Where ever you are today

Where ever you are today.

Be it with family, friends or alone at home.

Be it following a recent diagnosis, another BFN or failed treatment cycle.

Be it holding the child(ren) you fought so hard for or grieving the loss of the ones you will not be holding.

Be it on the road to resolution or finding yourself still uncertain of the path ahead.

Please know I'm thinking of you all today.

I'm thinking of you during those moments where it feels impossible to keep the tears at bay, when someone says something that hurts your heart, or during those moments where it feels like you're on the outside looking in.

I'm thinking of you as you finally watch those first moments, of when you hold your child(ren) in your arms and when you look around and see the family you've worked so hard for.

And I'm thinking of you as you reflect on this year. All the good and the bad. All the fear and uncertainty and even those moments of hope.

Wishing you all find peace at some point today. And a moment to remember that you are not alone.

Finding new paths

Apologies in advance for the brain-dump here. It certainly is less than eloquent, but I'm hoping that writing will help. Or at help detangle all that is spinning in my brain.

Like many, I spent most of my young adult life building a career that I thought would be sustainable. Starting during my time as an undergrad, I spent a lot of time seeking out training options that would help prepare me for a career in science, both with networking and acquiring skills that would be needed in order to meet that goal. Not long after completing graduate school, I landed a rare position that afforded me an invaluable opportunity to gain hands-on teaching experience while putting into practice new techniques I had learned. About a year into that position, more opportunity came in the form of a postdoc at an institution in Boston. Despite infertility and continual failure with fertility treatments, I felt like my career was at least moving forward. That my efforts towards building were at least being rewarded.

All of that came to an end in 2013. Despite applying for five separate fellowships and reviewing a grant by my future postdoctoral mentor, I was unable to secure funding. And without funding, the position I had planned on disappeared. In addition, because the institution assumed I would be starting a postdoc and then later learned I was pregnant, my contract with them was not renewed. Meaning that within a blink of an eye, I was facing unemployment. While most women spend their maternity leave focusing on their new bundle of joy, I was craving out time to apply for jobs and make connections. I've been fortunate to be able to piece together short stints of employment since January, but nothing that is permanent. All of which has left me feeling like a complete failure.

The problem with being a scientist in today's world is there is a severe lack of funding. Particularly for basic scientific research. Though there was a boom in the 1990s, since 2000s there's been continual cuts to funding. The recession has only exacerbated the problem, with deep cuts to both NIH and NSF funding making so that even the most needed research is no longer getting done. Over the last 5 years, I've watched labs close, research buildings become almost vacant and promising young scientists completely abandon the field. Those who have hung on have had to make huge sacrifices, some of which include drastic pay-cuts, delaying family expansion, enduring relocations and playing games just to secure funding. Many of us feel lied to and undervalued. After 5-6 years of graduate training, where we were promised a future, we're finding that not only is the well dry, but there are many fighting for those few remaining cups of water.

Part of this issue has to do with the current way we train scientists. An editorial by Bruce Alberts, Marc Kirschnerb, Shirley Tilghmanc, and Harold Varmusd outlined some of the systematic flaws that exist in the field, calling for change at all levels for change. But equally problematic that many of us were promised something that no longer exists. We were told if we worked those long hours, made those connections, made huge sacrifices and just "wanted it enough," we could achieve our dream. What has become evident is that none of this was true. That working one's self to the bone won't resolve the lack of funding or lack of value.

What I realized recently is that since losing that postdoc in Boston I've been grieving. There are moments where I scheme for ways to resurrect the project that I proposed or somehow piece together enough funding to actually do this work. But the problem is that doing so will require sacrificing my family in the process and even if I find a short-term solution, the long-term goal is still nonexistent. So I've been frustrated on my good days. Incredibly angry on my bad ones. All the while feeling like nothing I do matters and internalizing this failure as a personal flaw. The realization that I am grieving shocked me. After all, you're not suppose to grieve for something like this. It's unbecoming and selfish. And yet, after years of infertility and being in the trenches, I know the signs and symptoms all too well.

