recovery.

Today I completed my 5th half marathon, the OKC Memorial Marathon.  They say it takes a village to raise a child.  Well, I feel like it took a village to get me to the finish line.IMG_5310

I posted a few weeks ago about how I had injured my right hip.  Well, I’m not really better but I decided to run anyway.  My running buddy Shane told me I was brave.  I think maybe I’m stupid.  My pace this year was about 30 minutes longer than my previous longest 1/2 marathon.  But I finished.  My body kept going and I convinced myself I could finish even though with each step my right leg asked me to “please stop.”

My finish today happened because I had wonderful people from my church praying for me, including one of my heroes Linda C., as well as my “church girls” dining group, my friend Bree, my extremely worried mother, my SIL (who is my editor in chief for this blog) and many others.  It happened because Mandy G, my amazing friend who happens to be an amazing physical therapist, saw me when her schedule was full and I’m sure she would have rather been eating lunch.  It happened because Dr. Barrett at OU Family/Sports Medicine reassured me that, although it would “hurt like hell” that I probably wouldn’t die.  It happened because I knew the smiling faces I would encounter at Gorilla Hill, the Milk Bottle and 18th and Classen.  It happened because my husband never stopped praying for me and texting me, even though he was running 7.3 miles in his own relay team.

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The OKC Memorial Marathon is a “run to remember.”  We run to remember the 168 lives lost on April 19th, 1995.  I can remember the exact spot where I was standing when it happened.  I remember the chaos and confusion.  It’s easy to forget when it’s been over 2 decades ago.  But today, when the pain was at its worst, I think I got a glimpse into what those who have been and are truly suffering endure each day.  And what it means to be a survivor.

You see, suffering and survival are not idle terms.  They do not always have a clean beginning and end.  Many of those families whose mourning began in April 1995 are still suffering and surviving through each day.  Today I was reminded that I am surrounded by people in pain, people in suffering, people in need.  Along those 13.1 miles I thought about the mother who labors without an epidural.  The mother who labors with an epidural that just doesn’t work well enough.  The mom who gets up in the night to feed her baby despite having the still fresh wound from her c-section yelling at her to stay in bed.  The woman recovering from surgery, the woman suffering from complications of her disease or the surgery that was intended to make it better.  I couldn’t help but remember the faces that walk into my office who suffer daily pain that, despite my best efforts, I don’t have a great remedy for.  Along with those are the faces of patients whose pain is not physical, but the emotional pain of great loss, need or injustice.  I hope I always try my best to aide in the relief of suffering and the hope for survival.

I am also reminded that when I am that person who is suffering, I am surrounded by a great community of faith and friends who will carry me along until my suffering is relieved.  It truly was a day to #runtoremember.

fear and pain.

I was leaving my hotel yesterday to travel to the airport.  My cab driver was not born in this country.  He was very friendly and I’m sure he worked long hours and had to deal with some crazy people…a life I can identify with.  As we left the downtown area we passed a woman with a baby in a stroller holding a sign reading “homeless and hungry .”  The cab driver rolled down his window and handed her some cash.  I was floored.  I’m assuming he didn’t have a lot of disposable income (I could be wrong) but he made a choice to give to someone he assumed was in need more than himself. IMG_3505

I would characterize this behavior as living without fear.  I think most of us live somewhere between fear and pain.   Or maybe in the midst of both.  We live in fear of what the future might hold.  Will there be enough?  Will I be enough?  We live in pain of what has happened in the past.  What we have done, we has been done to us and what has been left undone.  We are held in the tight grip of being afraid of what others will think and in the pain of rejection from those around us. IMG_1859I am complicit in this thinking.  I’m not sure how we arrived as a culture that moves through life in fear of what might face us in the future and in pain from what we have faced in the past.

The two photos in this post are my kids immersed in the world of medicine.  Tubes in the small ones ears and wrist fracture for the big one.  I was fortunate enough to have them both cared for by people I love and respect.  By coincidence only, Pastor Jason was unavailable for both of these moments.  I remember, though, handing my kids over into the arms of people I trusted not only to do their best but to absorb their fears and take away their pain.  Now, I know in medicine we are not always successful in these endeavors.  We work to relieve pain and fear but are not always able to achieve either goal. But I think as health care providers we really want our patients to be at peace.  We want them to find comfort and hope in our visits.

