A Concert of Prayer

We had a beautiful and powerful experience this past Sunday at our church. At our request, our entire church family surrounded us in prayer. As our pastor opened the time, he said he wanted this to be a "concert of prayer," and I love that he used this phrase. There is the musical connotation to the word concert, but the word can also mean people coming together in agreement. That is exactly what happened. Our families and friends gathered around us in agreement, asking God together to bring healing to our bodies and provide us with a child. Some of them prayed aloud, some of them laid their hands on us, and some of them silently wept with us. I was absolutely overwhelmed and overcome by the love, compassion, and deep understanding our church, family, and friends gave us that day. I still can hardly think about it without tears coming to my eyes. It was awesome -- the best concert I've ever been to.

After church, we had an early Thanksgiving celebration with the Vander Kooi side. Robby and I had to leave early, but as we were on our way out, my aunt Ann asked us to share what had happened at church. All of my family listened intently as we shared our struggle, our plans, and what God has been doing. When we finished, my uncle said simply, "Well, let's pray," and that we did. 

I know the verse well that says, "With God, all things are possible." This is so true. I keep thinking to myself, How would I get through this without God? Honestly, I couldn't. Because of God and because He listens to our prayers, it is possible to face each day and trust that He has a plan for us. It is possible to believe that good will come out of this, to know that God can and will redeem anything, even barrenness.

Thank you for praying, for gathering around us and bearing with us and lifting us up. We have so much to be thankful for this Thanksgiving and always!

What I wish I would have known - Part 1

The struggle of infertility can be painful and sometimes very lonely, especially at the beginning. I look at where we are now, and even though our state seems worse off, I remember those early days when nobody knew, and we were heartbroken all alone.

It's so much easier for me to share now. Now, opening up my blog and writing is easy. Now, mentioning to a friend that we need prayer or support seems so natural. In a couple of weeks, we are having our entire church pray for us! But there was a day when I was terrified and humiliated to talk about our struggle to have children.

There were a number of reasons we didn't share our struggle. In the first place, we were barely recognizing it aloud ourselves. Both my husband and I has silent concerns long before we ever spoke them to each other. I didn't want to be an alarmist, and I felt too young to bring infertility up. We talk about it all of the time now, and so I forget that there was a point when we didn't.

On top of that, I was afraid at what people might say. Strange enough, my fear was not that they would have some horror story about a friend never getting pregnant, but that they would brush me off when I knew something was wrong. I didn't want to hear that I was young and had plenty of time. I didn't want to hear that Robby and I should be enjoying our early years alone together, not planning for a family yet.

Finally, I simply didn't know what to do. I didn't know who to talk to or what to say. I remember mentioning to my doctor that I had been off of birth control for a year with no baby, but I didn't press it further, and neither did she.

Even when I made my first appointment in Visalia, I nearly backed out of saying the real reason why I was there. I was led back to my room, and a nurse came in to get me ready for an annual exam. I almost kept silent, but finally I said, "I'm not here for that, actually." She seemed perplexed and double-checked the chart she was holding -- apparently the reason for my appointment had been written down incorrectly. I made myself be bold: "I can't get pregnant, and I'm wondering what to do." My OB was wonderful, of course, and sat down to have the first helpful conversation I had had at that point. I was amazed. So this was as simple as it could have been all along! She wasted no time starting me on a medication, and then soon referred me to a specialist.

There are many things I wish I would have known, such as the following:

• Infertility is a common struggle that affects many couples. Most statistics say one is six couples will have some form of infertility. That being said, if a couple has been trying for a year (some specialists even say six months now) and has been unable to conceive, it is perfectly right and acceptable (not overreactive or silly) to share their concern with their doctor.
• Infertility affects all ages. And actually, if you consider that women naturally become less fertile as they age, it seems all the more reason to see a doctor sooner than later if you are young and experiencing difficulty in conceiving. 
• You can make an appointment with your doctor simply to discuss your concerns. (I didn't know I could do this! I felt like I needed a "real" reason to see my doctor.) Be straightforward when you do meet: "We have been trying for ______ months/years and can't get pregnant. What can we do?"
• You can make an appointment with a different doctor if you don't feel yours is listening or responding well. (The idea of disagreeing with my doctor was completely foreign to me!)
• There are easy tests that can be performed to check important baby-making information. A trip or two to the lab to get blood work may be all you need to get some answers. You can request labs from your doctor if she doesn't suggest them. (I didn't know this, either!)
• There in an easy test for your hubby to check his count and motility. Do this right away. 
• Have bloodwork done every year. I've just learned this one the hard way. Your levels may change. In fact, my doctor recently said that as far as FSH and AMH levels, he sees significant drops take place every six months in women with DOR and other imbalances.
• Endometriosis is serious, so if you or your doctor suspects it, don't waste time.  With endometriosis, your body is functioning incorrectly, and tissue that should only grow in your uterus is growing in other places. It doesn't go away on its own, and usually it gets worse if untreated. I used to think it simply meant painful menstrual cycles, but it's so much more than that. 
• Endometriosis cannot be cured but it can be prevented from getting worse. If you suspect endometriosis, don't wait. There are hormonal and surgical treatments.
• There is a reason specialists exist! Our OB/GYNs and family doctors can only go so far.
• Be brave and proactive as you seek medical answers. This is your health and your life.

Gratefully, God gives grace even when we don't have all the right answers. He cares about infertility and cares deeply for the infertile couple. I look back at our journey and am amazed at where we are now. Most of the time it was a slow process of placing one foot in front of the other, unsure of where the next step would take us but recognizing that we seemed to be headed somewhere. We would have a hunch or feel a nudge or meet the right person and then--another step taken. A phone call, an email, a conversation--one more step. It was God always. Moving and guiding us. Calming and encouraging us. Taking rests with us and directing detours for us.

There are things I wish I would have known, but I recognize that I could have never known how God would show up in our lives all because of infertility.

New bad news

Yesterday's appointment did not go as we had planned. We headed to the doctor around 3:30 expecting to hear that everything looked good and our IVF was an easy go. The news we received was disappointing. No, that's a nice way of saying it. It was devastating.

The doctor diagnosed me with something called Diminished Ovarian Reserve (DOR), sometimes known as Primary Ovarian Insufficiency. What this means is I have a reduced number of eggs left, a reduction that shouldn't be present for another ten years. All women begin to experience some form of "wear and tear" on their eggs in both quality and quantity as they age, but a significant drop doesn't usually happen until late 30's and early 40's. It's uncommon for women in their twenties and early thirties to have this. When they do, it's diagnosed as DOR.

