The Pros and Cons of Fertility Drugs

Posted on July 25, 2016 by Alisa Hafkin

Infertility is being unable to naturally conceive a child after regular, unprotected sexual intercourse for over one year. Many couples who hope to become parents are diagnosed with infertility. The causes and treatments are many and couples face a number of possible interventions and choices that can be overwhelming and confusing.

One option may be the use of fertility drugs.  As with any medication or medical procedure, there can also be some side-effects or unintended consequences.  

  • Fertility drugs release hormones that induce ovulation to increase egg production and make the uterus more receptive to embryo implantation.
  • The use of fertility drugs may be a viable option for women who don’t ovulate regularly. There are many factors that influence the effectiveness of fertility drugs such as damaged or blocked fallopian tubes or scarring from endometriosis. A possible next step, should the drugs not lead to pregnancy, is in vitro fertilization.
  • Fertility drugs are very effective in helping women become pregnant but there still remains a significant number of individuals who are unable to conceive.
  • Costs can vary widely, depending on the form and whether blood tests and ultrasounds are included. If you have health insurance these drugs may be covered.
  • The pros are that these drugs are normally the first choice in fertility treatment due to their low cost and relative convenience.
  • The cons are possible side effects including bloating, headaches, hot flashes and nausea  and the possibility of multiple births and premature delivery.

I help couples coping with infertility issues. They can benefit from a holistic approach to achieving the desired goal of having a child. I educate couples so they can learn about the diagnosis of infertility and develop the skills and coping strategies that are needed on the journey to becoming a parent. If you have any questions or are seeking help during this challenging time, I can help you. Please contact me today.

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Successful Couples Therapy

Posted on July 6, 2016 by Alisa Hafkin

You constantly fight, you’re struggling with infertility…one of you mentioned divorce…someone had an affair.  There many reasons why marriages are strained and pushed to the limit and these complex issues compel couples turn to a counselor for help.  Whatever situation or scenario is driving your relationship downhill, a good counselor can work with you independently as well as together to build a safer and more solid foundation. Additionally, if you are miserable in your relationship it may be helpful to look at whether staying together is the healthiest goal.  I work with couples to help them see the bigger picture of their marriage and we explore what has led them to a place where hurt, anger, resentment and frustration has taken the place of love, caring and support.

If you feel like it is time to “do the work” of  couples therapy, here is my best advice.

  1. Be open to the process.  We will talk about your feelings and emotions and for some, that can be difficult to navigate.  You might be scared of divulging your feelings and revealing what your role has been in hurting your relationship.  You may also be scared of what your significant other will reveal.  But, the more open you are to sharing and listening the more you will get out of the process.
  2. Acknowledge your part.  While you may think your spouse is completely to blame, you probably have done something that was not in the best interest of your relationship.  If you go in without trying to blame your partner and share what you are willing to do to improve the situation, your partner may really appreciate that honesty and effort.  Try to stay away from defensiveness and explanation and substitute that for “how can I help my partner know and feel that I care”.
  3. Have goals.  Sometimes you just want a safe place to talk where a therapist can act as a guide, intermediary, referee, interpreter and a buoy in a stormy ocean of emotions. You might decide that separation and divorce is the best solution for your particular situation and therapy is a place where that decision can be made with mutual respect.
  4. Be realistic.  Couples therapy will not work overnight and can not completely change a person.  You need to be willing to dig deeply to uncover your own demons and sit with your partner as they do the same. Being open to self and mutual exploration is how couples learn about one another and grow. Vulnerability is the path to intimacy and if you are willing to commit to the process, you will learn so much about yourself and your partner.

If you are considering couples therapy I applaud you.  Sometimes just admitting there is a problem or catching something before it escalates can mean the difference between a happy marriage and a sad and dysfunctional relationship.  Take some time to find the right therapist and then be ready to engage in a journey with your partner.

