Tag: Fertility

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Medical

Day 1008 and Pesky Hormones

I’m enjoying a double header of hormones today. I’m in my luteal premenstrual phase which always leaves me tired and emotional. But I am also just letting go of the last bits of adrenaline and cortisol from my travels last week.

As the last bits of stress hormones drain away and my cyclical hormones flow in all I can feel is the weight of the world. I’m sure this dramatic phrasing is merely a function of the pounding hormonal migraine that always accompanies this time of my cycle.

If this all sounds a little foreign to you, Alisa Vitti’s life’s work has been to help women understand their hormonal cycles impact. I’m always looking for ways to hack my physical performance and health so I’ve been especially focused on pesky stress hormones.

Hopefully a little bit of salmon, some greens, and more rest will get me through it. And by next week I’ll be well on my way to peak creativity and energy. The lull will pass soon.

Categories
Homesteading Medical

Day 987 and Eggs

One of our hens died today. My husband took on eight chickens from one of our friends a month ago It was an exciting moment. He really wanted chickens and it felt like great luck.

The family was moving and so Alex stepped in. If it were just me alone I probably wouldn’t have any animals as I don’t necessarily always have the physical capacity to do daily chores. I realize that’s a funny statement for someone who lives on a homestead in Montana but you get used to your limits and work around them.

But my husband lives for doing shit. I call him a “man of action” as he’s happiest when working on something. Chores and animals and homestead work are a hobby for him and I’m deeply grateful we could bring that way of living into our lives. I am envious that he has the capacity as there are few joys as deep as improving the world around you. I wish I could do what he does.

So it’s sheer bad luck I find myself on my own when one of the hens died. Alex was literally gone for a day and one of his birds dies on me. I feel responsible for the death even though I know I am not.

Death happens. Chickens are strange finicky animals and do in fact sometimes just up and die. I’m capable enough with death. I did plenty of farm work as a kid. But I’m not the one who does the bulk of the hard physical work and never will be. I contribute other things.

I simply wasn’t expecting that with just one day on my own being responsible for the hens that something bad would happen. But there I was finding myself responsible for dealing with the physical reality of a dead bird on my own.

I happened to have a doctors appointment in town this morning so I didn’t check on the chickens when I woke up. And that’s what I feel worst about. That I didn’t even notice.

I got in the car, went to get my own eggs checked (a follicular ultrasound if you are curious) and came back to find an entirely different egg problem on my hands.

I went to collect the morning’s eggs and saw a red hen laying underneath the raised coop. I briefly panicked wondering what the fuck was I supposed to do. She was clearly dead and I’d missed it. I’d just left for town without even checking on the hens.

I panicked and tweeted that I’d had no idea what to do. And then I found the heavy duty trash bags and nitrile gloves and moved the carcass out of the coop. The remaining hens seemed disturbed. The leader of the group in particular was quite vocal and came up to me as I was moving the body.

They didn’t seem to mind the body in the coop but began loudly clucking at me as I pulled her out. Did you know that chicken rigor mortis sets in about three to four hours after death? I do now. The body was in rigor when I found her so she had clearly died overnight.

I feel horribly guilt that I didn’t check the hens before I left for the doctor. But what would I have done? Judging by the rigor she was dead before I woke up.

I’m not sure I could have done the clean up quick enough to make my appointment. But the idea that the hens were just poking about next to their dead compatriot for any additional time while I went about my business of living seems horrifying. I guess that’s my own human bias setting in as they didn’t seem particularly disturbed by the body only by me removing it. I bagged it and put it in a bear proof trash can. I pulled up poultry disposal procedures and asked my internet friends what the duck to do next.

Some of our neighbors came over after their workday to help me dig a hole in the back pasture to bury the body. Digging a hole 3 feet down to keep the predators from sniffing it out is the recommended procedure.

I wasn’t up to the task of digging a grave on my own. Mostly because I’m not good enough with the tractor to get the post hole digger mounted. Thankfully I had help.

The remaining hens had laid three more eggs in the intervening hours. I had also learned in those hours that my ovaries were producing more than ample follicles. It would seem that, like our hens, I produce eggs in adverse conditions too. The circle of life in just one day.