Three tests were done to check this. Blood tests checked my levels of FSH (Follicle Stimulating Hormone) and AMH (Anti-Mullerian Hormone), and the Saline Sonogram checked the development of follicles among other things. A woman with DOR with have high FSH and low AMH. Furthermore, there will often be a lesser amount of follicles present than with a normal woman. All three tests confirmed each other.

The doctor said that a healthy, fertile couple has about a 20 percent chance of conceiving every month. He guessed that we have -- are you ready for this?? -- a 1 percent chance. 

One percent. My eyes filled with tears when he said those words. It was quiet in the room for a moment because neither Robby nor I really knew what to say. We weren't ready for news like that. How do we even continue talking about having a baby when our chances have just plummeted to be one in a hundred?

There was more. The saline sonogram showed something a bit abnormal with my uterus, something the doctor performing the procedure called a bicornuate uterus. My doctor didn't agree with the diagnosis, though. He said we would have seen this on our previous HSG done a few years ago. Who knows. Something's there, and it could be a problem. The options are to have surgery and fix it or to move on.

So, there we were hit with two huge bats of bad news. Somehow we started talking with all that and we actually had a really good appointment. IVF isn't out for us. Not all doctors will perform an IVF on a woman with DOR because the success rate does drop, but ours will. We just have to realize that we won't have the chances we thought we were going to have.

Still, a 30% chance is world's apart from a 1% chance, and we want to take it. In a way, it confirmed for us our desires to move toward IVF. The doctor also didn't think the surgery to correct whatever is up with my uterus was necessary. That was good to hear although I'm still not completely settled about it. Googling doesn't help, either.

We were positive on our way home, albeit completely shocked and shaken by the news. It's all settling in still, and unfortunately I usually feel worse before I feel better. But God's with us, and we hold to that truth.

Lifted up in prayer

Today my friend at church commented multiple times on how happy I seemed. I was a bit perplexed at first -- am I usually a downer? But then I realized she was right! I didn't just seem happy; I felt genuinely joyful inside. What was the difference, I wondered? I immediately began spinning through the different things that could have caused this change.

First, no doubt about it, the extra hour of sleep last night had to have helped. I mean, who doesn't benefit from some extra snoozes? Second, I have taken steps to remove extra burdens from my life. These burdens were good things - a great ministry (Kid's Praise) and a fulfilling part-time job (piano teacher). But I had felt for some time that I was having to squish everything to make it all fit, and that was getting exhausting. I knew that no matter what happens in our pursuit of a family, some roles and commitments were going to have to change. So, as hard as it was to let these things go, I did, and I know it was right. Finally, our labs are over and there is a "plan" in place. That feels good.

But even these things don't equal joy, at least not for me. I've had extra sleep before, and I've removed extra activities from my life. And I know that in this struggle--as in life--no plan is full-proof.  These things have been good and have been gifts from God, but I have no doubt about the reason for my joy these days. It's quite simple:

Dozens and dozens of people are praying for me and Robby.

As we have become more and more open about our struggle and our needs, more and more people are pleading on our behalf before our God. There already were many people praying for us fervently and diligently, and now more have been added. It's humbling. Hundreds of prayers have been offered for us.

The phrase "lifted up in prayer" is a common one among Christians. Although I don't think it's necessarily a phrase taken directly from Scripture, the idea certainly is present in God's word. When we pray for someone, we bring them and their needs before God.  We hold them before the Lord and ask his blessing and comfort upon them. This is the picture of the Church, is it not? In Romans 12, one of the key chapters and books about the Church as the body of Christ, we read the following:

Be devoted to one another in brotherly love. [. . .] Be joyful in hope, patient in affliction, faithful in prayer. Share with God's people who are in need. Practice hospitality. [. . .] Rejoice with those who rejoice; mourn with those who mourn.

I know we have been lifted up in prayer, and physically, spiritually, and emotionally, I do indeed feel lifted up. I am full and overflowing with hope and joy. I am no longer weighed down but instead am raised.

A few people have written out prayers for us and given them to us to read. This is new for me, but I have been so encouraged to get to hear what another has asked of God concerning us.  It's like eavesdropping! Here is a recent prayer, given to Robby by a friend last week. I love how this prayer reflects the person who prayed it.

“Be fruitful and multiply. Fill the earth with your offspring.” 

Father,They would love to do that. There’s no command they would rather walk in obedience to than this one.. To multiply. To fill your earth with new life. 

But what’s the deal? Who gives children but you? Whose capable of creating life where there was none before but YOU? 

Do you not see the pain this causes them? Do you not see how hard it is for them at every announcement, “it’s a boy” or “it’s a girl.” How many more baby showers must they go to before their own? 

What keeps you from speaking the words that bring life? “What Father doesn’t want to give their children good gifts?” 

There’s no doubt in my mind that you love Rob and Candace, that they are your beloved son and daughter, and that you SEE them. So please YHWH, live up to your name, and ACT! 

BRING YOUR KINGDOM! Touch your resurrection power on their bodies. 

Bring that beautiful bump on her belly. 

Jesus, its you who taught us to pray so boldly, and it’s in your NAME that I pray amen.

These are sweet words to us. I smile every time I read that line about the bump. Prayers are sweet and powerful, and I'm reminded that God's people, just as II Corinthians 2 says, are the fragrance of Christ.

Thank you for praying. Thank you for lifting us and our needs before God. Your prayers have not gone unanswered! Although we wait to see if God will grant us a baby, we know He has answered. He's with us. He's guiding us. And His Spirit and His people are bringing us more comfort that we knew we could receive! Thank you.

Finished!

My procedure today is over, and I made it through! I thank God for providing me with a new doctor who was able to make it happen without causing me too much pain. So, I'm finished with all of my labs, and now we wait for our appointment on November 6th to hear about the results.

Please pray for us. Specifically, pray for:

• Continued guidance in pursuing IVF
• Wisdom for our doctors and nurses as they review results
• Provision of necessary finances
• Insurance coverage
• Peace

Recently, I have come across a ministry site called Dancing Upon Barren Land that has been such an encouragement to me! There was a place on the site to send a message, and so I did, thanking the woman for the wonderful ministry. The very next day, she sent me a kind response, and I wanted to share her prayer here.

