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Bridging The Doctor-Patient Gap

admin — Fri, 11 May 2012 03:30:43 +0000

Doctors are invaluable. But they often fail to make a connection with their patients. How can doctors and patients overcome this?

By Dr. Lakshmi Ananth

Veena Sunder*, 45, is not happy with the doctor treating her for arthritis – she feels he just writes out medicines and doesn’t explain things to her. Rohini R*, 28, changed her gynaecologist in the fifth month of her pregnancy because she felt the doctor wasn’t communicating too well with her. Sound familiar?

Have you ever booked an appointment with a ‘world famous’ specialist that everyone recommended, sat in the waiting room an entire evening only to end up with a five or ten minute meeting with the great man himself, a prescription in your hand and none the wiser about your condition?

Why do doctors not talk to their patients? Or at least, why do patients get this impression? Here is an attempt to explore the communication barriers between doctors and patients.

The language of doctors

A new medical student is said to learn about 13000 new words in the first year alone. These are often, literally, Greek and Latin words. Technical terms or jargon soon occupy the vocabulary of the doctor to such an extent that they often know of no alternatives to these words. Many doctors continue to speak this way even to patients, often never realizing that the patient probably doesn’t get it. So if your doctor says, “We’ll have to marsupialize this cyst” instead of “We’ll have to open this fluid-filled swelling to remove the water from it” – you know what the problem is.

A doctor receives absolutely no training in the communications department.

Doctors aren’t taught communication

Believe me, all the tomes a medical student has to read for a degree only deal with symptoms, signs and complications. The stress is on how to diagnose and treat various conditions. There may occasionally be words like “reassure the patient” but never any details on how. A doctor receives absolutely no training in the communications department. So once a doctor graduates, the way he/she talks to patients and explains things to them depends on their inherent communication skills, not on anything that they have been taught in medical school.

The time factor

Let’s face it, doctors get busier as their practice grows. They get better at what they do as their practice expands, but it leaves them with little time for individual patients. This is the commonest reason for doctors not talking enough to their patients. Much as some of them would like to spend more time with each patient, the sheer numbers waiting outside deter them.

It takes all types of doctors…

Some just love to talk and you may receive enough information to graduate medical school. Others are reticent and barely get by with answering the essentials. But the way a doctor talks is not a reflection on his/her skills, so you will find some of the silent types with a huge following.

…and all types of patients

When an ophthalmologist Dr.Rao’s* practice grew to an extent where he couldn’t give detailed responses to all his patients’ queries, he had systems installed to give information. So patients would consult with him, get their prescriptions and be directed to one of the systems to view detailed presentations, videos and FAQs. The response? A third of his patients were delighted, they were very happy to have their questions answered. Others often made their way back to him with even more questions. Yet others complained at having to see “such graphic stuff”. Some people politely refused saying the prescription was really all they wanted and some others just didn’t have the time for any explanations.

Some things are just difficult to explain

In healthcare, not everything is known – the reasons for many medical phenomena and the causes for many conditions are still unknown. While it is relatively easy to answer a question like “Can I eat cold foods?” there is no simple answer to a question like “I’m just 35, vegetarian, don’t smoke, lead a sensible life and meditate, so how can my coronaries be blocked?” And there are definitely no correct answers to questions like will I be better in two days (I have a wedding to attend), is there a guarantee for this operation and just where did I get this infection from.

Doctors are people, too

And finally, doctors are just people like anybody else. They have to stand in queues, send their kids to school, deal with potholes on the road and see the dentist when their tooth aches just like anyone else. So even they have their good days and their bad days.

What can be done to improve doctor-patient communication?

Throw in a little of each of the above and what you have is a doctor who appears uncommunicative and insensitive to patients. But communication between doctors and patients can be improved with just a little effort on both sides. Most people, when they get sick, want to know what has happened to them and, more importantly, the cause for it; knowledge that will help them take better care of themselves and prevent a recurrence of the problem. They also want to know what their options for treatment are, how they can expect them to work and any other precautions they will have to take. Not unreasonable at all.

…do your homework – it is your right and your duty to be informed of the state of your body and your health.

All that doctors have to do is use more common or plain speak with patients. They can get someone to counsel patients and answer their questions if they are too busy to do it themselves. Handouts with dietary advice and answers to common questions often save many a heartache on both sides. If a patient is net savvy, the doctor can help by recommending websites the patient can refer to.

As for patients, it helps to go prepared – don’t be longwinded with your symptoms, instead make sure the doctor gets all the information about your condition precisely, especially if your time is limited. Keeping in mind a list of questions you want to ask also helps. But definitely do your homework – it is your right and your duty to be informed of the state of your body and your health. Search the net, find out more about your condition and even check if you are being treated correctly but always make sure you get your information from reliable sources. If you find contradictory information, the doctor is still the best person to check with.

Above all, remember that only you know what your needs are. So find a doctor you are comfortable with.

*Names changed to protect privacy

*Photo credit: Alex E.Proimos and Hiking Artist respectively (Used under the Creative Commons Attribution License)

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Prenatal Classes For Indian Mothers

admin — Fri, 27 Apr 2012 03:30:57 +0000

Have prenatal classes come of age in India? How can they help the busy, expectant Indian moms of today?

By Priya Mani

While childbirth is a cherished moment in a mother’s life, it can also be quite overwhelming. Prenatal or antenatal classes serve to help expectant mothers by teaching them about pregnancy, labour, delivery, postpartum recovery and baby care. The thrust of these classes is to equip a mother-to-be with the technical know-how, physical fitness and emotional competence to embrace the experience of childbirth in a confident and positive manner.

Origin of prenatal classes

Prenatal classes had a modest beginning in Lamaze – a coping technique popularized by Dr. Ferdinand Lamaze in the 1950s. Although they have been in vogue abroad for over half a century now, in India, the concept of childbirth education has trickled in only in the last decade but is catching on well in the metros.

What to expect in prenatal classes?

Rakhi Kapoor, Founder, Dwi Maternity Studios, a Chennai based childbirth education centre/wellness centre defines the role of prenatal classes, “While the medical support is provided by the obstetrician, the other parameters that attribute to a pregnant woman’s general health and vitals are provided by these classes. These include adequate changes in an expectant woman’s diet and lifestyle to accommodate the nutritional needs of the growing foetus, basic fitness parameters to counteract the various changes in an expectant woman’s body owing to pregnancy, the demands of labour and childbirth, and post-partum recovery as well as emotional and psychological support for the various fears and anxieties revolving around this whole phase in a woman’s life.”

