This week

This was a rough weather week and a lot of people didn't feel well, myself included. For some people it was their joints aching, for others it was constant headaches. For me it was sinus pressure and neck pain. On Tuesday I made a same-day appointment at my pcp and went in to get it checked out. I was complaining of dizziness and lightheaded feeling. It alarmed me because at one point I thought I was going to pass out. It had started a few weeks ago, right around the time I cut sugar out. I thought that I was cutting too much sugar out so I had slowly reintroduced some back in, but the lightheaded feeling didn't go away and just got so much worse during the week with bad weather. Maybe it's related to the anesthesia from my hysteroscopy? No idea.

The doctor who saw me -- not my pcp but whoever in the practice had an opening that day -- did an exam, asked questions, took down history, etc. He couldn't find anything specific other than pressing on my sinus causing discomfort so suggested that I treat the sinus pressure symptoms to see if that helps. One thing that did concern him was my blood pressure: 160/90. It concerned me too. I know it usually reads high at the doctor's office, but it's been closer to 130s/80s the past few times I've been to - even as recently as all my pre/post op appointments for the surgery. He said he wouldn't put me on meds just for one reading (even though it was two within the time span of 30 min, same results). His recommendation was to record readings for a week at home and if symptoms persist to come back.

The next day I was scheduled at my clinic to take their two hour IVF class, which is mandatory for all new patients regardless of whether you've done IVF before or not. I didn't necessarily learn anything new but I did get more acquainted with the clinic, nurses, and protocols. It relieved a bit of the anxiety that has been sitting on me about starting another cycle and a new clinic.

I brought in my blood pressure cuff with me. After the class I asked the nurse if she could help me calibrate my cuff: she would take my pressure on their machine, then I'll take it on mine, and I can compare to see if it's at all similar and whether I could rely on it. Came out to 150/85 -- similar on both machines and still high. I thanked her and left for work.

This morning I tried my cuff again at home. I took three readings and they were each different, even though they were two minutes apart: 150/86, 142/89, 120/84. The last one is basically normal! I also noticed that the pulse was going down with each one.

I know some people have this "white-coat" syndrome where their bp spikes when it's about to get tested. I have mixed feelings about this - if something makes you nervous and your bp spikes then you have high bp. If someone cuts you off in traffic and your bp spikes? If you're caught off-guard and your bp spikes? Basically if you're getting these really high spikes then you have a bp issue, no? Maybe I just don't entirely get how bp works. I assume it's like your pulse that rises and falls throughout the day but that the baseline should test normal.

Anyway. Apparently I have this syndrome because I've had issues with my bp for years. At one point they put me on medication to lower it because every time I had it tested at the office it would be high enough to alarm them, even though when I was testing it at home it was fine. Eventually the meds were making my bp so low that I advocated to get off them and I did with doc's blessing. I haven't been on them for years. I even remember that some of the bc pills raise blood pressure and I had to switch from that. I feel like I'm back on that brand now and that might be a factor too.

From what I'm reading, limiting salt is a factor in controlling bp via diet. Oh awesome. So now I can't have sugar or salt. This is fabulous. I also read that getting rid of inches off your waist is a big help in lowering bp: approx 8 lbs off for every inch you want to lose.

So what's the moral of this story? Exercise is important to get blood pressure under control, to lower resting heart rate, and to control insulin. As much as I can't get away from it, I have every reason to up my exercise.

I treated the sinus pressure with some not-yet-expired flonase spray I had from last year's sinus infection, plus the weather finally cleared up, and some of the sinus pressure receded. I was still feeling fatigued and lightheaded. I used to wake up in the morning full of energy - I'd get up before the alarm most days, get up and immediately do things like load the dishwasher, fold laundry, or some other noisy tasks that would annoy my husband. These days I'm so tired. I feel alert and awake for maybe a few hours before I feel like I need a nap, and when I don't get a nap I just function at like 40% capacity until I collapse into bed.

The tightness in my neck led to the base of the skull and felt like heavy cement just hanging out there. I debated whether it was worth going for a massage or going back to the doctor. I decided to visit a physical therapist. I got in on a cancellation appointment on Thursday morning and got a full workup. She found that my right side is more tight and after several prodding questions deduced that it was probably because of the way I sit at my desk at work. She asked about medical history (I skipped the whole fertility part), did a few diagnostic tests, and then put heat on my neck and back for 15 minutes. After cooking my muscles she started to work on them.