I have prayed for you and will send your prayer request to our team to pray as well. I asked the Heavenly Father, "To make your steps sure and full of peace. For your eggs to be plentiful and healthy. For no adverse reactions to any meds. For our wonderful Lord to grant the desires of you and your husband's heart." As Luke 1:37 says, "Nothing shall be impossible with God." Hold daily to Jesus, He will carry you in this process, He is faithful.

I know that all of you are lifting us up in prayer, and I thank you. We have continually recognized the blessing we have in our family and friends. You have been and are God's grace to us. Thank you!

I'm up (and I'm a new creation!)

It's 3 in the morning, and here I am. I woke up not feeling great, and then I started thinking about today, and then I couldn't fall back asleep.

In just a few hours, I have to have Monday's procedure, the saline sonogram, done all over again. I'm not looking forward to this, mostly because I'm afraid that whatever happened Monday might happen again.

Monday's appointment was terrible. It was hands down the worst medical experience I've ever had. It's difficult to accurately explain how awful it was without going into lots of personal details, but I'll just say what should have been a relatively simple twenty-minute procedure took an hour and a half. And it was an incredibly painful and uncomfortable hour and a half. All said and done, the doctor performed the entire procedure twice (after first trying unsuccessfully to do it with improper equipment) only to get up, turn the lights on, and tell me it didn't work. He gave me a physiological excuse which didn't really match up with my past experiences, said he was terribly sorry, and left. When I asked for more details about his reasoning, he said it could be something permanent, some type of scar tissue or blockage. Those kinds of things cannot be said to a woman desperately trying to have a baby.

I only made it about two steps outside of the building before I began sobbing, overwhelmed by the whole excruciating and emotional experience. I could barely get the words out to Robby to tell him it hadn't worked, and it took a few minutes before I could relay the information the doctor gave me.

A bad experience, to say the least, and one that I'd rather not relive in the slightest. So it's no surprise to me that I'm up.

I've found comfort in 2 Corinthians this week. This morning, I read the end of chapter 5. It says:

Therefore, if anyone is in Christ, he is a new creation; old things have passed away, and look, new things have come. Everything is from God, who reconciled us to Himself through Christ and gave us the ministry of reconciliation. (2 Cor 5:17-18)

This passage, and specifically chapter 5, is about Christ's death bringing life for all. We have hope for today and for our future because of Christ. We are made brand new through Jesus, and we have been reconciled to the God who made us through Jesus' death and resurrection.

Sometimes we need to be reminded that we are a new creation in Christ. Sometimes, when it seems like our bodies just aren't working the way we'd like them to, we need to hear that God has placed inside us something that will never fade or dim or grow old. He's given us a new Spirit, His Spirit, our seal of salvation and our downpayment for the perfect and whole life to come. He's given us Himself and His very presence. It's true that our bodies and our flesh may fail us--Paul in this chapter writes of us groaning in this body, desiring for Heaven, longing for life to swallow up this mortality--but we have and are being saved, reconciled, and redeemed by God. Newness has already come! Salvation is already here!

Insurance Surprise

I'm feeling great today. Yesterday was a productive lab day -- we somehow managed to get three of the five labs done in one day, which was pretty lucky as most of them are "day this, day that" types of labs. I only have one more procedure to do, the saline ultrasound, which will be this Monday. I'm surprised with how quickly we have been able to do the work-up, which is nice because those tend to cause a bit of stress. The labs themselves aren't too bad (the worst one is definitely still to come), but the difficulty lies in planning them around our work and church schedules. It's nice to have them nearly over.

The other fantastic news came today when I decided to double-check my insurance coverage. Over the past three years, only a few things have been partially covered, those procedures that could be considered purely women's health. Some ultrasounds were covered, as well as a portion of my surgery in January of 2010. Anything related to our medications or IUIs came completely out of pocket. Turns out (fingers crossed) that our insurance will cover a lifetime max of $2000 (75/25 coverage) toward infertility once our deductibles are met. (That's right, deductibles, plural. They add in an infertility deductible on top of our regular one.) We should meet all the minimums, though, so it is likely that Blue Cross will kick in something around that amount for us. This is pretty amazing since infertility coverage at this point in time is quite limited if not practically non-existent. What a blessing that ours has it and that my doctor is a participating provider! Even the insurance representative I spoke to on the phone said that is rare to see!

It's been an encouraging week for me, and this was a beautiful, surprising icing on the cake.

IVF Answers...and Anxiety!

After I wrote my post following our doctor's appointment last Monday, I was hit with the 24-hour Anxiety. Have you ever had this? Mine came on that night, kept me wide-eyed and sleepless until about 4 am, then stayed with me all the next day. My heart was racing, my body was panicky, my breath was short, and overall I was a mess. I think it was a case of information overload, but perhaps the bigger cause was realizing that we had thrown ourselves in the midst of a huge decision...and I hate making huge decisions. Honestly, who likes them?

That has been one of the key struggles for us, this whole having-to-decide-things-that-ultimately-scare-us-to-death struggle. It was hard to make that first decision to see my doctor, knowing it was a recognition that there was something wrong. It was hard to decide to do treatments, knowing the cost and side effects and emotional strain. It was hard to decide to have our first IUI, and then the following IUIs. Decisions about cost, treatments, careers, even adoption--we've made too many to count, and I haven't liked the process a single time!

I guess I shouldn't have been surprised that anxiety hit, then. It wasn't a simple decision of having or not having an IVF. It was recognizing all the in-between decisions that must be made, decisions that stretch our thinking and planning and beliefs more than any others have. It was realizing that if this all works, we have taken only one tiny step of the journey. And it was also realizing that after everything, there is a chance we may be left with nothing.

All that jam-packed into twenty-four hours was enough to knock me flat! Thankfully, Robby and I were able to have a good conversation that following night. (He had been feeing anxious about it all, as well.) We remembered that there is no rush. We have taken a tiny first step, and the steps that follow may be tiny, too. As much as we don't want to make these decisions--because as I've shared this is not the way we would have planned it--we know God has equipped, is equipping, and will equip us to do and decide what we need to do.

I have also remembered that sometimes, when you're in the midst of a struggle, every decision and emotion is amplified. It was helpful to take a step back and allow myself to see the decisions in front of me in their real form and size. It was helpful to remind myself that we are not the first to decide what to do about infertility, nor are we alone in this struggle.

