Crazy thoughts

Oh, the flights of fancy one's mind conjures up while in the shower.

I've been trying out some new Chinese herbs lately. And dang, they've made me feel perky and healthy, and full of vim and vigor. And you know where this is going, right? I keep thinking that I bet my ovaries are also perky and full of life. And therefore, full of good eggs. Or, at least one good egg.

And so this morning I was mulling over how next month it'll be a year since my last IVF, and how I was supposed to be getting a boyfriend, but have failed at that so far (although I haven't given up hope). And that it'd be really nice to be trying to conceive the old fashioned way before my eggs get far too ancient even for me to kid myself that there's any life left in them. So then I mulled over getting someone to donate, but it's so hard to ask people that. So then I thought about going to an RE and asking if they'd do some IUI's for me - after all, it wouldn't go on their stats like an IVF would. But I thought, nah, that'd never work. So, yes, my mind went.....there. What, I thought, what if I went back to Big NY Clinic and did another IVF? I bet they'd still treat me - they treat women up to the age of 45. I have a 2.5 week break in August. I could travel to NY, shoot myself up with some drugs, and bingo! The new healthy me would produce some awesome eggs and I'd get knocked up before I hit my next birthday.

But don't worry, Anonymous, I said it myself: What, are you CRAZY????

It's not going to happen. I don't have the money. It's a ridonkulous idea.

But I really must try harder on that "finding a boyfriend" thing...clearly my mind is never going to rest until something happens.

Memorial

As always, it comes back to infertility. It shouldn't. It won't, at some point, because I will find other ways of looking at the world, but for right now, I reference everything through the same lens.

I was watching a PBS show yesterday about American war cemeteries overseas. It made me cry. Which is as it should be. One should spend some time on Memorial day thinking about those who gave their lives for us.

But it also made me feel guilty. Here I am, with so many choices open to me. OK, so I was not so lucky in love and ended up trying to conceive on my own and it didn't work. But wow, what choices are those - first not to be forced into an arranged marriage with someone I didn't even know, second to have any option outside spinsterhood or the church if marriage was not on the cards, and third to have the option to bear a child out of wedlock and not have it be a terrible sin. Wow. Then, here I am, earning my living, making my own way in the world. I own property, I have leisure time, I have a life expectancy longer than 39. I can go to school and have an education. I live in a free country. And finally, I have not been drafted off into the hellish nightmare of a war. And have not been maimed or killed. So what if my genes are not going forward into the future? Should it really matter so much? At least I am alive and free and healthy. I can still leave a legacy in the world by making at least one person's life better. It makes me think about all the hundreds of thousands, nay millions, of people whose genes also did not make it into the future, but because of war or conquest or famine or natural disasters or atrocities or even just plain old car crashes. I should wallow less, and feel grateful more. At least I'm still here.

Therefore, thank you, to the people who gave your lives so that I may have freedom. Thank you for laying down your lives so that I may live mine by making my own choices, even if those choices don't always work out. At least I am, and I was, able to try.

Morning coffee

It was almost like being in New York today. Almost.

I don't know about you, but where I work and live, it doesn't feel like I'm in a real city. I'm a city girl at heart, so it pains me that while parts of my (small-ish) city are vaguely city-ish, the area immediately around my place of employment was until recently full of 1960's-1980's era high rises (well, actually small to mid rises because, let's fact it, it ain't New York). With parking garages. Interspersed with run down old car dealers or empty lots. So it's like each building was an island surrounded by a great forbidding moat of wasteland or a parking garage, and is not exactly pedestrian friendly, to say the least. And let's not even mention the unbearable heat and humidity in summer. But let's face it, people have a tendency to drive absolutely everywhere in this town.

But my city saw the light in the 1990's and imposed new codes which required pedestrian friendliness, and sidewalks, and shade trees, and mixed use, and internal/hidden parking, and street level retail space. And some areas slooowly started to come back to life a bit. But not the area right around where I work. Except for when the heady building boom of the last few years hit, and they suddenly started to fill in some vacant lots and knock down a few underperforming buildings, and....presto! There are fancy new places with fancy sidewalks and retail space.

