Secret Hope Stories are what perpetuate the what ifs in our head. You know what I’m talking about–they’re the stories of the ninth IVF that was finally successful and resulted in healthy twins. Or the blood work that finally revealed the problem and allowed the habitual aborter to carry to term. They’re the debris that you grab for when you’re drowning in the ocean. And they may help you float. Or they may drag you under. And you just don’t know.

Hence the what if.

I am the product of a Secret Hope Story–the woman told to go onto Plan B because she wasn’t going to get pregnant/carry to term. And then the miraculous conception and pregnancy resulting in a baby that a doctor told you that you would never have. Thank you, Mommy, for still trying even though you had already built your family.

I recently met up again with a friend from high school (hi!) and she had one of those Secret Hope Stories. Four failed IVFs and a doctor telling her to move onto donor eggs. And a “what if” nagging in the back of her head took her up to CRMI (don’t these stories always end up taking the person to CRMI? I’ve begun thinking of it as a pilgrimage site) which resulted in the IVF cycle that worked and two chubbulicious twins (I just saw them and I swear, you could just eat the cheeks off the boy–that delicious).

You hear these stories and you can’t help but ask 1000 questions, all the time comparing it to your own life and wondering if they found the key that could unlock your fertility as well. I’ve been trying to figure out why these stories give me hope and make me want to try “one more time” vs. the stories that well-intentioned relatives pass along when you tell them about your infertility. You know–the exact same ones I’m talking about now. But when they talk about their neighbour’s cousin who became a mother after five miscarriages, I want to scream, “I am not your neighbour’s cousin!” But when a fellow Stirrup Queen says, “I don’t know why it worked that time, but it did” I want to start rolling the dice rather than following a doctor’s rational thought.

Because fertility treatments at some point–especially if you have unexplained infertility–begin to feel like gambling. As a rule, I don’t gamble because I could totally see myself becoming addicted to it. Just one more time. Just one more time. This will be the time. And it truly is gambling with stakes much larger than the quarters I would use if I ever went to a casino. You’re gambling with hundreds or thousands each cycle as well as your general physical health and mental well-being. So…I won’t try Vegas, but I will try the fertility clinic? It doesn’t make complete sense.

And this gambling analogy has become even more constricting with secondary infertility. Do we take the gamble knowing that the money we use is being taken away from our current children? I think the money is well spent if it results in a child, but what if it doesn’t? Part of me says, “play it safe–go with adoption. It’s a real child in the end.” But the other part of me starts thinking, “but if I got pregnant the first try with IVF, I would be spending half the amount that I would on adoption. So then IVF is the best financial option!” And you can see how you get back into that “what if” mentality.

My doctor shook his head and told me I should play the lottery with the odds I encountered during my journey. Odds of having FSH as high as mine at my age–slim. Odds of developing hyperemesis gravidarum during pregnancy–.5% of pregnant women. Odds of having perfect prolactin levels prior to pregnancy and no prolactin produced after pregnancy–under 3%. So if I hit that trifecta, who’s to say that I won’t have that next Secret Hope Story in my back pocket?

Nina at Stella and/or Ben is going through this “what if” right now. She’s not ready to move onto Plan B regardless of what the doctors are telling her. She’s trying Plan A again while tweaking some lifestyle changes–no coffee, no alcohol, no fast food. And she asks at the end of her post, “Do you think we are just fooling ourselves? Do you think we are nuts?”

No, I don’t think you’re nuts Nina. And to be frank, if my heart was still on Plan A, I would continue with Plan A until someone pried Plan A out of my sweaty little hands. Because you know the same hope stories that I know. And in the back of your head, they start nagging you. It’s not that Plan B isn’t a beautiful and bright path. Finding it emotionally difficult to give up one path does not mean that you think the other path is a lesser path. It’s apples and oranges. And if you were in the mood for an apple and your heart was set on an apple, it’s difficult to start eating the orange, even if the orange is a perfectly delicious fruit that you usually enjoy.

It’s hard to give up the desire for that apple when you know stories of people who went to a different food store or knew a different way to ask and received that apple. If it was a moot point–if the manager made an announcement to the store, “no apples today. Terrible frost up north. Killed off the apple supply. No more apples. Ever.” Well, you would probably grab your bag and head over to Plan B and a huge pile of oranges in a heartbeat.

But it’s that “what if.” And it makes you gamble because you know too many stories of women who are happy that they didn’t take the advice offered and kept pushing through until miraculously Plan A came true. Or didn’t take the advice offered, stopped pushing through, but miraculously, Plan A came true anyway. And I don’t know if overall these stories help or hinder. My heart tells me that they help. But I’m a gambler at heart. So should I listen to myself?

