Chanukah: A Prayer For Miracles This Holiday

I remember the aftermath of my first miscarriage. Many times people don’t even realize they have had a miscarriage when it happens so early in the game, but since I was going through fertility treatments, in this case an IUI, I knew that I had conceived, I knew that it had implanted and the cells of the embryo were splitting… and then they weren’t.  When they say “your body takes care of it,” the pregnancy hormone or BetaHCG numbers, or “Betas” in the fertility lingo, slowly go down to zero. Well, my body wasn’t doing that, and so I had to have a shot of methotrexate to help me get there.

One of the warnings I got when taking methotrexate was to NOT TRY to conceive on my own for 3 months. Anyone who is trying to get pregnant through an A.R.T. knows that you are pretty much chained to a lab during that time, and I was being released from those chains. So what does one do when given freedom of movement but can’t actually physically do anything? Well, I went to better my soul. My husband and I went to Israel.

We spent Shabbat in the old city of Jerusalem and had a meal with the Rosh Yeshiva that my husband had studied with for his gap year. He asked me to sit next to him and I confessed to everything we were going through. He told us he wanted his son to take us to see a specific Rabbi for a bracha the next day.  On the 2 hour journey for our bracha, the son, our guide, turned to me and said “You likely will not get to see the rabbi, so tell me what you want to ask since my father feels your husband is quiet and would not push through the crowd for a blessing.”  My husband spent a year in this yeshiva, was nicknamed “pareve” since he was coming to learn, but not change. The head of the yeshiva knew my husband’s personality and accessed that his wife was a true ezer k’negdo and could speak, if allowed, for both, but wouldn’t have the opportunity. I was very grateful to have a representative who would not hold back. I told the Rabbi’s son that we had recently had a miscarriage and we wanted desperately to have children and I was losing hope. Should we switch to IVF or continue with IUI, will we have children… what should we do?

When my husband came out from seeing the Rabbi, I asked what had transpired. I wanted details. “He asked what I did for a living. I told him I make lights. He asked for your Hebrew name, and I told him Zehavi. I asked for a bracha for my livelihood and for children. He told me I will LIGHT UP THE WORLD.”

That’s it?  I was disappointed. Will we light up the world through his work? Would my “golden” Hebrew name allow me to light up the world another way? Will we finally be able to see the light at the end of our dark fertility tunnel and have children? How will we light up the world? In hindsight, it would be all of those paths and only now can I see it revealed, and I truly thank G-d.

Chanukah is a festival of lights, a time for miracles, and every year at this time, I think back to this event in my life and the bracha that we would “light up the world.” I know how lucky I am that Hashem gave me my miracles! I still cry in disbelief and nachas during candle lighting when I hear my boys recite the brachot. But I don’t forget the past.

I speak openly about my journey, tell my tale on blogs, youtube videos, symposiums, wherever people will listen. People I have never met come over to me, call me, email me to share what they are going through and just knowing there is someone else they can talk to brings light into their eyes.

I reflect on those who have to endure this holiday without children. I relate to the couples who are praying that this is an auspicious time for their cycles and perhaps Hashem will give them a Chanukah present, a miracle this time, that he will bring light into their dark days, and I pray too.

Whoever you are, where ever you are, know that you are not alone. You may not know me, and I may not know you, but I feel you – your pain, your heartbreak, your despair, your doubts, and your fear. There will be miracles for you, it may not be clear how it will manifest itself, but Hashem has not abandoned you. With each day of Chanukah, may the increasing lights and warmth of the candles on the menorah bring you comfort and I hope that your gift will be revealed sooner rather than later. 

Silent Sister No More

I got a call the other day from my sister-in-law.

She had seen my blog and had asked me what my aim was in creating it.

I told her that I wanted people experiencing infertility not to feel lonely, that someone else out there thinking what they were thinking, experiencing the same shots, mood swings, weight gain, also understanding the doubt they felt, sometimes hopelessness and futility, and even sharing funny anecdotes about infertility situations to add a little humor to this arena since G-d knows we could use a break from the seriousness of our cycles.

I wanted them to know me, and that I was them.

She said, "Then why do you hide behind the name ‘Silent Sister No More’ if you don't tell them who you are?"

She was right.

 If I want to be a resource for people who may be ashamed to comment on my blog, to be able to reach out to me if they need to, I need to be "out there."

So here I am.

My name is Elie, and I am silent no more.

