Pregnancy, PCOS and a Pessimist
At the time I am writing this, I am 26 weeks pregnant. And while I have engulfed myself in the world of pregnancy videos, parenting books and a whole lot of nesting; it did not occur to me to reflect back on my ‘getting pregnant’ journey until my husband recently reminded me, of how a lot of our conversations before getting pregnant revolved around alternative options, in case, a natural conception seemed impossible or unlikely.
And this is the problem with a pessimistic brain. At the age of 18, I was diagnosed with PCOS (Polycystic Ovarian Syndrome), and as I went ahead with my studies to become a doctor, my brain kept registering and memorising, every possible negative symptom associated with the disease. The biggest concern being, as it is with a gynaecological disorder, infertility. It was a worry, which I lived with for so long, that even as it intensified, it was so much a part of my life that I didn't even classify as anxeity… it was just a part of my personality. This is probably why, I would not classify anything I went through in the year after we decided we were ready for a baby and the time until the test showed 2 lines, as a struggle. Because I got off easy.
And yet “what would you do, if I can’t get pregnant” and “there is a possibility, we might never have a baby” was the first serious conversation, I had with my boyfriend; when we confessed to each other, that we would both like the relationship to go to the next level. Thankfully, his answer calmed the nerves I had built up in the days before the conversation. It is probably because I have him, as my partner now, that my fears never turned into a full blown panic.
When you live with a chronic problem, the emotional and mental toll it takes, becomes almost invisible.
In the years since I was diagnosed, I have seen the awareness around the subject slowly increase. And once it was established that insulin resistance plays an important role in the pathophysiology, the internet world naturally exploded with diets and exercises with strict regimes. There are success stories everywhere: how yoga helped someone conceive, how ketogenic diet worked for someone with PCOS. And you would think, all these articles and my deep dive into tapping every resource possible, would have left me feeling bright and hopeful. But here is the thing, it made me even more negative. It made me question the attitude of my gynaecologist, who was telling me to take Metformin and try to manage my work stress. He was not suggesting any miracle diets, not suggesting any special exercises. And despite years of medical training and knowing in my rational brain that every patient cannot be treated with the same set of treatments, my trust in him was on a shaky ground.
It is so easy for me to now see his line of thinking, when I am not in a mental fog of feeling inadequate and imagining worst case scenarios. I fall in the category of lean PCOS, a weight loss diet could have potentially triggered other problems. And I was tackling all this, while working as a medical resident, who can barely make sure there is time for lunch everyday, let alone a lunch which follows all the stipulations. He tried his best to spare me the stress which goes with “trying”. And I naturally labelled him as too laidback and went on a quest to find other answers. When I think back, on how many model menus I planned and then failed to follow, on how many exercise videos I kept saving in my playlist, I truly wish I would have taken a breath and analysed my personal situation. Of course these solutions work for people, lifestyle change is something doctors are screaming about from the top of the building for decades now. But not being able to implement these to the degree everyone seemed to, brought on a lot of depressive moods. It seemed like, I was handed a problem and solution both, but I was my own hinderance in implementing the solution. In a way, I was the problem. In the middle of all this, were of course, well meaning friends, asking if we were planning to have a baby, and a lot of first birthdays and baby showers. If it were not for the island of “it will happen, when it happens” which my husband lived on, I am sure I would have had exponentially more stress about the whole situation. Stress worsens Insulin Resistance, by the way, also is in general associated with various other causes of infertility. Not a great vicious cycle to be trapped in.
Millions of women, couples are going through this; and while we got pregnant a month before the deadline I had given to myself and my gynaecologist about seriously discussing Artificial reproductive techniques, many more couples go through rounds of IVFs and sometimes more than one traumatic pregnancy loss before being able to have a child. My gynaecologist got to tell me, “I told you this would work”, while so many go through cycles and cycles of disappointment with their patients. This is why I do not consider my pregnancy story to be particularly difficult or moving. Neither is this supposed to be a beacon of hope for every woman with PCOS who is struggling to conceive. All I hope it does is, add to the collective wisdom about the invisible struggles, people around us might be going through. Giving a “but there are so many ways now” or “why don’t you just adopt” solution to someone, disregards a lot of emotional trauma which they have gone through, all the while adding another round of shame for wanting a natural conception.
Empathy is sometimes, just in the listening… thanks for listening to me.