Thus, prenatal classes should include four components:

Diet – A dietician/instructor analyses the nutritional requirements for every expectant mother based on her medical reports and fitness history, and recommends fitting changes to her diet. A similar diet plan or chart is also recommended for post-pregnancy.

Exercise – Prenatal exercises are taught by a certified physiotherapist or prenatal fitness expert. They are specifically designed to prepare the body for parturition. Fitness for the expectant mother includes a combination of breathing techniques, antenatal yoga or stretches, and exercises that strengthen core muscles (especially the back and pelvic floor), boost stamina and enhance energy levels.

Most mothers swear by the efficacy of patterned breathing in aiding relaxation, relieving stress, and coping through contractions and labour.

Dealing with Childbirth – The joys of having a baby notwithstanding, going through the rigours of childbirth is typically a cause of apprehension and dread. The fear of childbirth is the fear of the unknown.

Prenatal classes familiarize their students with the signs and stages of labour, childbirth terminology, the procedures involved in delivery – both normal and caesarean, pain management during labour including the right positioning and breathing, as well as the choices of pain-relief medication available.

Armed with this knowledge, a couple can make informed choices even as labour unfolds and tension mounts.

Deepa Sridhar* shares her experience, “No doubt, a piece-by-piece account of what happens on the labour table did have me uncomfortable, even a tad scared. But in retrospect, I was glad to have been prepared. I was a lot less stressed on the D-day as a result. No amount of reading could have actualized this experience for me.”

Counselling and Orientation – If pregnancy is an uphill journey, the baby’s arrival is nothing short of a rollercoaster ride. Thus, prenatal classes also offer guidance on breastfeeding/lactation, fundamentals of newborn care and basic parenting, all during pregnancy itself.

Some of them even conduct postnatal sessions, three-four months after the birth of the baby to complete the transition from pregnancy to parenthood.

As Priya Srinivas, Childbirth Educator and Nutritionist, Mom’s Lounge, a wellness centre for moms succinctly puts it, “It is important to appreciate the fact that if a mother has twenty questions while being pregnant, she’ll probably have a hundred more once the baby is born. Hence it is recommended to go in for postnatal sessions after delivery.”

Prenatal classes are open, interactive, fun sessions where parents-to-be get to clarify a lot of questions associated with pregnancy and childbirth…

How to use prenatal classes

Prenatal classes are open, interactive, fun sessions where parents-to-be get to clarify a lot of questions associated with pregnancy and childbirth – a luxury of time not available at the gynaecologist’s. They are also a wonderful forum to ventilate anxieties, debunk myths, and bond with other expectant parents.

Veena Mehta* shares her experience, “I was in my third trimester when I enrolled in a prenatal class. It was a time when an aching back, lack of sleep, and listlessness were getting the better of me. I was constantly out of humour.

This changed when I met women at the classes, some of who were also combating gestational diabetics, arthritis or taking daily shots as a part of IVF treatment, apart from the usual pregnancy woes. They helped me put my pregnancy in perspective.”

Prenatal classes emphasize both partners attending the sessions together, rather than only the mother. This enables the husband to understand better what the wife goes through, be a supportive labour partner and become a more clued-in, hands-on parent.

Soumya Vasudev* shares her experience, “Prenatal classes define the husband’s role in the mother’s support system and equip them so that they can take well-informed decisions when the mother-to-be may not be physically in a position to do so. In my case, though breathing techniques were the last thing on my mind as I laboured through in the final stages, my husband stayed cool and led me through the steps, thanks to his training in the classes. An added advantage – the massaging skills he had learnt in the classes proved to be soothing during the various stages of labour.”

That said, the labour support person can also be a close relative, a mother or a mother-in-law, who is then encouraged to attend the prenatal classes with the mother-to-be.

Prenatal classes: more relevant in India today?

Unlike the West, where attending childbirth classes is a necessity (since the couple may have to fend for themselves), in India support is ‘taken for granted’. The pregnant mother either goes to her mother’s place for delivery, or secures help from the joint/extended family.

However, things have changed with the rise of nuclear families. Besides, a greater number of women today are multi-tasking, career women, who between juggling deadlines at work and responsibilities at home, find it difficult to take care of their health.

Priya Srinivas says, “Neglect often leads to problems with pregnancy like fatigue, back aches, absence of weight management and lack of exercise. Attending prenatal classes helps working women cope with the pregnancy better.”

Like all things nouveau, prenatal classes too encounter a fair share of scepticism.

Ratna Deshpande* who attended Lamaze classes herself, articulates her views, “I am split on the benefits of knowing. Some get completely squeamish seeing videos from the other end. All women need to care is what they feel within and what to do when you have to “push”. The West believes in knowing the “enemy” – that knowledge empowers. I agree to a large extent, but it also can un-nerve you. Women have been giving birth forever. A lot of it comes naturally to you.”

In India, the reluctance to embrace childbirth education comes with long-held attitudes like an implicit faith in the generations-old wisdom that frowns upon any exertion undertaken by a woman while enceinte. Priya Srinivas validates this, “There are some positions in prenatal exercises which Indian women are still hesitant and not comfortable doing, like full squats, low impact aerobics, using weights during exercise ( 0.5- 1 Kg ) and using the exercise / birthing ball.”

…prenatal classes prove to be a great bonding experience for expectant couples.

There is also the predominant perception that childbirth is a women-only affair. Unlike the West, where the spouse is the default labour partner, Indian society is squeamish about the inclusion of the husband, a male, in the birth experience.

But things are definitely changing, even as men are becoming more proactive fathers. Thus, prenatal classes prove to be a great bonding experience for expectant couples.

Prenatal classes are relevant especially in the Indian setup, where one is assailed by myths, misinformation, and midwives’ tales; and the dos and don’ts of pregnancy dictated by conventionality rather than any scientific basis.

By empowering her with knowledge, endowing her with health, and dispelling her fears/anxieties about childbirth, prenatal classes can help to foster the overall well-being of a mother-to-be.

*Photo credit: b.pellizzon (Used under the Creative Commons Attribution License)

*Names changed to protect privacy.

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Common Myths About Contraception In India

admin — Fri, 13 Apr 2012 03:30:03 +0000

Where talking about sex and sexual health is taboo, misconceptions abound. Clear up some such common myths about contraception now!

By Dr. Lakshmi Ananth

Urmila Rao*, 26, is reluctant to use the pill. She knows it is best suited to her birth control needs, but she has seen her sister gain weight with its use and is afraid of the same thing happening to her. Seema K.*, 25, on the other hand, has been using the pill for over a year now but has recently begun to have doubts. She has heard that prolonged use of oral contraceptives can later make it very difficult to get pregnant. Radhika Sriram*, 23, is certain that she will never remember to take her pills regularly, but has a lot of misgivings about alternative methods and is really confused about choosing one.