Last week, I finally allowed myself to internalize all of this and begin to let go. I've slowly been contacting people within my network and reaching out to those who can help provide advice as I try to find a new career path. It's been slow going, particularly with applying for jobs and considering options I never would have before. But, there are meetings on the horizon that show potential. There's people who have already come through in a big way with introductions and opening doors I never knew existed. Still it's scary. It's scary because I don't know what the outcome of all of this will be and my confidence is shaken.

But if I learned nothing else from infertility and loss, the one lesson that still rings true is sometime the scariest part is being willing to try again or try something new. That we can be our own worst enemies with assuming it all has to come out a certain way in order for it to be okay.

Wish me luck for the journey ahead.

#MicroblogMondays: Choosing to be Thankful

Sometimes its easy to get caught up in the negative. To succumb to the stresses and pressures from everyday life. There's been a lot of negatives lately, with me struggling to find permanent employment, Grey trying to wrap up his postdoc and transition to the job market, financial worries from raising twins and the fact we've all been sick in some form for almost a year. All of it draining.

Jos post today was the kick in the butt I've been needing. I reminder that even when things are tough, especially with this time of year, there is still so much good in the world.

So, inspired by Jos, here's a brief list what I'm thankful for today.

• Grey. For being an amazing life partner who has and continues to stand by me through thick and thin. For believing in me during moments when it feels like no one else does. For seeing the good when I'm surrounded by the bad.
• The Beats. For reminding me how crazy/wonderful this world can be. For helping me remember to find joy in the simplest things.
• Our support system. Who help keep us fueled with love, weekly meals and excuses to get outside. These friends and family members have been invaluable and I hate to think where we'd be without them.
• Our home. Though Seattle is gray this time of year, it's still amazingly beautiful here. The Beats and I have walked this city up and down and are still finding new wonders (like the Sea Lions at Alki Beach) at every turn.
  
• Connections and unknown opportunities. I currently have so many irons in the fire at the moment. Yes, I've been burned at times, but the fact that my connections are working with me as I work on finding a new path career-wise, I know I'm fortunate. 
• Finally, for these two amazing souls. Who know just the right moment to cuddle in when all seems wrong in the world. Who tolerate not-so-gentle pets from the Beats (we're working on correcting this) and remind me that sometimes the best cure is a good meal and a long nap.

#MicroblogMondays: Feeding the ducks

There are days when all seems wrong in the world. That no matter what you do, you feel like you can't get ahead. I've been feeling that way a lot lately with my career. I won't go into the details now, but needless to say the path I originally started on has become incredibly rocky, if not completely disappeared under my feet.

On days like this, the only cure is simple pleasures. Today, I decided it was time the Beats learned how to feed the ducks. Packing up some oats and defrosted peas, we made our way to a local park that has a fountain populated by resident ducks.

Amid lots of quacking and splashing, you could easily hear happy shrieks and coos from two very entertained toddlers. That happiness chasing the grey clouds hanging over my head away.

Nature vs. Nurture

This past week has been one filled with middle-of-the-night wake-ups, piles of snotty tissues, lots of coughing, many bottles of Pedialite and an unpleasant diagnosis of influenza for Grey (he was the only one in the family who didn't get a flu shot). The only highlight was hearing that the ear tubes were doing their jobs and ear infections have been avoided.

Due to all the sickness, I've had an unusual amount of time to linger on grading this week. This quarter, I am teaching a genetics course to non-science majors, focusing on topics like GMOs, genetic testing and genetic determinism. Unlike the courses I've taught in the past, this course is meant to explore specific examples, providing my students with basic information necessary to make informed arguments about the ethics behind these issues. So far, we've had a very lively debate as well as a couple of interesting discussions focusing solely on GMOs. But this last week we've shifted our focus to genetics and health. And to prepare them for the topics ahead, I assigned them to watch "GATTACA" and answer a set of homework questions.