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Coping with Infertility

Posted on July 6, 2016 by Alisa Hafkin

There are so many facets when dealing with infertility that can leave you feeling emotionally overwhelmed.  There is the medical/financial side of the issue with doctors appointments and insurance…then you have well intentioned parents and friends who ask “when are you starting your family.”  There is also the stress on your relationship because your dream of having a baby is delayed and sex seems like a chore.  All this is happening while you are coping with all the other aspects of your life. It can be too much.

How should you deal with the stress of infertility?

I work with my patients to provide them with coping mechanisms to deal with their emotional overload.  We meet regularly to discuss their struggles and together we find ways to shift the negative thoughts toward a more positive direction. The goal is to reduce the negative impact of the current challenging situation.

  1. Do not blame yourself.  Infertility is a medically diagnosed condition that has been around for ages.  Once diagnosed, it is important to find a way to feel empowered.  The more you blame yourself and your body the more stress you are going to experience.
  2. Talk to your partner.  Couples often visit my office together to work through these issues so they can feel that infertility is not going to break them.  It is important to talk about and process what is going on and make sure you are treating each other well during this difficult time.
  3. Educate yourself on the procedures and different options.  Here in New York City we have some of the most gifted doctors in the world, so find out what they are doing and what procedures might be appropriate for your particular circumstances.
  4. Know your limits.  Infertility treatment is expensive and the time it takes to conceive or make alternate plans can be lengthy.  As you go through the process of dealing with infertility you may need help setting goals so it is helpful to have an idea of your budget and also a timeline of when to consider other options such as adoption, surrogacy or remaining childless.
  5. Stay away from people and activities that make you anxious.  While it is healthy to still be social you might want to carefully consider situations that may make you feel uncomfortable.  If you find that people in your life want to know what is going on with infertility treatments, do not hesitate to protect your privacy. Only you can know what may trigger sadness, anxiety or grief so trust that if you don’t want to talk, it’s ok.

Infertility is not easy to deal with and it can stress and test the bonds of your marriage, your finances and the limits of your emotional capacity.  Sometimes, taking it easy on yourself and getting out for some distraction from the all consuming endeavor of trying to conceive can make a world of difference.  Get help with reducing the stress in your life so that whatever decision you arrive at will be achieved from a deep place of knowing what is best for you and your partner.

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Should We Just adopt?

Posted on June 13, 2016 by Alisa Hafkin

You have had dreams of growing a family with your partner but have had a few road blocks placed in the way.  If you have walked a path 0f infertility and have not had any success you may be wondering if you should consider adoption or surrogacy.  I know this is a hard time.  In my practice I work with clients dealing with these issues and questions and it is always challenging and often scary.

The decision to contemplate what lies beyond infertility is highly emotional.  And then to start learning about options and the business sides of different processes can be overwhelming. As you start to move past the dream of having a biological child you are hit with many questions you might not be expecting.  These questions can include whether you want adoption or surrogacy, private adoption, closed files, do you want to adopt from here in NYC, the United States, internationally?  Can we afford all the costs associated with adoption or surrogacy? Each question presents more questions and challenges but it also presents opportunities that will hopefully lead to your establishing a family.

The flood of emotions and hundreds of details can take their toll.  I help my clients through this time by using the resources we uncover in you to build up inner strength and an array of possibilities that can bring them closer to having a child.  When we meet to explore feelings and options during this difficult time we:

  1. Discuss letting go of the immediate plan of having a biological child.  You are never giving up that hope, you are just starting to grow a vision of building your family in a different way at this time.
  2. Ensure both partners are on board with the choice to move forward with adoption / surrocacy.  This will be an essential piece of working through this together.
  3. Work through all of the emotions that arise as you face a myriad of decisions.  What type of relationship will you want with the birth parents?  How are you going to tell friends and family?  What will you tell your child and when? Why does it take so long?

I act as an impartial sounding board for you. We explore and work through all sides of the issues so that you gain strength and confidence to face the process of adoption/surrogacy.  I can work with you and your partner to try to find peace, resolve, and most importantly, support for each other through this scary yet exciting time of growing your family.