You can reach me at esalomon@yeshtikva.org

Don't Judge a Book By Its Facebook Profile

Facebook is a funny thing. You see the best in people: their photos, status updates of awards or vacations.  Rarely does someone talk about struggles, depression or suffering a loss (unless, G-d forbid, they have lost a parent and want people to know funeral or shiva information.) Almost a year ago, I did the most taboo thing possible, and shared a video of me talking about my struggles with infertility, and the reaction was more than I expected...

I spoke locally to a group of women in my community about what it means to go through infertility treatments. The waking up at 5am to be the first in line for blood and ultrasound checks in order to get to work on time with no one being the wiser. The dreaded "2ww" (two week wait) to find out if your procedure worked and if you were pregnant. Holding your breath to make there was a heartbeat.  Trying not to look at the sonogram while they checked the NT scan. Suffering alone when you had a miscarriage so early on that people didn't even know you were pregnant. All these things that some people may not realize when they get pregnant on their wedding nights. 

Some women were moved to the point that they told their husbands "I wish you could have heard what she said." I think I got 5 emails asking if I would publish my speech. I thought about it, and the words in black and white are not the same as hearing the lighthearted jokes, the crack in my voice, and the tears in my eyes. So I asked a friend to join me in the kitchen and I re-read my speech. Just me, at the table, with the speech before me. And then I did the unthinkable: I posted it on youtube and linked it to facebook. At first, I put restrictions on it: if you don't have the link, you can't see it. You cannot just "search" for it, you had to have an "in." 

80 people liked it
6 people shared it.
41 people commented.

Many of the comments were similar:
So brave of you to share
You are an inspiration

Some came from inside knowledge and appreciation:
Thank you so much for sharing, you couldn't have said it better or more detailed. now people can get a glimpse of the total mental and emotional roller coaster people with fertility issues go through. may you have strength to always do good and be a source of help for others.

But one struck me like no other. It was from a former classmate of mine from elementary and high school with who lived in Israel now. We have not spoken in 20 years, but we are "friends on facebook."
Great video, and a treat to see you. Funny, I never would have guessed you were struggling with infertility given how you banged out those 4! Just goes to show you, don't judge a book by it's FB profile. Kol hakavod and lots of nachas from your little ones.

That was exactly the point! Sometimes people feel alone and upset when seeing others pictures on facebook. Weddings, kids' first day of school, the "I am 7 months old" pictures. Like my grandmother used to say, "everyone has their peckel" and infertility was mine.

After that comment, I decided, if I am public about it on facebook, why not let the entire world see it? Who am I hiding from? 

I went back to youtube and removed the privacy settings. My video has been "out there" for about 8 months now, and because of that one comment, 1,143 people have viewed and hopefully gained strength or knowledge from my story. 

I am a silent sister no more, and hopefully others will speak out and educate the masses as well.

MY FIRST PREGNANCY - A LESSON IN MANAGING EXPECTATIONS

I had gotten married "late" at age 31 and assumed since it took a while to find my bashert that having children would come when we wanted it. When it didn't come easily I immediately went for help.

After three failed "natural cycle IUIs" and two failed "hormone assisted" ones, I finally got a positive "Beta*" back. I was thrilled - YAY! Pregnant! They told me to come back in 2 days for a repeat. I came back and sat triumphantly in the phlebotomist's chair while they took my blood. My nurse called hours later and took my high down a notch. 

"The numbers are supposed to double, yours still rose, but not double. Come back tomorrow, sometimes it takes a little more than 48 hours."

Still with hope, but more guarded, I pulled up my sleeve to reveal the "good vein" for blood draw. I gave my sample and I waited. The call came hours later, and the number rose by 3, the pregnancy was ending. 

I had to come back the following week to make sure the number was headed to zero. So I did, and the number had risen a little. I asked "Does that mean the baby is fine since the number is now rising again?" No, it meant a special call from the doctor.

The doctor told me he was advising I come to get a shot of methotrexate. I had never heard of this before, but it alarmed my father. "Isn't that a drug they use for CHEMOTHERAPY?" So I called the doctor back, he said that cancer grows like cells do in making babies in that it is the splitting of cells. This is a LOW DOSE and would wipe out the pregnancy, or what was left of it. My special instructions were to refrain from sex (or use a condom) for two months until the drug got out of my system. A pregnancy with this drug present in the body could be dangerous for a baby.

It was my third hormone assisted IUI which failed, so I asked if we were moving on to IVF. The doctor said "No, it worked, you got pregnant, but it didn't stay. So we know you CAN get pregnant through IUI, so we wont jump to IVF yet."

