Saturday, December 29, 2012

Liebster Blog Question Challenge

1. What did you want to be when you "grew up"?
 - a princess.  Seriously.  But also a professional reader.  As in, if somebody would just pay me to read good books all day, I'd be delighted.  I quickly realized that wasn't a realistic possibility, and settled on a doctor.  Which is where I am today, and honored and amazed (almost) every day to don the white coat.
2. What was the last book you read, and what did you think of it?
 - currently almost finished with Charles Dickens's Bleak House.  It's lovely, as all his works are.  I love the way he intertwines the different characters' lives and the breadth and depth of his stories.  I also love the wit and the timelessness of his plots.
3. Ditto on the last movie you saw?
 - Les Miserables, the adaptation of the musical.  Generally I liked it very well.  Anne Hathaway was a stunning Fantine, and her demise was done so well.  Young Cosette and Gavroche were also great.  I found Valjean and Javert's singing lacking compared to the musical, but otherwise it was very well done if a bit heavy on the Christian symbolism.  Altogether: worth the investment.
4. Name a place you like to visit, and what you love about it?
 - Israel.  No question.  I love the warmth of its people, I love Hebrew, and I love the way I feel so at home there.  Choosing a specific place within Israel is trickier.  Obviously the kotel (aka the Western Wall) wins out.  After that, though, I really love Machtesh Ramon (מכתש רמון) at night when you can stargaze, and the Galil and the Golan because the green and the mountains are so beautiful and majestic.  There are some breathtaking hiking trails, and a breathtaking (in a more literal sense) ambulance ride from Kiryat Shemona to Tzfat (aka Safed) that I used to do when I volunteered for MDA.
 - Outside of Israel, I absolutely love Tuscany.  Dear Husband and I once rented a villa and it was the most romantic and beautiful place, and there is so much to sightsee as well!  Also the Dolomites are beautiful and the air is so crisp and clean!
5. What are you grateful for?
 - Family.  I have the most amazing, loving, wonderful family ever.  Tfu tfu tfu, kinehora, בלי עין הרע
 - Being a physician.  I get to go to work every day to try to save lives.  It doesn't get better than that.  To me, being a physician is a calling and I am continuously humbled by the trust patients place in me.
 - A really good cup of tea.
 - A good book.
 - Shelter and food and clothing, and the fact that (thank God) I don't go to sleep worrying whether I will have these things the next morning.
6. Describe your ideal Saturday night?
 - Depends on my mood.  Tired or depressed?  A good cup of tea and a good book next to the fireplace.  Happy?  Dancing with my husband :o)  (And then afterward, probably a book).
 - Generally NOT BEING ON CALL
7. What is something you remember loving as a child? (a favourite book, food, place... you get the idea)
 - my nunny (what my family called our security blankets)  It was light pink, and yes, I saved it, and still have it, though I don't sleep with it (day after losing Peanut excluded)
8. Have you made any New Year resolutions? (If so, please share)
 - Be more grateful, and complain less
 - be kinder and more generous
 - no speaking ill of other people!
9. Name 3 blogs that you follow, and why you love them
 - A Thousand Oceans because her story has similarities to mine, and we have the Israel connection, etc
 - Stirrup Queens because Mel is funny and thought-provoking
 - Unaffected by You
 - No Good Eggs
10. Favourite ways to relax?
 - Shabbat dinner with my family
 - Reading
11. Something in life you would like to master but haven't quite got there yet?
 - Other than infertility?  Haha.  That's easy: I want to be a truly excellent physician, and a truly excellent writer.

And there you have it, folks!  Hope your weekend is going well, and שבוע טוב

Monday, December 24, 2012

After a long reprieve: some infertility humor, and Israeli movies I do and do not recommend

I'm sitting on my living-room sofa, nursing a cup of tea and watching the snow fall.  Dickens himself couldn't be more satisfied.  While I obviously don't celebrate Christmas, I staunchly believe 25 December should be snowy white.