It. was. painful. I didn't actively cry, but tears sprang up when she touched the sore muscles. She worked on my head and neck for a while "loosening" up whatever was tight in there, but less like loosening it felt like the worst pain I can remember having. At one point she was working on a neck muscle that triggered a really bad headache/dizziness, literally like an on button. She then worked on my back to loosen the headache she caused. After that she moved to my lower back and the agonizing pain continued. At one point I asked through clenched teeth, "is it supposed to hurt this much?" and her response was that she wasn't going to work on a muscle she didn't feel needs work. In other words, if it feels good then she's wasting both our time. The full appointment took about 2 hours from paperwork to leaving. The torture massaging lasted about half of that. While my muscles did feel looser in the areas she worked, everything else hurt. My skin was bruised and my head was pounding. I didn't even have energy to buy lunch somewhere and just ate the small snacks I brought from home.

Today I'm just sore and tired, with remnants of a dull headache in the back of my skull. We were supposed to have out of town company for the weekend but they rescheduled for another week. I'm thankful to have the weekend to rest and recharge.

For the time being, or at least I can come up with a new passion project, I need to make my health my main focus.
- Balanced eating
- Drinking water
- Exercise

I want to get my blood pressure under control without medication. On the other hand, I'm exhausted. Tracking food is exhausting. Constantly utilizing self-control is exhausting. I'm limiting sugar and carbs, and apparently now salt is limited as well.

Exercise is my biggest challenge. I know it needs to happen. I know all the benefits: healthier weight, lower blood pressure, lower resting heart rate, insulin benefits. Secondary benefits are to look better and feel better. All those things are excellent motivation and yet this is a real struggle for me. I need to find a solution.

Let's say I don't do it? That means adding blood pressure medication and metformin to my cocktail of daily meds. That means side effects. That doesn't solve other problems that come along with unhealthy lifestyle which will eventually catch up with me, regardless of how many meds I take. Not least of which, not addressing these issues could mean complications during a potential pregnancy. I'm not there yet, but this is my chance to address and reverse these unhealthy issues.

Every single day I need to make the choice whether to take care of my body or to put in on a back burner behind... netflix? social media? What am I prioritizing instead of it? Whatever it is, it's not as important. I need to make an effort, make the choice, and just do it.


We're gearing up for IVF 8 as August gets nearer. The cycle starts as soon as I get a period so it's helpful to have somewhat of a say when that is with the bc pills. We're waiting for my husband's recovery window to end. In the meantime we got approved by insurance to move forward; I'm getting my meds ordered; and finalizing any last minute things with the nurses so nothing is held up once we're ready to start. This might change as we get closer, but I'm not worried or excited for it; it just seems like one more thing to check off a list.


I'm looking forward to the weekend. I'm excited to relax and catch up with people I'm too busy to talk to during the week. Shabbat shalom.

Energy

I'm feeling antsy. I want pathology results. I want insurance to get back to us with approval. I want the retrieval to be behind us. I want to move forward. I also want 9 Av to be behind us.

I noticed a trend on social media. I always feel bad after spending too long on Instagram. People aren't posting videos of their nap or folding laundry or watching tv. They're posting about vacations and adventures. 

People assume that since we don't have kids then we have lots of time and money to travel. That assumption is so far from reality. Thousands of dollars go into treatments. Even if we did have the money for glamorous vacations, any days off work get saved for sick leave for procedures. 

We took our honeymoon trip for our ten year anniversary this past January. It took a while to save up enough money and vacation time and then we needed to find a gap between treatment to go. Even when we were on our trip I didn't post anything about it. First of all because I didn't want my house to get broken into by announcing we're away. Second because I was enjoying the trip and didn't have my phone out the whole time! I was enjoying the trip for me not for my social media followers. 

Something else I noticed about social media is that most of the people I follow are doing things. Packing to travel, cooking something delicious, spending time in a pool. A lot of celebrities instastory from their dressing room or stage before/after or during their program. All that takes so much energy. I realize now that someone like Conan is spending all his time and energy promoting his brand. He's brilliant and I love him but that sounds exhausting to me.