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When Infertility is Hurting Your Relationship

Posted on June 13, 2016 by Alisa Hafkin

Young couples often dream of growing their own unique family.  When walking down the aisle there is an expectation that this will all be a natural part of their future.  The decision to start a family is an exciting one, but for many couples pregnancy does not come easily.

You get concerned after trying for about six months and your doctor may run a few tests or tell you to wait until a full year has passed.  When after a year pregnancy does not occur there may be more invasive procedures, time missed from work, medications, disappointment…it is a tremendous amount to handle.  Not to mention other friends are getting pregnant and you feel as if your dream is shattered.

Infertility causes stress on your relationship.

You may be in a slump or feeling agitated and snap at your partner.  You may be afraid to share your feelings for fear of upsetting your partner and he/she too may feel extremely scared and disappointed.  Your relationship is becoming strained and sex seems like a medically prescribed process.  There are fights and signficiant misunderstandings on both sides of the relationship.

I can help you both process these feelings and provide you with coping strategies to help deal with the stress so you can move through this time in your life with greater ease.  Individuals and couples need an impartial person to talk with because they know their feelings are safe when they sit with someone who can accompany them through this difficult time.  There are a few main areas that couples often struggle with when dealing with infertility.

  1. Both partners may feel inadequate or defective since a pregnancy has yet to happen. Whether you know what the problem is or have yet to uncover it, feelings of “what is wrong with me” creep into self-talk.  Women start to wonder why their bodies are not cooperating with motherhood and men feel like failures.
  2. When one partner gets in a slump or gets upset due to stress they tend to take it out on the other.  Fights are started for no reason and unreasonable expectations are put upon each other.  You may find yourself wanting to try and make every other part of your life perfect or you may need someone to be on the receiving end of your anger and sadness.

All of your feelings and actions are completely normal when struggling with infertility.  We work together to ensure that you build the skills and understanding to uncover the stress and not take it out on each other.  Put support in place so it can bring you closer together as a couple.  You are the only two people on earth going through this particular situation with your set of circumstances.  While you may feel as if you are being tested this is an opportunity and important time to build an even stronger bond.

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Getting Outside with the Baby in NYC

Posted on May 2, 2016 by Alisa Hafkin

You have a new baby in NYC and you have been going crazy in your apartment.  The weather is just starting to show signs of spring now that we are in May!  There are many resources out there with information on baby friendly places in Manhatten.  Here are a few suggestions you can use when it is time to get out and get moving!

Walk
Just about every New Yorker loves to walk (mostly out of necessity)  and with so many beautiful options you should put this at the top of your list.  Take a stroll on one of the paths in Central Park and do not forget about the zoo.  If the weather is iffy you can even stroll around a museum – the Met has so many wonderful exhibits and big open areas for strollers.

Eat
You may think that now you are a parent with a young child your days of dining out are over – not so!  In fact dining out at the right place and time can be the perfect scenario for parents who want to reconnect, not cook and clean-up, and of course…just get out of the house!  While dinners at a romantic restaurant are probably not a good idea with your baby, you can try places like outdoor cafes, and other family friendy establishments in your area.

Explore
On beautiful days you can get out your stroller and set your course for a new part of the city.  If you have never taken the time to roam around Battery Park now is a great time to get to know that area.  Get over and walk on the High Line or stroll down streets in The Village you have never visited.  You never know what you will find!

Getting our regularly with your new baby is important.  While your whole life has changed it does not mean that you can not enjoy our city.  You and your partner will enjoy exploring the city as a new large family of three and learn about so many new places you never knew existed.

 

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When You Feel Too Depressed to Move

Posted on May 2, 2016 by Alisa Hafkin

Depression can come on slowly or descend upon your life like a thud.  However it hits your life it is so important to keep moving forward, even if it’s just inch by inch…and we know this sometimes just does not seem possible.  You want to stay in bed all day under the covers or hiding on the couch…alone.  Caving in to depression is compelling but not the best way to help yourself because, while you think “I’ll get up in an hour,” you know that you just might not be able to.

So when the sky turns to grey and it becomes hard to mobilize, put a few supports in place so that you can bring light again in to your life.