Hang in there, Nina. I hope you find some peace and that this cycle is that one in twenty.

What are your thoughts on my bold questions/thoughts?

I am so angry right now that I need to write about this before I go to bed or I’ll never go to sleep. I just wrote this scathing response to some comments about infertility that were on a parenting board. And I didn’t send it. Because even though I eloquently compared them to Hitler (at the same time being kind and explaining Darwin’s survival of the fittest to a bunch of women who were essentially turning Darwin into a eugenicist) and felt better doing so, saying the words did nothing. I needed to know that they would hear them. And be affected by them. And I’ve had enough of these experiences by now to know that I’m not going to change their minds. Their minds won’t be changed unless they find themselves one day with their back on an exam table and a catheter snaking through their hoo-haa.

The original question was innocent enough: The British Fertility Society is recommending that women classified as morbidly obese not be allowed access to fertility treatment. Would you support a similar proposal in the United States?

Can you talk about strange coincidence? My third time reading about obesity and infertility in two days?

I actually started reading the responses, believing I would see a mix. And there were a few people who spoke without offense either in support of coverage for all or coverage for none. But the majority of answers became more and more Hitlerish in nature with each comment. Yes, let’s take away coverage for obese women!

“It’s unhealthy for the woman and for the baby if the mother is that overweight, and I’m sure there is some correlation between being obese and failure rates with IVF and I’m sure they don’t want to do it if they know there are more risks and high failure probablility due to the weight.”

“I feel for those women who would have to resort to IVF, as I never thought I would have my son, but there is no reason to go through it if the incidence if success is so very low, and they must have done studies on it or they wouldn’t have decided it.”

“I’m a mother of three and I weigh 208 and I got to say that I don’t really blame them. If I was told that my weight was a problem with successfully getting pregnant that way I would do what every I could to lose the weight plus I would rather be told no in the first place then spend all that money and get my hopes up to have it all go crashing down around me. Your emotions also play a role in it and if you get all depressed about it not working the first time then it makes any other chances of it happening all the much less likely.”

“I don’t think it is a discrimination issue, there are so many health concerns for a person of that size, let alone to have them take all the meds necessary for IVF, and then to carry a baby on top of it. I think it is more about the “first do no harm” part of they oath then discrimination.”

“I don’t think they’re saying that obese women can’t or shouldn’t have babies — just that they’re not going to pay for in vitro fertilization because of the health risks and the lower percentage of success. There are limited funds available for medical procedures and so I think putting some conditions on when they’ll make payments make sense. They’re not discriminating because of weight, they’re basing the decision on the health risks associated with being overweight. And when dealing with medical conditions you need to consider the health risks involved. I know it must be heart-breaking to not be able to conceive on your own, but it is not a life or death situation.”

“Not necessarily how I feel, just playing Devil’s Advocate a bit here … If natural selection is best, then couldn’t an argument be made that IVF interferes with natural selection? Which would open up the floor to a whole ‘nother debate!”

Followed by…

“Good point! I don’t want to open that can of worms right now, but I do agree with this statement.”

Which is where I stopped reading and started writing. And started deleting. Because what could I say that would change their minds? They’ll never understand unless they go through it themselves. Or have someone close to them go through it. And I want to be the type of person who just snorts and walks away from it, but it literally is still bothering me. And I don’t even know these women–they’re all faceless women living in America, raising their 2.5 children. And they don’t matter. Except they do matter. Because you’re commenting on me. And my right to parent. And whether I should be weeded out of the gene pool. And you have hit on my biggest fear–that I passed my own tendency to not produce progesterone or create good eggs to my daughter. Because I never want her to go through what I went through. And…I’m banking all of my hope on technology. That all of these problems with fertility will be solved or even more fine-tuned by the time she is of child-bearing age.

So there you have it.

And because I truly believe that you should have a bit more common sense to pass judgment on others. You never know where life will drop you years from now. How could I have predicted infertility until it happened? And how do I know that I won’t be classified as obese (and I have a whole problem with the classification of obesity since it is a ratio and not an actual commentary on the health of the person–yet it is considered a commentary on the health of the person) and wish I hadn’t withheld rights from my future self?

So that’s what is keeping me from sleeping tonight. Just in case you wanted a touch of insomnia as well. Sorry if I ruined anyone else’s night.