I barely have enough energy to get through each day. Every so often I feel like maybe I should start a new project to keep me entertained or occupied during the wait and I just can't wrap my mind around it. Gardening? The deer will just eat everything. Painting? Eh it's not worth making a mess I'll have to clean up. I wanted to organize my linen closet. It took maybe 10 minutes of work and nearly 3 days of lead time mustering up the energy to get there. 

I seem to have a What's the Point roadblock to getting started these days. Nothing seems as important as furthering treatment and getting/staying pregnant. What I need to remember is that it's not an exclusive activity, even if it does take priority. I just have to find the patience and energy for other things. 

I want to find a project that I'm passionate about. So far I'm drawing a blank on what I want to do. It seems like all my energy is spent on getting to and being productive at work, keeping the house running, and managing our treatment. On top of that trying to maintain a strict low-carb, no sugar diet. I need something to feed my mind and nourish the soul. I'll keep thinking about it; ideas welcome.

Motivation

CD1 was on Friday as expected. It was a much heavier period than anticipated. I thought that along with the hysteroscopy they did a D&C, so what else was there to slough off? Apparently a lot.

Without going into more details, it was different than what I had expected. The whole weekend I was incredibly crampy and uncomfortable and tired. I often felt the need to lie down or space out. I had such strong sugar and carb cravings but I used whatever willpower I had to try to stick to my healthy eating. I usually crave peanut butter during my period; this time I switched to unsalted peanuts instead hoping it would have a similar effect. It didn't but it was good enough.

Sunday I had to wake up early for Day 3 bloodwork for insurance. Even though I had it in my calendar with a reminder on my phone and I told my husband so he can remember also, I kept worrying that I would forget to go. New clinic is only open until 8 am on weekends (I'm keeping score of old vs new clinics, possibly more on that in a future post) and I knew that if I missed it then we'd have a delay in getting insurance approved which could delay the IVF by a month (really 2 months because we wouldn't do it during the holiday season) and that anxiety wouldn't let up until I got there and had it taken care of.

It was actually not so bad. Again, my clinic is part of a hospital so the lab had patients there for other purposes. When I got there I was second in line. As I was leaving there were 12 people waiting. I didn't have any wait time but I could see how this can become a problem during monitoring days. The tech was clearly a professional but my veins were being tricky and rolly that morning so she ended up getting on a superficial vein. It was the first time that was done on my arm instead of my hand. It hurt more but I appreciated the one-stick.

I was so tired that I conked out for a 3-hr nap on Sunday afternoon. I had a few things I wanted to do and none of them got done. I was ok with that because bloodwork was behind me and that felt like a huge accomplishment.

Even with all the cravings and setbacks, I've been good with my eating habits. It's so clear that what you eat reflects on the scale. To me it's very black and white. When I eat less, I weigh less. Right now I'm working on getting rid of the extra lbs that piled on after our March loss. My highest ever weight was about 30 lbs away from where I am today, which was 2014. I lost the 30 lbs in prep for our first IVF and kept it off, for the most part, with oscillations up and down about 7 lbs in either direction.


The insulin situation ramped up the need to eat better and to date I've lost 7 lbs since May. I'm trying to get down another 13. If I lose 13 lbs it will get me down to my lowest weight since I started tracking in my app in 2012. There will still be more to go after, but I will feel accomplished that I got past the regular 7+/- and get to a new realm. The eating habits are really down to willpower because it's totally doable when my brain in on board. Exercise is another story.

I was talking to someone about trying to stay motivated to exercise. The response was, "well isn't having a baby enough motivation?" I had to think about that. If I thought that it was a direct cause and effect, I'd for sure make the connection and use that as motivation. But I don't see it that way. I don't even see things working as it is. When looking at the calendar, I realized this is how I was timing things: Aug retrieval; Sept holidays; Oct ERA; Nov transfer; Dec recovery; Jan try again. That wasn't even a conscious thought! When I shared this with my husband he acknowledged that that's just how we've been conditioned on this road.