For the past two days, I've been slowly grading these questions. Though normally I read through every assignment, I usually get on a roll with grading and don't have much time to truly reflect on what my students are saying. But this time around, particularly with the nature of the assignment and the my foggy thinking, I finding my thoughts are lingering as they are tackling questions about genetic determinism and societal expectations.

If one is to do a Google search for "Nature vs. Nurture," you'll quickly find yourself inundated with various articles exploring genetics vs environment. A nice thought piece from NPR in 2007 explores this a bit, recounting a story of identical twin sisters who were separated at birth and reunited years later. Overall, the data is incredibly clear that who our genetics plays a big role in determining our make-up, our environment plays an equally large role shaping not only who we are, but the potential for what we can become.

All of this has been swirling through my head as the latest round of "mommy war" attacks and arguments have been circulating. Last year the stir was a study that came out showing the long-term benefits of breastfeeding had been drastically overstated. Most recently has been the discussions about extended breastfeeding and how society views it. Later on, a woman finds herself entrenched in arguments about introducing solid, sleep, transportation (stroller vs. baby wearing) and finally, the mother of all arguments, staying at home vs. working. In every single case, there are advocates on either side, with strong opinions for why their choices and views are correct and should be embraced. All while the other side is not only dead wrong, but is *gasp* harming their child(ren).

The universal thing missing from these arguments is the same acknowledgement that researchers tackling the "nature vs. nurture" question failed to address and finally had to acknowledge: for each issue and topic, there's more to the equation than initially considered. For example, with heritable diseases, geneticists point to examples like Cystic Fibrosis or Sickle Cell anemia for how single mutations can drastically alter protein function and cause disease. Based on these examples, it is easy to assume that genetics is the end all be all of causing disease. Yet we know that simple heritable diseases are rare, with most diseases being influenced by both genetics as well as environmental impacts. Example, we know there's a strong link between cancer survival and socioeconomic status, suggested links between neurodegenerative diseases and ethnicity and even a link between one's mental health and their waistline. Equally talked about is the impact of stress, familial, work and even financial on one's lifespan and mental health. In short, there's a lot more at play with human development and homeostasis and a lot of these issues are one's that reach up to a cultural and global mindset.

So why is it, then, that given all this complexity, we still apply simple arguments to the "mommy wars?" Why is it assumed that because something worked for one family in one situation (remember, each child is different), that it would somehow be universally true? Why is it that these debates continue to rage, with people on both sides belittling the other side instead of agreeing to acknowledge that it just might be possible to do things differently without drastic consequence? Yes, there are some things that are crystal clear for causing harm (abuse, neglect, starvation and incest/rape hit this list), but for other things, is it really worth the fight.

One question I asked my students has given me a lot of insight into how drastically different people view the world: " One of the chief arguments of GATTACA is that genetics determines everything about you. In the movie the main character’s family is mostly pictured as holding him back. In this situation how would you, as a parent try to balance between encouraging your child, and giving them a realistic set of expectations?" The answers have ranged and I'm certain would cause some bristling. But given that my students come from diverse backgrounds, with some being first generation students, to older students, to having veteran status to various cultural backgrounds, these answers have been windows into their upbringing and daily challenges. Given that, it's made me reflect more on why I made the decisions for how we brought the Beats into the world, how Grey and I have cared for them and the values we are teaching them. And it's helped affirm that there will never be a "right" answer for any of this as a society, just a "right" answer for our family. 

Reflections on egg-freezing

A barely audible whimper sends a warning that naptime is coming to an end. Tip-toeing in the room, I find a wide-awake He-Beat laying on his belly, nursing his pacifier, while his sister still fast asleep. Upon seeing me, he proceeds to sit-up and then lifts his arms high over his head, signaling that he wants to be picked up. After a kiss and a quick diaper change, we leave his sister to finish her nap in peace and head downstairs to begin our Saturday ritual.