Dejected, my husband tried to get my mind out of failure. He suggested we take a trip since we wouldn't have to plan our lives around early morning monitoring or shots. I needed a spiritual uplifting, so we decided on Israel. Eilat for our physical vacation, and visiting holy sites to help heal our spirits. 

No one knew about this loss since it was so early on, but it had a huge impact on me. It taught me a valuable lesson in my managing expectations in ARTs. A positive "Beta" meant nothing. In order not to get emotionally hurt again, we would not get excited until our numbers would double, then we would be able to breathe. 

Little did I know that level of expectation would change again as we continued down the road towards parenthood.








*"Beta" is the term used for blood test that measures your BetaHCG levels. Also known as Blood Pregnancy Test.

SURVIVOR'S GUILT

Last year, I was sitting in the Maternal Fetal Medicine department of my local hospital waiting for my 20 week ultrasound. I was very stressed. Many of my pregnancies didn't go well, and this was an important hurdle to tackle.

I was filling out the questionnaire when something hit me...

How many pregnancies have you had? __6_

How many live births have you had? _2__

How many women see these questions and answer them with ease, whereas I am counting on my fingers: my IUI miscarriage that had to be resolved with methotrexate - a strong drug that made me wait 2 months before trying again , my IVF with the chemical pregnancy, my miscarriage of the twins, you get the idea...

I wanted to do something for others who were in this lonely boat to let them know they are not alone. I was thinking about what point in the cycle made me feel most alone, and it hit me -

THE MIKVEH

The mikveh was the time when it was obvious to me that my body had failed me. I heard a Rebbetzin mention that the Gemarah in Ketuboth describes the "impurity of niddah" as a "whisper of death."

EXACTLY! A new life was in arms length for us, but a miscarriage so early on, or a failed ART cycle was just a whisper. No one knew how close I was, and its hard for others to understand the grief of something that was barely alive. The mikveh would be the place to publicize a support group for women.

I jumped through bureaucratic hoops in my little town to get "small pretty signs" up in the mikveh. And then I waited...

Would anyone email?

Would anyone call?

I imagined in my mind that my couches would be taken up by 10 women from my town who I may not know who just wanted to vent. Could it be that I was the only one?

Then I got a phone call "I saw your sign in the mikveh, but I don't want to meet in a group setting. Would it be ok if we just spoke on the phone?"

Sure! Anything to help someone out. We spoke on the phone for two hours. When we hung up I realized that it was a bracha she only wanted to speak on the phone. You see, there was one thing I failed to mention and left out of my story on purpose - that I already had two children through successful ART.

YES, I want to help, but I don't want someone to feel badly that here I was, mother of two, and in my 20th week of pregnancy with twins, meeting or speaking to someone about trying time and time again to have a child.

I got a call from someone else who wanted to meet in person. I got really nervous. I didn't want it to be one-on-one, so I called two of my friends whom I knew were seeing the same doctor I was. We planned to meet at my house. I picked out my BAGGIEST SHIRT, my friend who was also pregnant with twins came early to hide under a blanket. My other friend also failed to mention that she already had one child. We all felt we wanted to be there for others, but wanted to hide that we weren't presently in the same boat. Why did we feel guilty?

I had put my name out there as "THE FACE OF INFERTILITY" in my community, but I wanted to hide my expanding belly. Being in this sisterhood of infertility, I developed a GUILT that I had overcome infertility, not once, but twice, and was about to do it again.

Recently, at a YESH TIKVA (www.yeshtikva.org) event I was attending, I was able to get some peace of mind. The event had three professionals speaking about "Caring for Your Mind and Body Through Infertility." It was extremely informative, but the best part of the event was the mingling before and after.

I was speaking with someone who was going through the journey and when they asked "Where are you in the process?" (a typical question in such circles) I paused. I said "I have done IUIs, IVF, IVF with PGD and FETs." I was being vague because I felt guilty. Then they pressed me "Did any work?" With my head down, I replied, "I have 4 children, my first through IUI, my second through FRESH IVF with PGD and my twins through FET with PGD." They said "That's great, we are about to do IVF for the first time, what is PGD? What can you tell us, any advice?" I told them I felt guilty mentioning my success in this forum. They said, "You shouldn't feel guilty, you are giving us hope!"

HOPE... that's all I ever wanted to give. Hope and support.

