Subvert the Subverter - Getting Rid of Stress

Supporting Your Treatment and Your Life

May 22, 2007 - Tuesday
7:32 PM to (EST)
Guest Speakers: Joann Paley Galst, Ph.D.

Categories
Acupuncture • Donor Egg • Infertility • IVF • Pregnancy Loss

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Corey_Whelan	Hi everyone, welcome to tonight's AFA chat. Tonight we are going to tackle the issue of stress and the role it plays in your treament, and in your life. I'm Corey Whelan, The AFA's Director of Development and your chat moderator tonight.
Corey_Whelan	Tonight we are very lucky to have Joann Paley Galst, Ph.D. as our special guest speaker.
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Corey_Whelan	Joann Paley Galst, Ph.D. is a specialist with over fifteen years of experience in the field of reproductive health issues. She understands the tremendous physical, emotional, and financial challenge that infertility and assisted reproductive technology can present to both the individual and the couple.....and...she's having some computer issues folks, so please have patience!
shortygoldstein	if we can't stay the whole time would we be able to get a copy of the transcript--I have never done this
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Corey_Whelan	Hi Shorty - yes, the transcript will be up in about a week, keep looking for it.
Corey_Whelan	Welcome Dr. Galst!
shortygoldstein	thanks--I have never done one of these before
Corey_Whelan	Welcome again, everyone. Please feel free to type your questions for Dr. Galst. May I also say that when I was first starting out as a patient almost 15 years ago, I did a workshop with Dr. Galst that supported my treatment and reduced my stress levels tremendously.
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jgalst	Thanks, Corey. I look forward to chatting with everyone tonight.
Dee_Dee	I'm just 3 1/2 weeks pregant. I read your article about others having miscarriaging. Any tips on when after one finally suceeds in getting pregant and not stressing out too much about losing the pregancy?
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kkf	My doctors keep telling me that there is no proof that shows that stress can effect an ivf cycle. I think they just tell patients that so they don't stress about being stressed. What are your thoughts? I can't imagine that stress does not play a huge role in all of this.
jgalst	You have worked really hard to get here, Dee Dee. It is very normal to be anxious about the pregnancy. Hopefully you are comfortable with your OB and have made lifestyle adjustments along the way. So, you can rest comfortably that you are doing everything in your power for a healthy pregnancy.
Kelly	My husband and I are TTC 2 years and have completed our infertility workup. We have decided to try IUI. Has anyone done this? Did it result in pregnancy? How long?
Dee_Dee	Thanks
jgalst	Kelly, your doctor is correct in some ways.We have no definitive evidence that stress causes infertility.
jgalst	However, we do know that infertility causes stress. And the more stressed out you are, the harder it is to process information and follow-thorugh on what you need to do to make it through your treatment.
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shortygoldstein	how about unhappiness?
shortygoldstein	can that cause reasons of some unfertility?
lolhardman	My doctor stressed that stress was one of the main reasons woman don't become pregnant. The question is is how does one avoid stress?
jgalst	Shorty, I have never met anyone who was happy about their infertility.
shortygoldstein	heh
shortygoldstein	true
kkf	My question is not related to causing infertility, but more about the role it plays in an ivf cycle.....especially during the 2 week wait, after the transfer of the embryos.
jgalst	I think women, in particular, deal with their anxiety as they go througth this by being defensively pessimistic, while men deal with their anxiety by being defensively optimistic. But, we're all anxious as we go through treatment.
lolhardman	sorry...yes my doctor said it plays a large role, not to accept phone calls from friends that tend to create drame etc etc and to generally rest, take it easy and avoid any situation you may peronally find stressful.
jgalst	It's important to remind yourself that you trust your treating physician (you really need to feel this) and you are doing everything you can within your power to follow his/her instructions and try to reach your goal.
shortygoldstein	I just feel so overwhelmed at times--I thought it would be so so easy to get pregnant
jgalst	lolhardman:I don't believe that stress is one of the main causes of infertility, as success rates have increased enormously over the years and yet, from my clinical experience, women are still stressed.
