Thursday, May 8, 2008

Can You Focus Too Much on Plan B?

Obviously you don’t have to be in the moment to conceive a child, but does it help? The power-of-positive-thinking people out there (who, in my opinion, tend to be those who have not been burned by its failure to come through in a pinch) would say “of course” your state of mind matters! Those of us who have had our hopes dashed one too many times would say that it doesn’t matter, that conception all about microscopic science, and that our losses are more a matter of dumb luck than anything else.

But I ponder this question today, in the wake of another total breakdown, this time at my acupuncturist’s office last night. She asked me how I was doing “in here,” tapping at her heart, and I shrugged noncommittally. I started telling her about how the hormones are making me bitchy (at J, and only J, because I can control it well enough around everyone else), which makes me not like myself very much. Then, as she started putting pins in various places, I started telling her about how much this cycle was costing us, and about the shared risk and about our plans to go right into it if this cycle doesn’t work, and about how much that was going to cost.

“You’re talking like you’ve already given up on the cycle you’re doing right now,” she said, seeming appalled.

“I know,” I responded, thinking to myself, I have. “But I need to get the next one set up, or we’ll miss our deadline for it and it will be August before I can fit another cycle in.”

“You’re thinking like a lawyer,” she said, to which I responded, a little hotly, “Well, I am a lawyer.”

“But can’t you just be in the now, just take this one step at a time? It would be such a shame if you were sitting there next Thursday (transfer day) and you weren’t even a part of what was happening.”

Of course, that got me crying, and kind of mad. Because what she described is exactly what I am trying to accomplish this cycle. I am trying to pretend it isn’t happening, to just go through the motions but keep focusing on the next cycle, to be so ready for the negative beta that it’ll barely sting. (I’m actually kind of worried about the timing. My BFF from Boston is coming to visit me at the end of the month; by my calculations she is going to arrive one or two days after my beta. It’s okay if I fall apart in front of her, but I don’t want to ruin her whole trip by being depressed.)

My acupuncturist thinks that crying is a really good thing, that there are tears stuck inside my head that need to come out. After three years of IF, I’m of the belief that I have a limitless supply of tears. Once I start crying, I usually can’t stop unless I take a xanax. And if I cry for more than a few minutes, I get a really bad headache. You would think that with this combination I wouldn’t let myself cry much, but the truth is that I cry a lot. So while my acupuncturist is telling me it’s good for me to let it all out, I’m trying to tell her that I’ve let it all out many many times, but it’s never, well, out. Instead of having a fixed amount of grief in me, it’s like I have this bottomless well of it, and letting it out does nothing to decrease the amount that’s still in there.

But after she left the room, as I lay there trying to slow the tears slipping sideways along my cheeks into my ears, I started wondering if she was just a little bit right. Not necessarily about the crying, because, seriously, how much can a girl cry before it’s just enough? But about my entire approach to this cycle, and probably the next and the one after that. I started to wonder if maybe I could jeopardize my cycle by refusing to acknowledge it. If I could be doing myself a disservice by refusing to acknowledge how devastated I’m going to be if this fails. (Have I mentioned that I think this is likely to fail?)

She certainly was right about one thing—I am deliberately distancing myself from what is happening to me. I am thinking like a lawyer. And let’s face it, that’s how I deal with life. While I like to think of myself as a hippie, flower-child type, the truth is that I’m not. I’m not spontaneous. Nope. I’m all about Plan B. I have been for a long time. I like to know my driving directions four steps ahead of where I am. I make long lists (and enjoy doing it) before I go on vacation. I constantly rehearse conversations in my head: what I’m going to say to opposing counsel about settlement; how I’m going to handle the receptionist at the RE’s office if she presents me with a bill tomorrow morning; what is the best way to e-mail my mom that will keep her from calling me; even how I’m going to talk to J about delicate issues. I like to have a backup plan for every life event, and a backup if the backup fails. So is it any wonder that, in the no-guarantees world of trying to get a baby, I’m all about Plan B, and C, and even D? (Note: if you think I’m using these terms randomly, Plan B is shared risk IVF, Plan C is IUI with donor sperm, and Plan D is adoption.) And something I realized last night? I break down my backup plans to myself when I’m tense, or scared, or completely freaked out. Case-in-point: all I’ve been able to think about or talk about in the past two weeks is “the plan,” particularly getting into the shared risk program. Not about how I’m feeling. Not about whether this is going to work. Just, over and over again, the details of the plan.

But is my acupuncturist right about this being a bad thing? I’m starting to think maybe she is. The most obvious point is that “the plan” is constantly on my mind, but I’m not at all sure it is bringing me comfort or peace. As she rightly pointed out, it isn’t going to take much of my time and attention to set up the shared risk program. But I can’t stop thinking about it. And maybe being all OCD about it isn’t all that healthy.

