Sunday, August 29, 2010

Humble pie, no coffee

It's been a nice Sunday morning so far. I've baked muffins, cleaned the kitchen, practiced yoga and, wait, I hadn't had coffee yet. Ooops! This post may be less than lucid because of that. I hope your Sunday morning is lovely and involves coffee (but probably not for Adele)

I read your comments to my last post with some degree of horror. It was difficult to read about the comments you had received in relation to your infertility. Yes, of course I got mad about it. How could these people say those things? But my first reaction was one where my heart ached for yours. I wish those comments could be given back to their owners somehow. My examples felt a bit mild compared to what you've had to endure.

I regret to report that the last entry has also had some unfortunate consequences in my IRL friendships. One of my most beloved friend believed I was describing her in one example (I wasn't). Another friend wrote to me and said she was worried about having been insensitive in the past (she never has been). I did not intend to make my dear, dear friends feel like they had mis-spoken, but that was the consequence of it. I guess this parallels how people who make insensitive comments to infertiles usually don't intend on hurting our feelings. It's a great irony, as Foxy pointed out.

I looked back on why I had written that post. I know that I was feeling burdened by the sting of the comments and was finding myself ruminating about them and how I should have responded (rumination: sucking the soul out of healthy women everywhere. see psychologist Susan Nolen-Hoeksema's research for more info on that). I was hoping that writing the comments on my blog may help me just s.t.o.p. ruminating.

I think it did, but unfortunately, it created this other problem. The response from my IRL friends made me reflect on the principle of "Right Speech". The basic principle is that one needs to avoid creating harm in the world through lying or saying things that will be hurtful. One of my teachers would say that before one speaks, one should ask themselves "Is it true? Is it kind? Is it necessary?". In the same way that those folks who made comments that hurt me, I have also written words that caused harm in other people.

This left me quite conflicted in my theoretical orientation (and what am I without a theoretical orientation, I ask you?). On one hand, I believe that some limited, carefully timed venting can bring a bit of relief. On the other hand, I believe in not harming other people. So I sit here with my heart half-filled to the brim with regret, and the other half glad that we were able to write some of the comments down and (perhaps) let them go.

I also want to write that overwhelmingly, my IRL friends are absolutely amazing women and men. They have brought incredible grace and kindness to my life. My friends are my family. I credit them with helping me through dark days and with celebrating joys at each turn. My friends hold my heart. I can't tell you how sad I was that some of them felt like I might not appreciate what they have done for me.

So I may still vent on the blog. I probably will. Yet I think next time, I may give some more thought about right speech before I lay it all out.

Tuesday, August 24, 2010

What not to say

[Warning: This post was written for the purposes of venting. Rainbows and unicorns are off on a professional development day and weren't able to participate in the writing of this post.]

I've been thinking of my top 10 list of things not to say to an infertile, but I never make it past 3. So I thought I would post what I've got, and you could maybe add yours in the comments.

There are a great many horrible things I've heard being said to others, but there are only 3 very awful things that have been said to me. Here they are:

1) "Well, maybe I'll be infertile too, you know" from a friend who was not yet ready to have children. I recognize that this was said out of compassion and I truly love the friend who said this to me. She meant so well by it. She didn't want me to feel alone in my sorrow, so she opened the possibility that she too could have problems conceiving. Unfortunately, thinking about her not being able to conceive makes me so sad, I almost start to cry. She is a wonderful woman and deserves to have the children she wants to have. So, unfortunately, not a helpful comment, especially not when it was one of the first thing that she said after finding out about our infertility.

2)"Well, at least you won't have to suffer through all the discomforts of pregnancy" This one is wrong on so many levels, I don't even know where to start. Perhaps the thing most wrong with it is that my Family Doctor said this to me. Yes, I was in her office in July and she asked how the fertility treatments were going. I was feeling particularly down on that day, so I started crying. She was of course trying to provide comfort, and missed the bulls eye oh, by about the width of 3 Canadian provinces.