Corey_Whelan	Kelly - are you seeing a reproductive endocrinologist? If not please contact me after the chat - corey.whelan@theafa.org
jgalst	What one needs to try to do is learn some techniques to manage the stress as effectively as possible, as well as try to balance various other areas of your life so you don't become focused solely on your infertility.
lolhardman	sorry I meant to say during the period between the embryo transfer and the pregnancy test
Kelly	Yes we have seen a RE
jgalst	Shortygoldstein. I think alot of women had the same belief as you. That you try to avoid pregnancy for so long, it must be easy. And then it isn't. Also, we don't like to work really hard for something and then be denied it.l
jgalst	lolhardman. The period between the transfer and the pregnancy test seems to be the most stressful time for women
shortygoldstein	just so many other stressers as well
kkf	i have been through 2 ivf cycles. the first round, i was very stressed. no success. the second round, i was much calmer and we got a chemical pregnancy out of it. what role does stress play in the outcome of an ivf cycle? the 2 weeks after the transfer seem to be the worst.
lolhardman	it certainly was for me
shortygoldstein	this one chat here seems to be my one and only sounding board
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jgalst	I recommend some yoga (no inversions, though - and check it out first with your RE), learn meditation (even simple sound meditation (close your eyes and focus in on all the various sounds around you), start a project that can allow you a feeling of acckomplishment...
Kelly	does everyone in the chat room work full time/part time/ not at all?? Just curious if not working is easier/harder to undergo some of the treatments available
lolhardman	shorty maybe try resolve.org, they have great info and the blog is great...very informed
shortygoldstein	I work full time--I am a middle school autism teacher
jgalst	kkf. see my last answer.
Kelly	I work fairly steady I am a substitute teacher
ksmcbride	Has anyone traveled while taking Lupron and the stims?
jgalst	I think it is tough for women to juggle work and treatment at the same time, but I have found it even harder for most women to be at home, watching the clock and obsessing and worrying without any outside structure or distraction.
bride03	I also work full time and find it tiring with all the monitoring but it does keep my mind busy. I have the summer off and am a bit nervous I will focus too much on treatment.
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kkf	what about stress on the male side??? we are experiencing secondary infertility, on my husband's side. can stress play a role there?
Kelly	that's true too - I didn't think about being home all the time
jgalst	KSMcbride Check with your doctor on travel. Some seem to think flying is fine (even when in early pregnancy) lothers not. You need a doctor's note to carry syringes on the plane, howevefr.
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kkf	i travleled a lot for work while taking meds....never had a problem.
jgalst	Male stress seems to play its greatest role in being able to produce a sperm sample. Many men get so anxious, they can't produce.
bride03	Dr. Galst, I am prone to anxiety and when I am on the meds it seems to increase my anxiety and acupuncture. Any tips for dealing. I do yoga already but my anxiety gets worse with the meds.
kkf	that's not the problem.....it's related to poor motility, rather than the quantity. it doesn't sound like stress plays a role then.
Kelly	how many cycles for IUI should be tried naturally before trying with meds?
jgalst	bride03. Yes, many women find themselves more emotional in general while on the meds. How about trying to learn some meditation or even progressive muscle relaxation, as that's an active form of relaxation.
rcl29	Hi Dr. Galst. Can stress be a factor in the number of antral follicles that you have or on the response to stim meds used in IVF?
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bride03	Thanks.
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jgalst	kkf: I'm not familiar with any research correlating poor motility with stress.
lolhardman	do you know of anything other than acupuncture that can help with ones fsh levels
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jgalst	rcl29. Again, I don't think we have any solid evidence that stress impacts directly on number of follicles produced or on the response to stim meds. But, learning to reduce the stress can just make it less difficult to get through a cycle.
jgalst	lolhardman: FSH levels vary naturally from cycle to cycle. I think acupuncture has been the most helpfrul with this, although I can't say exactly why that is.
ksmcbride	Kelly. As far as how many natural cycles of IUI to try before using meds, discuss with your dr. depending on your reason for infertility. However, I recommend, don't waste your time doing more than a couple IUI cycles.
jgalst	Have you all learned how to do diaphragmatic breathing? It is my favorite relaxation technique because it is portable and can travel anywhere, anytime with you.
lolhardman	Thanks ladies
lolhardman	bye
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Kelly	I plan on talking our dr.- we have a follow up with her in June. However, I hope we are able to pinpoint ovulation and try a round of IUI before our scheduled appt.
