Revolutionary Care for Fertility and Infertility, Guest Post

Following is the testimony my husband, Matt, and I gave in June, 2010 at a local Catholic family group.  Updates to our journey were added in January, 2012 and in April, 2017.

 

When we were first asked to speak tonight, Matt was very hesitant, as he feared it would be very difficult for me.  I knew it would be difficult, but also felt compelled to share our story.  We compromised by agreeing that I would write out what I had to say, in the spirit of Engaged Encounter and CRHP retreats, and that he would read it if I became too emotional to do it myself.  So here goes…

My journey with infertility began long before I met Matt.  It’s something I’ve been dealing with, in one way or another, for ten years now.  While we talked at length about the infertility prior to our wedding, I’m not sure he really had any idea what the reality of infertility would look like.  He is the youngest of six and no one in his family had ever had any trouble conceiving.  I don’t think he’d ever really considered that having children could be difficult.  I knew there were problems, I had a family history of infertility (the reason I am an only child) and, at 31, I heard my biological clock ticking loudly.  So, true to my goal-oriented and methodical personality, I had a plan of action in mind long before we were married.

I had begun charting my cycles using the Creighton Model FertilityCare System in 1999, nine years before we were married in 2008.  I had had painful menstrual cycles (to the point of prescription strength pain medications at age 14), PMS and intermittent abdominal bloating since shortly after my cycle began.  I had been to a number of doctors in the past, some mainstream and some pro-life.  None were able to give me a diagnosis for my problems or even any real way to arrive at one.  I even had an exploratory laparoscopy in 2004 that yielded no useful information.  I was extremely frustrated.  In addition, as a doctor (of veterinary medicine) myself, I was well aware that not all doctors are created equally.  For those reasons, I’d made up my mind long before I met Matt that, when the time came, I was going to be treated by none other than Dr. Hilgers himself.

Dr. Hilgers, inspired as a medical student in the 1960s by the words of Pope Paul VI in Humane Vitae, decided to dedicate his career to helping women and couples approach their fertility in a way that, “unlike common suppressive and destructive approaches, maintains the integrity of the human person, respects the dignity of women and supports the institution of marriage.”  To that end, he founded the Pope Paul VI Institute in Omaha, NE and developed the Creighton Model FertilityCare System and Natural Procreative TECHNOLOGY (NaPro for short), a women’s health science that uses the biological markers from a woman’s cycle to help identify the cause of her symptoms and then treats the underlying cause in cooperation with her cycles.

As logical as that approach sounds—cooperate with a woman’s cycle to find and treat the disease that is causing the problem—it is completely revolutionary.  Mainstream women’s healthcare today is all about masking a woman’s symptoms, regardless of their cause, by shutting down her cycle with the birth control pill.  Likewise, mainstream treatment for infertility, no matter the cause, almost always ends in a recommendation for IUI and IVF.  These methods, while in addition to not being in line with Church teaching, again often completely overlook the condition that is actually causing the infertility.  Medically, that approach makes little sense, but that’s where we are.  For me, then, as a doctor, a Catholic and a woman who truly wanted a diagnosis and a treatment for whatever disease had been plaguing her for so long, I knew that Dr. Hilgers was the only doctor for me.

With couples using NFP, 60% become pregnant the first cycle they try and 70% are reportedly pregnant by the second or third.  So, a little less than six months after our wedding, with no pregnancy in sight, we sent our Creighton charts and my medical records to the Pope Paul VI Institute to be reviewed by Dr. Hilgers.  A few weeks later, on a day when I was particularly upset by the infertility, I received a personal letter from Dr. Hilgers detailing his recommendations for us.  Not surprisingly, God knew just what we needed, just when we needed it.  We were going to Omaha.

The following month we completed the first steps in the diagnostic work-up. Let me just say to those of you who have not experienced infertility, count your blessings that you have never had to go through a Catholic approved semen collection.  While we were very happy to have a morally acceptable method, it is not something we hope to ever do again! The next test was my hormone profile, for which Matt drew my blood at home every other day for an entire cycle.  At the end of the month, we shipped the samples off to lab at PPVI to be analyzed.  The next phase of the work-up was an ultrasound series to monitor ovulation and a surgery that would include an exploratory laparoscopy to look for problems that can’t be diagnosed any other way and a test to check for increased pressure and blockage in my fallopian tubes.  This phase of testing was to be done at the Pope Paul VI Institute and required a ten day stay in Omaha.  We called in January to schedule and were given the first available appointment, at the end of June.