Maybe on some level I'm trying to hold back on something in case that next transfer doesn't work so that we have something else to try. We're literally throwing the kitchen sink at this next transfer and if it doesn't work then not only will we be devastated all over again but we'll be completely stumped at what to do next.

I've gotten up to 30 min twice a week. Once I'm already in workout clothes and working out, it usually lasts closer to 45 min, but it's that hump of getting to that space of working out that's my challenge. It helps to recruit a friend. If I schedule a time to take a walk with someone then I feel bad canceling and so it's much more likely to happen. I'm also working on getting my husband on board but our schedules don't line up and if I wait for him to be available it ends up not happening.

I am motivated to succeed and I'm doing anything I believe will help. I guess I'm just having a hard time believing that our efforts will pay off since they never have in the past. Without even realizing it I've clearly built a protective wall. Maybe now that I've realized it, it will take less effort to get around the mental block.


Right now we're waiting for pathology results and insurance authorization. The wait continues.

Hysteroscopy Post-op

I went in for my post-op yesterday. My appointment was scheduled for 2:50 pm and they ask that you arrive 15 min early to check in. I had already confirmed my information online so I didn't think I need to be there that early but I was hoping if I got there early maybe I'd get seen sooner.

On my way there, my gas light turned on and I debated whether I had enough time to get gas before the appointment. My gas light rarely goes on, it's not something I procrastinate because I have no interest in getting stuck anywhere. But recently I drove my husband's car and that needed gas so in my mind I had already gotten gas recently and kept forgetting to fill mine. I decided I didn't want to risk getting stuck without gas so went to the pumps near the office and ended up getting to the appointment by 2:40 pm. Plenty of time. Checking in took about 30 seconds because I had done everything online. Then I sat and waited. And waited. They were clearly running behind.

At 3:15 I got called back by the assistant to get vitals. She took bp, pulse, and temp. She asked me to get on the scale and I asked if I have to since I was just there. She retracted quickly saying, no no we don't have to it's just part of the protocol. Well eff protocol. I'm really quite done doing stuff "just because." I'm pretty much game to do anything that will be helpful but I'm not a puppet and if something isn't necessary then what's the point? I had also weighed myself earlier that morning and I know how much I weigh and just gave her that number which was good enough. I know when we start actual IVF or something then I'll have less of a choice and I'm ok with that. Honestly, I was wearing complicated sandals and didn't want to deal with taking them off if it wasn't necessary.

Nurse left and I waited some more. A medical student comes in and said she will get some information to tell the doctor and then the doctor will come in. At this point I was feeling annoyed. The wait didn't bother me until that very moment. When the medical student tried to explain why she's there instead of the doctor she said something like, "Well, because we can give you more time and get the information to the doctor." I'm paraphrasing but that's the gist. This upset me because I'm paying to see the doctor, I'm not paying for a med student's time nor did I schedule on the med student's calendar. Surely they will bill me with the doctor's fees. I'm not a case study or a charity case - I'm a paying customer and I didn't come here for a med student. This was all going through my mind as I tried to not get angry because when I get angry I cry. So I switched gears in my mind and said, fine let's do it. This is, after all, a "teaching hospital" and something else to get used to in a new clinic. Awesome.

So she started asking questions about my recovery - fever, chills, nausea. I told her that recovery took a while, in my opinion because of the general anesthesia. I told her about my cramping and spotting. She asked a few more questions and then went to the doc. The walls are pretty thin and I could hear the discussion in the doc's office. What I think happened was that the doc was running so behind schedule that she never had time to eat lunch and so instead of making me wait she sent in a med student to do the grunt paperwork before coming in. I'm on board with that. I would have been even more on board if the student had introduced herself by saying, "Hi I'm a med student and I know you've been waiting for the doc so in order to maximize your time here and get your appointment moving, I'll get some notes before the doctor comes in." That would have made me feel like even though they're running behind they're still respectful of my time and that my appointment isn't truncated with the doctor just because the schedule is messed up.

ANYWAY. Doctor comes in, says hi, and says she doesn't like that I'm still spotting. She asked if she could do an exam to check for infection. They left and I got undressed... the sandals had to come off afterall. She didn't see signs of infection. She took samples to look under the microscope and didn't see anything alarming there either. She recommended I stop the bc pills to get a period even though I'm not due to do that for another week. The thinking being that the procedure may have irritated the lining and it's off balance or something. If spotting and cramping continues after my period then she wants to put me on antibiotics. Ironically, in the quest of searching for inflammation, it's possible that the procedure triggered some inflammation.