The problem is, the retail space is mostly empty. No great revival has come, because of course the recession hit just as these buildings were being finished up. Oh sure, some of the fancy condos got sold, and some people are living in them, but there are swathes of empty, vacant windows staring out into the world.

But right across the street from my building they put in a hotel. A hotel! And it opened a couple of months ago. And we all said "but who's going to want to stay there? It's not on the beach, it's not by the shops, it's not a fancy resort or upscale business establishment, it's not right downtown near the little nightlife that there is around here." But lo and behold, I guess it is priced right or something, but there has been a steady and growing trickle of guests. And I also heard this week that they have a Starbucks kiosk in there. It's not a real Starbucks, you understand, just one of those mini "We proudly brew Starbucks" arrangements. But I was all excited. Gosh, I mean, a Starbucks right next door. I almost did a little dance.

So, even though I shouldn't, and didn't I just post about getting healthier (but, hey, it's all about balance, people - I won't do it every day), this morning I walked across the street to get a Starbucks on my way into work. I stopped in, dealt with the inept receptionist who actually forgot she was supposed to be brewing me a latte half way through and walked off to clean up the breakfast area. But once I'd got her back, finally got my beverage and walked out with my distinctive paper cup and sleeve, I felt all grown-up and citified walking the half block back to the building entrance.

It's the little things in life that please me these days...

Does acupuncture really help infertility?

OK, so I didn't ask for any opinions on the effectiveness of acupuncture for infertility, but seeing as I got them, I thought I'd give my views. And yes, Anonymous, I know you snuck a comment in there, but seeing as it was just a study that most of us know about anyway, I let it stand.

Now, bear in mind, that these thoughts have been formed after much infertility, but not much acupuncture school (yet). I will probably revise my thoughts as I learn more.

Right, that's that out of the way.

I do think acupuncture can be very helpful. But I don't think that acupuncture performs well in the context of the studies that have been undertaken, and when used short-term as the studies tend to do. I also wonder some times whether Randine Lewis' The Infertility Cure didn't do some harm as well as good - for example, she talks about flooding the ovaries with energy during the follicular phase. Which is all well and good if your body has energy to spare in the first place. However, if your issue is that you don't have enough energy, where is this extra going to come from? It's like we've got into this Western medicine mindset that a quick fix can be achieved. I mean, yes, she stresses a lot that it's not short term, but we all tend to take segments out of books and focus on those component parts without really taking in the whole teaching.

To my mind, infertility is caused at the end of a long chain of events (ignoring blocked tubes caused by an infection, say). We don't eat well, or we don't exercise enough, or we weigh too much or too little, or we are under stress, or we are getting older. Or, let's put it another way, we are just living in this stressful, difficult time on earth. Our bodies will fight hard to keep the important functions performing well - our hearts will beat, our lungs will work, our stomachs will digest food. But if something is a little off, it'll draw on some resources from systems that are not essential to survival - maybe our skin starts to look a little tired. Maybe our hair starts to go grey. Maybe our thyroid starts to have trouble. Maybe we start getting digestive issues. Maybe we find ourselves not sleeping well, stressing. Maybe our ovaries start to run out of steam. Reproduction is an energy-intensive business, and especially the female system is extremely delicately balanced. But let's face it, it's not that important in our bodies' orders of priority, so it may go into decline before the rest of us.

So, can we fix things by shooting some drugs in? Sure, some of the time we can. Sometimes it doesn't work quite so well, though. Can we fix things by doing some acupuncture for the 2-week period before an egg retrieval? Well, maybe sometimes, but most of the time, it is not enough time, and it's not specific enough. If my problem is that my digestion is off because I haven't eaten enough protein and have had too much sugar and not enough exercise for the last 20 years, and this means I am lacking in energy, will 2 weeks worth of acu fix it? No. Similarly, if your problem is that you are a stockbroker/lawyer/tax accountant who is also marathon runner and arguing with your husband and you are so stressed out that you are not ovulating at all any more, can you be fixed with 2 weeks worth of acu? And, more importantly, will using the same acupuncture points on both of us work equally well for both of us? No, and no.