In the months preceding the trip, I was so excited!  I was finally fulfilling my dream of working with Dr. Hilgers and was looking forward to obtaining a diagnosis and treatment plan.  I was so hopeful.  However, in the beginning of June, I began to feel differently.  All this time, for years, I’d been looking to my work-up at the Pope Paul VI Institute as the END of my journey.  However, nothing could have been further from the truth.  I certainly wasn’t going to come home from Omaha pregnant.  Rather than the end, this was just a new beginning.  I’d done my research and had spoken with many women who’d been treated at PPVI.  I knew that the diagnostics and treatment took time.  And, though he was the best of the best, not even Dr. Hilgers’ success rates are 100%.  I became disheartened and depressed.  It was during that time that I made my first appointment with a local Christian therapist who specializes in infertility.  Though I have never seen her consistently, she has provided so much support and encouragement when I’ve needed her.

So I made my first trip Omaha anxious and excited, but also a bit brokenhearted.  The day before my surgery I spent some time praying in the hospital chapel.  It was Tuesday, so I was praying the Sorrowful Mysteries of the rosary.  I felt so connected to Jesus as I knelt in the chapel meditating on His passion.  I, too, prayed, “Father, if you are willing, take this cup away from me.”  I would have given just about anything to not be on this road, to not be in Omaha preparing for surgery, but to be back home in Jacksonville holding the baby I so desperately wanted.  But no matter how much I didn’t understand it, I knew that, like Jesus, I must pray for God’s will to be done in my life and not my own.

 

Our first appointment with Dr. Hilgers was a truly spiritual experience.  I had been to the PPVI Institute for my ultrasound appointments, but hadn’t really had much of a chance to explore the facility.  Where most doctors’ offices have posters comparing different forms of birth control pills, stacks of brochures on various STDs and life size models of contraceptives like the NuvaRing, the PPVI Institute has beautiful statues and images of our Blessed Mother, the Holy Family, saints and popes and quotes from Humane Vitae.  What a spiritual place.  There was even a chapel on the third floor where we were able to celebrate Mass with the staff one morning.  The receptionist and nurses were caring and compassionate, many of them wearing miraculous medals or crucifixes.  Dr. Hilgers was as knowledgeable and kind as we had imagined.  We left feeling completely at peace with him as our doctor and with little doubt that we’d just met a future saint.

I will never forget waking up from surgery the following day.  I was in a recovery room feeling the groggiest I’ve ever felt in my life.  It was a terrible feeling—I wanted to wake up, but just couldn’t seem to get my head clear or keep my eyes open.  I heard one nurse ask another, “Did he use the laser?”  The reply was, “No.”  As groggy as I was, I knew that this was not a good thing.  All my previous symptoms pointed to one diagnosis—endometriosis.  Endo is the growth of the tissue the lines the uterine wall, called the endometrium, on the outside of the uterus. The misplaced endometrial tissue secretes hormones, fluid and inflammatory mediators, often causing many problems, including pain, adhesions and infertility.  The laser is the tool used to surgically remove the endo.  Dr. Hilgers had suspected endo based on my history and charts and I was certain I had it as well, despite being told I didn’t after my 2004 laparoscopy.  The fact that the laser was not used meant either that I didn’t have endo or that it was so extensive that removal of it would require a laparotomy, a major surgery where a 10” incision is made into your lower abdomen and a 2-3 day hospital stay and 6 week recovery period is required.  I was pretty sure I was in the latter camp—not something I wanted to hear before I’d even fully awoken from my laparoscopy.

We had a post-operative meeting at the PPVI Institute the next day to discuss the results of all the diagnostics, including the semen analysis, the hormone panel, the ultrasound series and the surgery.  Dr. Hilgers was very comprehensive and spent a long time going over the results of all of our testing, reviewing the video of my surgery, detailing his plan for treatment and answering all of our questions.  Unfortunately, it was as I had feared, I had Stage II-III/IV Endometriosis that required the major surgery to remove.

The diagnostics revealed a number of other problems in addition to endometriosis, including limited cervical mucous, inflammation in my uterus, hormonal abnormalities and thyroid and adrenal problems.  So, in addition to the big surgery, my treatment included a laundry list of medications and an injection that I had to give myself on three different days of my cycle.  After all of that we asked the big question, the one we were most hesitant to ask—what is our prognosis?  Much to our delight and to my surprise, he gave us a 70-75% chance of conceiving in the 18 months following the second surgery!  So, when we left Omaha, I was taking 13 pills per day and three injections per month, drawing blood to send to Omaha for hormone testing once per month and had an appointment for Dr. Hilgers’ next available surgery date, five months into the future.  However, despite all of that, I left feeling pretty good.  My prognosis and my faith in both God and Dr. Hilgers gave me more hope than I’d had in a long time.