These are not uncommon situations. At a time when contraception is an accepted part of life, when there are so many options available that we are actually spoilt for choice, the reality is that many people are just confused. With an abundance of myths surrounding the subject, many couples make birth control decisions based on false beliefs and misinformation.

Dr. Shubha Dwarak, senior consultant gynaecologist, agrees. “Ignorance or, in many cases, incomplete knowledge, anecdotal evidence and hearsay are the reasons for the existence of these myths.” A lot of people get their information from peers, friends or the internet. She adds, “Somebody who forgets to take her pill regularly and gets pregnant is likely to tell her friends it doesn’t work.”

Myths surrounding the pill

So, do oral contraceptives cause one to gain weight? “No,” says Dr. Shubha, “people gain or lose weight according to their lifestyles. Women using the pill are no more likely to gain weight than those who aren’t.”

But it appears that Indians aren’t nearly so worried about putting on weight as they are about regaining fertility when required. They also worry about contraceptives causing cancers and congenital anomalies in babies. Oral contraceptives actually cause none of these problems. In fact, they are known to be protective against ovarian and endometrial cancers. As for congenital anomalies, they occur due to disorders or defects in the genes of the parents. They may also occur when harmful medications are taken during the first trimester or the first three months of pregnancy when the foetus is in its early formative stage. This is why it is very important to avoid drugs and harmful substances during pregnancy.

…it appears that Indians aren’t nearly so worried about putting on weight as they are about regaining fertility when required.

Myths surrounding intrauterine devices

Other methods of contraception are not without their fair share of false beliefs. Intrauterine devices (the commonest in India is the copper-T) are recommended as a safe and effective option to limit fertility. Shreevani P.*, 32, was advised by her doctor to get one after her son was born. “But I had heard that it causes very heavy menstrual flow,” she says. Some people fear that these objects may migrate to other parts of the body and lodge themselves in the heart or some other organ, while yet others worry that the device may be preventing pregnancy by causing abortion.

Intrauterine devices are small, flexible contraptions placed in the sac-like uterus to render its environment unfavourable for pregnancy. They work by preventing fertilization from occurring, not by causing abortion after fertilization has taken place. Also, the device cannot go anywhere from the uterus. At worst, it may be extruded completely from the body, in which case it has to be replaced. Women using them may experience irregular or heavy periods in the first few months but usually go on to have less bleeding and rarely, even no bleeding.

Myths about other methods of contraception

Injectable contraceptives, hormones taken as injections instead of tablets, are effective and long acting. But they commonly evoke fears of later facing difficulty with regaining fertility. According to Dr. Shubha, women are very wary of birth control methods that cause complete cessation of menstrual bleeding.

Sterilization is often preferred by couples who have ‘completed’ their family. While tubectomy or female sterilization is widely accepted by women who have two or more children, vasectomy is traditionally linked to weakness, fatigue and even impotence. What many people don’t realize is that the surgery only blocks the tubes that deliver sperm to the semen leaving the rest of the reproductive system intact.

Sterilization is often preferred by couples who have ‘completed’ their family.

In the immediate postpartum period, breast feeding is supposed to be an effective means of birth control. In women who nurse their babies, menstrual cycles resume later than in those who don’t. Most nursing mothers are aware that once their cycles have started they have to adopt other contraceptive methods. But the timing of the first ovulation and menstruation after delivery can be unpredictable. Ovulation can occur before the first period, leaving a person unprotected in the time between the two events.

Other misconceptions about contraception

Surveys reveal that misinformation is very prevalent among young people. They believe pregnancy can be prevented by adopting certain positions or by washing, douching or even bathing after intercourse. Also, they are often unaware that avoiding pregnancy is different from protecting themselves from sexually transmitted infections. They need both and condoms probably offer the best solution for casual relationships. This is probably the basis for the belief harboured by some people that condoms are only meant for casual affairs, while the truth is that they are a safe and effective method that anyone can use.

With each contraceptive having its own benefits and limitations, the important things to keep in mind while choosing one are its safety, efficacy and how suitable it is to your lifestyle. What works for one person may not for another. Also remember that your own needs may change over time. So make sure you get your information from reliable sources and don’t give in to myths.

*Names changed to protect privacy

*Photo credit: Carolina Coca (Used under the Creative Commons Attribution License)

It Can’t Happen To Me!

admin — Fri, 30 Mar 2012 03:30:23 +0000

Cervical cancer is fully curable – if detected early enough. Putting aside our typical Indian hesitation to discuss reproductive organs, let’s get ourselves checked!

By Vandana Chatterjee

One woman dies of cervical cancer every seven minutes in India. By 2025, cervical cancer is expected to claim one victim every 4.6 minutes.

Still think it can’t happen to you? I thought so too. For almost a decade, knowingly, willingly, I skipped gynaecologists’ appointments to get a checkup and PAP smear. There was no reason other than inertia and the feeling of omnipotence – it can’t happen to me! Add to that work pressure, domestic commitments, Saturday schedules packed with grocery shopping, PTA meetings and every imaginable important unavoidable engagement that could not be postponed or rescheduled.

When I finally managed to reach a gynaecologist, I had a severely abnormal PAP report and was diagnosed with the earliest stage of cancer. I was lucky. I escaped with just a surgery as treatment. A few more months and I would well have been in an advanced stage, trudging from home to hospital for endless treatments, work and life in cold storage.

An overview of cervical cancer

Cervical cancer like all other cancers is completely asymptomatic in its early stages. Symptoms show up once the cancer has already reached dangerous stages. If there are any early symptoms at all, they closely mimic PMS or ovulation pains and are easily mistaken as routine gynaecological / hormonal issues.

The cervix is the lowest portion of a woman’s womb. Most of the uterus lies in the pelvis, but part of the cervix is located in the vagina, where it connects the uterus with the vagina. Cancer of the cervix occurs when the cells of the cervix change in a way that leads to abnormal growth and invasion of other tissues or organs of the body. Infection by the HPV (Human Papilloma Virus) is one of the commonest causes of cervical cancer, causing upwards of 90% of all recorded cases.

If there are any early symptoms at all, they closely mimic PMS or ovulation pains and are easily mistaken as routine gynaecological / hormonal issues.