Originally, the next step would have been the ERA. But since she wants to make sure there's no inflammation before testing the lining, her recommendation was to do IVF next. Moving up the timeline on the IVF is fine and this schedule lines up with when my husband's mandatory wait is over. It actually works out well to move up this period because then we're doing a retrieval as soon as he's ready. We're waiting for pathology results regarding the stain that the RPL specialist wanted to see. That's taking a little longer than expected and coupled with this newest unexplained spotting, she wanted to change the timeline a little bit.

In summary, here are the next steps:
- Initiate period asap
- Break cycle in July waiting for spotting to resolve and pathology results
- IVF cycle in August
- ERA cycle in September
- FET in October

There are a lot of ifs in that timeline and I know it's not set in stone. For example, depending on the timing after the retrieval we may push off the ERA/FET by a month due to the holidays. Also there will only be an FET if there are embryos from the IVF cycle, obviously.

The ERA is supposed to be a natural cycle, which means multiple days of monitoring, possibly on a daily basis. She asked if Saturdays are out completely and I said not necessarily. I'll come in for a procedure if I have to, especially for something like a retrieval or a very specifically timed FET because there's so much at stake. But for something like the elective ERA where I know there will be lots of days I have to go in, it's just not worth the hassle and stress to try to do it over the holiday season where there will be so many days that it will be a challenge to go in.

While I don't like the delay of the ERA, I'm happy with this switch. It means having the retrieval in the summer before things get hectic for me at work in the fall. It also means getting the heavy recovery procedure out of the way. I like the idea of possibly taking a break for the holidays before getting back into it for the ERA/FET. I know it's all going to work out how it's supposed to and I have no say over things I can't control, but for right now I'm content with this schedule and I'm trying not to worry about the spotting.

Taharat Hamishpacha

Disclaimer: After writing it, I realized this post got a little technical. This blog is an outlet to sort out my feelings and chronicle our journey. But it's also public and online and searchable. I try to balance limiting personal details while still being true to the content, which is mainly about my private parts and a difficult chapter of our life. In any case, if this goes over your head feel free to skip it. If you found this blog because you're googling the same issues and you might find this helpful, welcome. 

Healing from the hysteroscopy is ongoing. As of today there is still spotting. For someone who keeps the laws of taharat hamishpacha this has been a challenge. The procedure needed to happen between days 5 and 12 of my cycle. That's literally the shiva nekiim, which means a potential issue for mikvah.

I know enough about the laws that I understand where there is leniency. There are three non-negotiable bedikot that need to occur for a kosher tevila: hefsek, day 1, and day 7. I got the first two as well as an additional few days up until the morning of the procedure - all were fine. After the procedure I refrained from doing bedikot, knowing they would be compromised. I knew that day 7 might be an issue because of the procedure. I also understood that even if I can't get a clean bedika on day 7, there is leniency to wait an additional day and use days 2 and 8 or even 3 and 9 as first and last. The caveat it that there cant be more than 5 days between the bedikot and so if spotting continued, I couldn't use day 3 and 11, for example.

Day 7 comes around and I'm still seeing staining when wiping. It's very mild but enough to convince me that there's no way I'd get a clean bedika. I considered just waiting it out. Surely this will subside in the next day or so - the last hysteroscopy didn't last nearly this long so maybe just a day or so extra is needed. Then I decided that there is no reason to be stringent for no reason and I reached out to someone more knowledgeable.

I needed an answer before sunset. Due to the time sensitive nature of the question I decided to call the yoatzot hotline. I was connected with a lovely woman who was able to answer my question. According to the rav that runs nishmat, staining from a known procedure is considered dam makkah and therefore doesn't invalidate the bedika. I was advised to do the bedika and if I see anything other than bright red to assume its dam makkah and disregard. I'm glad I called and didn't just assume it was a no.