The other part, which I’m less sure about, was what really got me crying––her concern about my state of mind when we do the transfer (and presumably during the 2ww). I’m not a big believer in wishing-makes-it-so, but as I was lying there in the dark (at this point desperately wishing I could get up and blow my nose and take some Tylenol), a horrible though occurred to me: what if, by repeating to myself—mantra style––that this cycle won’t work, and by distancing myself from the transfer, my poor little embryos don’t feel welcome in my uterus? What if they feel rejected and sad? What if I really can sabotage my own pregnancy? What if they really do sense my feelings towards them?

Because let’s face it, I have been openly resentful of these little frosties. They probably aren’t as good as the three that failed last cycle, and there are only two of them, so I have been dismissive of their chances. And, because they exist, we have spent almost $7,000 on the freezing and FET. I was all set to lay out the money for shared risk––money that we get back if we fail––and be into the relative freedom of a flat rate for 6 cycles. But then these two little guys survived, and they put a wrench in those plans. Because you can’t lay out $22K when you could get pregnant just by spending another $5K. I’ve even told a few friends that I kind of wish we hadn’t bothered paying for the freezing in the first place.

See? I’m obsessing about the money again.

The bottom line is this: I’m not coping with this cycle. That negative beta hit me hard. I thought a miscarriage was the worst thing that could happen to me. But the miscarriages, while awful, gave me hope. This failed cycle really shook my confidence, and J’s confidence, and for the first time since I decided to have the surgery and keep trying, it occurred to me that that might not work at all, that we could end up with nothing.

I’m scared about my reaction to the negative beta waiting for me at the end of this ride. And I’m scared about J’s reaction, too. We both got burned badly last month. A repeat would be devastating. So I distance myself from it all.

I don’t know where this is going (and obviously I don’t know how to end this post). But I think about all the people who haven’t been through this, who think they know what’s hard about IVF––the needles, the early doctor appointments, the hormones, the fist-sized ovaries. They’re so wrong. That stuff sucks, but it’s nothing I can’t handle. It’s that negative beta at the end of the rainbow. That’s the killer.


Newt said...

I hope this cycle surprises you. Stranger things have happened in the IF blogosphere, as you well know.

But I don't think your mental state makes a difference. I wish it did, because we could all just put on a smiley face and get pregnant and keep babies. But if you will cope better by focusing on plan B, I wouldn't let the acupuncturist talk you into doubting yourself.

Newt said...

I forgot to say I'm sending huge hugs and best wishes. Best, best wishes.

kate said...

Oh, man. I'm so sad for you. I, too, am a wanna-be hippie, who is really a planner. It's a hard place to be in when you can plan, but you can't control the results. So fucking hard, and so sad.

I think that it's possible to "enjoy the ride" whilst still planning. I mean, just because you know what the next step is, and just because you are prepared to take it doesn't mean that you are ignoring the current cycle. I mean, you self-stated that you kind of are ignoring it, but from everything you've said, it's so clearly out of self-preservation that you do. I mean, if you never get your hopes up, you never get your hopes dashed, right?

I don't know what to think about the positive-thinking thing. It kind of smacks of blind belief in prayer (no insult to people who believe in prayer, but stick with me for a second...), in that I've always imagined that if prayer truly worked, then we have a cruel and unusual God, who picks and chooses who to gift and who to not gift based on arbitrary conditions like who has the most people on their side, or who says the exact right thing in prayer. And so, if positive thinking works, then for those of us who don't get what we want, we either have inferior brains, or we just aren't trying hard enough, or we must secretly not want it badly enough. Which is just bullshit.

I refuse to believe that you haven't tried as hard as the next person, or that you don't want it as badly. That's just fucked up. Our brains are powerful, but thinking that they can create some sort of vibeish energy that causes embryos to stick around when they otherwise wouldn't, just by wanting it badly enough or thinking the right kind of thing, is just a sadistic thought pattern to me.

I don't know. I try to be hardline and scientific about it, but yeah. I would be lying if I said that I wasn't curious about that theory. I ultimately just have to believe that it sometimes is just a crapshoot. Sometimes it's perfect and it doesn't work. Sometimes it's jacked up terribly and it works fine. Ultimately, you are doing what you need to do. Your doc is doing what she/he needs to do. If it works, it works. And if it doesn't, then you still know that you've got your alphabet soup of plans waiting in the wings.

I really am hoping for the best for you. The well-wishes of strangers sent into the universe may be of little concrete help, but I hope that they can at least be of some comfort to you.

Ms Heathen said...