  1. Reach out to a family member, friend or therapist for support.  If it all seems like too much, send a simple text, email or leave them a message.  Let them know that you are having trouble.
  2. Eat and drink water.  Starving your body and not having healthy food can cause your depression to really spiral as you start to feel even more exhausted and helpless.  You can put a little pack of nuts by your bed for some quick nutrition and a cup of water always filled by your bedside.
  3. Watch TV that makes you happy.  Get involved in a story that takes you away from the sadness you are feeling. Think about your favorite uplifting movies and use them as a resource to help you focus on something other than your distress.
  4. Move a bit.  Even if you don’t want to get off the couch or out of bed you can still stretch.  Any movement will help your body to feel better.
  5. Do not beat yourself up.  Self deprecation can make your situation worse so, even if you are missing plans and feel you are disappointing others, do not beat yourself up at this time.
  6. Acknowledge your depression. Many of us make statements like “I shouldn’t be feeling this way” or “I have nothing to feel depressed about”. We often think that depression comes from difficult circumstances and sometimes it does, but for many of us, it is easily triggered by unknown factors. Allow yourself to feel what you are feeling and this sometimes alleviates the pressure by validating your state of mind.

For many individuals, episodes of depression work themselves out.  They find the energy or the resolve to start moving again and hopefully that will happen to you.  When you re-emerge it is critical that you engage in a therapeutic relationship so that you can strengthen your coping skills and have them available should your depression return.  With the right set of tools you will be able to catch and hopefully shorten and/or avoid debilitating bouts of depression in the future.

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Finding a BabySitter in NYC

Posted on April 6, 2016 by Alisa Hafkin

It is important for any couple to have date nights on a regular basis. Reconnecting as a couple and as adults will help with the stress of raising children. You can talk without the distraction of littles ones. The biggest problem parents face in making ‘date night’ occur is finding a babysitter they can trust.  Grandparents and other family members may be far away or unavailable. A service may offer prescreened options but still, having a stranger walk into your home and care for your children may be beyond your comfort level.

Here are three great options for finding a sitter in NYC:

  1. Trade time with a friend
    If you have children and a good friend has children you could trade babysitting hours.  You go out on Friday night and your friend comes to your home and cares for your children.  Then next night, weekend, or other date you go to your friend’s house and return the favor.  You get an experienced parent watching your children and someone you trust with your family.
  2. Just ask a friend
    If you are the first of your friends to have children you might not be able to return the favor with baby sitting hours, so just ask a friend to come over for a few hours.  While this may seem like an imposition to you, a friend may actually love the idea of helping you out.  How do you return the favor if your friend does not have children?  While cash may the answer it could also be awkward so send flowers, movie tickets or a restaurant gift certificate.
  3. Recommendations
    This can get a bit tricky because your friends may not easily part with names of babysitters.  Afterall, once a reliable and trustworthy babysitter is found you yourself may not want to part with the name for fear of someone else scooping them up!  If you have an honest conversation with your friend and explain that you really need assistance she may be willing ot share as long as you do not monopolize.
  4. Children of friends
    Remember babysitting when you were younger?  Teens today are still looking to make some extra spending money.  Ask your friends who have older children if they are ready to babysit!

When you are trying to find a babysitter start slow.  If you feel anxious, have the individual come over first to meet your children.  When going out with your partner for the first time with a new sitter make sure to stay close and limit your time to just a few hours.  As you and your children become more comfortable with the new sitter you will find that the time away with your partner will strengthen your relationship.

So many couples forget that it is important to ‘keep dating’ throughout their marriage, especially when they have younger children.  When you are raising young children, finding the time can be hard and finding a babysitter even harder.  It is very important for you and your partner to reconnect outside of your home and kids and it is an essential part of reclaiming and feeding your relationship!

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Date Nights in Your NYC apartment

Posted on April 6, 2016 by Alisa Hafkin

The kids are young, you are exhausted from work, you do not have a babysitter…yet you and your significant other desperately need some time to reconnect.  You need a date night but it is just impossible for you to get out.  What can you do?  Here is a recipe to have a great night together in your own home.