Kelly	Thanks ksmcbride
Kelly	what is diaphragmatic breathing?
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jgalst	Kelly: diaphragmatic breathing is alternatively known as belly breathing.
Kelly	ok
jgalst	You try to inhale to a count of four, filling your lungs all the way, so that your belly protrudes when you inhale
jgalst	Then exhale to a count of four, as well, letting your belly fall back into you.
Kelly	sounds simple enough - thanks
jgalst	It re-balances your oxygen and carbon dioxide, making you feel more relaxed (hyperventilating makes you feel more anxious) and occupies your mind, as well, as you focus on your breath and your counting.
jgalst	One other thing I like to recommend to individuals going through fertility treatment is some focus on balancing the rest of their lives.
jgalst	For example, placing some focus on their artistically creative side, their physical side (e.g., yoga, dancing, things that make your body feel like it is working for you), their spiritual side, their professional side,
jgalst	All of the many other aspects of our lives that we forgot about when going through treatment. Some focus on these other aspects can make us feel stronger and more empowered.
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jgalst	Any other questions??
nkobal	if you have a major even happening one month, is it best to hold off treatment so you are not as stressed. or woul you just recommend going ahead with a treatment and try to handle the other stuff
Kelly	what exactly does acupunture do for infertility?
rcl29	You mentioned Progressive muscle relaxation...How do you train yourseld to do this? Are there DVD's?
jgalst	nkobal: I think it makes most sense not to take on any additional stress during a treatment month. Sometimes it is unavoidable, but don't go looking for stress overload.
jgalst	Try to clear your month as best you can. Some stress is good stress and can be experienced as excitement. That would be fine to incorporate during a cycle.
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jgalst	Kelly: I'm not an acupuncturist, so I don't know exactly what it does for infertility. My hypothesis is that is helps with blood flow to the uterus,however.
Kelly	okay - thanks
shaymer01	I have an extremely stressful job. It seems that every cycle there is something crazy going on. I am wondering if I have to lose the job altogether.....Do you ever feel this is necessary?
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jgalst	rcl29: Progressive muscle relaxation is progressively tensing and relaxing various muscle groups throughout the body (either starting from your toes up or your head down). I don't know of any specific DVDs, but try to google it.
jgalst	I do like Brenda Strong's dvd for fertility yoga.
rcl29	Thanks for answering my questions!
jgalst	shaymer01: Is there anybody at work you could talk to about your need for some flexibility during your cycle?
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shaymer01	Yes, but what if this one cycle does not work....I have had 'flexibility' built in for a few lately. Deadlines, however, and other fires pop up that need to be put out.
shaymer01	It seems something is always happening right at the worst time.
jgalst	I know women worry about being put on the 'mommy track', but if your job is stressful, it may be better to share somethiing about your needs than worry so much about it. Alternatively, you could just say you require some medical treatment througthout the month and need worki flexibility.
trishwalla	hi. i guess to build on that question what if you have flexibility with your job but the job itself is stressful.
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jgalst	It's usually possible to take a leave of absence from work, or take two vacation weeks if you think that would make the process easier for you.
shaymer01	Yea, I guess that is more what I am getting at trishwalla. I have flexibility, but the job itself is unyielding.
nchristoffersen	I'm sorry if this question has already been asked, but I am starting my first IVF next month and I am terrified that it may not work. Do you have any suggestions, especially for the two weeks wait, to help calm me down?
shaymer01	thank you. I am getting to the point where a leave of absence might make the most sense.
jgalst	trishwalla: I think you need to give yourself permission not to be working at peak performance at work when you are going through a cycle. Perfectionists often put too many too high demands on themselves.
jgalst	nchristoffersen. See above, as we have addressed this tough two week waiting period already.
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Dee_Dee	Any tips if one is pregant through the use of a donor egg and if one should tell one's extended family? We are little concerned on who to tell and how.
jgalst	To all of you who have very stressful jobs, remind yourself of how committerd you have been to the job in the past, and during a cycle, your have dual committments. So, something's going to have to give.
jgalst	DeeDee: Deciding who to tell and who not to tell when you use donor gametes depends first on your comfort with having used DO, and secondly on the people you are talking about. Do you find them accepting, loving and nonjudgmental? Then you could take the opportunity to educate them so when your child mentions it to them, they'll be very acceptingt and cool about it.