Categories
Medical

Day 985 and Know So Little

Every time I have have cause to interact with any medical speciality I find myself blown away by just how little we know.

I’ve been going back to doctors to understand what my options are for living with an autoimmune condition and having children. And the truth is we just don’t know much.

I made a life altering decision several years ago by letting a medical decision be framed to me like a consumer product. We opted to freeze eggs and embryos and it turned our entire lives inside out. It triggered an autoimmune response in me that I’ll live with forever.

Somehow in the intervening half decade years we’ve learned precious little about women’s health and fertility. And we are advocating for somehow knowing even less.

Because that’s what we’ve done by letting the government into our health decisions. Don’t kid yourself into thinking when we involve government and bureaucrats we somehow improve our knowledge and safety. At it’s most friendly, when the government shows up it’s about ass covering. At it’s most hostile it’s about control.

We argue about ethics, safety and life as if we even have a shared ideal of any of those concepts. Whose life? My life? My unknown children? I’m not convinced we ever cared about women’s health as an independent variable. We treat fertility as a sideshow and hormones as some variable over which we pretend to have control. And yet every time I try to assess my own risks I find out that we known just about nothing. There are no good answers. And it’s all poorly understood risks.

Categories
Medical

Day 982 and Not Small Men

I’ve been working on getting a deeper understanding of my hormone profile and where I can better support my cycle.

I’ve been surprised by just how little we seem to know about women’s health and the baselines that are considered ideal. Between the battles over health education in school (abstinence only) and the eagerness with which we put my millennial generation on birth control as teenagers, we’ve got both an under-informed and potentially over medicated population. Which wasn’t the case for our mother’s generation who went on birth control much later in life if at all.

A tweet from last week

I’ve had my fair share of fucked up fertility experiences and yet I’ve only just in the last few years learned to understand how my follicular phase impacts me so differently from my luteal phase. If you don’t know what that means either well it’s probably time.

The phases a woman’s cycle

I generally feel most energetic, pain free, and happy during my follicular phase. Despite knowing this I couldn’t tell you what an ideal FSH hormone level would be. I don’t know what balance of estrogen I should have at any given phase. I have no clue what my LH should be during my luteal stage either.

It strikes me that these levels should be taught along with implications for what it means and how to work with them just as we know our ideal blood pressure rage and resting heart rates. It’s some of the most crucial and basic self knowledge about our bodies.

When I think of how many other crucial biometrics I’ve got memorized (I track my SED rate and CRP quarterly for inflammation) it seems odd that something so crucial as one’s hormones wouldn’t be known, tracked and improved. I watch my heart rate variability like my recovery depends on it because it does. So do most serious biohackers.

Knowing more about own health is part of being a responsible adult. And I’m sad that we do so little to educate women on basic rhythms. I can’t tell if it’s a lack of interest from women or a dismissal from the medical profession. Women aren’t just small men.

Categories
Culture Internet Culture

Day 977 and Insecurities

A toxic morass of content has been circling on Twitter and corners of the chattering classes on TikTok, Substack, and podcasts that I’ve taken to calling gender bait.

Topics like “body counts” and the relative degrees of acceptable promiscuity in women (as little as possible) is everywhere. We are main charactering single women for sleeping in on Sundays. Hot takes on how women are failing men is everywhere.

The insecurity is palpable. The lust for control is high. How many people you’ve had sex with and how it affects marriage and family formation has been a contentious topic in culture wars in America for sometime. For a private matter between partners, it’s shocking how much it’s become fodder for social media grist.

Presenting scorn to women for being without significant others and children strike me as callus. Fertility is one of the most sensitive possible areas for anyone. I know it has been for me. You never know why someone is childless.

I wouldn’t recommend diving into gender bait topics if you aren’t already aware of the discourse and it’s champions. This variant appears to have gained momentum with a YouTube celebrity boxer feud.

It’s now percolated out to every engagement farmer looking to grow their outrage crops. And it looks like business is booming. Sadly, lonely people are desperately searching for control and reassurance and gender bait gives it to them.

It feels as if we are repeating the same slut shaming I saw as a teenage girl but on some new variant of reactionary steroids.