My mother bought my kids a new book called Little Quack’s Bedtime and we were reading it at dinner tonight for the first time. It’s about a mother telling her five ducks to go to sleep. It’s a simple tale of ducks being scared of the dark, but of course, if you think as I do, you can see infertility references in everything. The ducks point out all the things that are scaring them about the dark and the mother reassures them.

And then that last duck…goddamn Little Quack…had to twist his figurative knife into my literal heart.

Puddle shut his eyes and went to sleep.
But Little Quack was still awake.
Little Quack looked. Little Quack listened.
All around was dark dark dark.

“Mama!” he cried. “Why, oh, why is the night so dark?”

Mama snuggled close, and then she said,
“So the stars can shine their twinkling light.
That’s why the night is, oh, so dark.”

And I bawled.

Here I am, sticking to my convictions 🙂

I feel pretty strongly that it’s fine to have opinions, but it’s not always fine to express them (ha–coming from inside a blog that is nothing but opinions). I found the whole Tom Cruise thing interesting because he still feels the need to express his opinion on something that apparently has nothing to do with him–neither Brooke Shields nor depression itself. He isn’t saying that taking vitamins worked for him or that he has ever suffered from depression and tried non-drug therapies. And I always wonder the purpose of those opinions.

I’m trying to figure out how Brooke Shield’s taking antidepressants affects anyone other than Brooke Shields. You could make an argument that it affects her family. But you can’t really tell me that Tom Cruise is affected by the personal actions of Brooke Shields to treat her depression. Not in any significant way.

And I feel the same way about everyone else’s medical choices. They may not be the same choices I would make, but everyone is entitled to their own personal choices as long as your actions to not negatively impact another person. You may choose to take antibiotics at the drop of a hat, and I may choose never to take antibiotics if I can help it. And I don’t need to tell you my feelings on antibiotics. It doesn’t serve any purpose–especially after you’ve taken the antibiotics. What is the purpose of Tom Cruise expressing his opinion about Brooke Shields after the fact? To keep her away from antidepressants? She’s already done that. I think it’s just to make her feel like shit. Not intentionally, but if he took a moment to consider his words and their purpose, I think he would see that these opinions (like many of the ones we receive daily in regards to infertility) do not actually serve their intended purpose, but they do make the receiver feel like crap.

Which brings us to the third topic in the stigma trifecta. After depression and infertility, the third taboo topic that garners no respect and a lot of opinions…bariatric surgery and obesity. Does this sound familiar? You could go on a diet. You could exercise more. It’s a matter of willpower. Join Weight Watchers. Join Jenny Craig. My friend’s sister lost 200 pounds by eating only grapefruit three times a day.

It sounds familiar because it’s very similar to the lame advice we’re given about infertility. Does the speaker actually believe other ideas weren’t tested before turning to bariatric surgery? Does the speaker actually believe I haven’t tried all of their ideas before I turned towards fertility treatments? And can’t they accept that if the person makes this choice that it is the best choice for that person? Just as A.R.T. was the best choice for me. It may not be the best choice for you–either due to your own opinions or the advice of your doctor. But it was the best choice for me. And in reality, it doesn’t affect you. It only affects my husband and my children. And no one else.

So it makes me angry when people suggest that I didn’t try enough other things before turning towards the extreme. Or I didn’t try the right things. I did what was best for me. What was best for my family. What the doctor believed would work the best. What was financially feasible.

Last night, I was reading the letter-to-the-editor section of People while trying to enjoy a spinach burrito when I read this comment on a family who had undergone gastric bypass surgery:

“While I applaud the Sheltons for choosing to change their lifestyle, I balk at the extremes they took to get there,” writes Jennifer May of Stockton, California.

Balk?

Truly?

To be honest, I didn’t even know I was suppose to form an opinion on gastric bypass surgery. I had been under the impression that it was something I knew nothing about, therefore, I should probably not form an opinion on it. And beyond that, I was under the impression that people made decisions that fit them best and therefore if they utilized gastric bypass, it was the best choice for them. Not that I blindly follow the advice of doctors without doing a bit of my own personal research, but I am paying for health care and their professional opinion. Therefore, if a doctor recommended gastric bypass, I would have to say that it’s probably an option that should be strongly considered.

The next comment could have applied to infertility as well:

Adds Jennifer Christiansen of Sussex, Wisconsin: “Instead of spending $11,000 per person on gastric surgery, how about [hiring] a personal trainer and nutritionist?”

If I had $11,000, I would certainly turn it over to Jennifer Christiansen because she has great ideas on how to spend health care dollars. I trust her even more than my doctors. I mean, my doctors only went to medical school for four years and then completed years of residency programs or additional training. Jennifer Christiansen probably went through that much training–IF NOT MORE–in order to form her opinions on gastric bypass surgery. Of course, all mental health decisions will be turned over to Tom Cruise.