Dear Husband's parents arrived yesterday from Israel and we have had a lovely visit thus far.  The volume of the house has, however, risen several decibels.  That's what happens when you deal with Israelis.  But I love it.  I've tried to tidy in bits and pieces to keep it manageable.  Having two extra people in the house nudges us toward entropy, to put it scientifically :o)  We had an especially cozy night last night with a fire in the fireplace, me snuggling next to Dear Husband on the sofa, and watching בוקר טוב, אדון פידלמן.  I can't actually recommend the movie even to those of you who understand Hebrew because I didn't feel it came together well.  I do, however, HIGHLY recommend the hilarious if completely sacriligeous and crass זוהי סדום.  I promise, you will NOT be disappointed.  It stars the cast of ארץ נהדרת, need I say more?

I realize this blog has been woefully lacking in humor lately.  For shame, Mim!  I haven't got anything hilarious up my sleeve, but we will try.

Holiday gifts/activities for the infertile, particularly she with any form of premature ovarian failure:
1. chocolate and wine (no explanation needed)
2. a carton of eggs (can't use them for IVF, but at least you can bake a cake to eat during your pity-party
3. baby powder (just add water?)
4. a test-tube ornament -- looks great when complemented by silver tinsel
5. For us Jews, use the test-tubes to make a Chanukiyah (aka menorah).  I recommend tossing the traditional olive oil and burning baby oil, of course!
6. Decorate your negative pregnancy tests with glitter and hang them as ornaments.
7. Pomegranates (going biblical never hurts)

Hope that was good for a few laughs!

Sunday, December 23, 2012

On Depression and on What it Means to be Infertile. (Warning: self-pity alert!)

I am still trying to battle the despair, and it's a struggle.  Even if I lift my mood temporarily through dance, or music, or exercise, in a matter of hours (at most) I am my same depressed self.  One can only fight so many hours a day.  It's exhausting.  And yet I told my internist/mentor (who I hope is having a wonderful, warm, blog-free vacation right now) that I don't want to take an SSRI.  Partly it's the side affects -- I refuse to be somnolent and weight gain is absolutely out of the question.  But more than that -- I want to get through this myself.  I need to believe in my ability to overcome this feeling.  My body is defective (thanks, genetics!) and I have no control over that which is most important to me.  I'm not even remotely connected to this Operation InFutility.  I want at least to control my emotions.  Can I have that small corner of control?  Taking medication would mean surrendering.  If I survive this alone, it will be because I clawed my way out.  Not because I let medication modify my neurotransmitter chemistry.

It's funny, though.  I have no problem taking levothyroxine to replace my perpetually-out-to-lunch thyroid gland, or amlodipine and losartan to control my blood pressure, and while I detest it I (relatively) faithfully take my OCP.  I suppose the difference is that I know that without my levothyroxine I could end up in a myxedema coma, and if I don't take my antihypertensives I will end up with left ventricular hypertrophy and diastolic dysfunction and possibly hemorrhagic infarcts, and that estrogen in girls my age has bone and heart benefits.  I won't die without an SSRI.  I might just feel miserable.  I know exactly why I am miserable and I know that it can't get much worse.  Expectations of failure cannot disappoint.

Or am I just buying into the stigma of mental illness?  I do believe mental illness should be respected equally with physical illness.  It so often has worse consequences (at least among my patient population) and it is the result of chemical imbalances in the brain, not weakness of character.

 Could I argue it as a case of severity?  Were I suicidal or endangering patients I would likely be far more inclined to acquiesce.

Enough, though, about my conundrum.

I wish my mother and grandmother understood what it means to go through this.  The other day, Mama told me I am "too preoccupied" with infertility and babies, etc.  Would she tell a cancer patient he or she was too preoccupied with his illness?  Would she be surprised when that person was disappointed when four rounds of chemo failed?  (Yes, I understand COMPLETELY that IVF and chemo have very different stakes and that my life itself is not threatened, nor my physical health.  I am very grateful for this and I am NOT trying to compare the two!)  Would she tell a diabetic not to think about his or her glucose, and which foods he ought not eat, and whether he had foot sores?

This is what being infertile means:  It means watching all your friends have children, feeling envious, and feeling guilty for your jealousy.  It means wondering if your husband will leave you for someone who can have children.  It means trying to keep a mask when asked if you have children, and trying to find a neutral answer but wishing you could say "No, I don't and I am angry and hurt and upset about it!"  It means planning your career when you know you would only work part-time if you have children, but you have no idea if the children will even come.  It means explaining to your grandmother that no, adoption doesn't just happen overnight and there isn't an overflowing supply of pregnant women waiting to give up their babies, and it takes more than just finding a lawyer.  It means an intrinsic part of the life cycle is on hold.