Like all cancers, cancer of the cervix is much more likely to be cured if it is detected early and treated immediately. One of the key features of cervical cancer is its slow progression from normal cervical tissue, to precancerous (or dysplastic) changes in the tissue, to invasive cancer. It is estimated that it may take from one year to fifteen years for such changes to become a frankly invasive cancer. This slow progression though numerous precancerous changes is significant, since it means there are several opportunities for early detection and treatment.

Symptoms of cervical cancer

Abnormal bleeding: Women with cervical cancer may experience abnormal vaginal bleeding. This can be heavy or light bleeding during the month.

Unusual heavy discharge: An increased vaginal discharge which may be foul smelling, watery, thick, or contain mucus is also a symptom of cervical cancer. It is important to report any unusual vaginal discharge to your doctor.

Pelvic pain: Pelvic pain that is not related to the normal menstrual cycle can be a cervical cancer symptom. Many women describe them ranging from a dull ache to sharp pains that can last hours. It can be mild or severe.

Pain during urination: Bladder pain or pain during urination can be a symptom of advanced cervical cancer.

Bleeding between regular menstrual periods, after sexual intercourse, douching, or pelvic exam: Bleeding after sexual intercourse, douching, or pelvic exam can be cervical cancer symptoms.

Remember this!

Vaginal bleeding after menopause is never normal. If you have gone through menopause and have vaginal bleeding, see your health care provider as soon as possible.

Very heavy bleeding during your period or frequent bleeding between periods warrants evaluation by your health care provider.

Bleeding after intercourse, especially if the bleeding happens repeatedly needs evaluation by your health care provider.

If you have vaginal bleeding that is associated with weakness, feeling faint or light-headed, or actual fainting, go to a hospital emergency department for care.

Early detection of cervical cancer:

The incidence of full blown cervical cancer has reduced dramatically in the United States since implementing annual pap smears for all women. All sexually active women must get annual PAP smears to detect any abnormal cell changes at the earliest. Typically a PAP smear costs in the range of Rs 250-500 and takes just a few minutes for sample collection. This investment of a few minutes can save you several hundred thousands in treatment, not to mention the severe emotional trauma of accepting the reality of the C(ancer) word in your life.

All sexually active women must get annual PAP smears to detect any abnormal cell changes at the earliest.

Cervical cancer in the Indian context

Many women in India, no matter how educated & independent, will invariably put home, children, husband, family and work before their own health & well being. Many will see a doctor only when they are unable to get out of bed. We need to look at ourselves as essential productive members of society and give our personal health & well-being the importance they deserve.

In our country, a woman’s relationship with a gyn/obs, typically begins & ends with childbirth. Menstrual pain, PMS or any other gynaecological problems are swept under the carpet or treated with pain killers and a cavalier attitude. We stubbornly refuse to acknowledge the presence of reproductive organs in our bodies, other than for purposes of procreating. Some of us may consider giving importance to medical issues as a sign of weakness. The need to keep our uteri and ovaries healthy along with our hearts and lungs and joints is critical. And yes, this is true even after menopause!

*Photo credit: KWDesigns

Tuberculosis: Why Gender Matters

admin — Fri, 16 Mar 2012 03:30:28 +0000

March 24^th is World Tuberculosis Day. Women in India affected by TB have to battle the associated stigma and misconceptions as well.

By Hamsini Ravi

A couple of years ago, homemaker Martha Thoma* from Chennai suffered from spinal tuberculosis. Due to the acute pain it caused, Martha was unable to get up and perform her normal household duties. As she was undergoing medication and recovering at a relative’s house, she found out that her husband had plans to desert her and marry her sister.

As a mother of two children with only a high school diploma and limited job opportunities, Martha felt as if her whole world had come crashing down thanks to her illness. Martha’s story has a happy ending: she recovered in a few months, and thanks to support from her physicians and counsellors at the centre she was taking treatment from, she saved her marriage, and finally went back to living with her husband and children.

M. Deenadhayavari, a Social Worker at Resource Group for Education and Advocacy for Community Health (REACH) who helps tuberculosis patients in and around Chennai, says that Martha’s case is just the tip of the iceberg. A story in a popular television channel in July 2010 showed that every year, more than one lakh women are thrown out of their homes in India because they are affected by tuberculosis.

Women and the stigma of tuberculosis

Yet another study revealed that 15 percent of women tuberculosis patients were shunned by their families. Deena has encountered several such hostile relatives of patients. He says, ”I have been told by many women patients not to come to their house, or to not reveal my true professional identity, simply because they don’t want their family members and neighbours to know.” Many women patients prefer to meet their Directly Observed Therapy (DOT) provider in a public place outside home. ”They don’t mind taking the extra effort and paying to travel long distances to avoid their households from knowing about their condition,” Deena adds. This phenomenon spans women of all age groups.

“If it is a girl of marriageable age, her condition is hidden from potential suitors, neighbours and relatives, for fear that she won’t get married. For a married woman, it is about anticipating harassment from her in-laws and husband, and fear that her marriage is at risk, or potential domestic violence. Older women fear that their children’s marriage prospects are endangered,” Deena elaborates. Tuberculosis is not hereditary at all, and this message is often the crux of major education and advocacy campaigns.

Tuberculosis is not hereditary at all, and this message is often the crux of major education and advocacy campaigns.

Akhila Ram*, a Communications professional, who recovered from tuberculosis a few years ago has a slightly different story to tell. She affirms that this stigma towards tuberculosis, especially if you’re a woman, transcends class. ‘”People thought my condition (spinal tuberculosis) was contagious. They used to tell their kids to stay away from me and not eat food from my plate,’ she says. Akhila also talks of instances when friends and family would ask her things like, ‘”How did you land up with this? I thought only poor people get it.” From the stories of these women, it is clear that basic tuberculosis knowledge is lacking across all sections of the society.

Women’s health always takes the back seat

P. Vidhya, a colleague of Deena’s at REACH, talks of another dimension to women and tuberculosis. “I have noticed among male patients, that there is almost always someone to take care of them, and ensure that they’re on the right path to recovery. But with women, this is hardly the case. They’re often left to fend for themselves, and don’t get the right kind of care,” says Vidhya.

Since many tuberculosis patients come from weak socio-economic groups, a lot of cases (particularly among women), go undiagnosed or untreated, because of financial burdens. “This is also because women are primary caretakers of children and elderly people,” she adds. It is also worth pondering over the fact, that in India, while two-thirds of tuberculosis cases are males, women in the reproductive ages of 15 – 44 are most vulnerable to the disease.