I know that some people feel that once you have one kid you are no longer part of the sisterhood, but I am glad to know that there are some people out there who want to hear from people like me, so I am in the process of overcoming my survivors guilt. Thank you fellow fertility travelers from the YT event, you have no idea how you’ve helped me.

Support Systems - A True Lifeline

In 2012, I was pregnant with my second child. Some of my friends knew the scary drama that came with this pregnancy because I was open about it, I needed the support and their tefilot helped give me strength. 

One friend called me up and asked if I could give her friend, Emma*, strength. I said she should definitely give Emma my number. Emma never called.

A month later, I was standing in shul and I thought I saw her. I wasn't sure, since we weren't friends, but decided to be bold and walk over and introduce myself.

"Hi, you're Emma, right? You were supposed to call me about fertility stuff?"

"Yes, I know, but I figured that you are already pregnant, so how would you be able to help me?"

"Well, getting pregnant wasn't easy for me, it was really hard with different treatments, many failures..."

interrupts me

"Well, I have no problems GETTING pregnant, its just keeping the pregnancies. I have gotten pregnant 5 times already, and I bleed out by week 9 or 10."

In hindsight, I now know why Hashem had her WAIT to reach out to me. 

You see, for the two years prior to that moment I was a dedicated member to an online fertility support community called fertilitycommunity.com (I think they changed their name at this point). The Thursday before this chance meeting in shul, I was reading a thread by a virtual friend about how she had a blood clotting disorder, and that once she gets pregnant she has to take blood thinners in order not to clot and bleed out the pregnancy.

I told Emma to ask her doctors about this at her next visit. She said she was meeting with Maternal Fetal Medicine on Monday. I was surprised, since I thought they only dealt with women once pregnant, but didn't want to overstep. She said she would call me on Monday after her appointment.

On Monday she called to say MFM told her they couldn't help her, but she should see an RE. (What I expected) But she wanted to stay in touch with me.

The following year she called me again, she had mentioned to her new RE about the blood thinners and the next time she would get pregnant they would start the blood thinners, like we were hoping. Good, a new protocol, new hope.

I told her I was supposed to have a frozen transfer on Monday. She said she was scheduled for Friday. Did I need a ride to my transfer. YES! (You see, I didn't like having anyone in the room with me so I could focus on staying relaxed, so my husband wasn't going to drive me.) Emma volunteered to drive me and my 7 month old baby, drop me off and babysit while I had the transfer and then drive me home. It was perfect.

I was so grateful that on the way home I gave her a bracha "In the merit of you driving me to my transfer, may your transfer be successful." AMEN!

I went in for my beta, it was positive, so was hers.
My numbers doubled, so did hers.
I had two sacks, so did she.
I had two heartbeats, so did she.

Every Tuesday she would call me since Tuesdays were her appointment days. I would talk her through things and give her a sense of calm. She said she wouldn't get excited until she made it passed her first trimester without bleeding out. That day came and went and we were both so relieved. 

Having a fertility buddy is such a help and comfort to both, to compare notes and know you are not going crazy. We were both on bed rest, both cervix shrinking, and the babies were born one week apart. Each of us has a set of twins: a boy and girl. These 4 kids have no idea that they were connected way before they came out of the womb, and their mother and I are forever connected. FFF - Fertility Friends Forever.

* Name was changed to protect the innocent.

Unexplained Infertility - Pros and Cons

I remember going to my first appointment with my R.E. (Reproductive Endocrinologist) It was a cold winter day in September of 2008. I was 32 years old, married for a year and felt it was time to JUST CHECK if everything was ok. 

Here is what I did know:

• My cycles came like clockwork
• I ovulated on the halachically appropriate day (and if I did ovulate a day or two earlier, I had a psak from a Rabbi on how to handle the clean days vs. bleeding days)
• My mom had no trouble conceiving (granted she was about 23 when she got married and was done having kids by 28.)

My husband took the morning off of work since we BOTH needed to be present. Our appointment was around 11am. We took a cab from our apartment on the Upper West Side cross town to Cornell Reproductive to see a doctor who was very successful with helping people I knew. I was nervous, I looked over at my husband who didn't say anything and was stoic. 

I realized something. I knew we both wanted to have a family, but I didn't really ASK him if he was ok that WE, yes, BOTH of us were going to get checked out. You see, I am a "take the bull by the horns" type of person. If I have a thought in my head, I move heaven and earth until that thought is settled in my mind. I knew I wanted us to get checked out, so I called, made an appointment and THEN told him he was coming with me so we could find answers. I think my "take control" attitude was one of the things he loved about me, so his silence meant he was "in for the ride ahead."