A week has passed since that visit, and already we feel more confident and prepared. I'll take that any day over anxiety :)

IVF Answers

Today was the big appointment! We left this morning anxious and excited and came home a bit overwhelmed and emotional. I keep forgetting that every step we have is like this: overwhelming and emotional. Our appointment was great, though. We were able to meet with one of the main OB/GYN Nurse Practitioners at the clinic, and I love her. She had been one of the few gals who did all of my ultrasounds and even IUIs there. Kind and patient, she explained to us what our next steps are.

She was on the same page with us as for not wanting to do anymore IUIs (we've done five) and skip to IVF. She recognized that even though my fallopian tubes appear to be open, we have no way of knowing the extent of the damage which is in those tubes. The little "hairs" (cilia) that pull the egg along to get fertilized--if that is happening--may themselves be damaged.

This bit of info was a strong confirmation for me to hear. I'm not sure if I shared on this blog but in August of 2011, Rob and I went to see a new fertility specialist, mainly to get a second opinion on our whole situation. He was great and spent at least a half an hour with us just talking about our entire journey. He said that he felt we had done everything "correctly," all of the steps there are available to do, and his guess was that the problem lay in my fallopian tubes. Incidentally, he also knew my doctor and the clinic, and said that would the place he would have recommended, the only other being a referral to Stanford.

Back to the appointment today. There were four main things we wanted to discuss:

1. Am I still a good candidate for IVF, and if so, what are the chances of conceiving?
2. What are the steps of IVF?
3. What is a cost estimate of the whole thing?
4. What about our own ethical and religious beliefs, specifically concerning the embryos?

Am I still a good candidate for IVF, and if so, what are the chances of conceiving?

I am most likely still a good candidate based mainly on my and my husband's age, health, and medical situation. Rob needs another analysis done, and I have to do three tests again, two that check all sorts of hormone levels, and one that gives a clear picture of the state of my uterus. This one is like the HSG I did a couple of years ago, which basically is an x-ray of the uterus and tubes. This new one, called an SIS, focuses on the uterus, though, and gives a clearer assessment of the health and shape of my uterus. This is better if you're not as concerned about the tubes, which at this point, we're not! Read about the procedures for and differences between the HSG and SIS here. 

The chances with IVF sky-rocket compare to those they gave me with IUI. A textbook answer is at least a 30% chance of conceiving, but the NP told me it is more like 50% if one embryo is placed, and 65% if two embryos are placed inside the uterus. These statistics are based on a blastocyst stage embryo transfer, which is an embryo that is five days old instead of three. (More on that in the next section.) I was on Cloud Nine when I heard these stats!

What are the steps of IVF?

Any research will tell you there are four steps: Stimulation, Monitoring, and Triggering; Egg Retrieval; Fertilization; and Embryo Transfer. Our NP broke them up in different ways, though, so I'm going to use what she said:

1. Suppression: This is the first step in the process, and it definitely feels like you're headed in the wrong direction. Before any stimulation of the follicles occur, you are put on birth control to encourage suppression of the follicles. This is because each month, there is always one follicle (potentially mature egg) that is a little bigger and that sucks all the follicle-stimulating hormone (FSH) the body produces. We want all the follicles to be the same size when starting so that more than one will get to grow because of the FSH.
2. Stimulation: After a cycle of birth control, you are ready to begin the real process! Follicles are stimulated by injecting FSH into the body. This is something our bodies produce naturally each cycle, but we want more than one mature egg. Naturally, just like in a normal situation, eggs may "die" or fertilization may not occur, so the goal is to get a good number of mature eggs. This step also includes a medication that triggers ovulation. Timing is everything, whether fertilization is occurring inside or outside of a clinic! This "trigger shot," as it's called, ensures when the woman ovulates. Once ovulation has been triggered, it's time for egg retrieval.
3. Retrieval and Fertilization: Because IVF means that an egg and a sperm are coming together outside the body, the egg has to be retrieved. In the case of IVF, there are multiple eggs being retrieved. Now, we can't see eggs -- they are smaller than a single piece of dust. Basically, the fluid from the follicle (which we can see in an ultrasound) is withdrawn and examined. At that point, the embryologist can see if the egg was retrieved, its size, and even its health! This is done one-by-one with the embryologist examining each bit of fluid and ultimately each egg. The woman, by the way, is completely sedated, so she doesn't feel any pain and often doesn't remember anything. The eggs are then placed in an incubator. Within a couple of hours, the eggs are fertilized using the cleaned sperm sample. 
4. Embryo Transfer: The fertilized eggs, now embryos, "grow" for a few days. A typical IVF places three-day-old embryos in the uterus, but it is possible--and higher success rates come--from giving the embryos a couple more days to grow. At five to seven days after fertilization, the embryo is called a blastocyst. All kinds of factors may go into whether a three-day-old or five-day-old embryo is placed inside the uterus, but the NP definitely favored the five-day-old guys. The main reason is there is a higher chance of implantation and survival, as well as a better way to control the chance of multiples. In typical IVF, more embryos are placed inside the uterus, but with the blastocyst embryo transfer, only two are placed inside the uterus. The transfer is straight-forward: the embryos are placed inside the uterus at the appropriate time, and the woman is on bed-rest for 24 hours. Fourteen days after the transfer, a blood test lets everyone know whether the IVF was successful...and hopefully it was!

What is the cost estimate?

I won't go into the breakdown, but if you would like it for your own knowledge and benefit, please ask me. Basically from initial visit to pregnancy test a couple is looking at anywhere from 12,000 - 15,000 dollars at our clinic. This includes all the ultrasounds, doctor visits, tests, medications, hospitalizations, sedation, embryologist fees, clinic fees, lab fees, doctor fees...you name it. There is the slightest of chance that our insurance may pick up some of the non-fertility labs, but I don't like to count on them. They haven't helped much in the past.

When I looked into this a couple of years ago, the cost alone sent me running. But now--especially after multiple IUIs and many dollars poured into this--my view on it is simple: it is worth it. If it works, and we have a baby, it is worth it. If it doesn't work, and we don't have a baby, it would still have been worth trying because the potential is so wonderful. Plus, I always like to tote that this cost is less than what most people our age are spending on cars...and we don't have a new car and would gladly go without in order to have a baby.

Although the clinic doesn't offer financing, they do have a few companies that they recommend, so we will research that if needed.

What about our own ethical and religious beliefs?

This ethical issue is so huge that entire books have been written on the topic. What we believe is this: Life occurs at fertilization. Those embryos are not little cells that we view lightly; we believe they are life, and we will treat them as such. This means that we will limit the eggs fertilized and ensure--to the best of our ability--that the embryos have the best possible chance of survival.