A WHO- Stop TB Partnership study in 2009 determined that TB is the third leading cause of death worldwide among women of reproductive age. Pulmonary and genital tuberculosis have the potential to cause infertility and chronic reproductive illnesses. Dr. Nalini Krishnan, Director, REACH, emphasises that early diagnosis and treatment can go a long way in mitigating fertility and allied reproductive illnesses. She cites the example of a 25-year-old patient who delivered a healthy baby a couple of years after recovering from tuberculosis.

…in India, while two-thirds of tuberculosis cases are males, women in the reproductive ages of 15-44 are most vulnerable to the disease.

It is not that men are completely shielded from gender-related stigma. The word tuberculosis conjures up images of a skinny man coughing – and this stereotype works its way into male egos. While women face an integrated combination of violence and abandonment, men tend to feel less macho, due to their inability to contribute to the family’s income. The RNTCP 2011 Annual Status report stated that on an average 3 – 4 months of work is lost as a result to tuberculosis. This results in a loss of 20 – 30% earning potential of the household income.

It is worth noting that the RNTCP Annual report has no concrete numbers or statistics on gender and tuberculosis, or even a sex-wise split. Gender sensitive tuberculosis programming in India is the exception rather than the norm, and this needs to be rectified. Tuberculosis may physiologically, socially and psychologically pose different challenges to men and women, and the India specific challenges are even more underlined with nearly 2 million people getting infected and around 330,000 Indians dying of the disease every year.

*Patient names changed on request

*Photo credit: Gates Foundation (Used under the Creative Commons Attribution License)

Anger Management For Emotional Wellness

admin — Fri, 02 Mar 2012 03:30:33 +0000

Lack of anger management can affect all aspects of your life – including relationships and health. A look at why anger management is essential.

By Maitreyee Chowdhury

A scene from the movie ‘Jab We Met, showcases the female lead advising her friend, who is sad and angry at a girl dumping him. In a strange way, the central character Geet advises her friend to burn his ex-girlfriend’s picture and flush it down the toilet; symbolically, ending all the pent up anger and frustration that he has for her. A rather unusual and dramatic move I thought, but in many ways perhaps very effective in handling anger, especially the way many modern women see it today.

Haven’t we all wished a thousand times that we could flush out the anger that brews within us at certain situations or certain people? Perhaps the aforesaid solution is a rather simplistic way of treating pent up anger. But that’s not important, what is important is that one feels good after this pent up anger is washed out of the system and one hasn’t hurt anyone else in the process either.

Lack of anger management can be disastrous

The lack of better anger management can actually have disastrous results and affect not only one’s mental health but also hamper relations both personal and professional.

A recent report in the Huffington post revealed the incident of a woman (Faribah Maradiaga) enrolled for an anger management class, venting her anger on a fellow participant (Luna Oraivej) and almost injuring her. The report elaborates on how Faribah unable to control her anger over a minor argument, physically abused Luna. While all cases might not be as extreme, anger management and its control are a must for all of us, if we are to live happily and perform better in private and professional lives.

Incidentally, the inability to control one’s anger could also lead to related disorders that might manifest themselves with deeper issues.

Rehana D’Souza* who is a freelance writer and a highly creative person, is going through a divorce and fighting a battle in court for the custody of her child. Rehana’s husband wants to divorce her on the grounds that she is a patient of BPD (Border Personality Disorder). While this is actually not true, to her own amazement, Rehana found that her behaviour had drastically changed over a period of 6 years, without her even knowing it. The pressure of a creative job, managing home and a child, were finally showing on her. And while she was lucky to have the doctors certify that she was not a BPD case, she certainly had problems with anger management she was told.

…the inability to control one’s anger could also lead to related disorders that might manifest themselves with deeper issues.

Are women fatigued by too many responsibilities?

In times like this, one is reminded of the Hindu Goddess Durga. The lady with the ten hands seems to be the modern incarnate of the woman of today who manages several responsibilities all at the same time, while trying to be a perfectionist in each. Quite frequently, we take our responsibilities too dearly, too seriously, because that’s how women are built. Whether you like it or not, women start multi-tasking from very young. In India, the girl child from a tender age is often taught to bear with the tempers of the men of the house, look after the other children too and help the mother in the kitchen. All this while the personal wishes and emotions of the girl are suppressed. In certain cases this accumulated anger may find some vent in later life.

While this may have reduced in the urban scene today, women usually go through their lives, looking out for the interests of their family. Most women also juggle careers that include job pressure, work place politics and gender related issues too. Even if a woman does have outside help, much of the responsibility that she takes on has an effect on her psyche as a person. Under the circumstances, many women buckle down and are unable to manage this stress, leading to unpleasant situations.

Quite frequently, we take our responsibilities too dearly, too seriously…

Anger management, a solution for wellness?

There are some safe and easily practicable anger management techniques that you could try for sustained mental and physical wellness:

- Stop trying to do everything yourself. Learn to delegate and share responsibilities. As soon as children are old enough, make them responsible for their own work. Indian women have a habit of pampering kids and mothering them for far too long! Stop that, you are making your life hard and the child a dependent.

- If you have had a traumatic past, try sharing that with someone you can confide in. Don’t keep it to yourself. Sharing is good for our mental health. It will make you feel much lighter.

- Cultivate a hobby, give yourself some ‘Me’ time and do the things you like doing. Stop depriving yourself of little pleasures. Taking off some time for yourself is not going to hamper your family; in fact it will make them more independent and look out for themselves.

- If possible, switch jobs to something that is less stressful. It is always better to enjoy what you do, that keeps you and others happy too.

- While this may sound clichéd, be happy, have a positive outlook towards life, take care of your health.

Anger management can develop into a serious problem if it is not heeded in time. Do not fight shy of visiting a counsellor or talking to friends and family you trust about your problem. Your anger OR your wellness is in your hands, help yourself and help others.

*Name changed on request

Photo credit: Dario J Lagana (Used under a Creative Commons license)

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Self Defence For Women

admin — Fri, 17 Feb 2012 03:30:38 +0000

Violence against women is an everyday occurrence. Protecting ourselves is important, if not essential – and it is never too late to learn.

By Nisha Salim

India is the fourth most unsafe country for women, according to a 2011 poll by TrustLaw. When it comes to women’s safety, we rank just above Somalia. Delhi is the most unsafe city for Indian women, even during the day.

Over-protection fosters helplessness

A typical Indian girl from a middle-class or affluent family is raised chaperoned and over-protected. Rarely does she learn how to protect herself or react in a situation where she is attacked.

“If a woman is interested in regaining control of her life then it’s really important to break the mechanism of over-protection. Learning self-defence is the only way to do this,” says Ashwin Mohan, a martial arts trainer who runs Savage Fighting Arts in Bangalore.