If you are looking for ways to judge, shame and coerce others into behaving in a way that provides you comfort without their consent please consider that the problem might be you. It’s your insecurities speaking when you apply sweeping generalization to an individual you may not even know.

Once you are secure in your value and worth it’s a lot easier to get what you want from others simply by having boundaries and standards. There is no need to rain judgement on others. You wouldn’t want them doing it to you. Apply the golden rule and nurture empathy. The security you will find will last longer than any temporary control you may find through shame or judgement.

Categories
Biohacking Medical

Day 974 and Flare

As most casual observers of this daily log have probably noticed, one of my main interests is biohacking. It was a hobby in the time of my life I mislabel as “before chronic illness.” It’s not accurate so much as recency bias. I’ve been into biohacking my whole life because I’ve had to manage an unruly body.

I had the best health of my life between 24 and 34. I am rounding the end of my 39th year as I write today. I didn’t think of myself as being chronically ill for that decade.

Probably why I think of my life as having a “before” illness is more that I’ve been in the worst flare of my life for the last five years. It came crashing down with a one two punch of being a startup founder & getting pumped full of hormones for fertility treatments at 33. I was on bedrest and chemotherapy drugs by the time I was 34.

So I have to remind myself there is no time before chronic illness. There was remission. I had long years of robust health interspersed with autoimmune diseases that flared and were contained.

Diagnosis has been a lifelong battle which started with inflammatory skin conditions and horrendous allergies and ended up with the inflammation going inside my spine and joints. Ankylosing spondylitis and psoriatic arthritis is what codes with insurance.

Looking at my health records, I had my first issues at 7 when I entered school, then after puberty as teenager around 15 & 16. I had to drop out of high school and ran a giant let of standardized tests to claw myself to university.

I was hale for college and my first startup but flared so badly after the acquisition of my first company I was put on an experimental immune reboot protocol. Ask me about being put on cyclosporin without an organ transplant.

My most recent, worst and longest flare was in the five year battle after doing IVF and egg freezing in my early thirties. I’ve only really felt like I was able to work my preferred hours this past year. So perhaps that flare is finished. I don’t want to tempt it. Though I yearn to live harder & faster and bigger.

Writing it all out in a timeline makes it seem like the pattern is introducing change and stress into my routines but also there are two big incidents involving hormones. Being put on birth control as a teenager and then whatever the opposite of birth control might be with IVF. Maybe no more synthetic hormone control for me.

Managing your health isn’t easy for anyone. It’s particularly challenging for me. And if the current post pandemic climate is any indication a lot more people are grappling with poorer health. I wish I could offer more help other than saying it’s not easy but flares can be contained. Sometimes with a lot of pharmaceutical intervention. Sometimes with better habits. Sometimes with time. And sometimes it’s just a crap shoot.

Categories
Medical

Day 845 and Fucked Fertility

A bit of discourse stirred up a lot of grief and sadness for me. Noah Smith did an analysis of the much discussed Atlantic piece “The Myth of the Broke Millennial.” His breakdown is excellent and I recommend the Twitter thread where several of my geriatric millennial friends weigh in on how late in life security has come for many of us and how precarious it still feels.

What jumped out at me most in Noah’s breakdown is whether millennials will feel financially secure enough to have kids if it’s indeed true that we are getting less precarious.

That matters as a question as having children appears to be a driving force towards conservative politics but also a general preference for less government involvement. Noah wondered if millennials will be less woke and less inclined to socialism if we don’t turn out to be downwardly mobile. The theory is we might be if, and it’s a big if, we feel secure enough to have children.

There is one age-related factor that appears to draw people to the right, however: having children. Fertility rates are down, and Twenge discusses some reasons for this in her article. But what really matters for politics is probably not the number of kids that get born, but the number of people who end up having any kids at all.

I’ve got bad news on this front as the first wave of elder millennials who haven’t already had kids probably can’t. Why? Our women are aging out of fertility before they find the security they feel they need to consider having kids.

By the time millennial women get to a place where it seems feasible we’ve long entered “geriatric pregnancy” territory. I froze my eggs right before it was considered a geriatric situation. Which is give or take 31-32 now as we redefine fertility. I am now 39.

