Patient Story: The Things Nobody Tells You
In 2019, my now-husband and I had been engaged for three months and had been living in Colorado for two months (having moved from New York, where we were both born and raised). We were ready to start a new adventure living out West, but it turned out to be a different adventure than we envisioned. My husband started experiencing some strange symptoms, which we thought were related to altitude, but when they grew more extreme and he lost vision for a few minutes, we went to the ER. Long story short, he had a brain tumor and underwent emergency brain surgery the following day. Upon receiving pathology results, we found out that the tumor was cancerous and he would undergo radiation and chemotherapy. This was the start of a long journey for our family, during which we learned a tremendous amount; I want to share a few things that I wish I had known back at the start.
1. Consider how major medical issues will impact your family planning:
It seems obvious now, but when we were in the thick of navigating surgery, recovery, cancer treatment options, insurance coverage, etc., planning for our future family was not top of mind. I am disappointed that this was not something raised by any of our doctors. When I started asking questions about the impact of cancer treatment on fertility, we received important information that we otherwise would have missed. I am grateful that we were able to bank sperm to allow for our future family, but it was not simple. It would have been much easier to do before brain surgery or before relocating temporarily to Texas for radiation, but we didn’t know. It makes me feel like the system is broken and that we could have avoided some very real physical and logistical complications, if the topic had been brought up earlier. It is recorded that less than 50% of oncologists talk to their patients about the damage that cancer treatments can have on their fertility. I urge anyone who is navigating major medical issues (or knows someone who is), and also wants to start a family one day, no matter how far away that day might seem, to start the conversation about family planning early.
2. There is a lack of cultural sensitivity surrounding family planning:
It has become common social etiquette that you do not say anything about a woman being pregnant (no matter how obvious it is) until you are explicitly told that she is pregnant. However, there are so many other sensitive topics related to family planning to consider. For us, the big one was using a sperm donor. We did end up being able to have two biological children from our egg and sperm, but along our journey, we did briefly use donor sperm, as it was unclear if we would be able to use my husband’s sperm. Going through this process brought up a lot of questions about how to deal with this sensitive topic, which we had never discussed previously. It was daunting to think about how we might navigate the topic with our family and friends, how we would tell the child, and how to respond to seemingly innocent comments about who the child resembled.
Not every family is built in the traditional way, and it's important to consider the impact of your words. For those navigating their own journey, know that you might face tactless commentary from strangers and loved ones alike. You are not alone, and I hope that sharing our experience helps even the smallest amount.
3. Sometimes it's NOT easier the second time around:
Been there, done that, old pro, right? In reality, there are many aspects of this process that are more difficult the second time around. One was managing expectations, as every round is different. For our family, the most impactful difference was having a 2-year-old at home. IVF involves having doctors appointments almost daily at times, and also giving injections at the same time every day. Pulling this off with a young child in the mix makes planning for appointments and medications significantly more complicated. We did IVF in NYC for our first pregnancy, at a practice associated with a large hospital. At that time in our life, and our journey, it was a good fit for us. But the second time around, we had different needs.
If you are trying to get pregnant, it’s important to reduce stress, and part of this means examining your needs, and removing stressful obstacles wherever possible. The first time around, I found comfort in being at a large hospital with a huge practice and lots of doctors. But the second time, those same factors provided hassle rather than comfort.
With all those things in mind, when it came time to conceive our second child, I’m so glad we went with RMA of New York.
The RMA of New York locations were a game changer for our family. We mostly went to Mount Kisco but also used the White Plains office a few times. Both the geography and the accessibility of the offices were very important to us. We could drive up and walk in, rather than having to navigate multiple forms of transportation, plus elevators, escalators, crowded waiting rooms, and unpredictable timing.
Considering how important building a family is, we really appreciated feeling like people, rather than numbers. When I checked in at the front, I was always greeted with a warm smile, and a familiar face. The phlebotomists taking blood are incredibly friendly and personable; they make you feel like family. Dr. Lederman took the time to know us, and our case. He talked through everything and answered all our questions. We never felt like he was checking his watch, or his mind was elsewhere. He was committed to making sure we were informed and comfortable. We almost always saw Dr. Lederman and if we were going to be there on a day he wasn’t in, he was sure to make sure we knew who we were seeing.
Even after I graduated from RMANY, the door was never shut. Dr. Matthew Lederman and Dr. Natan Bar-Chama were speakers on a panel for an event I hosted for my company on fertility. When we were looking info bilateral salpingectomy (removing fallopian tubes) and evaluating a final semen analysis, Dr. Lederman saw our analysis order in the system and picked up the phone to talk it over with us. When we had our second daughter and sent information and pictures to the team, we received the kindest, most sincere response. We are done building our family and incredibly grateful to have an ongoing relationship with RMA of New York and to share our experience for whatever help it may bring to others as they navigate their own journey.
Written by Ali, a patient at RMA of New York - Westchester