3) "oh Augusta, you always do things in such an unorthodox way. I guess you'll also just do this (have a baby) in an unorthodox way" That was said to me by a friend who came to dinner on the same day I visited my family doctor (see 2). Part of why I was having such a tough day before I went to my GP was that I knew this friend was coming and she had said in her email she had a "surprise" for me. Last time I saw this friend, she failed to order her reliable glass of red wine at the French restaurant, which, of course, roused my suspicions. She waited until dinner to tell us about her pregnancy, although at 5 months, it was quite visible. She went on and on about the pregnancy (full disclosure here: when I feel too vulnerable, I start asking people a LOT of questions and make them talk about themselves. So I had my part to play in that). This friend knew about our infertility, although had not been updated recently. Then when she asked about when we would start a family (another gem), I told her about the failed fertility treatments (egg donation was still very tenuous at that point). I didn't feel like raining on this woman's parade and was hoping we could change the topic, but she was steadfast. And then the comment about my unorthodoxy. I actually was so dumbfounded that I had to ask her what she meant by it, which did not clarify much since she was making desperate and not very coherent attempts to back paddle on her comment, seeing it had upset me. Sheesh! That one was obviously uncomfortable for both of us!

So let's review what we've learned here. First, as a woman in childbearing years, never tell an infertile that you also may be infertile unless you know you are. This is never comforting. Second, if you are a family doctor, find a way to talk to infertiles that will be empathetic and won't involve your foot going into your mouth. Third, never, ever be the one highlighting an upside to infertility if your are not the one who is infertile. Very. Bad. Form.

Ok, what comments have people made about your situation that have stung you?

Thursday, August 19, 2010

The August appointment

I had hopes about today. I was hoping it would go well. Just that we could go to this appointment, that I could avoid being completely stirred up like a snow globe, and that we could get news that would make me feel like we are going forward. I'm pleased to report that this was accomplished.

First, I had of course written down notes and questions to ask Dr. RE and when we were waiting in the exam room, I had narrowed it down to 2 categories: discussing my current hormone dosage and discussing egg donation. Dr. RE walks in, looks at us and shakes our hands, and then says: "You are here either to discuss the hormone dosage or egg donation. Which one is it?" "Both", I said, "which one should we start with?" He picked the hormones, which is how I had it laid out in my book (and he wasn't reading it!)

I've been feeling for a while that my estra.ce dosage was too low. Remember from an earlier post that my body does not produce LH and FSH, hence, does not produce estrogen and progesterone. So, I'm completely dependent on meds. You will also remember from my February post that he wanted to know at the last appointment if my mood was very low and could that be related to lower than optimal levels of estrogen. Well, I was in fact quite grief stricken still at that point, and really, let's call a spade a spade, I was depressed. But I couldn't really tell if it was the estrogen, because I've been depressed before while taking the bcp, so I couldn't parcel it out. But lately, I've been thinking I shouldn't really be feeling THIS crappy ALL the time. Again, it's not only the estrogen, but coupled with word finding problems and atrociously low sex drive, I was thinking maybe there was something to do. I didn't even need to tell him that. He just said "Oh, if you think it's too low, it is too low. We'll up it to 3mg and then 4mg if you need". I liked all that trust he gave me.

Then came the egg donor topic. Dr. RE is quite unflappable (perhaps one needs to be after working with infertile couples for decades...what with all that affect from patients), but I think in his range of expression, he was positively psyched to hear we had a donor. Ok, the cues were very subtle. He says we need to have an appointment with me and the donor to discuss it with her and start the testing. He want me to have a sonohysterogram to look at my uterine cavity. He thinks we can all do that in the same appointment (the hospital is a 90-120 minute drive from where we live). He explained that the rates of success are not those found in the literature since those data come from US clinics with strict criteria for donors. He did not say she was too old, but instead thought that the age of her last child presented as a good omen for her fertility. He did explain that she could be running low on her reserves, but that of course, we won't know if we don't try. He reported that they will attempt egg donation with donors who are 38.

Dr. RE also assuaged my fears about sustaining a pregnancy by explaining that supplementation with estra.ce and pro.metrium during the first trimester would sustain the pregnancy, and that after that, the placenta would take care of it. He said that without the meds, I would not be able to sustain it because my ovaries would not produce the estrogen and progesterone needed while the placenta develops, but that the medication would suffice. And then he said something that pleased me. He said "You're a healthy woman, so I don't see why you couldn't carry the pregnancy". For someone who visited death's door (when I had anorexia), being told I am healthy is really, really lovely. I take so much pride in my red cheeks, and love when my health is recognized. I have worked so bloody hard for it.

One last thing before I close and go hang out with some wonderful women friends. When I arrived at the hospital, I was starting to get the feeling of being overwhelmed. The environmental cues, the nervousness about the appointment, the coffee, were all contributing to a sense impeding doom. However, I went to the bathroom and once I was alone, I noticed that I was starting to feel off my centre. (warning: I'm about to get a bit sappy). And then I thought of all of you. And I felt your presence with me. I thought about Bunny having her IUI. I thought about Kelly's appointment at 11:30. I thought about what you have all gone through in the land of IF. This comforted me greatly by making me feel so much less alone. Thank you so much. Thank you to you who read my thoughts, and leave a comment or even those who don't leave a comment. Thank you for sharing your story and allowing me to share mine.