Now that’s a longer story for me personally as freezing my eggs felt like a consumer decision, was marketed as insurance policy, and ended up being a life changing catastrophe. And I still don’t have kids.

The process of egg extraction triggered an inflammatory disease and I may never be able to carry to term. And I have complicated grief stricken emotions about the entire affair. And we spent a small fortune getting me healthy enough to go back work.

But my suspicion is that many millennials will learn that fertility isn’t as easy as they imagine if they try to deal with it past 35 let alone past 40.

And we simply cannot seem to discuss the issue in a way that is productive. The discourse is toxic as cultural warriors, often men weigh in with their complex emotions about what it means to have a family, support children and generally deal with women’s health.

Shaming and controlling women’s bodies doesn’t really do much for the cold hard reality that we failed many millennial women by assuring technology could solve for the hard questions on fertility. So we marketed these new medical options and sold it at premium. Silicon Valley mounted a whole campaign to freeze eggs for its female workforce.

I’m afraid we are too deeply entrenched in a culture war to discus this productively as most of the people I see with the message that fertility is complex tend to view things in a more traditional context.

I personally love playing a tradwife on Twitter because I’ve learned a lot about how reactionary feminists and baroque online misogyny views motherhood. They talk to me and I’ve listened.

But we need to get women of all politics and preferences and family structures involved in this conversation as a full decade of millennial women are going to need to consider their relationship to their own fertility and bodies in short order. And for many of us it’s too late.

Treatments like IVF and egg freezing & extraction are expensive and have considerably more risk than we are comfortable discussing. Surrogates are a quarter of a million dollar expense which disgustingly is for bureaucratic costs not the surrogate herself. If you want multiple children it’s not crazy to plan for a million dollars. And don’t get me started on how adoption plays into all of this.

A generation of fucked fertility with myriad corporate profit motives driving decision making sounds like the stuff of conspiracy and cranks but don’t be fooled by extremism. We’ve done a shitty job investing in women’s healthcare in America and it will have consequences.

I know it’s scary to look at head on. I regularly break down with my own grief on the matter. I’ve been looking at it for years. Having a serious health crisis brought on by family planning has been a blessing to my marriage but that blessing has enormous costs. I’d expect this process of addressing the fertility of a generation of women to be challenging for us all no matter your personal choices or politics.

Categories
Emotional Work Politics

Day 768 and Memory

I’ve not ever read Proust in its entirety, because what am I, an eternal being who exists outside of linear time? But, thanks to Wikipedia and university survey courses, I am familiar with its basic themes of memory and it’s frustrating insufficiency.

Anyways, when not pondering madeleines, I am often confronted by how resilient the mind is in protecting us from the horrors of the world. Memory is a very funny thing. As good a reason as any to maintain diaries or engage in hagiography, is that you’d be surprised at what you forget if you don’t write it down.

A doctor asked me to get a pelvic ultrasound. I surprised myself by saying absolutely not unless it’s an emergency life or death situation, I am not doing that. And she, in sincere surprise, asked me why not.

And, because I guess therapy works, I recalled a pelvic ultrasound from maybe 10-12 years ago. I’d been referred in to a specialist as there was concern about a uterine cyst. This doctor, a gentleman over 50 in the kindly white patrician archetype, who I did not know know, proceeds to tell me this won’t hurt a bit.

But it does hurt. I am screaming bloody murder. It hurts so much I cannot stop. He tells me he will call security unless I quiet down. I cannot and I am in tears hysterically trying to convey the pain to him. I pass out.

I had utterly suppressed the memory till today. It happened to coincide with my husband mentioning a think piece in New York Magazine about women who empathized with the Clare Danes character from Fleishman Is In Trouble. There is a profoundly violating scene around reproductive health and consent that culminates in dark emotional trauma.

And of course, because it’s happening to a striving insecure aspirant white bitch, it totally doesn’t count right? The internet is not sympathetic to whining Clare Danes types. Fucking Karens. It’s super cringe to consider where the system hurts you, because, you dumb bitch, you benefit more than anyone else except the men.

So I guess I am not surprised I had banished the experience of something bad happening to me at a doctors office, but you know, it was not so bad that I am allowed to complain about it. And that is how the patriarchy perpetuates itself. Shut up you are rich. Look at the skulls upon which your empire is built you witch.

