distraught girl with numerous question marks coming out of her head (thoughts)

Pride Masquerading as Anxiety

I guess I’ve kind of been stuck in one of my uninspired ruts – the last time I posted was 7 weeks ago. At a minimum, I like to challenge myself to write and publish a post once a month. But if I have nothing valuable or important to say, it seems silly to post subpar writing. I confess, you may be about to embark on some “less-than-par” writing in this post.

October was a stressful month, kicked off by an emotional appointment with our fertility doctor. The days after the appointment consisted of a lot of processing about the infertility journey, and trying to decide what steps we did or did not want to take when considering trying to have a second child.

October was also chock-full of too many events. I get stressed out even when there are too many fun events happening. I need down time – though often I’m my own worst enemy when it comes to overscheduling myself. In October it seemed like we had about 10 different Halloween or Fall Festival carnivals (it was probably only 3 or 4 in reality), we had our first-grader’s big school fundraiser, our son (the same aforementioned first-grader) had just joined Cub Scouts and their biggest campout of the year happened to be the third week of October, and to top it all off I ended up needing to go out of town to Nashville for a work event… everything in the world felt like it was crammed into a 4-week time period.

I like being busy. I like hanging out with friends, traveling, and doing meaningful things with my time. But when I get so busy that I can’t do some of the essential things anymore, that’s when I know I’ve gone too far. When it becomes difficult to even have a conversation with my husband (as in, we have to try to schedule a time on the calendar when we can connect), when I don’t have time to workout, when I can’t find the time or energy to grocery shop or cook… those are my red flags signaling me that I’ve overcommitted myself. And I guess I didn’t leave much time for writing the last month or two either.

One of the things I did still make time to do over the last 7 weeks was read. And one thing I read has been mulling over in my head for a while now. I like reading books on spirituality – and I’ve been interested in prayer, so I was reading Timothy Keller’s book Prayer: Experiencing Awe and Intimacy with God. On page 219 (I noted it because I was so struck by his words) Keller says, “it takes pride to be anxious.”

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flowers in the shape of a uterus

The Appointment that Finally Happened: Seeing a Reproductive Endocrinologist

One year ago I shared about my husband’s and my struggle with secondary infertility. At that point, we had been trying to have another child for about a year and a half.

Today we’re past the two year mark, right at 28 months.

28 months.

Also in my previous post, I had shared that we had been referred to see fertility specialists, but that the doctor I was needing to see had about a year-long waiting list.

Well, the year passed and the appointment finally happened – on August 26th of this year I had my initial appointment with a reproductive endocrinologist at The Center for Fertility and Reproductive Surgery at Texas Tech.

Entrance to Center for Fertility and Reproductive Surgery at Texas Tech

I had really been hoping that it wouldn’t come to this, that I would find myself pregnant before the dreaded appointment arrived. We had tried one intervention that we were hopeful would give us a better shot at getting pregnant, (a prescription medication), but still nothing had happened so far.

Usually at any kind of fertility appointment, I find myself very jittery and emotionally fragile overall. Also adding stress to the day was the fact that this appointment was three hours away (because there are no fertility specialists in Abilene, TX) and I was by myself (because the logistics of work and picking up our son from school didn’t really warrant both my husband and I being gone all day).

I didn’t really know what to expect at the appointment. I had Googled about initial fertility specialist appointments, but the not-knowing also added to the levels of anxiety I had that day.

The appointment started with me paying a $125 copay up front, which was not covered by insurance. (From what I’ve heard, most fertility services are not covered by insurance at all. So you’re potentially paying hundreds to thousands of dollars all out of pocket.)

After waiting a long time, I was finally called back so I could wait some more in the much smaller waiting room. At every appointment I always bring a book with me to read, and I never end up reading it. When I’m anxious, I find that I can’t concentrate enough to read. So I end up just staring at random objects in the room, like counting the ceiling tiles or reading the informational pamphlet about IUDs.

The two biggest concerns I had for my doctor at this appointment were:

1) the pharmacy we had previously been getting the medication from stopped providing it (and it had seemed like it was potentially increasing our odds of getting pregnant) so I wondered if they could figure out another way to get it?

2) I had major reservations about IVF, and was assuming the doctor was going to tell me that it was really the only feasible option I had left.

When my doctor finally arrived, she was great – she was so warm and kind, and it was obvious that she understood the toll that infertility takes on the patients she sees. (I had read great reviews about her, so I wasn’t surprised, and that was also why I decided to wait a year to see her – I figured if I was going to go to a reproductive endocrinologist, I wanted it to be a highly-recommended one.)

She reviewed my chart, and then proceeded to do a vaginal ultrasound (which was a new thing for me!) Honestly though, it was kind of amazing how much information the doctor could get via ultrasound. She measured how thick my uterine lining was (in millimeters) and was even able to see which ovary I had ovulated from (the ultrasound literally showed a little hole where the egg had come from!)

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three faces, sad, nonchalant, and happy

Anxiety Screenings – Helpful Or Not???

You may have seen in the news earlier this week that a health panel (specifically the U.S. Preventative Services Task Force) recommended that all adults under age 65 get screened by their doctors for anxiety. This comes on the tails of COVID, inflation, and the rise of crime (among other things) that have left many in our country (and the world) feeling a lot more anxious.

The Task Force cited a study which showed that between August 2020 and February 2021, adults with symptoms of anxiety or depressive disorders increased to 41.5% from 36.4%.

Initially that doesn’t seem like a huge increase to me (about 5%), but the fact that over 41% of adults may be experiencing symptoms of anxiety and/or depression does seem concerning in its own right.

As with anything, there are pros and cons to asking (or requiring) doctors to perform anxiety screenings on their patients. So let’s take a quick look at both sides of the issue:

PROS

  • Screenings could help prevent mental health disorders from going undetected and untreated for years
  • Standard screenings help to reduce the stigma of mental health – it would just be another thing to get checked out annually like any other health issue
  • Standard screenings could help “combat the effects of racism, implicit bias, and other systemic issues in the medical field” (you can read more about mental health disparities among people of color in this New York Times article)

CONS

  • Screenings alone will not solve a mental health crisis – patients who get flagged as being “at risk” would need other interventions and could not be forced to get treatment
  • Some worry that screenings may primarily favor doctors and healthcare providers financially if there is an uptick in diagnoses
  • Some doctors expressed concern that adding “one more thing” to their already long checklist for physical exams is not practical or doable – there are also staff shortages to consider

As a mental health advocate, I am in favor of making anxiety screenings (or more broadly, mental health screenings) a standard practice for all adults and children. But I understand the logistical problems with carrying that out, and I also understand the fear that it may allow the medical community to take advantage of people (due to over-diagnosing or over-prescribing medications).

I am also aware that mental health treatments like therapy are expensive, and that unless there’s a more cost-effective way for everyone to have access to that service, it may not be realistic for everyone.

The problems with increasing mental health services are real and something that need to be considered, but my hope is still that more and more people would be proactive in taking charge of their mental health – and standardizing screenings could be one way to help accomplish this.

What are your thoughts on the Task Force’s recommendation? What other pros and cons have you heard about the issue?