The studies use particular points in particular combinations for particular periods of time. That's like using one cholesterol medication for a short period of time to see if it is effective on every cardiovascular problem - when some of the problems may be due to high blood pressure, or high blood sugar, and not high cholesterol. The cholesterol medication may work for some people, but perhaps others needed a different drug, or needed to be on it for a longer period of time. Or maybe they just needed to go on vacation and de-stress. Likewise with acupuncture. While there are a fairly large number of points that are useful for "infertility," each point can have a slightly different effect. If it is on the spleen channel, maybe it helps with infertility that is related to poor digestion/diet (because in Chinese medicine, the spleen is related to digestion). If it is on the liver channel, maybe it helps with infertility that is related to stress. One size does not fit all.

It seems that infertility acupuncture has got away from its basics. Acupuncture is very good for chronic health problems, and pain. Infertility is mostly a chronic health problem, and needs to be treated using a very individualized approach on a long term basis, to build up the patient's energy reserves or whatever they need. And if that means not using points for infertility, or ignoring the infertility aspect for a while to just bring the patient's health into balance while letting the body deal with the ovaries in its own way, then that's what should be done. So that when the patient gets to an IVF cycle, their own body is more prepared to do what it needs to do to respond to the medications.

And, the patient needs to be involved - they need to be given clear help with food intake, exercise and stress management. Because I think these are key with infertility. We patients don't like to admit it, but it's our own lifestyles that are big contributors. But it's no good to just throw suggestions out there in a random fashion - people need to be sat down and really taken through all this. And, importantly, acupuncturists need to be flexible and keep looking for answers and ways to help the patient. My first acupuncturist told me to eat meat. I said no. We reached an impasse and got no further. Actually, there are plenty of vegetarian foods he could have suggested that would have helped me - not as quickly as me tucking into a steak, admittedly. But I would have slowly got somewhere if I had known how important it was for me to limit sugar and fat, and increase protein, and pay attention to whether foods are "warming" or "cooling" and the like. Likewise, telling someone to give up coffee when that is what they love and what gets them through the morning isn't going to go down well - perhaps the acupuncturist can work with the patient and say, OK, it's either give up coffee, OR cut down on the coffee but also give up ice cream and chocolate and do some meditation in the evening - in other words, work with them to find out what they really don't want to change and offer alternatives. It's got to be something that the patient can actually do. Books like The Infertility Cure offer plenty of diet suggestions, but they are so confusing, especially when it's not clear what your problem really is, and you are trying to incorporate two or three different patterns like spleen qi deficiency and liver blood deficiency - if one list of foods says "eat black beans" and the other says "don't eat black beans" what is a patient to do?

Now, I know that many acupuncturists don't want to offer diet and lifestyle suggestions until the patient is an established patient and trusts the acupuncturist. You don't want to scare someone off at their first visit by telling them to do and change too much. But I also think that there's scope with some of the more chronic problems (and infertility is just one of them) to sit with the patient at the first visit, and spell out that it'll take a number of sessions to help, and that it's going to be a partnership, both the patient and the acupuncturist working together and making changes to the body. And to say, if it's not working (or not working fast enough), let's keep talking and making adjustments until we get it right. I think I would have appreciated that - after all, to know that there is a plan in place and to know that it might take a few weeks to see changes are both helpful, and help you to keep hope alive that things will improve.

Remembering failures

My school is running a big infertility seminar. Which you would think would please me, but sadly, no, it does not. First of all, various people have been going around smugly saying how much acupuncture helps with infertility. Which it DOES, don't get me wrong. But they are implying that it is the answer to everything for everyone, which it is not. And when I say meekly "but it doesn't help everyone" I am usually met with a blank stare, or some tale of how someone somewhere got pregnant after acupuncture treatment. Uh huh. Ye-es. But you don't know if that person would have gotten pregnant anyway, even without treatment, and how much of any gain was actually caused by the treatment.

And then the annoying guy in my class is of course friends with one of the RE's from the big local practice (where I went, and was a patient of the senior RE before he fired me for being too, well, infertile). So the annoying guy is being insufferable about how amazing his friend is and how open he is to acupuncture, and that they are making these huge gains, and blah blah blah.