Once his feet make contact, He-Beat toddles over to the broom closet. Once I open it, he reaches inside for the red dust pan while I grab for the broom. Situating him in the middle of the kitchen floor, we begin our usual rhythm of sweeping, with him following the broom and reaching out at moments to help me push it. As I turn a corner, I have a flash of myself from a few years ago, sweeping this same floor. But that woman pushing the broom is in the thick of fertility treatments, suffering from the grief of failure after failure. As I move the broom across the kitchen floor, I remember thinking how far away motherhood seemed. And it is as I'm in the middle of that thought, feeling the shadows of that grief wash over me, that He-Beat greets me with a happy shriek, pushing the red dustpan towards me. Seeing this little boy in that moment causes me to drop the broom and scoop him up into my arms. Instead of pushing away, he allows me a sweet moment to hold him, taking in the intoxicating smell of him and to kiss his head that he rests on my chest. Somehow, we survived the nightmare. Somehow, it became okay.

I'm a bit late to the party on this one, but there's been a lot of press recently about egg freezing. Pamela has been running a very informative series about this issue, talking about the push for marketing this procedure as a form of "fertility preservation." On the heels of Apple and Facebook's announcement to offer egg-freezing as part of their benefits package, her articles in WIRED and FORTUNE magazine combined with thoughtful work from others,  has sent a strong message that this procedure isn't the silver bullet to balancing career with family building.

Like many, I agree that egg-freezing is an amazing technology that gives those about to undergo life-saving treatments, such as chemotherapy for cancer patients which would otherwise eliminate their ability to conceive, a chance to spare that. But the way egg-freezing is now being marketed turns my stomach, for a couple of different reasons. The first being that it assumes that egg quality is the only factor for infertility. For me, like many others, this wasn't the case. After two rounds of IVF, it was concluded that my embryo quality wasn't the issue. Instead, I was told I had issues with implantation, an area that we still know so little about. Yet what is being promised with egg-freezing is that by using younger (and assumed healthy) eggs, any issues with infertility would be eliminated. Never mind that biology, not just reproduction, is far more complex and that egg quality is truly only one factor in this equation.

The second issue is harder to explain as it's an emotional one. It goes without saying that I love the Beats with my whole being and there is not a single moment of my journey to bring them into this world that I would trade. These kids are amazing miracles and I would go to hell and back for them 100 times over. But just like anyone else with a life-changing illness, I would not wish the hell I went through on anyone. If someone told me 10 yrs ago that I had the option of getting my babies and never having to go through IVF if I simply started trying earlier, I would have done that. To know there was a way to prevent having to walk through this hell. With egg-freezing being marketed to women who are otherwise healthy, I feel they are unknowingly choosing to walk through hell. Even if they research it and make what they think is an educated choice.

The truth is infertility has been successfully suppressed in society. From the assumption that relaxing is a cure for infertility, to general misunderstandings about fertility treatments, to even outlandish suggestions that adoption is a guarantee way to ensure a future pregnancy, society perpetuates the myth that infertility is rare and something we can easily overcome. The scary truth is that this is far from the case. Not only is infertility a life-changing medical condition, but an emotionally traumatic one. Between the financial stress and the hardship of treatments, there's also the emotional rollercoaster fueled by hope and grief. A rollercoaster that many who live through have ridden many times, often to the point of developing some form of depression, anxiety and even PTSD.

What otherwise healthy women may not understand is that by electing to go through egg-freezing, they are buying multiple passes for this rollercoaster. What they are signing on for is periods of anxiety, fear, uncertainty and, when failure comes, grief from loss. And with a 2-12% success rate, the likelihood of this grief is almost certain.

I remember those days of grief all too well. Of waking up daily to a feeling that my heart had been ripped out of my chest. To having moments where, if I wasn't numb, it hurt to breathe. Where it felt like I had ceased to live and instead was watching the world go by me. To even having moments where I prayed I didn't have to wake up in the morning. What fueled a lot of this was being told that I had brought this on myself. That by waiting until I was 31 yrs old to expand my family, I had eliminated my chances. Or that I had done something in my life to deserve this pain. Worst yet was the guilt I felt for putting Grey through this hell. Even when he made it clear time and again that he would not leave me because of infertility and loss, I still felt I was robbing him of the happiness he deserved.