I made it to the mikvah on time and was able to dunk. I barely got home and the spotting restarted. According to the doctor we were supposed to refrain from sex until spotting stopped. The same holds true for halacha even though I was no longer nidda.  I waited until spotting was done for at least 24 hours before calling the green light. However the next day spotting was back on and hasn't stopped since. It's so mild I don't even need a liner, I just see it on the paper.

On Friday I emailed the doctor if it's normal to still be crampy and spotting. Her answer was that yes it's very normal up to a week. It's now 10 days. I'm concerned and don't like it at all. I'm not going to email again since my appointment for the post op is on Wednesday so I can mention it then.

I feel pretty confident in my knowledge and ability to diagnose and address my own questions. But when a situation comes up like this, I am grateful to have the resources available from an organization that's set up to help people do this mitzvah. It's uplifting to have this support system set in place. Instead of sighing in frustration and giving up, I can lean on a more knowledgeable person to help me through it.

Lifestyle changes update

I've done some more research on my glucose/insulin results and what I should be eating to go with my lifestyle changes in an attempt to avoid meds. My glucose levels were fine and well below normal levels. My insulin levels were borderline, and I use that term loosely because it depends on who you ask. Some sources say that my numbers are fine, other say that they're just a hair above the normal limits making them high. It doesn't make a difference to me about how to treat it, but I felt it was important to understand.

Of the research I did, everyone agrees to limit all forms of sugar if you're trying to control insulin levels. One drastic approach is the Blood Sugar Solution by Dr. Hyman. I found the cookbook at the library for some recipe inspiration and read a little about his approach. He recommends six weeks of eating just vegetables and lean protein, and eliminating sugar in all forms, white flour, and white rice. For the Advanced Plan he recommends limiting all grains as well as all fruit except for 1/2 cup of berries as a treat. I hear what he's saying and I'm happy to implement a few of the suggested ideas and recipes. I don't think being so restrictive is a good idea for me because taking on too much at once might backfire and I'll burn out too quickly, so I'll take on new changes slowly to help them stick.

Last week I saw a documentary called "That Sugar Film" (available on Amazon Prime) about an Australian actor who changed his eating habits to see what effect sugar had on his body. It was a very interesting film. Between that, my research, and other sources, I learned a few things:

• Sugar is bad for you. I believe it's ok in small, measured doses but that's rarely the case these days between processed food and take-out.
• Oatmeal isn't necessarily as super a food as I originally thought. I don't remember where I saw it but apparently it can raise blood sugar as well. More research needed.
• A calorie is not a calorie. To me this was mind-blowing. I used to think that as long as I kept my calories counted and under a certain number that it didn't matter what I ate. In terms of weight loss, maybe. But in terms of nutrition that's not true. For starters, eating 200 calories of avocado, for example, will give you nutrients and keep you full because of the fat. In contrast, having 200 calories of juice gives you a sugar spike which then comes with a sugar crash shortly after, which leads to cravings and overeating. 

I've made some significant changes to our menu but there's still a way to go. Breakfasts are either eggs with something (avocado or cottage, or some veg) or a green smoothie. Lunches are either leftovers, salad with tuna, or veg with hummus. Dinners vary and include some sort of roasted vegetables with salmon or chicken. There's room for improvement, especially with snacks and desserts. For shabbat I made a five lb dough for the bracha. I split it in two and made half into challah and the other half into seven babkas. Fresh, sweet baked goods are my #1 weakness and they were by far the most delicious babkas I have ever made or tasted in my life. I ended up giving away five of them - I just couldn't risk having them in the house, even buried in the freezer.  I also need to work on getting to my goal of getting at least 30 min of exercise four times a day. It's not a struggle of finding the time, it's looking for the motivation.

Recovery and July 4th

It's been a tough week for me. The recovery from this procedure really kicked my butt. Cramping lasted nearly a week; spotting lasted nearly as long; I had all kinds of side effects from the anesthesia like puffy and dry eyes, headaches, fatigue, nausea, and constipation. I tried to stay hydrated and eat right but I was barely making it awake through most days. I am so lucky my office was closed for the holiday week because I don't think I would have taken the time off to recover and I clearly needed it. It wasn't enough to warrant drugs, but taking it easy and staying hydrated were key. I don't know how much of my symptoms were because of the procedure and how much due to the weather; either way it sucked. It was definitely more of a recovery than my procedure in January.