How do we get to a place where we are living without fear of the future and without dwelling on the pain of the past?  For me, I try to have my faith overcome my fear.  My God and His people have gotten me this far in life, right?  I have been listening to a new version of the old song “It is well.”  To be honest, I used to hate the song.  Mostly because it wasn’t well.  For most of us there will be times when life just isn’t well. Not with our minds, not with our bodies, not with our souls.  And I don’t believe that reciting “it is well” over and over, no matter how well sung, brings about some kind of magic that makes all things right.  But now as I listen I can’t help but think about what it means to live in the “it is well” world.  And how do we ensure “it is well” for those around us.  When my cab driver leaned out the window and handed that cash to the woman on the street, he was trying to ensure “it is well” with her.  When my friends take great care to comfort and heal my kids with their hard work and patiently learned skills, they are trying to ensure “it is well” for both me and my children. When the people in my church community reach out to their neighbor and into the neighborhood around us to provide hope and meet needs, we are trying to ensure “it is well” with them.

I think to live in a place with as little fear of the future and pain of the past is to find a place where you are surrounded by a community who is trying their best to ensure “it is well” with you.

the business of fertility. (part 2)

In part one of this post, I shared a bit about the “funny business of infertility.”  How no one thinks twice about asking when you’re having babies or thinks it odd to advise you on why you should have babies and how many you should have.  In fact, this was the topic at a lunch conversation with my colleagues at work this week.  I have a physician partner who had someone try and convince her to have a baby…about how great it was.  Like she doesn’t know how pregnancy and childbirth works so she needs someone else to convince her to do it?  People are crazy.

In that post I also told you to what great lengths it took Pastor Jason and I to become pregnant with our second child.  Infertility and recurrent miscarriage affect about 11% of people in this country.  Men and women both contribute equally to the problem of fertility, although I never heard anyone ask the pastor when he was going to have more kids. During the long journey to baby number 2 we got lots of “input” from many around us.  We were blessed to have many people from our church and our family praying for us to experience the joy of parenthood again.  We also had opinions about whether or not we should continue with treatment, adopt, and all sorts of things in between.  And I get it.  There’s some risk involved.  Personal and financial.  People have fundraisers for fertility treatment and adoption.  Marriages begin and end based on fertility.  Adoptions fall through…over and over again.  Treatment fails.

Another funny thing about the business of fertility is you don’t know what you would or wouldn’t do until you’re in it.  When I got pregnant I was in discussions with my specialist about moving forward with much more intense treatments.  I speak with women and their families every week that face decisions about pregnancy and fertility.  Some of them are trying to decide if and how they should pursue treatment to become parents.  Many of them are deciding whether or not this child will be their last.  Others are facing choices like whether to give their baby up for adoption or what to do if their child has a lethal malformation.  I believe that most of us think we know “what I would do in such and such situation” but the reality is that you won’t know what path you will choose until you get there.

So we should just mind our own business…right?  Well not entirely.  In some aspects fertility is everyone’s business.  While we are quick to ask when a baby or more babies are coming…we need to understand that the right to plan a family is paramount to the health of our society.  Unplanned pregnancies, closely spaced pregnancies, teen pregnancy all have a higher rate of poor outcomes.  If you want to talk about fertility then let’s focus on providing effective and affordable and reliable contraception to those who are young, vulnerable and who don’t want to be a parent at the moment.  We have spent far too much time talking about what we think will drive down the abortion rate.  We have a higher abortion rate in this country than in places where there is no regulation at all.  If you want to end abortion let’s drive down the unintended pregnancy rate.  Let’s stop filling up the shelters with children waiting for families.  Let’s stop asking when Dr. Smith is going to have baby number 3 (seriously) and start thinking about how we are going to educate, love and care for our young women so that they can lead us into a future filled that we will WANT them to bring kids into, a future with hope and peace.

And that, my friends, is the business of fertility.

 

 

the business of fertility. (part 1)

The distressed child pictured above is the product of three long years, 8 treatment cycles, 2 infertility docs and their awesome PA, several procedures and thousands of prayers.  She is well worth the effort.

This begins what will be a 2 part blog on fertility and infertility.  Thanks to my best girls who suggested it for the blog.  It’s a big topic with multiple angles so it will take more than one post to cover everything I think is important to discuss.

My oldest child was born during my third year of residency.  I got pregnant the second month we attempted to conceive.  I had a hunch I would have fertility issues so when I didn’t I questioned whether I really knew what I was doing in my career if I couldn’t diagnose myself!  Turns out…I was right.  My chances of getting pregnant on my own are about 5% per year.  PER YEAR.  Normal fertility is about 20% per MONTH.  My first pregnancy was literally a miracle.  I ovulated and got pregnant on my own.  It is probably the only time I have ovulated on my own since that month 9 years ago.  I have no desires to have another baby but am pretty sure I would be in for another long haul if I tried.