I won't lie, friends. This is tough for us. This was the hardest part of our appointment today. We were honest with the nurse, though, and she assured us that they act based on our beliefs. I'm not going to go into too much detail yet because Robby and I need to formulate this together. There are many different opinions, even among Christians (perhaps more among Christians!), and we plan to continue with prayer and counsel. We already have our key beliefs which will be the foundation; there are just some other trickier situations that may arise.

I had picked up a small book a few months back published by Bethany Christian Services. It is called Christians and IVF: Wise Choices and Life-Affirming Options. It has been very helpful! I would encourage everyone to read this as IVF and other forms of AI are part of our culture today. 

Robby also reminded me that this is not our first choice as the way to have a baby. How we wish we could be "normal" and get pregnant on our own! But this is where we are, and every step of our journey has been drenched not only in tears, but in prayer, as well. 

The Big Question

As I shared the Cliffs Notes version of this with my mom this morning, she was of course concerned with the big question. When will this happen for us???

We chose not to rush into the next IVF cycle that the doctor is performing, which is in November. (To which my mom responded with a sigh.) This is, as I've already said, huge. No rushing is necessary! The following IVF cycle will be in January, so our plan, our tentative plan, that is, would be to begin our cycle at the beginning of the new year. This gives us time to get all of our labs done and discuss the outcome of each, budget the cost, and spend lots of time together in prayer.

We are excited, friends! We are also overwhelmed and a bit terrified. We desperately need your love, support, and prayers. Thank you for caring enough to read this long thing and stay updated on this huge step in our journey!

First Steps...Again

Yesterday, Rob and I arrived home after a week-long trip with our family in Washington, DC. We had a great time and were busy, busy, busy, seeing the sights and savoring the unique time together. As busy as I was though, I kept thinking about a key event coming up on our return home.

A few weeks ago, I felt a strong peace come over me about pursuing IVF. It came out of nowhere, like a sudden storm, and I knew it was the Holy Spirit. We pray about what to do with our infertility all the time. Not only do Rob and I pray, but our families and friends also constantly lift us up. I knew it was no accident that I felt this, but I simply tucked it away for a few days. This wasn't what we had planned, you see. We had decided a few months ago that this year would be a year of saving, and next fall would be the time to act. However, as it was very clear to me that God was speaking, I finally told Rob that I thought we should look into IVF sooner than we had been planning. There wasn't even a discussion about it -- he said he had been feeling the same way.

The next day, I called my doctor in Clovis and set up an appointment. It has been a year and a half since my last visit there, so I have to do another major appointment with all the initial tests and talks. It's scheduled for tomorrow, Monday, October 8, and we're hoping to find out if I'm still a good candidate for IVF, what the cost estimate is, and when I could begin the process.

It's exciting, terrifying, and all the other adjectives in between. Not doing any treatments this last year and a half has been good in many ways, lessening the physical and emotional strain. But it also feels like I'm starting all over, and that is hard. I thought that there would have been an "end" by now. I had hoped that we would have already had our baby.

And, strangely enough, starting this again throws a wrench in the groove we've finally settled into. We are never truly content with our family of two, but we have tried to be positive and recognize we have worth as a couple even if we don't have children. I'm enjoying my job, and Rob is at a great place in his ministry. Starting all over means shaking things up, and that's scary.

Finally, IVF is just plain huge. It's a huge financial, emotional, and spiritual commitment. It's something I recognize we cannot do without the support and love of our family and friends. That means that people need to know, and that means that people will ask, and that means that we'll have to share news, even if it's heartbreaking. It's hard to allow others to bear that burden with us, and it's hard to open myself up to that vulnerability when so much of our struggle is private and personal.

So, tomorrow is a big day. There are all sorts of unknowns, and my stomach is in knots just thinking about it. Providentially, yesterday when we got home, there was the latest newsletter from Stepping Stones on my counter. The cover article is called "A River of Optimism." I love what the author wrote:

The hope of a Christian is not just positive thinking; it is absolute certainty about who God is, His goodness and love, and ultimately, His plan of salvation in my life. While the path I am walking is certainly not one I would choose--maybe one I will never understand, already filled with heartaches and disappointments--I know that I will ultimately not be disappointed. This is not because God answered my every prayer according to my wishes but because He drew near to me in my time of deepest need and loves me with an unfailing and sufficient love.

I don't know how any of this will turn out. I may find out I'm not a good candidate for IVF anymore. We may be overwhelmed by the cost. We may go through the process unsuccessfully in countless different ways. But I am certain, as that author wrote, about who God is, His goodness and love, and ultimately, His plan of salvation in my life.

Stepping Stones Newsletter -- Hey, that's me!

I was so excited to receive my Stepping Stones Ministries e-newsletter last week. I immediately began perusing and felt my little heart skip a beat when I saw my name at the top of page three! Stepping Stones had published my article, "The Tree of Life"!

The article was actually a blog post from August of 2010. I submitted it to them earlier in the year and was told it would be showing up sometime soon. You can read the original post here or hop over to the newsletter here. And if you have not given this resource a good looking-over, now is the time! It has been such an encouragement to me and so many other women I know.

Maybe...

My husband and I spent the last week in New York celebrating our seventh wedding anniversary :) It was a fantastic time, packed full of sweet memories and moments. It's funny but I always find I learn a lot of lessons while vacationing, perhaps because I'm out of our normal routines and comforts. I tend to come back inspired and invigorated, which I guess is exactly what a good vacation should do.

This isn't really a lesson. It is just one tiny thought that emerged, and it happened on our flight home. Our plane sat three to a side, and our third seat was filled by a young kid who was traveling alone, flying for the first time, on his way to visit family in California. He was a sweet boy, a soon-to-be seventh grader, friendly and happy to have an adult nearby to explain the ways of the plane and talk with to pass the time. I too was quite happy to offer my "expertise" and be a friend, even if only for the six hours on the plane.

So, the thought was this: I could love a kid like this. I could be the adult for some child who needs one. I could open my heart easily, perhaps more freely than I sometimes think I could.

And when Robby helped him get his music player out of his bag and was kind and sweet to him, I thought, He could do this, too.


It's a tiny thought, as I said. Adopting or fostering is no small decision, and as I've shared, we never went into our marriage thinking we would be a couple who would pursue that. I still dream of having a child who looks like me or my husband, of carrying a baby in my own body, of experiencing God's healing.