Wednesday, August 18, 2010

Anticipating Tomorrow

Tomorrow at this time, I will be driving to our appointment with the RE. As some of you know, the reason why we are meeting with the RE is that we need to discuss egg donation. A donor came forth in June, and we need to see whether this is possible.

It's difficult for me to feel positive. I wish I could. I feel like this process deserves my positive thoughts and feelings.

At the moment, all I am thinking of are the road blocks that would stop us from going ahead. Here is a sample of what goes through my mind when I think of the ED: 1) The donor will change her mind, 2) The clinic will think she is too old, 3) my RE will reveal that since the gonadotropin stimulation did not work for me, the egg donation will not result in a viable pregnancy 4) we won't be able to afford it in the end, 5) I am a complete and utter failure in every way including becoming a mother.

Ok, I agree, the last one is too harsh. But numbers one through four are worthy of my worry. And I guess the only way to assuage those worries, OR to confirm them, is to go to the appointment and discuss it with the one who has the medical degree and the decades of experience getting infertile women pregnant.

The other part that worries me is this one. The last time I went to the clinic in February (read about it here) it rattled me a great deal. It was the first time I returned after the last and final cycle, and not surprisingly, I had a huge emotional reaction. Tears are fine with me in general. I also encourage them in others, every chance I get. But somehow, crying when I'm required to be coherent and put together fills me with shame. I can just hear my mother yelling at me to get it together. So with regards to tomorrow's appointment, I fear what going back to the clinic will do to me. The added piece is that the hospital in which the clinic is located is where I did my residency. And that was such a great experience for me, and I haven't been that happy professionally since. So, there are losses associated with that place.

But chin up, Augusta. Remember this is hopeful. There could be a baby waiting for you at the end of this road.

Monday, August 16, 2010

Chicken





At the request of Bunny, I give you pictures of my kitty cat, last Wednesday, after she got what's called the lion shave. Tibbs (her given name, but I just call her chicken) got sprayed by a skunk in July and after a bath in tomato juice, another in hydrogen peroxide, baking soda and dish soap, her fur was just one big dreadlock. She looked supremely uncomfortable, so we saw no alternatives but to get her shaved. I know, I know, it's like we took her dignity away. I mean, look at her! Mr. August calls her an Ookpik, after the little rhyme that follows:

Ookpik - by Dennis Lee


An Ookpik is nothing but hair.
If you shave him, he isn't there.

He's never locked in the zoo.
He lives in a warm igloo.

He can whistle and dance on the walls.
He can dance on Niagara Falls.

He has nothing at all on his mind.
If you scratch him, he wags his behind.

He dances from moring to night.
Then he blinks. That turns out the light.

-from Alligator Pie

Saturday, August 14, 2010

What a week!

My week in small college town, Ontario was fairly quiet. I made some small progress on the big D, our cat got shaved and I ate ice cream on Wednesday. That was about it.

However, in this online world, which represent in a partial way, the outside world through your eyes, there seemed to have been much turmoil. There was illness and near-death experiences this week. First of all, Foxy's grandmother had a stroke. This is of course very worrisome to her, so stop by her blog to leave her a little love. My thoughts are with you and your family Foxy.

There was also very unwell pets. Adele's dog Hobes got sick and is now on meds and full rest for a month. How hard that must be for a dog to stay still for all those days. And then there was Jess's cat Bucky who had a most unfortunate accident. Having just acquired a cat, I know how meaningful their presence is in our lives. It's pretty scary to see them ill or hurt, and the thought of having fur babies taken away from us on top of being infertile, is a little much to bear from the Universe, I reckon.

My thoughts also go out to R. at One Good Egg who has had a pretty terrible week. I really hope things start to look up soon for her. I am also thinking lots about my friend IRL who has been struggling so much with her IF lately. She is constantly bombarded with bellies and babies everywhere she goes, and has had just about enough.

I'm also thinking about Bunny at Glum Bunny who, despite her reports of feeling pretty emotional (read about the snotfest), she still manages to make us laugh and salivate with her most delicious infertility remedies.

Kelly had some good questions for us to ponder this week. I haven't replied to her post about IF and its impact on friendships, but it has generated lots of in-my-head replies that I hope to formulate online soon.