It means that unlike your friends who say "when," you say "if" I have children.  A two-letter word makes all the difference.

Anyway, my in-laws are in town and I am supposed to wake them from their nap.  Happy  Christmas to all who will be celebrating, and a Happy and Healthy secular New Year to everyone!  May 2013 be a fertile one!

Wednesday, December 19, 2012

Vacation, all I ever wanted

That's right.  Since Monday afternoon I am on VACATION!!!  I don't have to be at the hospital for another two weeks.

How will I spend said vacation?  Good question!  I started by having my every-three-year cardiologist appointment.  I only have to go every three years since my heart is fine.  If you're wondering what to expect at a cardiologist appointment, they started with an EKG, then an echocardiogram (ultrasound of the heart), and then I saw my doctor.

My doctor is a sweetheart and an excellent clinician, and we got to read my echocardiogram together.  I have sinus bradycardia, but am asymptomatic (can wearing a scarf increase vagal tone?) and my EF and diastolic function are normal.  Translation: I have a slightly low heart rate but it doesn't bother me, and my heart's pumping and relaxing functions are normal.  I also have an adorable ventricular septal aneurysm, which means where the hole between the two bottom chambers of my heart filled closed itself into a really adorable shape.  It looks like a little heart!  Also (phew!) my aorta looks normal.

The other screening for girls with Turner's Syndrome is MRI/MRA of the thorax and abdomen to evaluate the aorta, the renal arteries, and the kidneys.  FYI not all of these tests can be done at once.  You should also expect to have an IV started because these tests require contrast.  The contrast is gadolinium, and when it is injected one should expect a flushed, warm feeling throughout the body.  It is such a curious sensation!  I have the abdominal studies completed and they're normal, so we are just waiting on the thoracic studies.

But not to worry, I do have plans for fun.  I am reading Charles Dickens (Bleak House, and it's wonderful!), with plans for Chitra Banerjee Divakaruni next.  Also I hope to do a little shopping.  And some writing.  And exercising!

And now, for the irony of the day: Jehova's Witnesses just came to the door and offered me a pamphlet about being a single parent.

Tuesday, December 11, 2012

In Which Our so-called Heroine is Confused. And also invites the input/mentoring of anyone in general medicine or infectious diseases.

Very confused.

I am about to be 50% done with my residency.  I don't know how time passed so quickly and so slowly.  I also don't know what I want to do after I finish.  That, dear readers, is the challenge.  I love general medicine.  It intimidates me a bit in that one must know everything.  But I like everything, and I l like the variability.  At the same time I am a meticulous, inefficient physician who fails ridiculously at multitasking.

My mentor/internist suggests I make lists of pros/cons for each option and talk to people in the different fields I am considering.  As usual, she is right.  IF YOU ARE OUT THERE AND YOU ARE A GENERAL INTERNIST OR AN INFECTIOUS DISEASE SPECIALIST, YOUR INPUT IS GREATLY APPRECIATED!!!

And then there is the other issue -- that I highly doubt I will ever be a mother, but if I were, I'd want to work part time.  Yet what point is there in crafting a career that allows me to work part-time when there is almost no chance of needing it?

I'm not even sure how to proceed with Operation Infutility.  Husband is not showing signs of wanting to move forward.  I, on the other hand, am not ready to give up.  I need children!  My dearest, best friend is still offering her ova and she is now married long enough that they should let her.  On the other hand, she doesn't have proven fertility.  But I think it's worth a try.  I could always find an anonymous donor at the same time.  It's just that Husband isn't currently interested in trying.  I don't understand.  I know there are lots of people out there who have meaningful, complete, happy lives without children.  But I am not one of them.  I dreamed about having babies from the time I was not much more than a baby myself.  I am happiest when I have a little one in my arms, when I get to nurture.  I am not ready to give up yet.  Because personally, if I can't have children I would rather overdose on all the potassium in my medicine cabinet, and all the antihypertensives, and all the NSAIDS.  Dramatic?  Yes.  But true.  I do not want to live a childless life.

Oh, one other little tidbit.  I got to care for a young woman with Turner's Syndrome the other day!  I am not alone, and I can make a positive impact on her.  I hope she choses to follow up in my clinic.

Have a good night, everyone, and Chag Chanukkah Sameach!