But in the last couple of years, my prayers have included not only pleas for a biological child, but pleas for open, willing hearts to go and do whatever God has for us. I know God is going to answer us, and so I thank Him for the ways He speaks to us, even when His voice comes unexpectedly on a plane flight home.

Book Review: When the Cradle is Empty

When the Cradle is Empty is a book about infertility written by John and Sylvia Van Regenmorter and published by Focus on the Family and Tyndale.  When I decided a few months ago I wanted to read a book on the subject of infertility, I became overwhelmed by the options.  This actually was the first one I had perused before I gave up the search.  A couple of weeks ago, I went back and ordered this book, along with another.

The authors seek to answer tough questions about infertility, including chapters on the journey, the pain, holidays, marriage, family and friends' questions, prayer, treatments, miscarriage, infant death, secondary infertility, adoption, and moving on.  Yes -- it covers the whole spectrum.  In some ways it is an overview of information, but in other ways it speaks directly to the couple struggling to find words and explanations for what they feel.

The first few chapters were the hardest to get through because they were the most painful to read.  Chapter 1, "A Journey Begins," outlines the seven steps most couples go through in their process of infertility and pain.  I read this chapter through tears -- it seemed someone had peered into my life and written down my journey thus far.  Chapter 2, "Pitfalls Along the Path," opened up some wounds I've tried to close forever, such as the guilt over using "the pill," waiting too long to seek professional help, and playing the blame game.  Chapter 3, though only a few pages long, spoke of the loneliness and hopelessness of infertility, attempting to shed light on the question we've asked: "Why Does Infertility Hurt So Much?"

It seems the authors had intended those first few chapters to pry open their readers' hearts--as if this needs to be done!  They quote from Phil Nienhuis, a professional family therapist, who says, "One cannot begin to recover from pain, until he or she is willing to own the pain and acknowledge that it is real" (33).  Hope and help are on the way, they promise, in the subsequent chapters.

Chapters four through fifteen do indeed offer hope and help.  Some of the help is very practical, such as a list of agencies and organizations that provide infertility counseling and services; or the explanation of the different types of ART (Assisted Reproductive Technology); or the steps a couple goes through in the process of adoption.  Some of the help is spiritual, such as verses and stories that encourage and speak directly toward a hurting heart.  Some of the help is just plain common-sense, such as advising couples to recognize their boundaries or giving couples words to say when the inevitable questions come or even setting time-limits to how much time they spend talking about infertility.  And then, thankfully, some of the help isn't really help at all.  It's simply experienced people reminding couples that there may not be easy answers or fix-all band-aids, and that's okay.  We may never know the "why's" of infertility, but God is with us, and He is guiding this seemingly unsteady path.  The reminder of hope is always welcome.

For me, the book was encouraging because--as I already said--the authors provided me with words I haven't been able to find.  They shed light on emotions I haven't taken time to recognize or pains I haven't been willing to acknowledge.  It's all been there, of course, but there is something freeing about reading just what you want to say.

I also was encouraged because of some of the difficulties shared that I haven't had to deal with.  My husband, for example, is right there with me in all of this, which is a blessing.  He doesn't shut down or try to fix things and move on.  He feels the pain and sorrow just as I do.  We truly carry this together, and I know not all women have that support.  My close friends and family are sensitive and careful with me.  They think of me when sharing their pregnancies or joys of their children; they ask me about my hopes and desires; they pray for me.  And, although I hesitate to write this, there is another excruciating element of infertility I haven't had to bear: I haven't had to experience the pain of miscarriage.  I grieve over an empty womb, but not over a heartbeat that stopped.

I definitely recommend this book, not only to couples facing infertility but to their families and friends who may want a closer look into their hearts.  Not everything resonated with me, of course, but enough of it did that I would suggest anyone wanting to understand us better to read it.

I'll take some time over the next few weeks to share some of the things that stood out especially to me, but I thought I'd end with this one line that is just brilliant:

"Any comment beginning with 'at least' is likely to be unhelpful" (121).

How true is that?  "At least you're happily married." "At least you're healthy." Or--for my friends who have tasted the pain of miscarriage, infant loss, or secondary infertility--"At least you got pregnant."  "At least you have one."

Thank you, God, for caring about all, even the least of all.


To order the book from Bethany Christian Services, click here.

The Other Half

It can be easy for me to forget that there is another person intimately involved in this grief and struggle: my hubby.  He is such a rock to me, so solid and strong, that at times I may selfishly focus on how infertility affects me, perhaps broadly how it affects us, but not often how it affects him.  Sure, I write about "our" desire to have a baby and "our" struggles, but, because I am the woman, it naturally becomes more about me.

In fact, if our infertility had not continued as it has, I probably would never have known how much this has pained him.  In the early stages, perhaps the first year or so, I don't know if I once asked him how he was coping.  I was absolutely overwhelmed and could only think how my dreams were being dashed.

The reality is that my process most likely did begin before his.  Even before we knew definitely that something was wrong, I expected it.  I'm the one in my body, afterall, and the problems I have, the issues that have led to our infertility, didn't appear over night.  It didn't take long for me to find myself pedaling full-steam ahead when he was still using training wheels, trying to wrap his mind around our new reality.

I have learned a few things, though, and, because he and I have become better at sharing how we feel regarding this, I continue to learn.  Like any struggle, this is simply what has happened with us and what has worked--for the time being, anyway--for us.  I hesitate to call these "tips" for everyone, so I'll just say these are my tips to myself to keep my husband and me sane together.

1. Ask him how he feels.  Ask him again.  And again.  Then wait patiently, and wait some more.  Know that sometimes I'll get a release of response, and sometimes I won't.  It's the same with me, though -- sometimes I want to share a lot, sometimes I don't.
2. The response of "I just feel sad" is perfectly acceptable.  Sometimes there are no grand ways to explain our emotions.  We know we're sad, and that's enough.
3. Keep him filled in and updated on conversations I have with others.  Naturally, people ask me more often than they ask him how we're doing.  He can easily get out of loop, and that can be hurtful to him.
4. When it's appropriate, remind others to encourage him directly, to ask him how he's doing, to recognize his pain.
5. Embrace his optimism, even when I want to shut it down.  Know that God may be giving him a word or understanding that, for whatever reason, I don't have.  At the same time, allow him not to be the rock sometimes and give him the freedom to question and cry just like I do.
6. Pray together and share Scripture that has been encouraging, even when it feels forced.  And it will feel forced, at times.
7. Know that we will be at different points of grief, understanding, and even excitement throughout this journey, and that's okay.  It's about going through it hand-in-hand, not necessarily experiencing it the exact same way.
8. Take advantage of every "outing" he wants to have, whether it's late night runs to Taco Bell or seemingly extravagant vacations.  We're in this together, and our life cannot be on hold just because we don't have children.  Our life is what it is, and we need to embrace it.
9. Tell him why I think he will be an amazing dad someday.  And tell him why he is an amazing husband today.
10. Let him believe that we really are going to have the little girl he wants even when I think we'll have a boy.