Life went on after the laparoscopy.  I began my new treatment regimen and anxiously awaited the laparotomy.  During that time I prayed fervently that we would conceive and I would be spared the major surgery.  However, that was not in the plans and, in November, we were headed back to Omaha.  The laparotomy went so much better than I had anticipated.  By the sheer grace of God, the pain was truly minimal and the recovery was both quicker and easier than I could have imagined.  Dr. Hilgers reported that the surgery went perfectly.  My endometriosis was removed, as were two fibroids and my appendix, which was covered in endo and scarred into the wrong location.

We are now starting our seventh cycle post-surgery.  I am pleased to report that, after twenty years, my periods are now nearly pain free and my PMS is minimal!  That, in and of itself, is a miracle.  While many other doctors before him failed to know or care what was causing my symptoms, Dr. Hilgers was able to correctly diagnose and effectively treat my condition.  And I know that even if I never conceive, I will be forever grateful to him for improving my overall health.  That’s what NaProTECHNOLOGY is all about.  As for a pregnancy, I know it takes time and, as I said, Dr. Hilgers measures his success rates in 18 months following surgery, so by that standard, I still have a long way to go.  But it’s difficult to be patient.

So that’s our story.  Or the short version anyway.  I could never describe all the emotional ups and downs…it’s something that changes every day, sometimes every hour, something and that you probably can’t even begin to understand unless you’ve been there yourself.  But I’d like to at least try to give you a glimpse of what this emotional journey is like if I can.

I want all the mothers who have never struggled with infertility to imagine for a minute that you are unable to have children.  Your house is silent; there are no toys or little clothes scattered about.  There are no sloppy kisses or “I love yous” whispered from tiny voices.  If you’re a stay at home mom, you are out of a job.  You may have a career outside the house, maybe even a career that you love, but it’s not the one you want and every day you go to work crying out to God that surely He has called you to something more than this.  You have absolutely no idea what the future holds.  If you’re anything like me, you have always been comforted by the fact that, with enough hard work and dedication, you can accomplish anything…a strong and happy marriage, a rich spiritual life, a college degree, home ownership, a promotion at work, etc.  However, no matter what you do or how hard you try, you may never succeed at getting pregnant.  And, unlike many trials in life, where the passage of time is a great healer, even that is less certain with infertility.  With most other trials, you can say to yourself, “In six months I will have more resolution and will feel better than I do today.”  However, infertility is nothing like that.  In six months or a year or even two or three or more years, you may still have no resolution and you may feel worse than you do today.

Emotionally, you are a mess.  Despite how much you wish it was different and how hard you try to fight it, your moods are controlled in large part by where you are in your menstrual cycle.  You sometimes cry when you see a pregnant woman at the grocery store or when you see status updates from pregnant friends on Facebook or when you see all the pregnant women and large Catholic families at FFC meetings.  You always cry when another woman tells you she’s pregnant.  Then you cry again because you truly want to be happy for her, but her pregnancy just illuminates your own loss.  You feel guilty that your husband often comes home to find a moody or crying woman in his house.  Where is the fun and happy woman he married?  He doesn’t deserve this!  And neither do you, but some days, no matter how you try to talk or pray yourself out of it, you just can’t feel any differently.

Infertility has deeply affected you socially, as well.  Your friendships are changing as all of your friends get pregnant and start families, leaving you feeling left out and isolated.  At parties, all the women naturally gather to talk about pregnancy and children and parenting.  Not only do you have nothing to say, but you often have to get up and leave the room to cry quietly in the bathroom.  You feel alone.  Your husband may be truly wonderful and the best man you could possibly imagine standing by your side through all of this, as is the case for me, but, as incredible as he is, this struggle with infertility just does not affect him in the same way that it does you.  He doesn’t think about it every hour, he doesn’t burst into tears every month when you start your next cycle and, at least in our case, he’s not the one taking all the pills, giving himself injections and being subjected to all the various invasive procedures and surgeries.  In all of that, you often feel very alone.

Your spiritual life is full of ups and downs as well.  You often cry in church, as you look at all the pews, all filled with children nestled between their parents.  All but yours.  You hear about the Theology of the Body—about how God loved us so much that his love came to life in Jesus and that in the same way a husband and wife love each other so much that new life is created.  But it doesn’t happen that way in your marriage.  Despite how much you love your husband, no life comes forth.  No matter what you do, there is no face for your love.  There are times when you feel close to God and remember that His own son suffered immensely during His time on Earth.  Bible passages and worship songs abound that bring hope and comfort during your struggle.  However, there are also times when, like Jesus on the cross, you feel abandoned by God and want to cry out, “My God, my God, why have You forsaken me?”  You pray fervently for a child and when your new cycle starts, signifying yet another prayer that was not answered in the way you had hoped, you may be tempted to wonder if God has indeed completely forgotten about you.