  1. Talk with your partner about the importance of this time together.  Your partner may also feel the desire to reconnect but probably feels stuck in the hustle and bustle of a busy life in a busy city.  By starting the conversation you are taking the first step showing your desire to connect and your partner will appreciate your effort.
  2. Your plan will include getting the children in bed at a reasonable hour.  This is going to include homework, baths, dinner and chores.  Start early to ensure the schedule goes according to plan.
  3. Do not plan chicken nuggets for your dinner but do not stress about creating a fancy meal.  The goal is connection not gourmet.  There are so many amazing restuarants in NYC that will provide you with a gourmet take-out meal so take the short-cut and remove a stressor from your to-do list.  If you have a budget issue bring home a pizza.
  4. Stick to the plan.  If your house normally operates in fire-drill mode then commit to a peaceful night and make it happen.  If this includes writing out a timeline then do that.
  5. When it is time for your date drop everything.  Stuff the laundry away, forget the dirty dishes, and do not worry about lunches for the next day.  Your time with your partner needs to be a priority and it is precious so treat it that way.

Your relationship with your partner can get lost in the craziness of raising a family in a fast paced city like New York.  Making regular time to reconnect might seem impossible but it will strengthen your relationship.  It does not have to be perfect, it just has to happen.  In fact, sitting on the laundry while eating pizza with a glass of sparkling water or wine and a lit candle will make for a fun memory for years to come.  You have years to perfect the in-home date night specifics so start simply. Remember, taking time to focus on your partner and your relationship will help during stressful times. You will remember and cherish the closeness you create on your date night at home.

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Anxiety at Work

Posted on March 7, 2016 by Alisa Hafkin

Deadlines, pressure, budgets.  A cranky boss, overbearing colleague, or a client you just can not make happy.   All these aspects of your professional life can add up to feeling over stressed and may trigger your anxiety.

When you experience anxiety at work it can inpact every aspect of your life.  We spend more time at work than we do at any other activity so, if time in the office is stressful it can bleed into your home, social and physical well being.  Acknowledging the problems, reducing stress, and then putting a plan in place to manage your work environment can help you cope.

Here is a basic three step process to use when dealing with stress so you can reduce the impact before it takes over your life.

  1. Acknowledge what the issues are at work.  You can keep a small notepad by your desk and monitor stress throughout the day.  Does your stress increase when your boss calls or a particular co-worker stops in?  Do you start to experience a hint of anxiety as a deadline approaches or when you have to deal with your staff?
  2. Take responsiblity for your part of the problem.  If you feel stress around deadlines it might be because you are not planning far enough ahead to complete your work.  Maybe you have an employee who is not performing and you are ignoring the problem at hand.  It could be that you are contributing to the stress and not realizing you have the power to make it better.
  3. Put a plan in place to fix the problem.  Create timelines for projects and review daily to ensure you are on track.  Consult with human resources for options when employees are not performing.  Keep your boss informed more often of what you are working on so he/she is aware of what you are doing.  Be vigilant about the time you need to complete your work by closing your door and asking others to respect that boundary.
  4. Take care of yourself.  If you work in a particularly stressful environment I always recommend a walk at lunch to help ease the stress.  Breathing in some fresh air and moving your body can have a profound effect on lowering stress and ensuring anxiety does not creep into your mindset.
  5. Get social outside the office.  It can be beneficail to regularly meet-up with others who are in your same position but not necessarily in your office.  Maybe a fellow partner at your law firm that manages a different department or a friend who also manages individuals but for a different company.

If the above tactics do not seem to be working, it might be time to get some extra help.  We can strategize together and build a stress reduction program that will help ease your tension and anxiety.  We will review and fine tune your plan by enhancing what works and eliminating what doesn’t and in that way we will build a stronger foundation for you that will positively affect all aspects of your life.  We can ward off the stress, make you more successful at work and most importantly make sure the anxiety does not take over all aspects of your life.

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