and make me see the world from an entirely new angle. You can pick up advice in places where you least expect it. But I listened to your babysitter, and she didn’t change my mind.

You’re the parent, you make the rules.

This is not to say that there can’t be differences in the way you do things or rules that apply when they’re with some people and not with others. But those changes need to still reflect your overall philosophy and how you put your child to sleep–one of the first ways we nurture a child–is usually tied to a larger picture of how you want to be as a parent or what you believe works best for your family.

In other words, our twins can have an extra sugar when they’re with grandma because complete hedonism is part of our family philosophy (I’m joking…but only a bit…there is only so much joking in my joking), but they can’t break kashrut. It just isn’t allowed in our family and anyone who wishes to be alone with our children needs to respect that. It is too hard to teach a child the basics of life when they are getting conflicting information. I can’t expect them to keep kosher if they don’t see the point of it and I can’t expect them to see the point of it if we only follow it when it’s convenient. Or if they only follow it here or there. It is just too important to our family’s overall philosophy to let that one change from caregiver to caregiver.

Sleep training is very similar–it’s something that you are teaching your child. So it is understandable that you want consistency. And it sounds as if your feelings about sleep training are tied to an overall family philosophy. In addition, from your blog posts, you sound far from inflexible but you also sound like you’ve given this a lot of thought without dismissing the babysitter outright. In other words, you heard how she wants to put your child down for a rest, considered it, and decided that it didn’t really work right now with your family.

And that decision should be respected. She is free to quit, but she isn’t free to give you advice on everything from the way she likes to do sleep training (if it differs greatly from your method) to which toys she believes you should be buying to how you set up your home. She gets to do all of those things in her own life, but she doesn’t get to go into another home and tell them how to run it. The only exception to this thought would be if you were doing something that was physically or emotionally detrimental to your child, and this, of course, is a slippery spot. I am talking about things that would fall under the guidelines of CPS (child abuse or neglect) and not differences in parenting.

It’s funny that you used the example of an RE because when you hire an RE (because that’s what you’re doing when you use his clinic), you are asking someone with specific knowledge to fix a specific problem. The RE should be focusing on your ovaries, uterus, fallopian tubes–he should not be focusing on your marriage, cooking advice, or what he thinks of your wardrobe. At the same time, you may have opinions on how he should do his job, but ultimately, what you are paying for is his expertise and therefore, you should take his advice because he knows more than you on the topic. Plumbers work on pipes and not in doling out commentary on your choice of wall paper. Interior decorators should be concerned with the choice of wall paper but not with the contents of your refrigerator and your caloric intake. Most of the people you will hire have specific knowledge that you are paying to access.

But here’s where the analogy fails–a babysitter is there to fill a need rather than fix a problem. The need is that there must be someone at all times with the child and if it isn’t going to be you, it needs to be a replacement you. The babysitter is not hired for her expertise (and with the exception of a sleep trainer or Super Nanny, is not there to fix a specific problem), but for a very specific reason–she can replicate you. She can provide nurturing as you provide nurturing; she can provide education as you provide education; she can provide safety as you provide safety. Which is why I have a deep respect for babysitters, nannies, and caregivers–they are the parents when the parents cannot be there.

Lest I sound like a hardass just with hired babysitters, I want to reinterate that I feel this way about anyone you trust with the care of your child from five minutes to five days a week. It doesn’t matter if they’re friends or family or someone you hired from a nanny agency–everyone should want to know about how you do things and should want to work with you rather than against you in raising your child. They can be the nicest person who knows how to entertain children for hours with origami butterflies and making macaroni-and-cheese from scratch. But those things are secondary–I’d rather have someone that I trust will be forwarding the core beliefs of our family or the necessary rules than someone who is going to teach me how to be a parent. And this isn’t to say that we can’t learn from one another and pick up tips from babysitters or other parents. But once you’ve weighed the advice and decided that it doesn’t work for you, everyone should be respecting your decision.

If she believes that your family isn’t working, it isn’t her place to fix it. It is her place to match with a family where everyone works well together. I think Super Nanny has gone to some people’s heads, but truly, unless you are asking for advice in terms of core parenting issues, she should not b
e weighing in on the main issues: food, sleep, and discipline. And therefore, even though there are drawbacks in changing caregivers–major drawbacks that need to be considered too–weigh the drawbacks against your feelings on your core beliefs and see which one weighs heavier.

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely.

Leave a comment in the reaction box below–only keep in mind that conflicting advice is embraced and rudeness is not. Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday’s installment of Barren Advice.

For the past few days, my computer has been grunting at me while I’m trying to sleep. The first time it happened, I assumed that I hadn’t shut it properly therefore, it wasn’t going into the usual dormant mode. The second time it happened, I assumed my computer was trying to tell me to write. The third time it happened, I decided to update my Norton anti-virus software that I had allowed to lapse.

And, for the love, I had the skankiest computer in the world.