“Crimes against women were never about sex but about power. Men who grew up with ‘controlled’ women in their households now see women seeking greater freedom, as their contemporaries. They have trouble not having someone subservient to them, so they exploit the one weakness everyone thought was not important – women’s lack of self-protection skills,” adds Ashwin.

Crimes against women were never about sex but about power.

Franklin Joseph, a Bangalore based social entrepreneur and self-defence trainer who runs Power To Women, agrees. “Even independent women may still follow only age old safety advice such as ‘do not walk alone in dark streets’ and remain unaware of the modern methodology of crimes. So they end up as victims.”

Both Ashwin and Franklin are quite vocal about how important it is for women to take ownership of their own safety.

Myths about women’s self-defence

Several myths abound about women’s self-defence. It is necessary to recognize these myths to take the next step and to empower yourself with the necessary skills for your own protection.

Myth 1: I am too weak/fragile/old/out-of-shape to learn martial arts.

You are not training to be the next Karate Kid. You are merely learning how to protect yourself, should the need arise. “Self defence is more about superior deception and manipulation, this requires thinking capacity rather than brawn,” states Ashwin. Martial art forms like Taijiquan can be learned even at 70. A woman who is aware of the possibility of attack and confident in her ability to fight abuse can fight back both mentally and physically. Self-defence techniques teach you how.

Myth 2: It will never happen to me because I do not step outside the house after dark.

Most sexual assault crimes happen within homes, and are perpetrated by those who are known to the victims. Walking alone in the dark is not the only dangerous thing you can do.

Myth 3: I move only among well-educated people; they are not rapists.

We have been culturally conditioned that people with a high status in society such as doctors, teachers or religious people will never attack anyone. But the truth is that assault cuts across all socio-economic classes. A person’s economic status or educational background does not guarantee non-violence.

Myth 4: I do not dress provocatively; so I do not attract unwanted attention.

Sadly, at least some women still think that the victim is to blame. Most rapes happen because an attacker happens to be in the vicinity of a person whom he thinks he can overpower easily, not because she was in a bikini.

Myth 5: Men are physically stronger, it is impossible to subdue them.

Self-defence is primarily about being aware of warning signs, recognizing dangerous situations so you can avoid them and understanding that you are physically as capable as any man to fight back. Stressful situations evoke a fight, flight or freeze response. Self-defence skills prepare you to fight rather than freeze.

Myth 6: I have a pepper spray in my bag, so I’m safe.

“Pepper sprays burn a lot but they make the attacker really mad. On Indian skin it is virtually useless unless it goes to the eyes. The eyes are a small target, movable and easily defended by a person habituated to violence,” reminds Ashwin. He trains people to recognize bad vibes or the ‘scent of violence’ so that they can get out of the danger zone immediately.

“The usefulness of pepper spray is limited. One cannot use it effectively in a closed or air-conditioned room where there is a high chance that you may get affected too,” adds Franklin, who is also not a fan of pepper sprays. He suggests that stun guns, which give a mild electric shock to the attacker, may be a better option.

Stressful situations evoke a fight, flight or freeze response. Self-defence skills prepare you to fight rather than freeze.

Self-defence 101

Here are a few self-defence tips from the pros:

- Pretend to be submissive and fight back when the attacker is off-guard, while faking an epileptic fit, asthmatic attack, nervous breakdown or a heart attack.

- Stay fit enough to run fast.

- Always walk on the right side of the road to avoid groping or chain snatching from behind.

- Always walk paying full attention to your surroundings, keeping your purse to your front.

- Avoid wearing high heeled shoes when you have to walk back to your home. Avoid too much jewellery while using public transportation.

- It is not rude to say STOP. Say it in a loud voice, but avoid using swear words or threats which may further enrage the attacker.

- You may trust and love a man, but your intuition is most likely to be right, so listen to your inner voice.

- If you have to fight a man, assume the role of a woman possessed. Keep kicking him repeatedly, attacking only the knees, groin or eyes or chin.

Remember that there is no substitute for self-defence training. You may not learn everything about taking care of yourself just by reading a few tips or attending a few weekend classes, but they will help you rethink what you have been taught so far.

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Caring For The Aged – And Yourself

admin — Fri, 03 Feb 2012 03:30:57 +0000

The experiences of five women who have cared for an elderly family member – how they coped and what we can learn from them.

By Melanie Lobo

We will all have to go through it one day or the other – caring for our loved ones as they grow older and infirm. Many of us have already been through this process and looked after our parents/in-laws when they fell ill and were unable to do for themselves. In the process, it is usually women who have to invest a lot – emotionally, physically and mentally.

With understanding

Nidhi Gupta has been married for 6 years and her time with her husband has been, “compromised from day one”. While her sister-in-law who also lives with them suffers from Down’s syndrome, her mother-in-law suffers from dementia. Nidhi’s husband, Nikhil used to be the caregiver for both mother and sister till he got married. Nidhi used to work earlier but gave up work when their son arrived. Since she stopped working, she is in charge of taking care of both mother-in-law and sister-in-law completely. This has taken a toll on her relationship and in the early stages, she and her husband would often end up fighting.

Here are her tips for women in similar situations:

- Communicate: Talk to your spouse about how you feel. Listen to what your spouse has to say as well.

- Understand: A certain amount of understanding is required in any relationship. Nikhil, she says, understands what she goes through and does not take her for granted. She views it from the angle that today it is her in-laws who are in this position, tomorrow it could be her parents.

- Don’t sweat the small stuff: Nidhi has also realized the importance of picking her battles with Nikhil. She has long since understood that she has no control over her privacy or the amount of time they spend together as a couple. She has just let go.

- Coping with her own needs: When Nidhi gets depressed at times, she turns to close friends to vent. When all else fails, she turns to reading which has always been a hobby and is a source of comfort and distraction.

- Make the effort: She feels it is very easy to wallow in self-pity and say, “why me”. Nidhi however, makes the effort to snap out of this, if the feeling ever occurs and carries on with life.

One’s mindset/acceptance

Dr. Sadhana Natu is another woman who was in a similar position. Her take on this is, “It depends on the mindset”. Dr. Natu looked after her mother who was bedridden with severe arthritis and related complications for several years, right up to the time she passed away. She is very matter of fact about this and feels that looking after one’s parents, “is part and parcel of life. As we grow older, so do they and we must accept the challenges that come with our parents growing old”. She was living with her partner and son at the time and stresses that her partner gave her complete support during those dark days.

There were many adjustments to be made but she did not look at these as “sacrifices”, but as “alterations” that were needed.