I feel hopeful for Cassie who had her DE transfer in Colorado this week. Join me in thinking happy, nestling embryo thoughts for her. I am also hopeful for Lisa who is about to have her transfer from IVF #1 early next week.

Finally, I really liked hearing that jrs has her adoption phone on and is ready to receive the call!

Hope you all have a great weekend.

Wednesday, August 11, 2010

Yum!



Tonight was a random, for no good reason, ice cream for supper night. Yum! Ice cream is so good. It's got everything going for it. Creamy, sugary, cold, filling, and complete with chunks of candy. We had to go buy food for our cat and a new ice cream parlour has opened next to the pet store. Perfect reason!

I know what Traditional Chinese Medicine doctors think about ice cream. Let me sum it up in one hyphenated word: Pooh-pooh. Much like Adele, I have the very strong suspicion that wheat and dairy are about to make a conspicuous exit from my dinner plate (and my lunch plate and my breakfast plate). So, the ice cream for supper night is better now, than when I have it confirmed that my body doesn't tolerate those things very well, that they promote inflammation, triggering the immune system to work all the time.

But I didn't care 2 hours ago. I just had my banana ice cream, with butterfinger bits and peanut butter cups in a waffle cone.

Friday, August 6, 2010

Notes on impermanence



Todays' thoughts are brought to you by the letter I. I is for the self, of course, but also for Impermanence, which is what threads my thoughts around this necklace of a post, on this August 6th. I feel like since I've started learning about Buddhism in the late 90s, lessons about impermanence have been the most helpful and the most sobering. Impermanence means that I and everyone I love will die. Impermanence means that everything changes, all the time. Impermanence means that who I think I am is a mere illusion. But at the end of the day, breathing into the truth of impermanence has helped me through rough times. I hold on to the truth that difficult times will not last forever. Thich Nhat Hanh says that 'Thanks to impermanence, everything is possible'. And today, I choose to remember that. Here are a few thoughts.

Thought #1: Food poisoning will not stick around...much longer.

I thought I was all better from the food poisoning, but last night I had a little bit of a set back. Lots of unhappiness in the tummy. I ate about 1/3 cup of rice for dinner, as well as big cup of kefir, trying to repopulate my digestive tract with happy little friends. My morning has been slow, to say the least. Not having eaten much yesterday, I really wasn't able to jump out of bed. So, I didn't. That worries me of course. My productivity. My sense of accomplishment. My work. (Lions and tigers and bears, Oh my!). But I won't feel like this forever. I just had this bout of food poisoning. I'll be all better by tomorrow or the next day, for sure. I can count on things changing.

Thought #2: A bride's bouquet is lovely and compostable. Enjoy it later in pictures.

I looked at some of our wedding pictures this morning and wanted to share this one with you. I absolutely loved my bouquet and it's so nice to be able to still enjoy it through pictures. My bouquet survived for a long time after the wedding, almost 2 weeks and then we put it in our composter. You see, the day after our wedding, the furnace broke and our house was without heat for the week of our honeymoon (this was Canada in early March. Brrr. Cold). This meant that the flowers from our wedding, including my bouquet, were kept in the best possible conditions to survive. The bouquet lasted longer than I thought, but it did eventually have to go. I really like that we just composted it and it will make good soil for the garden. It didn't last in all its beauty, but here it is in pictures and in the soil.

Thought #3: Infertility sucks, but it doesn't mean we won't have a baby

I've been lurking on many blogs lately and find that many women are pregnant. As much as it feels like reading about these pregnancies would break my heart, it doesn't. It heartens me. I read about the veteran IFers, who've completed their 5th IVF cycles and finally got pregnant! I must say it brings me to question my negative attitude, grim prognosis, and fear of hoping. Sure, our situation is difficult and there are many hoops to jump through before the egg donor cycle can go ahead. But we have a donor! And we can borrow money! And things change! Yes, things change. Mr. August and I are not parents at the moment. But that absolutely does not mean we will not be parents in the future. You can see that I am loosening my grip on dire certainties.

Thought #4: Helping things change is not wrong (sorry about all the double negatives)

I made another phone call this morning. Yup! I did. And I am proud of myself. I have a friend who is also struggling with infertility. She has consulted with a Traditional Chinese Medicine doctor in town and has found him to be excellent. She feels that her health has improved and that his interventions may help her conceive. So, I called to make an appointment. In preparing for the donor cycle, this surely cannot hurt. I've also been wondering about food sensitivites and it may be the right avenue to explore this issue. I'm most certainly not thinking that this doctor can cure the hypothalamic amenorrhea, although that would be swell (I may have to visit Disneyworld for that kind of cure). However, I think it can help prepare my body for a pregnancy, should the egg donation be successful. My appointment is September 28th, but she put me on the cancellation list for an earlier appointment.