Kelly	Dee_Dee - it's your choice on who you want to tell and who you don't want to tell. I personally think it isn't anyone's business but yours and your husband
Dee_Dee	Thanks
jgalst	Kelly: I agree that it is your deciswion. But, if you plan to share information with your child and you want them to be comfortable with the information, you can't then go and tell them not to say anythingt to anybody. As that seems to send a message that the way they were created is shameful in some way. And non of us want our kids to feel ashamed.
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Dee_Dee	good point
Corey_Whelan	Folks, I need to let you know that we only have about 15 minutes left.
Kelly	I do know that but as far as many other people it's a personal decision
jgalst	Kelly: Certainly we each make the decision about telling others from the perspective of who we trust and who needs to know.
Kelly	yes
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jgalst	Regarding disclosure to one's children of their origins through donor gametes, there's an excellent DVD available through the Donor Support Network in the UK called Talking and Telling.
Dee_Dee	Some people are ok with high tech donor egg babies until it is some one that they know. Then some people can get funny. We tackle the situation. Thanks again.
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Dee_Dee	Thanks for the DVD title.
jgalst	They also publish some booklets that can be downloaded, geared toward various age groups, all the way up to adulthood.
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Dee_Dee	Should I "Google" to Talking and Telling or the Donor Support Network to find more about the DVD? Is there a website?
jgalst	Let me just mention our AFA Telephone Coaching Groups, which allow you all from throughout the country to be connected with a group of abouy 8-15 others going through a similar experience, and facilitated by one of our extremely experienced AFA Coaches
jgalst	Dee Dee . I don't have the URL here. Try the Donor Support Network first, though.
Dee_Dee	As far as the AFA Telephone Coaching, do we just go the AFA website to find out more about them?
jgalst	By the way, our AFA Telephone Coaching Groups are offered free of charge to our no-barriers members.
jgalst	Yes, go to www.theafa.org and look for support. Also, we send our e-blasts and announcements in the monthly Connections newsletter.
Dee_Dee	thanks
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nkobal	do you recommend any sae herbs or teas that would help with anxiety and sleep during the cycle?
jgalst	We are offering a coaching group on the disclosure decision on May 31sts (it's fully booked, already, so we'll probably offer another, as well as an over 40 coaching group in June and a general inferitlity coaching group in July.
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jgalst	nkobal: I'd talk to my RE about herbs or teas before trying anything, as some of them can interfere with the stims. Anybody for warm milk??
Corey_Whelan	five minute mark, folks
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jgalst	If any of you are interested in a face to face Mind-Body group in the NYC area, AFA is offering soon. All the techniques I mentioned, as well as visualization, and cognitive reframing will be offered, as well as general talk time for emotional support.
Corey_Whelan	I really want to thank everyone for being here tonight. When you guys ask your questions, we all learn. And I very much want to thank Dr. Galst for taking the time to work with all of us!
nkobal	thank you
jgalst	Check out the e-blasts and Connections newsletter for contact information
Dee_Dee	Since finally getting pregant, my cholestrol has gone up, I lost my appetite, feeling I guess heartburn. Any good books or tips that can reveal what to expect when getting pregant while using high tech means v.s. the usual methods?
shaymer01	thank you
jgalst	Good talking to all of you and I wish you all the best of luck.
Corey_Whelan	The transcript of tonight's chat will be up in about a week. Thanks again to everyone. Let's get Dee DEe's question answered and then our chat is officially over
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Corey_Whelan	wow, just read your question DeeDee. I don't know of any books but you can try the Perspectives Press catalogue
jgalst	Dee Dee. The books that people seem to like the most when pregnancy are What to expect when you are expecting a
Dee_Dee	Thanks
Dee_Dee	Okie dokie
Corey_Whelan	Our chat is officially over. good night all
jgalst	and The Girlfriends's Guide
Corey_Whelan	there you go!
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jgalst	Also, take a look at The Long Awaited Stork
Corey_Whelan	thanks Dr. Galst
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Dee_Dee	good deal
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jgalst	Good night all.
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Subvert the Subverter - Getting Rid of Stress

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