What I’m saying is that maybe you need to remember who it is that benefits from you not remembering the pain. Who benefits from forgetting? And trust me they are very scared when you realize that you remember. Even the rich striving white bitches have scares from this system.

Categories
Emotional Work Medical Politics

Day 765 and Kobayashi Maru for Women

I woke up to a totally off handed tweet of mine going viral. I had done some googling on the cost of pregnancy surrogacy and learned that it would probably cost $200,000 a pop. I’d never really considered the cost as to be honest as I didn’t think I’d be having children that way. The responses to the tweet left me feeling despondent.

Five years ago I did IVF to freeze embryos (and eggs too) and it kicked off a massive health crisis that I only feel I’ve gotten under control recently. It took everything from me. I was on medical leave, I sold my startup, and my marriage got to learn what “in sickness and in health” really means. It was awful. I am crying just remembering.

It took years to get healthy again. Of course, I first had to get stable at all. I spent years, and a huge chunk of savings, biohacking my way back to a body healthy enough to work. I’m thrilled to be back doing what I love most which is working with early stage companies. But work wasn’t the only goal of getting healthy.

I’ve had a fantasy that if I just kept at my biohacking that one day I’d be off all these medications. That I could truly be healed. That all this trouble and heartache wouldn’t be permanent. That I could heal myself. Unsaid in all of that, is that I cannot be pregnant and on the medications that saved my life. How is that for a kick in the teeth.

I’ve got two embryos and ten eggs and a fleeting dying ember of hope that I could ever carry them. I don’t know if having them via a surrogate is my path forward. Maybe there is still hope I could be healthy enough. I frankly don’t know and I’m not ready to say where my fertility is headed.

All I know is that this feels like a no scenario. That having a child in America is a fraught and expensive endeavor even when everything goes right and you are healthy and young. There is no winning as a woman as any decision around family is going to upset someone.

It’s the Kobayashi Maru for American women. Juggling your partner (or partners), your money, your home, your health and your fertility means balls get dropped. You are going to lose somewhere. And it really hurts.

Categories
Internet Culture Politics

Day 764 and Natalism

There are a number of cultural streams in American life that have all aligned around being natalist. You want your country to have babies because it’s good for the economy. And presumably also good for national security.

This fairly basic insight means everyone from techno-libertarians to Catholic homesteaders believes that Americans should be having more babies. It is not just the Quiver-full types having six babies anymore, so are our wealthiest aristocratic titans of industry.

But this alliance is missing some crucial basics. Like for instance the fundamental civilization level things we need to do to make it desirable and affordable to have children. It’s expensive to be pregnant, it’s expensive to raise children, it’s expensive all around to be parents. I spent $40,000 on IVF and it ruined my health. If I counted lost wages and being forced to sell my startup I’m the total costs is seven figures.

I don’t know if you’ve looked at just the costs around having a baby but it will shock you every time you turn a new corner in the fertility space. I learned today you will spend between $100,000 to $200,000 to hire a surrogate. It’s a person’s salary and a lot of medical care so sure that seems right but damn.

I guess I am interested in the math of Natalism to see if I could afford it. I am one of those “tech elites” that thinks we have to have children to drive the innovation of tomorrow. Our future is based on an optimistic hope that maybe we can push for a better future. Humanity won’t continue without children.

But I don’t have a body that is all that healthy without medical intervention. I live a normal life now and can work full time again because I take some exceptional medicine.

But it’s not medicinal regime that can be combined with pregnancy. So if I want to carry a child I have to go off what amounts to life saving medicine. Without it I’d be on bed rest. You can imagine the math I’m doing in my head? Do I want to pour another million into having a family?

So what’s a girl like me to do? Surrogacy right? But I’ve got 10 eggs and 2 embryos so assuming a third of them make it, that’s nearly half a million dollars in surrogacy fees. To get three kids. That’s a heavy price tag on the future. If more of them take it gets even wilder.

Now ok sure I’d rather we encourage a world where younger healthy folks do things naturally but don’t we want everyone going at maximum effort for a better tomorrow? Shouldn’t we want technology to solve this? Where are my artificial wombs at?