We sat in the long waiting room and saw tons of chasidish looking couples and a sprinkling of secular and non-Jews coming out of doors and leaving. Lots of people coming in and out. I kept looking at the doors, when will they call MY name?

Finally, I was greeted by the administrative assistant who handed me a THICK booklet of questions to fill out, and I filled them out while my husband read a sports magazine. We were here at my insistence, so why make him fill things out?

Once the paperwork was done, we went to meet the doc. He took a medical history of me, and then took one of my husband. He explained we would then take blood from me, do an ultrasound of my ovaries and also require a "sample" from my husband. I assumed since I was the older one in our relationship that there would be nothing wrong with him. 

They took our blood and my husband's sample and took me to a room for my ultrasound. I was in shock that they asked me to remove everything from the waist down. Weren't ultrasounds done through the abdomen? When there is no baby inside they want to check your uterine lining and ovaries and do so with  a "trans-vaginal ultrasound wand." Basically, a phallic looking wand that they insert into your vaginal cavity. 

I was tense from the meeting and now even more tense from this "wand." When they looked on the screen, and i looked as well, I had no clue what I was looking at. (Remember that Friends episode where Rachel and Ross get to see their baby and she says "I don't see it!" It was like that.)

 So, I asked "what are we looking at, and what are we looking for?" They were looking to see if I had any ovarian cysts and if my endometrial lining was at the right thickness for that time in my cycle. He reassured me it looked great.

We came back a week later when the blood work and semen analysis results were ready. Bloodwork was perfect on both of us, my reproductive organs were great, my levels showed I would make an abundance of eggs, all seemed GREAT. There was one small issue, but the doctor didn't seem nervous. My husband had a few abnormal heads and tails in his "sample" but the volume he produced was so large that those wouldn't cause a problem with us.

Our diagnosis? They can't put their finger on anything wrong so it Unexplained Infertility. 

Great, there is nothing wrong with me. 

What the future would teach me is that sometimes I would hope for a specific problem because with unexplained, they try different protocols out on you and see what works. If you have  a specific issue they know how to resolve, the road is much smoother. But I would only learn that later on after 2 miscarriages under my belt.

"Well, That's Suspicious..."

I know I have been away for a couple of years, but thanks to an influx of wonderful people in my life looking for strength in anonymous corners of Modern Orthodoxy I am beginning to realize how important it is to be out and proud of being a traveler on the road of infertility.

So I am back, hopefully with more posts to come, but this one is a long time coming.


A couple of years ago my mother was sitting in shul on a regular shabbos. The Rabbi got up to announce the mazal tovs when something happened.

"Mazal tov to the Stern family on the birth of twin grandchildren, a boy and a girl, to their children who live in California."

A woman sitting down the row from my mother whispered to her neighbor "Well, that's suspicious!" My mother, involved in every step of my fertility journey, and not shy to involve herself in situations she thinks are wrong, leaned over to this woman and said "I'm not sure what you mean?" The woman replied "Well, it is their second set of twins, maybe they had... HELP." My mother said "and... G-d gave doctors the knowledge to circumvent the issue of infertility with many types of Assisted Reproductive Technologies. When we were having kids, if you couldn't have them naturally you were forced to adopt or give up on motherhood. What a bracha that families are growing by such methods. It is not suspicious, it is a miracle."

That's my mom!

Lately people have been telling me about how insensitive people are to their suffering of infertility. It is true that no one has any idea what each individual goes through, most of the time the reason for the insensitivity is ignorance.

• People may not know that you are suffering when they say hello to you and immediately look to see if you have a growing belly underneath your shirt.
• People may not realize that there is more to it that "just relax and it will happen."
• People may not know that today is the due date of the baby you miscarried.
• People may not know how long you cried in the prep room at the mikveh last night.

There are organizations that are starting to be created to help people, Rabbis, Rebetzins know how to TALK to people going through infertility. But unless you have been in the throws of it, you can't blame people for their ignorance, you need to educate them. Think about how in the dark you were when you began this process. If you are sensitive to people just not realizing, they will learn in a nice way how not to alienate you in the future and perhaps become your greatest champions.

This is a great list of things for others to know about in talking with people going through infertility:

http://www.resolve.org/national-infertility-awareness-week/25-things-to-say-and-not-to-say.html