You also feel as if our current culture of death is a personal assault.  Women everywhere are treating their fertility as a disease.  Women are entering abortion mills by the thousands each year in our own city alone to destroy the very precious gift for which you would give just about anything.  Even more women take contraceptives to willingly shut down a perfectly healthy reproductive system.  Others permanently sterilize themselves.  Oh what you wouldn’t give to have the fertility that they see as such a burden!

In addition to the social, emotional and spiritual roller coaster, obtaining a diagnosis and treatment for your infertility is also a challenge.  Mainstream ob-gyns laugh at your NFP Charts and tell you they are useless.  They are quick to refer you to a fertility clinic, where IVF will inevitably be recommended as your only option for ever conceiving.  If you are lucky enough to have a good, pro-life, NaPro trained doctor, you are still left with surgery, frequent blood draws, transvaginal ultrasounds, upwards of 10-20 pills per day and possibly some injections that you have to give yourself at home.  Some days you want to give up and you don’t take any of the pills.  Other days you are a Nazi about getting the right pills at the right time.  It’s a mess.  Forget what I said about being out of a job.  Your infertility is a job!  And there are always a thousand questions nagging in the back of your head, “Is there something else I should be doing that could help?  Should I try yoga?  How about acupuncture?  What about that crazy restrictive diet my doctor has recommended?  Maybe I should go see another specialist?”  The list of possibilities and options is exhausting.

So that’s what life is like with infertility…your lap is empty, finding friends to whom you can relate is a challenge, your kitchen cabinet looks like a pharmacy, tears are always at the ready and you have no idea what the future looks like.

I want to close with a few suggestions on how you can be supportive of those struggling with infertility.  It can be difficult to know what to say or do, especially if you have no personal experience with infertility.  Often times, people who want to be caring and supportive say things that end up not being very helpful.  And while most infertile couples realize, at least on their good days, that people really do have good intentions, every one of us has been hurt, at one time or another, by things well-intentioned people have said.  So I just wanted to offer a few suggestions for how you can be supportive of couples struggling with infertility and help to lessen the weight of this heavy cross.

  • Please ask how we want to be told when you get pregnant. Others may have other preferences, but for me, I would prefer email.  This may seem impersonal, but while I want to be happy for you, your news illuminates my own struggle and I will inevitably cry when I find out.  Over email, I can receive the news in the privacy of my own home and call you when I am composed and ready to truly rejoice with you.
  • Pray for us on our struggle, not just that we conceive, but also that we receive the necessary graces to endure this struggle and accept whatever God has in store for us. Pray that we find purpose and meaning in this struggle.  Remind us periodically that you are still thinking of and praying for our family.
  • Understand that we may not feel up to attending a baby shower or birthday party or baptism or even spending time with families with children at certain times. This journey is very difficult and there are times when we have to set boundaries for ourselves to avoid both undue personal pain and suffering as well as public emotional outbursts.
  • Be aware of what you talk about in our presence. We realize and accept that people are going to talk about pregnancy, children and parenting, especially at our age.  However, please keep in mind that these conversations may be difficult for those of us struggling with infertility.  Take cues from us and try to include other topics in the conversation.  And, while we know that pregnancy and parenting can be very difficult, please try not to complain about them when we are around.  This is the most difficult to hear.  It would be kind of like complaining about how tired you are after a night of dancing to a friend in a wheelchair.
  • Often just sympathizing with us is really powerful. There are no magic words that can take away the pain of this struggle.  But sometimes just feeling heard and understood can help so much.  Saying something like “Wow, that’s really tough.  I’m so sorry you’re going through that” may be all you need to do.