I have very mixed feelings on the whole 'power of positive thinking' issue - if it were really that simple, then surely infertility clinics across the world would be standing empty?!?

However, at the same time, I also worry that I'm too negative. Even before this cycle went so badly wrong, I was already looking to what I would do if/when it failed. But there again, I've been at this game for long enough to know that I can't just blindly hope that everything will work out OK.

We need to hang on to the chance that it may work - otherwise we would never put ourselves through another treatment. On the other hand, we need to prepare ourselves for the possibility of a negative at the end of it. It's a very fine line to walk.

I'm sorry that you're going through such a tough time at the moment - I'm thinking of you as you try to prepare yourself for this FET, and hoping against hope for a positive result.

shinejil said...

I feel like your last paragraph just gave me a serious education. Thanks for that.

I wonder if there's a way you can do both: be a planner and a hippy. Be in the moment and thinking ahead to what the next step will be if this one fails (which I hope and pray it won't). It's particularly hard to be in the moment when the ride you're supposed to be enjoying sucks, and has led repeatedly to dismal places and heartbreak.

I used to be a positive thinkist, without realizing it. Now I think it's just a modern revamp on the magical thinking our ancestors needed to keep from going nuts. I did visualizations, rituals, meditation, daily yoga, etc. etc. I'm still barren as the moon, for all I know. The last thing you need right now is more stress and complexity. So I say plan away. That's your very reasonable response to this anxiety and pain.

I just hope you get a little reprieve from the heartache.

Pamela Jeanne said...

"That stuff sucks, but it’s nothing I can’t handle. It’s that negative beta at the end of the rainbow. That’s the killer."

Amen, sister. Amen.

Don't be too hard on yourself. You're in self-preservation mode -- it's a state that I'm highly familiar with. Wishing you well...

peesticksandstones said...

Oh man, I could relate to so much of this, it's scary. Are you sure you're not really me?! :)

This whole FET, I'm trying to pretend it's not happening -- I sort of sneaked it onto myself while I'm busy so many I won't think too much. Because I know, know, know there's no way it's gonna be a success. We even have company coming the day of the beta to stay with us for a week! I thought maybe that would force me to pull myself together...

Like Newt says, here's hoping this cycle surprises you (and me!). Take care over there. Hope you're doing some nice things for yourself, living a little decadently.

Jen said...

I am definitely with you on the planning thing - I think through all of the multiple scenarios, what we will do if a,b,c,d, or e happens. Really? I see nothing wrong with it! We have zero control over 99% of a cycle, so if planning helps us be more in control? So be it.

I also disassociate. The negative beta is horrible either way, but I can't bring myself to be excited. I totally get that. We have to protect ourselves somehow. It is some type of self-perservation mode.

I am wishing you guys all the best this cycle (as always).

beautycourage said...

Oh boy, I completely relate to this, as well (being on day #6 of stims today, and just ignoring it as much as I can). I really like Shinjeil's comment that positive thinking is just revamped magical thinking. I tried it, as well, and my some of my worst "negative beta days" were a result. I think having a PLAN is a healthy, protective and necessary part of the process. I also KNOW that there is no thought, mind trick, or negative vibe that will prevent these embryos from sticking. It is out of your control (unfortunately).

Have you read Alice Dormer's book? She touches on these points, and writes about how having a Plan B (C,D) is crucial. She also is a big fan of group therapy (which I think is the blogging world) and meditation/ mindfulness. Maybe that is the hippie/ lawyer mix- layering mindfulness with a plan. Sounds good to me.
Easier said than done, though.
Hang in there....

Malloryn said...

I'm a bit of a wanna-be hippy as well, trapped in an accountant's body. I can't help myself when it comes to planning, whether it's on vacation or deciding on a new car. Perhaps I don't trust my 'inner spirit' to guide me the right way? I don't know. What I do know is when it comes to IF, planning makes me feel like I have a smidgen of control in the process. That's probably delusional, but it's what I have to hold on to.

I wish you the very best for your next cycle. I hope you have a good outcome this time. I'm sorry that this has been so hard.

Katie said...

Sorry I haven't commented in awhile. I have been a bad blogger.

I hear you about the FET. My RE has a 54% rate for freshies and 29% for frosties, so I am not that optimistic either. I feel like I am just going through the motions with it. But I also feel like I am not expecting it to work, so maybe in some seismic cluster-f it will??? Hope it does for both of us.

Barb said...

I don't think it's just that you're a lawyer. Most of us learn to distance ourselves after so many losses and bad tries. It just makes sense.

psychologists even say it's healthy to focus on this try AND the one after that so that you have a goal in mind so that if this try fails, you won't be completely destroyed.

I say you're just smart. :)