Fertility is a funny business.  Our culture has a huge problem discussing normal reproductive anatomy and human sexuality but feels like they can ask everyone they’ve ever shared lunch with “so when are you having kids?”  or “aren’t you going to try for a boy?”  Because I had one child everyone assumed two things.  First, that I wanted another child.  And second, that I could become pregnant whenever I wished.  We don’t tell our kids how pregnancy happens but we will ask the lady in line next to us at Target when she’s planning on having another baby.  Seriously.  It seems everyone has an opinion on fertility including what to do with yours and mine.  It’s an easy trap to fall prey to.  In my line of work you need to ask patients about their current and future fertility plans.  But sometimes I catch myself wondering about friends or acquaintances and have asked when it really wasn’t my business.

Another funny thing about the business of fertility is going through treatment.  I remember feeling a bit strange sitting in the waiting room at the reproductive medicine clinic and knowing that almost everyone in that room was seeking medical care in an attempt to expand their family.  These families are often investing a significant amount of time and money into having the chance to have a child.  You can’t help but look around the room and wonder where each person is in their journey and what will be their outcome.  Will I see them again?  Will their treatment be successful?  Will they get good news or bad news today?  All these questions get left unsaid, of course, because your fertility is your own business…even when you’re in the waiting room of the fertility clinic.

If you have difficulty becoming pregnant should you seek treatment?  Should you adopt?  Will it work?  How will you pay for it?  All these questions and more surround the business of fertility.  In part 2 I’ll tell you a bit more of our story about the business of making baby #2 and try to address these questions as best I can.  Stay tuned…

 

these legs.

I have a great group of friends that I run with.  They keep me both encouraged and entertained.  We often run together on Saturdays; usually between 6 and 12 miles when we are training for a half marathon.  We have these unwritten rules for those weekend runs.  They’ve developed over many weeks and months.  First rule is that what is said on the run stays on the run.  You can complain about whomever or whatever you’d like, tell your most embarrassing stories about yourself, brag on your accomplishments and get mad about your failures and it stays there.  Second is that no one runs alone.  If someone is struggling then another from the group will hang back and make sure they make it to the finish line.  The last rule is that someone always brings water.  Always.

I didn’t get to run with my friends this week because I injured my right hip.  It’s no fun missing out on the weekly run.  I was tempted to try and run anyways but truth be told I tried that theory out earlier in the week and it didn’t work out so well…so I will sit out for a week or so and recover and hopefully be ready for the next long run and then the race.  So running is on my mind.  And so is recovery.

Being a gynecologist is a lot like Saturday run with friends.

No really, hear me out.

First, almost exclusively, what is said in the office stays in the office.  I have a duty to report anything like harm to a minor, suicidal ideation and elder abuse.  There are a few other caveats but really, what patients tell us we keep.  People I know are always surprised when Pastor Jason has no idea that they are my patient or that I haven’t disclosed their pregnancy to him or anyone else.  It’s in the rules.  Your gynecologist and your pastor are similar in that regard.  They both get paid to hold things close to the vest.  Sometimes we hear things that need “fixing.”  In those cases we try and come up with the best possible intervention.  Sometimes just sharing what’s on your mind is relief enough.

The second rule holds true as well for gynecology.  No one runs alone on Saturdays and no one should run the steep hills of life alone.  I hope my patients know that I will do my best to support them through the sorrows as well as the joy.  Pastor Jason has taught me so much about the power of listening to those who are broken and the healing that can occur when you sit with someone who is suffering and really be present.

And finally we all need a source of water.  Your body is somewhere around 60% water.  So it’s pretty important to survival.  But in addition to actual hydration we all need something that fills our cup on a regular basis.  Many of my patients are busy working, taking care of their families, spending time being stressed over finances, health or world events.  I tell them they need to make time for rest and recovery.  For me, I have lots of water stops.  Running with friends is one.  Dinner with my favorite girlfriends on a monthly basis is another.  Jumping on the trampoline with the pastor and our girls is good too.  But my main source of refreshment is church.  I get a weekly reminder of the unconditional love available to me by God and His people.

I hope you have a running group.  First, because exercise is important.  But if you prefer the elliptical or yoga or whatever then I hope you have a tribe for your own mental and spiritual health.  I hope you have a people in your life who will sit with you and listen, or sit with you in silence.  I hope you don’t have to navigate life alone, that someone will come run alongside you.  And I hope you have a source of water…and if that source of water includes church, say a prayer for this gynecologists leg to get better soon so she can get back to complaining to her friends on Saturday.