I’ve been thinking about this post for awhile.  I don’t know for sure that I’m out of the woods yet, which is why I feel a little more comfortable using the past perfect in the title rather than the simple past tense.  At any rate, I’ve been thinking I’d like to share the things that helped me get through 4 IVF cycles and 1 DEIVF cycle, in the hope that they might help others just starting out.

1.  I let go of my fear of the clinical nature of  IVF and all of its medical trappings.  

This no easy feat for me and I wasn’t able to do this at all until my second IVF cycle.  Other people may not have such a hard time with this one.  Normally, I hate even taking medicine, and because of having a couple of run-ins with incompetent doctors in the past, I don’t have unquestioning trust in medical professionals.  During my first cycle, I could actually feel my stress levels surge as we’d walk towards the hospital building.  I felt broken and unwell because I had to take medications and do injections.  I simply hated the sight of all the medical paraphernalia.  I was angry and upset to be doing IVF at all.

With my second cycle, I was able to let go of that fear and anger, partly because the routine was familiar to me.  This change in mind-set made that cycle exponentially easier to get through.  I also then had a nurse who was warm, funny, and seemed to really care.  I learned that the injections were really no big deal.  It became routine – a known quantity.  I learned I really could pack my Gonal-F pen in my purse and do an injection in the bathroom of a movie theater.  I didn’t have to angst about it all the time.

It also helped to find a new way to phrase what we were doing.  I would say to myself, “we’re just getting a little help getting pregnant”.  Saying that in my head made the whole process feel less catastrophic and earth-shattering.  I’m telling you, my mental state was SO different in my second cycle.  If I could have gotten there sooner, it would have saved me a lot of stress and pain.

2. I organized my meds and made my injection station as attractive as possible.  

This tactic is partially related to my medical-fear issues above.  Because it upset me to see a sharps container in my house, I put it in a little paper shopping bag.  For most of my cycles I even clipped a pretty art postcard to the outside of the bag (I didn’t do it for the DE cycle, because, superstitiously, I just wanted some things to be different so I’d have a different end result).  I finally ended up with a set-up where the sharps container and a mini trash bag are neatly kept together in one larger bag.  They live next to my bed, and my injection supplies live in my bedside table.  I used a pretty tray to lay out the supplies I was using at the time – the syringe, alcohol swab, etc. for that one injection.  It just made me feel better to have things orderly and pretty looking.  It also helped to have everything organized when the injections were new to me and I was nervous about screwing up.

3.  I listened to audiobooks – a lot.

Normally, I like to read a lot.  But when you’re anxious, depressed, negative thoughts are spinning in your head, and you really need to sleep but can’t, it helps a lot to have a distraction that works for you when you’re lying down with your eyes closed and the lights are off.  Audiobooks did that for me.  Now for me, ’cause I’m a dork, 19th century English novels did the trick.  Give me 30 hours of listening time to an Anthony Trollope novel and I’m set.  Even during really tough times, I’d eventually get caught up in the story, get distracted from my worries, relax, and eventually fall asleep.  It was also helpful on walks, while doing boring housework, when commuting, etc.  I have a membership to Audible, so I would download a long, juicy novel about once a month and make sure it was loaded onto my phone.  I swear, the audiobooks could relax me despite myself, when nothing else could.

4.  I meditated

I’ve amassed a pretty impressive collection of meditation CDs by now.  I have the usual suspects – Zita West and Circle and Bloom.  Sometimes, though, I’ve found it more relaxing to use a meditation that is not IVF related – to take a break from my IF reality.  There are a lot of mind-body programs near where I live.  I found a CD at the Domar Center and another I really like at the Massachusetts General Hospital store (both available online).  My very favorite relaxation meditation is on one of the MGH CDs, and is narrated by Dr. Ellen Slawsby.  In it, you visualize a room with a fireplace and a warm bath.  There are even the sound effects of a crackling fire.  I also downloaded a free meditation app for my phone.  There are a lot of options out there.

5.  I made a playlist

Initially, I made the playlist for the times I did pre and post transfer acupuncture.  I began it with the appropriate pre or post Zita West meditation and then filled out the time with music I found particularly soothing and familiar.  I ended up using the music part of the playlist a lot more, though.  It was helpful having a collection of music on hand that would instantly calm me – for whenever I was waiting in the RE’s office, when waiting for transfer, and during some of the sleepless times.

6.  I spelled out to J – in slow motion and with hand signals – how he could give me the emotional support I needed.

Our first IVF cycle was an absolute disaster for me and J, as far as our interactions went.  I’ve never felt so alone and hated my husband SO much as during that cycle.  My stress levels were off the charts, and my being so upset basically freaked him out.  It was a really ugly combo.  It escalated into some seriously ugly screaming fights.

I ended up having to tell him EXACTLY what to say or do when I was upset about the IVF, because what I needed was not what he would need or want in my position, necessarily.  None of it was intuitive to him, and he was also panicking at seeing me so unhappy.

