The first was with my therapist, who is such an amazing clinician and is so phenomenally helpful with helping me sort out some of my mental chaos. It was good to talk through some of my recent anxieties about the IVF process and just life in general, and to be reassured and supported and given strategies to help manage and calm the mental storm.
The second was with a prenatal dietitian, which was arranged through my insurance and the division that deals with infertility specifically. I was very nervous ahead of time, because I've had mixed experiences with dietitians, between my history of eating disorders and my experience of bariatric surgery. I didn't quite know what to expect from the appointment, but spent some time in advance jotting down notes on some of the things I am worried about as I prepare for not only the IVF process but hopefully a successful pregnancy.
After a lifetime of dieting, I had bariatric surgery about two years ago, and it has been remarkable and life-changing and the tool that I needed all along. My only regret about the surgery is not getting it sooner, being too proud and too scared and just generally unsure about that type of medical modification.
But after being on one diet or another for about three decades before the surgery, it's still hard to quiet that diet-obsessed voice in the back of my head. The one that begs me to over-restrict after overindulging, or ties myself worth to specific numbers on a scale, or that obsesses over calories and portions and certain measurements.
At my baseline appointment on Wednesday, after I was given a demonstration of how to prepare my injections, I was told a few things about what to expect. It's all pretty standard: mood swings and emotional changes because of the hormonal shifts, constipation because of pressure from the enlarged and swollen ovaries, and a couple of pounds of weight gain due to fluid retention.
It's embarrassing to admit that the mention of weight gain was scarier to me than the needles I'll be injecting myself with nightly.
The main objective I had going into the dietitian appointment today was mitigating my weight concerns and trying to mentally make peace with necessary weight gain. Recognize that it's temporary. Celebrate that if I'm gaining weight, that means it's working. Consider it creating the soft, warm, healthy environment for my baby to grow. And please, please, please - don't fall into the same disordered eating habits of my first pregnancy, when I was being emotionally abused and constantly falling into a binge and restrict cycle.
The dietitian was very knowledgeable about nutrients and meal planning, but was not necessarily as aware of disordered eating and I'm going to keep looking for a dietitian who fits my needs a little better. The good news is, though, that the dietitian today had nothing but praise for all the work I have done with my weight loss and how I eat, especially in preparation for the egg retrieval and embryo transfer. I have a good understanding of how to properly fuel my body, and also what foods are best to optimize my health.
One thing I'm especially proud of during the phone call was when she asked about calories, and I insisted on not using calorie numbers. I had explained to her that after two years of active weight loss, I've been trying for the last month and a half or so to just maintain my weight so that I have a set point to be able to see if I'm gaining due to the medications. And she asked what my calories were for maintenance, and I told her that I do not count calories at all. That my entire life, I was on some sort of diet that had me counting points or calories or measuring things obsessively, and a big reason why I opted for bariatric surgery was not wanting to count calories ever again. I wanted eating to become intuitive, and that's where I am right now. I know what my portions should look like for weight loss, and I know that for maintenance, I should make the portions a little bit bigger and/or add some healthy snacks. But I'm not going to be obsessive about any numbers, because that has historically been more damaging than positive for me. She mentioned calories a few more times, but I always went back to focusing on the nutrients. And I'm very proud of that, because I have not always been assertive about my health needs, and this was a very big one.
She said the insurance covers a few more phone calls so we scheduled a follow up in about a month and a half. I agreed, even though I'm not quite sure how necessary it is - I figured, in that time, I'll either be successfully pregnant or will have failed the first cycle, and we can reassess from there. She also suggested a couple of books for me that I ordered, and hopefully those can provide some insight as well. I just feel very confident, though, in saying that if this doesn't work, it's not because of my eating. I'm taking tremendously good care of my body and will continue to do so throughout pregnancy and beyond.
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