 

Since I spent most of the week in bed or on the couch, I was on my phone for entertainment the majority of it. That's a bad idea and I don't recommend it. Social media is the devil and it will find your weak spots and exploit them. First of all, I was so disappointed to see how many complaints were being posted about the lack of camp on July 4th. No one wants to spend time with their children? No one wants to make childhood memories that last a lifetime? What is wrong with people? 

Second, there were the vacation photos. People are clearly posting their highlight reel, I know that. They're not posting the fight they had this morning with their spouse, or their regular day at work, or the broken washing machine, or the spoiled milk they put in their coffee, or the thousands of other daily life things that happen. They're posting pictures of beach vacations, pool parties, and exotic getaways. Smiling on a jetski, or posing with an icy cocktail on a boat in a cute summer dress with a floppy hat, or showing some ancient monument in Europe, or piling in big happy groups on the side of a pool with a bbq in the background. For someone who is already down because of what feels like a steaming pile of poo life has handed them, these pictures were a stab in the gut. It's the things I want but can't afford or don't have access to. 

I have a large group of acquaintances but not a big group of friends. I have people I can go out to lunch with one-on-one. But here is no cohesive group like on "Friends" the TV show where we default together. Usually the default group is family which I'm grateful and blessed to have, with all the politics and fun that comes with. Which means that on a day like July 4th when people post about potluck parties and large get-togethers, it makes me sad we're not invited to people's parties. My sister hosted a bbq which we went to but it was family and then their entire group of friends. I felt out of place and left after a couple of hours. I used to have really close friends but life took us on different paths and we're barely in touch. Geography is a big part of it. Being married to someone not as social is part of it. Spending all my mental energy on trying to build a family is a part of it. 

I don't know how people make close friends later in life, but I know it's not from doing what I'm doing. Something big needs to change, like moving to a new neighborhood or having a kid who has friends with parents, or starting a new job, or something similar that puts you in a position to spark new relationships.

Over my break I watched a documentary called "9/11 Faker," which talks about a person who pretended to have escaped the twin towers right before they fell. In the documentary, the real survivors of 9/11 talk about their experiences and how they started a support group for the survivors to get together, discuss their experiences, and lean on each other due to their shared experiences. Talking about the reason they started the group, and why he could no longer rely on his family for that support, one survivor said a phrase that stuck in my mind: "My need to talk is greater than their ability to listen." Even though his family loves him and wants to be there for him, they just don't understand. His story doesn't change and the horror replays in his mind all the time, so after a while people who weren't there just don't get the need to keep talking about it as a way to process. 

That phrase really touched me because it's how I feel with my support group. I call them my "out-of-network" group since they love me and want to be there for me but they just don't get it. My "in-network" support group are the people who have gone through it or are still going through it. I only have one non-online friend that we met recently who is still going through it and I often times find it easier to talk to her than some family members or even my oldest friends. 

At this point it's been three years since we started fertility treatment. I feel like I can't talk about it anymore to people who aren't in it. They're not as compassionate as they need to be, they're slightly dismissive without meaning to be, and they don't understand that asking "so what's next?" to get the timeline moving isn't going to make it move any faster. When I said I was having a hysteroscopy, one person responded with "oh you've had this already" as in ok so it's not a big deal. It's surgery. It's recovery. It's still scary and frustrating and painful. I don't need to hear that it's not a major surgery to make me feel better. I need sympathy and compassion and "Ugh I'm sorry you're going through that again; I hope you get some answers." When people downplay my procedures then I'm reluctant to share because it makes me feel like I have no right to talk about it, since it's no big deal right? I'm not asking to be coddled but I'm feeling dismissed. My best friend didn't check in. For 4 days. On Tuesday I texted her to make sure she's ok. I get that her job is very demanding and that my treatment is repetitive but still. A text. C'mon. 

One other thing contributing to my mood is the Handmaid's Tale. Anyone else watching it? I won't give away spoilers but during the latest episode my thoughts were "Omg, even SHE got a baby before me." It's a very intense show and I'm not sure why I watch it when it's so disturbing. 

Next week I go in for a post-op appointment and to discuss next steps. I can't believe summer is already half-way over.