Those are all my tidbits on impermanence for now. Thanks so much for reading. And for writing.

Thursday, August 5, 2010

Quick update

Thank you for your lovely, warm comments on my epic last post. It gave me new ideas to investigate. It also helped to have your support around my journey so far. The comments in my head are never quite that kind or generous.

After I posted my last entry, I went to bed and did not feel so good. The night did not bring any improvements, and by morning, I was positively ill. Unfortunately, despite being sick in the morning, it was not morning sickness. I'm pretty sure I had food poisoning and so did Mr. August. Bleurgh. It was awful. We both spent most of the day asleep, trying to ingest sips of water and keep them in, whenever we woke up.

Today, we're both better. I'm so thankful for the return of good health. I'm back at school working on the big D. I continue to make small steps towards finishing this very long overdue degree.

There were lots of good news in the blogosphere today and I was happy to read about all your plans and test results.

Tuesday, August 3, 2010

Our story

I've been meaning to write out the story of our infertility and now seems to be the right time. I've tried before, but there are hard bits to disclose in there, so I've had to gather up the courage before putting it out there. So, here our story starts.

The story of our infertility is the story of my infertility. Mr. August has no problems with his swimmers. They're all happy, fast and abounding little guys, with motility to spare. If only they could meet an egg, they would know what to do and they would do it.

I have primary amenorrhea, which is to say, I have never had menstrual periods without the lovely assistance of drugs. I was that girl in high school who kept waiting for puberty to show up. It never came. I finally started taking the birth control pill at age 18, and a puberty of sorts occurred, complete with a monthly bcp-induced period (which I refuse to call withdrawal bleeding, because for goodness' sake, it's as close as I can get to a period and I therefore call it a period).

In the different medical consultations I have had about this problem, there has never been a compelling explanation given to me about why this happened. I don't have turner's syndrome. I don't have a pituitary cyst or tumor. I don't have PCOS. But there is another piece of my medical history that muddies the waters BIG TIME.

At around age 17, I started to struggle a great deal with eating and I developed a full blown eating disorder. From the age of 11 on, there had been a number of significant stressors in my life, and the culmination was the eating disorder. At the time of my hospitalization, my BMI was down to 12.9, which was terrifying to those around me (and to myself, retrospectively). At age 20, I spent close to 6 months on a specialized ED hospital unit and it helped me to recover. I kicked the eating disorder out of my life, and today, I'm just a regular, normal weight woman with rosy cheeks and shiny hair.

Most doctors I've consulted with just chalked the amenorrhea to the ED and got me on my way with a bcp prescription. My bones took a beating with the anorexia and the lack of estrogen, so there was never any other option presented than taking the bcp because of the risk to my bones. When I asked about having children, the answer I got from different MDs was that it would be possible with the appropriate fertility treatments. They didn't seem to think it would be a problem. I worried about it, but I didn't know what else to do at that point in time, since I wasn't ready to have children yet.

In winter of 2006, I consulted with an endocrinologist in my town. It's not a very big town, about 100 000 people, and he is the sole endocrinologist here. I went through 8 weeks of blood tests to determine what kinds of hormones my body produced on its own. Ahem...ya, not very much. Not very much at all. He gave me a very grim prognosis, but still referred me to a RE in the big city near lake Ontario. Mr. August and I decided to go, even if we weren't entirely ready to start a family, because I was 32, turning 33 and time was of the essence. We wanted to know what was possible.

Oh gosh! It was a disaster. The RE was so, so arrogant. He said something like "I'll get you pregnant because my reputation depends on it". A big ego is a very strong Augusta repellent. This RE pressured us into starting diagnostic tests on the spot, that very day, when we had clearly said we were coming to gather information in order to make informed decisions. We left that clinic and never called them back.

In January 2009, I saw my family physician and asked her to refer us to the fertility clinic in the large hospital centre where I was completing my residency. It's 90 minutes from where we live, but I was there until August 2009, so I figured it would work out well for a little while. Mr. August's parents also live in that city, which meant that we could stay at their place for early morning appointments.