Norton couldn’t stop telling me about the viruses it was finding. It was practically gleeful, yanking out Trojan after Trojan. But my computer still wouldn’t stop grunting so I loaded Ad Aware and it found about 80 more pieces of malware on my computer. Every time we ran it, it would find more and more tracking cookies and viruses. It took my father all day to clean up my computer (thank you, Daddy). Finally, at night, I closed the cover and went to sleep. And my computer didn’t grunt.

Show and Tell is wasted on elementary schoolers. Join several dozen bloggers weekly to show off an item, tell a story, and get the attention of the class. In other words, this is Show and Tell 2.0. Everyone is welcome to join, even if you have never posted before and just found out about Show and Tell for the first time today. So yank out a photo of the worst bridesmaid’s dress you ever wore and tell us the story; show off the homemade soup you cooked last night; or tell us all about the scarf you made for your first knitting project. Details on how to participate are located at the bottom of this post.

Let’s begin.

A few weeks ago, I wrote about the mystery gift I received in the mail. Last weekend, we threw it in my purse and hit the road. Before we departed for Shepherdstown, I gleefully left a status message on Facebook crowing about going out for afternoon tea. That didn’t happen.

You see, I really missed the point of the book which was to travel outside my personal norm and not pack expectations. And while I claimed I didn’t have any plans in place once we got to Shepherdstown, the truth was that I assumed we’d have a light lunch at the Thai place and then go down to the river for a bit and then end the outing with tea and cakes. But when we got to the town, almost every business was closed because it was a holiday. The one coffee shop that was open didn’t have anything I wanted to eat. I ended up trying not to cry because we rarely get out there and we finally had this chance and the trip was ruined.

Sadly eating a chocolate croissant at the coffee shop when my heart was really set on tea and cakes

I left Josh and the twins in the coffee shop and went over to the public library where I googled surrounding towns and jotted down some directions.

Before we left, we tried to get down to the river, but a few wrong turns brought us to this bizarre little memorial for the inventor of the steamboat. While looking at this view of the river…

We found this tiny path behind the memorial. We decided to see where it led. At the end there was a message.

Not entirely sure what it means, but as we stood there, Josh reminded me that so few people in the world know about this tiny spray painted sign and that was surely more special than tea and cakes.

Also, mysteriously spray painted on an adjacent fence were inexplicably the words “Only in America.” It felt like another clue to a puzzle.

We got in the car and took the long back roads to another favourite town in West Virginia, Berkeley Springs. The Wolvog fell asleep on the ride, so when we got to the town, Josh and Wolvog remained back in the car while the ChickieNob and I walked over to a little store on the corner. “There is something in here for the mystery gifter,” I told her.

“How do you know?” she asked.

“Because, I can just sense it.”

We walked through the store and picked up many items and we both kept shaking our heads. Finally, we were about to leave when we both spotted the same box at the same time. We ended up purchasing three of the same item and there is a little story behind that too, but that will have to be a different Show and Tell.

I never got my cup of tea until I got home, though I ended the trip on a much happier note.

What are you showing today?

Click here or scroll down to the bottom of this post if this is your first time joining along (hint: link to the permalink for the post, not the main url for your blog and use your blog’s name, not your name). The list is open from now until late Tuesday night and a new one is posted every week.

I think I found So Close somewhere around July 22, 2006. This was the first post I read. Which, of course, made me wildly scroll back through her archives, reading her whole story. Who was this crazy woman who could make me laugh and cry and nod and yelp all in one blog entry? Her book came out around the same time and I was so frustrated that it was not sold initially in the US. Hopefully, Tertia will not unearth the long stream of emails of me saying, “what about now? Or now? Is it out now? Or now?”

Um…it’s out now.

Yes, Americans and Canadians had to wait a long time, but in honour of the book coming to America, I am throwing Tertia a book shower. A book shower is half online book tour, half book and author celebration. Anyone can participate, in fact, everyone should participate. Even if you read her book two years ago and have already written about it, please participate. I promise the format will make it a whole new post.

Now I need to convince you why you should join along: (1) Tertia is one of the pillars of the ALI community and one of the friendliest and warmest people to boot. (2) While she will most certainly make you cry–9 IVF cycles and death will do that–she will also make you laugh. (3) Lastly, one of the sentences on the book’s description rings so incredibly true: “If you are struggling with infertility, have triumphed over infertility or have felt empathy with someone who is going through this experience, you will find a friend in Tertia.”

I hope you will support one of our own by celebrating her accomplishment in writing this book as well as honour the life of her sons, Ben (who lived for ten days after being delivered at 25 weeks) and Luke (who was born still), who are written about in the book. If you’d like to join along on the book tour, here’s how it works:

• Sign up by clicking here and filling out the information needed to get on the list before March 20.
• Read the book–as in, don’t wait to order it, go get it immediately and start reading. In the US, it is available through Amazon and Barnes and Noble (but not brick and mortar stores).
• On April 16th, I will send you a list of ten questions based on the book. You will choose one to answer in a blog post that goes up April 20th.
• On April 20th, I will post the master list and people will be able to jump from blog to blog, reading wonderful things about Tertia’s book and leaving smooches and chardonnay.