The painful reality of life is that with choices, there are things we must sacrifice. As someone who is still very career-driven, I am one of the first to champion women reaching for the stars and changing the world. After all, I've had the opportunity to work with side-by-side with women who are changing the way we think life and the world around us, all while inspiring so many who follow in their footsteps. The idea that we are somehow weaker or well intelligent simply because of our gender is truly dated. But Biology is still something we don't understand, even with the advances that have been made. We can't cheat fertility any more than we can cheat death.

I recognize that what I'm saying here will anger some. That some will point to examples in pop culture or share stories they've heard about women who had children well into their 40s. That my words will be seen as simply a scare tactic to dissuade so many promising young women from reaching for their dreams. This is not my intent. But it would be remiss of me to not speak out about the false-hope these companies are marketing. To question the ethics of the doctors and business who are advertising egg-freezing to healthy young women. To not share with all of you my story in hopes that it would spare someone from having to go down this road. Eliminating the fear of her never getting to hold her child in a moment of sweetness or having to wonder if it would ever be okay.

Tubes, PT and all things toddler

It's been a crazy couple of weeks, with lots of developments on the career front, family front and home front. All of which are topics one could easily write multiple posts about. So to preempt that, below is a bullet list of all that is happening. Feel free to pick through.

The Beats: I'm long overdue for an update, so here's what's been happening

• She-Beat started PT two weeks ago and already we're seeing a huge difference. The physical therapist quickly agreed that her severe dislike of being on her tummy has likely impacted her gross motor development. So we're working backwards, focusing first on walking and cruising, pulling up, then getting her on hands-and-knees and progressing to crawling. Even with only 2 session under her belt, our little girl is now VERY insistent on standing, pulling-up from a seated position and has started cruising. In addition, her therapist got her to climb 3 steps on the school play structure. She's clearly so proud! I'm still learning how to do the different techniques to help her, but her teachers at school have already been amazing with continuing her exercises. Fingers crossed for continued improvement!

• Speaking of movement, He-beat is WALKING! Grey and I now understand why they call kids at this age toddlers. Each day, he's becoming more and more confident, practically spiriting across the room. He-Beat's other favorite activity is climbing. Particularly stairs, but high-chairs, ledges on windows and anything with a ledge will do. He's already eyeing the slats in his crib....

• On top of the gross motor, both Beats have started talking. She-Beat is more advanced than her brother with this as she is up to 4-5 words (He-Beat is 2-3 words). Favorite words at the moment: "Up" "Daddy" "Daisy" "Star" "Jaxson" and "No." We're working on "Mama."

• Hugging and giving kisses has become a favorite for both kids. Not uncommon to see Grey with a big smile on his face returning those hugs, especially after a long, hard day at work.

• Finally, both Beats had surgery yesterday to have tubes placed in their ears. Quite an ordeal for a 5 minute surgery as they had to give both kids general anesthesia. This meant a whole morning of fasting for 2 toddlers and stopping liquids at 9 am (surgery happen at 12:30 and 12:45 pm). Through some minor miracle, both kids stayed in good spirits until the masks were put on. Both are still recovering, with lots of napping, bland food and tons of liquids. I truly hope to never have to go through an experience like that again.

Family: Despite opening up to my brother, I've been dropping the ball with outing myself to my family. Here's where we're at.