Let’s all try this one from The Stirrup Queen’s Little Instruction Calendar: September 5, 2006: you don’t need to express your opinion on any medical procedures that do not directly affect you or a close loved one. Let’s leave the opinions on the validity of a medical procedure to an expert. Let’s trust that other people make decisions that are best for them and their family. At the same time, pass along information and opinions that you have directly experienced.

My mother has a desk calendar that’s called Life’s Little Instruction Calendar. Today’s “instruction”: offer no apologies for your convictions.

Really?

Not even when your convictions are highly offensive? I can think of a few former dictators who held some pretty strong opinions that led to a few genocides. Are you sure they shouldn’t apologize?

This comes on the same day that my mother handed me a clipping from the Washington Post about the apology Tom Cruise gave to Brooke Shields:

He came over to my house, and he gave me a heartfelt apology, and he apologized for bringing me into the whole thing and for everything that happened. And
through it all, I was so impressed with how heartfelt it was. And I didn’t feel at any time that I had to defend myself, nor did I feel that he was trying to
convince me of anything other than the fact that he was deeply sorry. And I
accepted it.”
— Brooke Shields on “The Tonight Show” Friday, describing Tom Cruise’s apology for his criticism of her use of antidepressants.

In another article on the topic, Cruise’s spokesperson, Arnold Robinson added their camp’s opinion on the apology. “It is true that his friendship with Ms. Shields has been mended.
(But) he has not changed his position about anti-depressants, which as evidenced by the black label warnings issued by the FDA on these types of drugs, are unhealthy.”

Looks like someone over in Hollywood has my mother’s Life’s Little Instruction Calendar.

Because in the end, he’s standing by his convictions. He still knows more about postpartum depression and vitamins than Brooke Shields, but he apologized for using her name during his rant and bringing her into the fallout from his comments. It’s sort of like slapping someone and telling them that you’re sorry that it hurts. You’re not sorry that you hit the person, but you’re sorry that they’re feeling pain from it. If only you could hit them and not have their skin smart.

And it all goes back to two things: (1) why I actually care about his opinion (yes, you read that correctly)–when he shouldn’t be expressing an opinion at all and (2) he forgot that even celebrities can’t unring bells.

Last week, we were talking about celebrities and being out about infertility. And people defended their right to privacy. And I’m all for their right to privacy–they are a private citizen first and foremost. But what about when their quest for selective privacy (and I’m talking about celebrities who pick and choose what they share–not celebrities who are notorious about protecting their privacy) is creating a skewed view of reality? The seemingly hyper-fertility of Hollywood creating a lower sense of self-worth in women who are struggling to conceive? They have great hair, great abs, great skin, AND easy breeding? It creates a fine layer of bright astroturf on land that may not truly be greener. As someone said in the comments, they may have the money to pay for treatments, but if they’re going through infertility, they’re experiencing the same emotional pain. So come stand by your sisters.

Which brings us to both points with Tom Cruise. I care about what he says not because I think he has any clue, but because I know other people are listening to him and it’s shaping their views (in the same way other people are listening to these seemingly hyper-fertile celebrities and forming ideas about infertility based on their withholding or lying). Someone who had no opinion on PPD now has an opinion on PPD, and it’s not a very sound opinion. Think back how often you’ve parroted something you heard when you didn’t have a strong conviction in place already. The times you said a restaurant sucked when you had never had a meal within its walls (but you had heard about it from a review or through a friend). The times you’ve argued with your spouse about which brand is the better brand–even when you had yet to try the product!

And you can’t unring a bell.

He can apologize and try to do a little P.R. spin on the whole incident, but his words shaped opinions and you can’t undo that damage with an apology. And he did a huge disservice to women everywhere because…well…united we stand, divided we fall. Never say never–PPD can strike on the first pregnancy or the second pregnancy or the third. It can strike women who adopt or women who do fertility treatments. In fact, women who do fertility treatments are MORE likely to experience PPD (4 times more likely according to a study in Fertility and Sterility). Even if you have not currently experience PPD, you have an obligation to support other women who have PPD because you never know when it may be you on the other side of that line.

Which brings us back to Life’s Little Instruction Calendar. How about this for a little instruction: if you hold a conviction, take it out every once in a while and examine it. Make sure you understand why you hold it. Make sure your internal argument is sound. Especially before you speak it. Since you can’t unring the bell.