There were many adjustments to be made but she did not look at these as “sacrifices”, but as “alterations” that were needed. Dr. Natu is the Associate Professor and Head of the Department of Psychology of a reputed college and admits that her professional training in Psychology helped. Some important lessons that she learnt during this process which she feels could help other women are:

- Live in the present: Enjoy the time you have and cherish the relationships you have. Make the most of the time given to you. No one knows what lies ahead.

- Acceptance: Accept that this might happen to your parents or your in-laws. Understand that this is a natural progression of life. “We will all be in this situation one day. Life comes full circle, they looked after us, and we must now look after them.”

- Support: Ensure that you have a supportive circle.

One day at a time

Shilpa Desai still does not know how she coped with looking after her father who eventually succumbed to colon cancer. She says, “I was used to my parents looking after me. Now it suddenly was the other way around.” Her father was diagnosed with cancer in 2007 and passed away three years later. Those were difficult years for her. Her husband was working away from home, her daughter was in the eighth standard, her son in the first. She had to see to all her father’s needs, coordinate other house related problems, see to her children’s studies and also look after her mother who had started getting depressed. She says, “Life had come to a standstill and we were only dealing with the disease.”

I was used to my parents looking after me. Now it suddenly was the other way around.

Her take on how she coped:

- She managed on a “day to day basis”.

- Her parents helped: Very often initially, her parents tried to solve minor problems on their own. She was only brought into the picture when they could not do so or when there was a major problem to be dealt with. Both parents were cooperative and sensitive to the situation. They didn’t want their grandchildren affected. She says, “That was the biggest help”.

- Support: Her husband, while not there with her at the time, would keep in touch daily and talk to her and support her.

- Remain cheerful: Although this is easier said than done, you have to make an attempt to remain cheerful and not let the situation get you down. Otherwise, this traumatic time becomes even more difficult to handle.

Be positive

Kalpana Moghe looked after both parents and her mother- in-law. Initially it was her father and now it is her mother who is partially blind. Her father had a heart condition and his heart was only capable of functioning to 10% of its total ability. He was bedridden and needed constant attention and caring. Her mother-in-law suffered from Alzheimer’s and dementia which became steadily worse. This was a traumatic time for Kalpana and it affected her mentally, physically and emotionally. Her pillar of strength was her husband who was very supportive and helped her manage. Her advice is to:

- “Learn to take it lightly. Laugh yourself out of it. If you let it get you down, you will get depressed. Don’t let the situation weigh you down.”

- Have a good support system: Apart from her spouse, she also had support from her mother-in-law’s family who would come around and spend time with her. This would give Kalpana a break from the duties and allow her to have some time to herself.

Laugh yourself out of it. If you let it get you down, you will get depressed. Don’t let the situation weigh you down.

Ensure that the problem is diagnosed

Pixie Lamech looked after her grandmother, her aunt and her own mother – all three women suffered from Alzheimer’s. She candidly admits that during this time, “My own needs took a backseat”. Looking after Alzheimer patients is frustrating, and they are very difficult to deal with.

Emotionally, it affected both Pixie and her husband. There was a lot of stress in their lives, this happened in front of their young children and many compromises had to be made. Pixie admits that she found it easier to look after her mother once she knew what exactly was wrong with her. She managed these difficult days with:

- Support: Her husband was very very supportive. She also had a strong support system with friends and her mother’s friends who used to drop in and give her a break.

- Getting the illness diagnosed: This also helped Pixie manage as she could then understand what was really wrong with her mother. Counseling is now available for the relatives of Alzheimer patients. Merely thinking that they are growing old and thus forgetful will not ensure that you are doing the best you can for them. Often, there is a medical condition and not just old age that is responsible for the way they have become.

So there you have it. Five women who learnt to cope with life’s challenges in their own way. What would you do if you were in a similar situation?

*Photo credit: wharman (Used under the Creative Commons Attribution License)

Falling For Fad Diets

admin — Fri, 20 Jan 2012 03:30:06 +0000

We know they are bad for us and yet we succumb to them; why are we lured by fad diets? Here we go behind the lure of crash diets.

By Dr. Lakshmi Ananth

Reema Dutta*, a 29-year-old nurse, is appalled with her sister for going on a grapefruit diet to quickly lose weight for the New Year’s party. “I mean, come on, she’s doing her masters in biochemistry, so you’d think she would know better!” she says, shaking her head.

This is not uncommon. Most of us know our body needs a fine balance of proteins, carbohydrates, fats and micronutrients to stay healthy. Even those of us who know very little about the intricacies of nutrition know that fad diets are not good. But crash diets have always had their proponents and continue to do so even in these days when ‘healthy’ is all the rage. What’s so alluring about these diets? Here’s a look at the top reasons why we still succumb to the temptation of indulging in them.

Fad diets promise quick weight loss

This is probably the most attractive feature of any crash diet. The idea that you can lose all the excess baggage you’ve been lugging around for years in just a month or so is enough incentive for anyone. And there’s always some event around the corner to get in great shape for – a birthday, a new job or a party. In India, it’s weddings. Brides-to-be often look for quick fixes so that they can look their best on the big day.

In contrast, most exercise routines only achieve slow and progressive weight loss and also require tremendous discipline for any obvious results. 34-year-old homemaker Sandra D.* is a veteran dieter who has tried every known fad diet in the market. “I can’t wait for months and years to shed a few kilos,” she says. “When I go on a diet I want to see some results and quickly.”

But quick results are also the reason why fad diets are not safe. They cause weight loss at a rapid rate that is not good for the body.

The idea that you can lose all the excess baggage you’ve been lugging around for years in just a month or so is enough incentive for anyone.

Fad diets are goal-oriented

Fad diets usually tell you exactly what to expect. You know how many kilos or pounds you can expect to lose if you strictly adhere to the diet. “I love knowing that I’ll lose 10kgs in a month,” says Priyadarshini Raju*, a 32-year-old lawyer, who has been on a strict soup and herbs diet this past month or so in a bid to greet the new year with 10 kgs less of herself. With healthy diet and exercise programmes, the promises are vague – you can hope to get into shape, get a healthy glow, avoid diseases associated with obesity and things like that. But the appeal of numbers – 5kgs in a week, 2kgs overnight – is much greater and tempts you instantly.

Fad diets don’t require major lifestyle changes

Fad diets don’t come with fine print that says ‘works best when combined with exercise’. Fad diets don’t ask you to change your eating habits, your attitude towards food or your lifestyle in general. Of course, they are often very demanding, you may have to subsist on just soup or boiled vegetables for days, you may have to entirely give up some type of food, say carbohydrates. But whatever the compromise, the silver lining is that it’s only for a short period after which you can go back to being who you were.