I've heard of marriages being torn apart because of infertility.  I can see why.  It is easy for anger, blame, and resentment to quickly creep into a husband-wife relationship, especially since no pre-marital counseling ever prepares you for this.  Communication is tough anyway, so trying to communicate emotions you don't even understand that well can make it nearly impossible.  But with God's grace, a marriage can be strengthened by such a struggle.  Love--the true, patient, selfless, sacrificial, undying love of Christ--must become the key.


Resources:
There are not many resources out there specifically for or about men and infertility, but Stepping Stones does have one article that is worth reading.  It is called "When a Husband Hurts" by Rev. Burton F. Wilbur, Jr.  It actually is about the pain a husband felt through two miscarriages.  Although it is not about infertility in general but is more about the grief of losing two babies, it is honest and helpful.

The Waiting Room

Originally written on June 21, 2011, this study and reflection inspired the song "With the Lord," written about a year ago and shared with you today.

I hate waiting.

If you know me, you probably know this fact about me.  I don't like the feeling that precious minutes are passing by, and we are just stuck until something comes.  I don't like factors outside my little realm of control dictating how I spend my time.  But more than the waiting, I hate the letdown of waiting for something that doesn't work out.  All the energy that went into that week or month or year seems to collapse right on top of me.  

I feel like that has been my life the last few years.  I've shared that we have been wanting a baby for some time, so you could probably guess that my life is lived in months.  A new month comes, a new opportunity, a new waiting game, and, as it has proven so far at least, a new disappointment.  

This whole routine gets me very restless and anxious.  I try to keep busy because that at least gives myself the impression that life is fine, but the truth is, distractions don't last very long.  At the end of the day, I still have to deal with the fact that things are absolutely out of my control.

I guess I shouldn't be surprised that Scripture tells us to "wait on the Lord."  Waiting goes against our human desire to control things.  When we are forced to wait on someone, we are no longer in charge; we are at the mercy of someone else.  Thankfully, we are able to wait on the Lord knowing He is good and kind and merciful.  There is hope involved in our waiting because we have a gracious and loving Father, and we know He will respond.  Nevertheless, it is still hard, which is probably why it is so good for us.  Waiting is what the Great Physician often prescribes to build our character and grow our faithfulness--but this medicine is hard for me to swallow!

As I was looking up Scriptures about waiting, I came across this little study.  It's quite lengthy, but I wanted to share some of the points.  You can read the whole text here if you'd like.  No doubt, I am not the only one playing the waiting game these days.

Waiting on the Lord

Study by J. Hampton Keathley, III

What is involved in waiting on the Lord?

1.  Waiting means confident expectation, so waiting and hoping go together.

2.  Waiting involves an expectation based on knowledge and trust - our ability to wait on God is connected to our confidence in who God is and what God has done!

3.  Waiting involves seeking the Lord, spending time in His Word, in prayer, and in meditation.

4.  Waiting involves resting in God's timing, acting when He is calling us to act and resting when He is calling us to rest.

Why should we wait on the Lord?

1.  Because of who God is and what He is able to do - again, we need knowledge of God through experience and Scripture

2.  Because of who we are and what we are not able to do - we need to have a right view of ourselves and our weakness

What benefits are there to waiting?

1.  Waiting strengthens and enables us.

2.  Waiting strengthens and builds character.

3.  Waiting lifts us out of despair and causes praise to God.

4.  Waiting encourages others and gives greater ability to witness.

I am looking forward to printing out the study and spending some time with it, but the truth is I always know that when I feel restless and anxious, God is calling me to Him.  No distraction on this earth can fix my heart when it's broken.  Only God can lessen my disappointment and ease my pain.  Only He can give me the strength to wait -- to wait with expectancy and hope and love.  Strangely enough, it brings me comfort to know that God wants us to wait.  It brings purpose to this trial in my life, when I am tempted to think it is all for nothing.  There is no trial, no struggle, no pain that God cannot and will not use for His glory.  Praise Him!

Out of the depths I cry to you, O Lord; O Lord, hear my voice.  Let your ears be attentive to my cry for mercy.  I wait for the Lord, my soul waits, and in His word, I put my hope.  My soul waits for the Lord more than watchmen wait for the morning, more than watchmen wait for the morning.  

Psalm 130:1-2, 4-6

Still waiting

I thought I was doing fine.  I really did.  In fact, just Saturday I was happily telling a friend about how well things were going, how we were excited about our "plan" (a loosely used term) to seek IVF, how church has been thriving and work has been grooving.  The last three weeks, in fact, I have been in super-woman mode, cleaning and organizing every corner of my home, planning weeks worth of lessons at a time, keeping up with responsibilities and activities.

And then Monday came.  I could tell it was going to be a different type of day.  I didn't feel well or rested at all.  The day seemed scattered and fragmented, and I felt like I was chasing my thoughts, trying to piece together what was going on.  People arrived for Bible study that evening, and we had a nice time, but the second they left, the break-down began.  By the time I went to bed, I was restless and, quite simply, sad.  Sleep wouldn't come, and the longer I lay there, the more anxious I became.

Finally, understanding came, and with that, words.

I don't want to make any decisions.

I knew Robby wasn't asleep.  How could he be with me rustling around and fighting my pillow and sheets?  He understood everything with those few words, and even though speaking them released the flood, I also felt a peace.

I don't want to make any decisions.  I don't want to have to decide to have an IVF or pursue adoption or take out a loan or go into debt or make an appointment or any other difficult thing.  Even though we have made these tentative plans, deep down I keep hoping a decision will never really have to be made.  Because, of course, I keep hoping that a miracle will happen, and I'll be healed, and we'll move on as if this whole thing was just a terrible dream.

I want it to be easy, and right now, it seems all our options are anything but that.  I feel so tiny and incapable of taking the next step because I feel paralyzed to make the next decision.