Oh god, it is going to be tough over the next few weeks leading up to this thing. It's like the whole school is buzzing about infertility and it is reopening some old wounds. But none of the people who are spouting off as experts are really thinking things through. Since going to school, I have realized that one of the people I went to (who sells himself as an infertility "guru") basically just used every single acupuncture point that was ever related to infertility. Rii-ight. And I'm sure it worked for a lot of women, but then again, there are many reasons WHY women become infertile, and one should presumably treat those reasons differently. A more targeted treatment may have been better for the harder cases like me, rather than using a scattergun approach. It seems to me like most of the acupuncturists only remember their successes, and don't think hard enough about their failures. They don't continue trying to find out the reasons for infertility. They don't keep trying to change the treatment, they don't keep refining. They don't know WHY it doesn't work for everyone. They don't remember that the failures gradually drift away and try something else. When they should dagnabbit.

If they were being rigorous about wanting this stuff to work, they would be researching more. Asking WHY more. But many, sadly I think, have some successes and rest on their laurels. And THAT'S what's annoying me. It's like like anyone who remains barren after acupuncture must be somehow wilfully barren, or something. Not like perhaps the practitioners could be at fault.

Dread

I am dreading school, which starts again this week.

Well, I should rephrase. I am not dreading school per se. I am dreading the driving to and fro, the studying, the time involved, and most of all, giving up my Saturdays and any free time. It is so hard to just be able to function during term time, and I have to live a very regimented life in order to be able to do it.

Oh well, at least I do get a 2-week break every now and then. I suppose if I'd been successful in having a kid I wouldn't get any breaks at all. I suppose that is a silver lining. Maybe.

Fail

UB40 were actually a lot of fun, and I thoroughly enjoyed watching them and dancing and singing along, but I failed at:

a) Operating my cameraphone with any degree of success.

b) Stopping my tenant from driving drunk even though I offered to drive her and her even drunker friend anywhere they wanted several times, and asked several times if she was SURE she was OK to drive, and admonishing them to be safe, and offering AGAIN to drive them. What is one to do when you're not close enough to demand that they do not drive? I suppose I should have demanded anyway. Like I said, fail. I feel like a shit for it.

c) Remembering to take hand sanitizer, so had to use porta-potties and probably get all sorts of germs when swine flu has been confirmed in the next county, allegedly. Not to mention wearing long jeans that drag on the floor through urine even though I was trying to hold them up.

d) Flirting with anybody. Tenant managed this, successfully it seems. In fact, she was even flirting in the porta-potty line.

e) Stopping myself from planning IUI's in my dreams during today's afternoon nap after berating myself at my failure over flirting. No, I DON'T want to sign up for more IUI's. But clearly I have a one-track mind, and I wish I could relax over this once and for all.

f) Feeling like an old fart for wanting to go home after the band and not wanting to go on elsewhere. Likewise with not wanting to have any more than 2 drinks when driving. Time was I used to be able to go out and enjoy myself and not worry about drinking or hand sanitizer.

Back to school this week, and I have also failed at doing any studying while on break. Oh well, c'est la vie.

Red, red wine...

I am feeling quite proud of myself.

This week I:
a) hired a pool boy. OK, it's a pool old man. But he is going to keep my pool in tip-top shape so that's one less job for me to do and means I can swim all summer. Yay! No more scooping leaves out of the darn thing.
b) discovered Pandora for my Blackberry. Free cool music!
c) cleaned a bit. I made a good dent in the cleaning work, though it isn't finished yet.
d) finally got on the scale after weeks of bingeing. I'm only up 3.5 lbs so that's nowhere near as bad as I thought.
e) went out to dinner with my friend P. We went to "the island" that is near where I live. Where all the rich people hang out. It was fun, but full of super-wealthy types. And us.
f) went out to dinner with my tenant A. Also fun. And we made plans to -

g) go out to a music festival on Saturday afternoon/evening with some of A's friends and see UB40.

Social life! And yes, there was wine drunk. And there may be dancing, when my life's theme song comes on.