But the downside is that, while you lose weight after a month on just cabbage soup, you may gain it all back with the binge eating you are likely to indulge in the moment your diet is done with. Look at Sandra, for instance. She loses weight every time she goes on a diet, gains it right back thanks to her bad eating habits and is ready for the next diet in a short time.

Fad diets come with very clear instructions

Reshma N.*, a 30-year-old secretary, is very clear about why fad diets work for her. “Have you tried eating healthy?” she asks and her tone suggests it may be easier to build a rocket. “There’s a whole lot of information about proteins and fibre and what not. Then there are lists about which food contains what, but nobody tells you exactly what to eat and how much to eat.” The problem with healthy eating plans is that there is no one-size-fits-all. Your diet has to be tailor-made for you taking into account your lifestyle, family history, occupation and needs.

But fad diets are easy. The diets are often as simple as ‘7 glasses of pumpkin juice a day’. Even the more elaborate diets come with clear instructions of precisely what to eat or complete menus that go ‘one slice of multigrain bread and a glass of orange juice in the morning’ or ‘snack on a cup of sprouted lentils’.

The problem with healthy eating plans is that there is no one-size-fits-all. Your diet has to be tailor-made for you…

Fad diets appeal to our vanity

Let’s face it, for many of us, weight loss is more about appearances than good health. We are more tempted to lose weight to fit into the little black dress or the jeans from college than the dull promise that losing weight can keep us healthy. This is what fad diets usually play upon. The celebrity promoting the diet has a figure to die for and you are tempted to try and look at least half as good. Or the person recommending it may have a story similar to yours, problems just like yours or may be a person you identify with. Things like these make people want to give it a shot.

Fad diets are often made to look like the result of a lot of research or extensive scientific analysis. But more often than not, they just turn out to be empty claims or overly-simplified inferences drawn from complex data. Remember that permanent weight loss requires commitment and a change in attitudes and lifestyle, not just shunning a type of food. There is, unfortunately, no magical method to shed weight. This year, resolve to lead a healthy and well-balanced lifestyle instead.

*Names changed to protect privacy

*Photo credit: just4you

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Surviving Infertility & Infertility Treatment

admin — Fri, 23 Dec 2011 04:15:31 +0000

Infertility treatment can be tough on you as well as on your relationship. A first-person account on dealing with IVF.

By Charu Katira

I always wanted three kids. I had no explanation for this wish. I just did. And I wanted my kids to be no more than two years apart in age. I ended up with two kids eight years apart in age. Talk about God disposing of your plans. Mine were disposed of in a grand, “Take THIS!” kind of way. My husband and I suffered from a very common condition called “Secondary Infertility”.

As per Resolve, the U.S. National Infertility Association, Secondary infertility is defined as the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications.

Feeling ready for infertility treatment

It took us years to realize that we needed help, mainly, because we had had no trouble conceiving the first time. We kept trying to explain our inability to conceive with “We have been very busy”, “We have been tired” and other such reasons. Initially we thought we had time, so we didn’t get too concerned. But slowly, as the years passed by and our older daughter turned 6, we grudgingly admitted that something was wrong and we needed help.

It took me another year to mentally prepare myself to go through assistive reproductive technique/treatment (ART). In particular, I was really afraid of what In Vitro Fertilisation (IVF) might do to my health. My husband made it clear to me that he was perfectly fine with just one kid and it was totally up to me if I wanted to go for infertility treatments to have another baby. And for a long time, I obstinately resisted the idea.

But, I was getting tired of the yearning. And the insensitive questions. Well-meaning friends started telling us to relax. One friend said, “Well, when I wanted a second child, I just put my mind to it and kept at it. I was pregnant within the year.” Family members started asking us for “good news”. Baby showers became excruciatingly torturous. Don’t get me wrong – I was happy for my friends, but even the most innocent banter from friends about “Get on with it now” would throw me into days of self-pity sessions. The last thing that broke my resolve not to go for IVF was when my older daughter broke down at the dinner table one night, crying, “I hate being an only child”.

Getting through infertility treatment

Fortunately, I worked for a company that managed infertility healthcare for a big medical insurance company. Caring and knowledgeable co-workers helped me figure out things to look for in an infertility clinic. They were also the reason I did not feel ashamed of having to go for ART. It was much later, when a whole room went silent during my account of how tough IVF had been, that I realized how people still view IVF or infertility. I had no idea, really. I have been socially clueless most of my life.

I was lucky in many respects. I had a husband who supported me through it. I had loving friends who rejoiced with me and never made fun of me; if they did behind my back, they never told me and I am thankful to them for that. I had a wonderful group of co-workers who supported me all the way through 5 Intra-Uterine Inseminations (IUIs), one failed pregnancy, two IVFs and a pregnancy. I did not have to live with extended family or tolerate taunts from family or neighbours.

…when a whole room went silent during my account of how tough IVF had been, I realized how people still view IVF or infertility.

But, IVF is an emotionally and physically draining process. I got through the whole process with the help of the following things:

1. Humour: My husband and I went through a battery of tests to find out that nothing was wrong with us but I still couldn’t get pregnant. This is called “Idiopathic (secondary) infertility”. I defined it as “infertility that results when two idiots cannot figure out how to have a baby the SECOND time around”. Humour helped dissipate any feelings of discomfort people around us were feeling upon being told that I was going through IVF.

2. The Royal Ignore: There WERE people who were ignorant or unsupportive about infertility treatments. They just weren’t on my radar. I ignored them. That was tough, but my husband and I were a team through it and that made it easy.

3. Communication: IVF can be tough on relationships too. My husband and I had a rule – we never blamed each other. And we tried to talk about anything and everything that bothered us. I understand it might not happen for everyone. In that case, refer to the first point. In our case, talking really helped.

4. Support: Nobody can, or should, go it alone. There must be at least ONE person in your life who understands what you are going through. Use their shoulders. If you cannot find anyone, email me at gettingtherenow at gmail dot com. I am serious. The least I can do is provide a sympathetic ear.

One thing that I would recommend for everyone going through ART is to believe that it is not your fault.

One thing that I would recommend for everyone going through ART is to believe that It is not your fault. I realize I have been very lucky because I got a baby out of this whole process. Not everyone is that lucky. I can’t imagine what I would have done if my second cycle had failed. So, I have no witty observation for that. Just hugs for whoever needs them.

Photo credit: kenziepoo (Used under a Creative Commons Attributions license)

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