Paul's words in the book of Romans brought relief and joy the next morning.  I am a child of God, filled with the Holy Spirit, led and guided by the very presence of my Creator and Sustainer.  My flesh desperately wants the next step and answer, but it is not mine to have unless the Spirit leads me there.  Trying to get there on my own will only bring anxiety and fear, which is not God's will for my life.  I know there will come a point when I need to be bold and strong, and hopefully, God will bring clarity for me to know when and what that is.  For now, I am still waiting.

Tied with Him

A poem on Psalm 103:

O soul, do not forget
our Lord and His benefits.
From the darkness we were redeemed
And crowned with grace and dignity.
All our hopes, satisfied.
All our stains, purified.
All our strength, renewed again.
Who we are is tied with Him.
Like a bud upon a branch,
Like a flame upon a match,
Our life, our breath,
Our drink, our fire
Now found in Christ,
Our one desire.
Do not forget, I cry again:
Who we are is tied with Him.

3/1/12

Song: For Today

I've shared a new song on my music blog called "For Today," and I thought I'd share it here, as well, and give a little more of the background of writing it.

I wrote the song in January of this year.  January was a tough month for me, and if you've been following my journey, you may remember me saying so.  It was hard for another year to come and go without my husband and me seeing new life coming to us; it was hard to turn another year older for the same reason.  I found myself struggling to stay afloat and keep hopeful.

One morning, Rob came in and told me that some friends of ours had just found out they were pregnant.  I feel like I always have to say this, but, here goes again: We love our friends.  We love our friends' kids.  We love that our friends share their joys with us.  It may seem hard to believe these to be true when I am honest about how tough it can be for me to hear of a pregnancy, but somehow, both exist.  I can be both happy for a friend's fullness and saddened at my own emptiness.

Most of the time.

This particular morning, there wasn't much happiness going on.  When you're doing all you can just to keep going, sometimes there's not much left for anything else.  I'm not proud of my response to Rob that day (I believe it was something like, Why did you even tell me this? *storm out of the room.  Nice, huh?), but it is what it is.  I walked out about the time he received a phone call, went straight to the piano, and wrote this.  I often keep my Bible by the piano, so during this cry, I pulled out Psalm 121 and read the first verse over and over.  "I lift my eyes to the hills--where does my help come from?  My help comes form the Lord, the Maker of heaven and earth."

Sometimes I struggle to write a song, and other times, the words come as easily as humming.  This time it was as if all these thoughts had been tucked away, just waiting for me to give them a chance to appear.

For Today

Sometimes strong, sometimes weak,

Sometimes full of words, and sometimes I can’t speak.

Sometimes joy, sometimes pain,

Sometimes understanding, and sometimes barely sane.

Then I lift my eyes to the hills where I hope to find

Another ounce of strength to save me just in time.

Just enough grace for today.

Sometimes peace, sometimes fear,

Sometimes laughter ringing, and sometimes tears.

Sometimes morning, sometimes night,

Sometimes overflowing, sometimes dry.

Then I lift my eyes to the hills where I hope to find

Another ounce of strength to save me just in time.

Just enough grace for today.

Sometimes life, sometimes death

Sometimes much to give, and sometimes nothing left.

Sometimes wise, sometimes a fool,

But always You are faithful; always You are good.

So I lift my eyes to the hills where I know I’ll find

Another ounce of strength to save me just in time.

Just enough grace for today.

You’re enough grace for today.

God's Faithfulness

You are constant, Lord.

We see glimpses
of your constancy around us --
the rising and setting of the sun,
the opening and closing of flowers,
the rushing and retreating of waves.

But these are just a shadow of the Greater,
just a brush stroke of the painter.
For even the sun does not appear each day the same;
even the flower falls before its time;
even the waves answer to a stronger moon.

You and only you
are constant and faithful
yesterday,
today,
and tomorrow,
For You and only You
are past,
present,
and future.

You do not shake;
You do not change;
You do not bend or bow
in any form or way.
You answer to no one,
and so You alone are able --
Able to be the same,
unchanging,
unmoving,
Always.

1/30/12

Stepping Stones

I was recently informed of this great ministry and resource for couples struggling with infertility.  It is called Stepping Stones and is published by Bethany Christian Ministries.  It is encouraging and helpful for couples dealing with infertility, as well as their family and friends wanting to know how to support them.

Anniversary

This little blog in blogland is coming up to its two-year anniversary, which means it's been two years since our first IUI.  I can.not.believe.it.  To "celebrate," I went back and read some of my old posts.  I have to say it was a big cathartic, and I had a good cry on the couch this evening.  To be honest, I've been having a rough time since the new year.  My birthday is in January, so I had both New Year's Day and my birthday to remind me that another year has come and gone, and the deepest desire I've ever had hasn't been met.  The pain has been sharpened as dear women from my small group have recently announced their pregnancies, as well.

Going through my old posts did show me how much I've grown and changed, though.  At that time, I could barely even think about adoption.  Although Robby and I still aren't ready to adopt, we did attend an information meeting a couple of weeks ago about adoption.  This was a good step for us.  I'll share more about it later, but for now I can say I'm grateful God gave us that opportunity to attend.  I know He wanted us there.

I also see that I'm better understanding the value God still has on my life and on Robby's and my life together.  I think we're so accustomed to giving value to our lives only if it includes a family, and surely a family is a valuable thing.  But I'm recognizing that God has a purpose for me, and I have value in His eyes even if I don't ever become a mother.

Finally, I recognize that I am more open about our struggle.  I think, at the beginning, it was almost embarrassing for me to share with others that we were unable to have children.  I didn't want to deal with people's reactions, and I certainly didn't want people talking about me.  I know now, though, that this is a load to be shared, a burden to be born by those who love us.  It has been freeing to share more about our journey, and I find joy in seeing how God uses us to do just that.

There.  This all helped very much.  Thank you :)

A New Year

I haven't spent much time on this blog in the last year.  I can only say that it's not due to the fact that I don't think often about a baby.  It's the opposite.  I think about it all the time, so much so that it's just part of my life now.  In some ways, this struggle becomes easier with time.  I feel that God continues to grow my patience and understanding.  I don't have the same levels of anger or anxiety I once had.  But in other ways, the struggle becomes harder the longer it continues, and I wonder if it will ever be over.

The New Year always brings new hope for me, though, and I look forward to seeing what God will do in our lives.