It’s as easy as that. It will be like a giant, online party. In addition, I have two copies of the book to giveaway. The form has a space where you can indicate whether or not you want your name put in the drawing (I can, unfortunately, only mail the book in the US). If you already have a copy of the book, please hold off so someone else can get a chance. The only catch is that the two winners of the two books cannot drop out of the book tour once the books are sent to them. The drawing will be done on February 24th, so the giveaway closes February 23rd at 11 p.m. EST. Just to be clear–you can keep signing up to participate in the tour/shower after that, but you can’t win the books.

So sign up–it is a wonderful way to celebrate our community, celebrate a writer, honour a life, and meet other bloggers online. Please spread word about the book tour on your blog, via Twitter, or Facebook. We may not be able to bring Tertia to America for a face-to-face book tour, but we can certainly pretend she is here, calling us whore and blowing kisses.

I loved the what if game so much last week that I think we should do this every Friday. So here is my what if. Add your own in the comment section below and answer mine as well as the others you find there.

The Weekly What If: What if, in order to keep all of the photographs you’ve ever taken, you needed to eat three live crickets? As in, they would be jumping around in your mouth before they went down. Eating live crickets or keeping your photographs?

Though single embryo transfer has been a hot topic debated in the infertility world for quite some time, it has been thrust into the spotlight by Nadya Suleman’s octuplets, the result of a six embryo transfer. Slate had an article this week asking “Pregnant Pause: Who Should Pay for In Vitro Fertilization” that doesn’t truly answer that question, but instead discusses the pros–but not the cons–of a single embryo transfer. If Slate is taking a pregnant pause, I’d like to fill the silence.

The author, Darshak Sanghavi, starts with a great argument in favour of eSET (elective single embryo transfer) but muddles it by contradicting himself and simplifying medicine with a one-size-fits-all approach. Is eSET a good idea when it is no longer elective but instead becomes mandated? No, just as we wouldn’t set a single protocol to deal with any other medical condition. Medicine should have guidelines that doctors use to tailor medicine to fit their patient and not expect patients to fit their medical conditions to protocols set absent of all possibilities.

On the first page of the article, Sanghavi states that the reason doctors choose to transfer (yes, they transfer, not implant. You’ll notice the term is eSET, not eSEI) is that “Implanting just one embryo leads to pregnancy roughly 40 percent to 50 percent of the time; two embryos are 75 percent successful; and three embryos are 87 percent successful. ” Yet his argument in favour of eSET quotes a study: “In 2004, Scandinavian doctors reported that implanting one embryo at a time, repeatedly if necessary, resulted in the same final pregnancy rates as implanting several at once.”

Which is it? Is a single embryo transfer just as successful as a multi-embryo transfer? Or is it ultimately successful if you do it 4 times rather than 2? I think the problem with boiling down people to numbers is that we are receiving no information on who was included in calculating the figure.

It all depends on the person and using statistics is reductive in a situation where every body responds uniquely to medication and procedures. Transfer of a single embryo in which woman? The one who also has a 28-day cycle a la the reproductive health books or the one with a luteal phase defect? A woman who is 25, 30, 35, or 40? A woman who has a uterine anomaly? A woman who still has her tubes? A woman who has had a previous pregnancy or a woman who has never carried to term? Sanghavi states these arbitrary numbers, but they are just that–arbitrary numbers. Without information about the people included in the study, we cannot possibly use these numbers against our own life to calculate out our chance for success.

That said, I do agree with Sanghavi that it would help reduce the rate of multiples overall by having fertility treatments covered by insurance. By which I mean, all fertility treatments; not just IVF (it disturbs me that people don’t realize that there are more options than IVF and that most of these options are not covered by insurance and need to be). It would steer more people towards eSET when eSET is the best choice in their situation. Of course, eSET is not the best choice for everyone. There will always be cases where time is of the essence or where the doctor weighs the risks of repeated exposure to fertility drugs against the risks of a multiple birth from a multi-embryo transfer.

I think when a doctor can soundly explain their reasoning–and I don’t think Nadya Suleman’s doctor can soundly explain his reasoning for transferring six embryos in a woman who has had a successful cycle every time she has had a transfer–they should be able to make decisions that are in the best interests of their patients and even with feedback from their patient in terms of what they can handle physically and emotionally.

So, yes, I ultimately agree with Sanghavi, but can’t follow the road he took to reach the same spot.

Lastly, it really makes me cranky when doctors do not push online journals to use correct terminology. Yes, it may be Slate’s practice to improperly use implant rather than transfer when discussing IVF in an article, but when doctors write for online journals perpetuating the wrong terminology, it is detrimental to me trusting their argument or taking them seriously. Dr. Sanghavi knows as well as I that embryos cannot be implanted. They can be transferred, but implantation is up to the body. Hence why IVF does not have a 100% success rate.

Cross-posted with BlogHer.