This is what I had to say: “When I’m really upset/anxious/worried I need you to give me a hug, because that calms me down and makes me feel safe.  I need you to say that you understand how [     ] could be upsetting/anxious/worrying, and that I’m doing a great job.”  I literally had to be this specific.

I also had to say: “When you get angry at me when I’m upset or if you try to tell me I shouldn’t worry or be anxious, it only makes me feel alone and judged, and will only escalate things.  THAT’S when I really lose it.”

Things got way better, and I have to say he was the most loving, supportive husband possible during this last 2ww.  The credit has to go to him.  He really listened, and worked hard to give me what I needed.

7.  I took an anti-depressant/anti-anxiety medication for awhile.

Now, this is one is very tricky and personal.  I’d never advocate taking medication, because each person has to make that decision for themselves.  But I do think it’s helpful for me to be open about the fact that I did – and that it helped me through the most painful time in my life.  As I mentioned above, I’m actually really reluctant to use any medical intervention.  I’m the kind of person who normally will only take a Tylenol if I really, badly need one.  I’ve sought therapy in the past when going through tough times, but I’ve always been adamant about not wanting to be medicated.  I didn’t want to change myself, and I wanted to feel what was real, even if those feelings were difficult and painful.  In my opinion, that’s what living life is all about.  And the thought of feeling groggy or fuzzy-headed freaked me out.

But then my 3rd IVF cycle failed, and we had repeated low fertilization rates, despite using ICSI.  I crossed that boundary from “the RE just needs to find the right protocol for you” to “clearly there’s something seriously wrong, and you might be one of the women who just can’t get pregnant “.  I would have super long crying jags, I wasn’t sleeping, and what was most worrying, I was aching all over.  My hands, arms, scalp, shoulders, and legs just hurt so much.  Nothing I did could get me to relax my body, because I was in so much emotional pain.  I knew that, besides the fact that I was miserable – and consequently J was miserable – there was NO way I was going to get pregnant when my body was so wracked by stress and depression.  So, I saw a psychiatrist who specializes in helping women coping with IF and I went on Zoloft.

It helped hugely.  What was surprising is that I didn’t feel groggy or “drugged” at all.  I felt like my normal self, but with a more protective emotional skin.  When things were really bad and before the Zoloft, I’d think something negative or something upsetting would happen and I’d feel this instant physical “pang” in my chest or belly.  With the Zoloft, I could have that same thought but the “pang” wouldn’t happen.  I’d have a moment to deal with that thought or emotion – to choose to act on it or to reason it away.  It was like I had a new buffer.  It helped me heal and to put other coping mechanisms in place.

The only downer was that it did affect my sex drive, which I really didn’t like.  I didn’t like having any part of me altered like that.  I guess a buffer can work both ways.  But things were so rough that J and I felt it was worth it.  We needed to get through the IF whole, even if it meant getting through it on a little less sex.

Now there’s conflicting research about the safety of using Zoloft during pregnancy.  We didn’t want to take any risks, so I was going to taper off if I got a BFP on my 4th IVF cycle – which didn’t end up happening anyway.  I was then able to taper off completely before beginning the DEIVF cycle.  By that time, I think I had done a lot of my grieving, and could fall back on the coping strategies I’d picked up by then.

Again, it’s something each person needs to weigh carefully for themselves, but I just wanted to put my experience out there.

8.  I tried to get outside and in nature regularly.

We’re lucky to live near a lot of green space, so it was easy for me to go out for a long walk regularly.  It helped enormously to just open up my world and to remind myself that there are countless of other living creatures busy doing their thing.  It also helped me to be around beauty and to breathe in fresh air.

9.  I was selective about my social interactions.

The friend who’s been the most supportive of me through all this once said that I needed to, “insulate, ignore, protect, and proceed.”  I’m sure she didn’t realize it at the time, but in that moment she made up my driving motto for coping with IF.  My biggest priority was getting through this with my sanity intact, and if that meant putting blinders on, so to speak, then I would do that without any guilt or regret.

I stayed in contact with friends who were supportive and who made me feel good, and I distanced myself from people who were threatening or who deep-down I knew I couldn’t really trust.  I completely avoided Facebook for years.  It was important for me to not compare myself to what others had, but to focus in on my goal.

I found immense solace in the blog and twitter community, but I tried to pay attention to when I needed to step back and focus in.  It’s a mixed bag.  It’s amazing to have support with an illness that’s so incredibly isolating, but it’s also frightening to learn more than you normally would about what could happen and it’s painful to be left behind.  I guess we’re always figuring out how to negotiate that.  Ultimately, I’m incredibly grateful to have met so many courageous, generous, and amazingly strong women.

10.  I defined my faith.

I’m not a religious person, and I don’t really believe in fate.  So, it was really helpful for me to figure out what I do have faith in – what I know I can rely on.  Through all the grief and disappointment, I had faith that J and I could get through it together, and I had faith in my strength to endure and heal.  The most valuable thing I’ve learned through dealing with IF, and something that I’m sure will serve me throughout my life – because life is fucking hard – is that there’s a huge, unfathomable store of strength in each of us.

– Patience