• Brief backstory: 3 years ago, following a diagnosis of infertility and 3 failed IUIs, my mom contacted Grey and me to ask us to adopt her sister's grandson. The state had recently pulled him from my cousin's custody for a second time and were looking for family to adopt him as they were looking into terminating parental rights. I learned later that my aunt's ex-BIL had offered to adopt him, which sent my aunt into a tizzy. The solution was to push Grey and me into the adoption, with the idea that when my cousin had finally got her acted together, she could simply take over raising him again. At that point, it became very clear that not only were we not going to be supported going into IVF, but my mom would always prioritize her siblings over her own daughter. I called my parents that evening and somehow maintained a civil conversation explaining why their wishes were not going to be honored. And then I said good-bye.

• Fast forward 3 years. Grey and I have decided that it is time to make my family aware of the Beats and reestablish a connection. But one with firm boundaries and a lot of distance. Step 1 was talking to my brother. Step 2 is drafting letters to uncles. The plan is to contact my parents' brothers and alert them to what is coming. The goal is to have 3 points of contact within the family (one on each side and my brother) prior to dropping the bomb on my parents. Problem is, writing these letters has been far more complicated than I originally thought. I've done one brain-dump and now need to edit. 

• The letter to my parents has been so hard to write. I'm still so angry with both of them about how they have treated me for the past 30 years. Through Dee and David, I've learned that it's all due to dysfunction that has spanned generations. Still, I'm struggling. I've been asked what type of relationship I want to have with them and I want them to have with the Beats. Quite frankly, I don't trust them in either regard and Grey and I have already agreed that they are not allowed alone with either of our kids for any reason. So for now, it's more of opening the channels and letting them know we're alive, doing well and are willing to talk. All the rest will need to be negotiated.

Other home-front news: I have a whole post drafted about the Pigeon Palace. But for now we'll focus on Fleur.

• On October 8th, she had a hearing with the county judge. I haven't had a chance to read the report, but from what little information I got from the lawyer, apparently the judge was very unsympathetic to her case or her family's. She was ordered off the property ASAP, with threats of jail-time if she failed.

• What this meant was that Fleur's 95 yr-old father hired movers to resolve this. She fired them, which meant her 73 yr-old sister had to step up and negotiate moving her. There was a lot of back-and-forth for the next couple of weeks, with Fleur clearly very agitated about the whole situation. 

• Late last week, we learned the sheriff would be on the property to do a lock-out. Fleur was alerted. Two days later her car disappeared from the property. We learned a few days after that that she had vacated the property.

• Since vacating, I've followed up with Adult Protective Services. Fleur qualifies for assistance and mental health treatment, but until proven incompetent no one outside her family could request this for her. With her forced eviction, the state now considers her incompetent and are intervening. The case worker sighed heavily when I talked with her, emphasizing the fact that so much hardship could have been prevented if the family had stepped forward to seek out these resources. That though mental illness is difficult to manage, there is help ranging from low-income housing, access to assistance and even assigned caseworkers. Needless to say, I'm still far from happy about how all of this went down.

Career:

• The short and the long of it is I'm currently teaching part-time and loving being back in the classroom. My students, though young, are thoughtful and engaging. It's been fun working with them.

• What I'm not liking is how temporary faculty are treated. There's been a lot of broken promises, last-minute demands and failure to provide important information. All of which is negatively impacting my students. It sucks that people in administrative capacities treat temporary faculty so poorly as it is clear the system absolutely requires them to function.  

• On top of all of this, I've been job-hunting. Both Grey and I are at transition points and are looking for the next steps. With the funding environment being the way it is, though, so many scientists are either struggling or completely abandoning their careers for options that won't break them. It's a frustrating time as there's a clear need to not only inject the whole system with money so important, life-saving research can happening, but also to completely overhaul the whole system so that those doing research and making advances can actually survive. Anyway, as stupid as it sounds, we've both been applying for faculty positions, corporate positions and looking into longer-term options. 

• Finally, I was invited to meet with a group of high-school girls to talk about pursuing careers in STEM. I almost fell over laughing. Fordes magazine recently ran an article listing Biology and Chemistry as no. 8 & 9 worst career options and majors. Computer science, engineering and physics? Awesome choices. But anyone pursuing biomedical research is considered a sucker. I'm debating about whether to go.