We liked our RE so much more there. Orders of magnitude more. He is a calm, no-nonsense kind of man who has been in this business for years. He is the director of the clinic. He talked to us about cautious optimism, which is something I could deal with. We liked the other team members as well, and felt like we were in good hands.

After all tests were completed, they conveyed the diagnosis of hypothalamic amenorrhea. Not a big surprise. But at least it gave me something to bring to Dr. Google.

We started our first IUI cycle in June 2009 with injectable gonadotropins (Me.no.pur). 10 days later, nothing. Nothing at all. No eggs, no lining, nothing. It was very disappointing, but as I walked out of the hospital the day it got canceled, I thought to myself, 'some women came here this morning and got a cancer diagnosis'.

Our RE seemed calm, as always, and fairly confident. He had another trick up his sleeve, he said (well, maybe not in those words. He is a very proper eastern European man). I took increasing doses of es.trace throughout summer 2009 so that I could build a good lining. And that seemed to work well. The lining got all nice and thick, and let me tell you, I was feeling fan-freaking-tastic on all that estrogen. In September, another IUI cycle was set up and I started injecting the gonadotropins again, but this time, we started at the dose we had stopped last time. And the dose was increased. And increased again, but to no avail. My ovaries stayed small and devoid of any follicles.

It was October 1st and I had gone for blood work in the city where the hospital is and I was waiting for the nurse to call our answering machine so I could pick up more meds before going back home. The message on the machine said the cycle was canceled and to call her back as soon as I could. I was at Starbucks with a friend, calling from a pay phone (because of course, being a Luddite, I don't have a cell phone). I'm not sure how I got home, but I know my friend was trying to get me to stay with her.

I did call the nurse when I got home, but I already knew what she would say. There was nothing more they could do for us beyond egg donation. My ovaries were just not responding.

I've been searching and wondering and constructing all kinds of stories in my mind about this. I wonder about whether there was a critical period for the development of LH and FSH receptors on the ovaries and, having missed it, they can never be used. I wonder if I lived in the US and had lots of money and could afford pulsatile GnRH whether that would do it. Those are the more logical questions I entertain. The more illogical ones go backwards in time and try to undo what was done.

There are other bits about my HPA (hypothalimic-pituitary-adrenal) axis I wanted to write about, but I'll put it in a follow-up post.

Thank you so much for reading and sharing this very hard IF road with me. I have felt so much less isolated since finding this rich online community. Thank you for your warm and sweet comments. They mean so much.

Monday, August 2, 2010

Ramblings

I'm such a Luddite. Hard to believe, considering how much time I spend communing with a computer. But, making my blog pretty was a bit beyond me and I didn't feel like I had the time to invest in understanding the ins and outs of good blog design. But, blogger did it for me. I just had to click a few things and voila! I'd love to get even fancier and put owls on it somehow, but that's the advanced course, and I'm already a little lost in my Intro to Blogging class.

Mr. August had been away on business for the past 2 weeks and he came home on Saturday evening. I was really glad he came home. I had missed him. I felt lonely, even though I enjoy spending time on my own.

We have enjoyed each other's company since his return. We've hosted friends, watched a movie, read the Globe and Mail while sipping coffee together, enjoyed good meals and went for a long bike ride in the countryside this morning (it's a stat Holiday in our part of the world. YEAH!). Now ask me how afraid I am about this not lasting. Very.

Yes, I know, the cognitive distortions are taking over and I must fight them with all my might. The thoughts lead to feelings which lead to behaviours. Classic CBT (cognitive-behaviour therapy). If you're a hard core CBT person, you believe that thoughts are preponderant, that they lead to emotions, which in turn lead to actions. In that order. If you're from a different school, you set it up like a triangle and really see that it can go in any direction. I've certainly had emotions that have led me to think in certain ways and propelled me into acting. I've also acted in such ways that have brought on certain feelings and subsequently, made me think in certain ways. All this to say, I don't believe in the preponderance of thought, and especially not when it comes to feelings.

I would like to feel more confident in our young marriage. I would like to feel confident in myself. I would like to feel confident in life a little more. I would like to feel hopeful about the egg donation.

And perhaps that is a tall order I really don't have a right to impose on myself at the moment. Perhaps just continuing with one small step, another small step, and then another small step is about all I can ask of me. It always helps me to think that others are doing the best that they can at any given moment. I usually feel more understanding and kinder towards them when I assume that they are doing the best that they can. I need to assume I am doing the best that I can. In my marriage. In trying to become a mother. In trying to finish my dissertation. In trying to be a good friend, a good community member, a good person on this earth.