 

This struggle, as all struggles, is a process, with good days and bad days.  It often seems like the bad way outnumber the good.  And on this journey, that’s probably true.  But, to be honest, there are actually a few moments when I have really felt glad that I have had the experience of infertility.  They are fleeting, mind you, but they are there!  What a true gift from the Holy Spirit, to see the sunshine through the rain in that way.  As much as I hate to admit it, we truly have gained so much from this struggle.  We have a deeper appreciation for the gift of children that I don’t think is possible if you haven’t tried and begged and prayed and cried and endured to get them.  We have a deeper faith, both because of the struggle and because of the extra time on our hands for prayer, scripture and studying that comes from being childless.  As a couple, we have experienced really stressful and agonizing times, which have only made our marriage stronger.  We have met some truly wonderful people that we wouldn’t have otherwise gotten to know.  And we’ve had the opportunity to really reach out to others on this journey.  God has called me to start Hannah’s Heart, a Catholic infertility support group that is now an official ministry at St. Joe’s.  This group has been a source of faith, friendship and support that was sorely needed and has borne so much fruit in its short existence.  So as much as I can’t wait for the pain to lessen and the struggle to fade and as much as I don’t see it on many days, God has blessed us richly on this journey.

Every month I daydream about what it would be like if I got pregnant.  What would it feel like to know that a new little life was growing inside me?  How would I possibly contain my joy and excitement?  How would I praise God?  And how would I tell Matt?  Oh, believe me, I’ve come up with some pretty creative and elaborate ways to tell him that we are going to be parents, that our love finally has a tiny, little face.  This month, however, I fanaticized about ending this talk with a pregnancy announcement.  Wouldn’t that be a truly fabulous end to this story?  What a witness!  But, alas, as I discovered this morning, our hopes and prayers for a conception have been answered with “no” or “not now” for yet another month.  Time to mourn the loss and try to regroup.  Maybe next month…

 

**Update–January, 2012:  As I said, we were given a 75% chance of conceiving in 18 months following my second surgery.  The months after surgery ticked by.  The 12 month mark came and went with no pregnancy.  The waiting was so hard and my hopes for a baby dwindled with each passing month.  However, 14 months following surgery, in late January, 2011, I got my first positive pregnancy test!  I couldn’t believe my eyes.  Literally.  I took a test every morning for four days in a row before I would allow myself to believe it was true!  I didn’t even tell Matt until the evening of the second day.  All the elaborate plans of how I would tell him I was pregnant fell by the wayside as I tentatively said, “I think I might be pregnant.”  He didn’t believe it either!  It was true, though!  I can still barely contain my joy that God has given us the desire of our hearts!  After a fairly uneventful pregnancy (though which I was monitored closely by Dr. Hilgers) I gave birth to our little miracle, Kelsey Marie Flaherty, on September 29, 2011.  …Why God chooses to bless some couples with children while others continue to wait, I do not know.  I do know, though, that God had a plan for my infertility and that all those years were not in vain.  He used my experience of infertility to help others, by starting Hannah’s Heart and by promoting Natural Procreative TECHNOLOGY, without which I have no doubt that Kelsey Marie would not be here today.  In addition, my experience with infertility has made me a different, more appreciative, more attentive, more self-sacrificing and more joyful mom than I ever would have been otherwise.  I don’t know what is in store for us in the future…I may have more years of infertility ahead of me.  Whether more children come easily or not at all, though, I know that I will always have the heart of an infertile woman.  And for that, I am finally grateful.

 

**Update, April, 2017—Well, for us, much to our surprise and utter delight, a second child did come easily.  Our son, Matthew Bernard Flaherty II, was conceived on my 3rd post-partum cycle and was born on December 27, 2013.  We couldn’t have been more thrilled.  With two successful pregnancies under our belts, we were hopeful that another one or two (or more?) would follow.  However, as the months ticked away after my cycles returned, this dream began to seem like a distant hope.  We were once again back to the seemingly endless cycles of hoping and waiting and being discouraged.  Of course, this wait was spent chasing two toddlers around and was, as such, significantly less painful and the emotions were less intense.  I simply didn’t have time to dwell on my feelings.  However, as I told my local NaPro doctor at my first appointment with him, “I never would have believed it before I was in this situation, but my desire for a third child is no less strong than my desire for a first.”  I was more distracted, of course, but the desire was the same.  Well, with a near 4 year gap, we have been blessed with a third child.  Why God has been so generous to us after our struggle, I cannot answer.  I almost feel guilty about it when I think of my other friends who are still childless.  But for reasons only He can give, this was God’s plan for our family.  I know my infertile friends now see me as a fertile woman (and maybe now I am?), my heart will always be that of an infertile woman.  And despite being pregnant with our third, I still feel like I don’t fit in at all with the fertile Catholic mom crowd.  Fortunately, there is a small contingent of “infertile with kids” where I make my home.  Our third miracle, conceived after only a month of resuming NaPro treatments, is due in late July/early Aug of this year. And although I will be 40 when he/she is born, we still hold out hope that we will be blessed again.  God willing, of course.

~Laura

#NIAW #NIAW2017 #infertility #fertility #NaPro Laura.jpg

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