Saturday, October 3, 2015

Realizing what Counts

I am slowly--but surely--coming to terms with the fact that I will NEVER have abs like these.
Jillian Michaels an endosister and adoptive mama truly being extraordinary through fitness and helping others.
                                             I have stopped counting my steps.
                                  I have stopped counting weight watchers points.
          I have stopped joining online exercise groups and drinking shakes for breakfast.
                      I have stopped beating myself up for living an authentic life.
At 36 years-old, as an endometriosis surgical veteran and infertility survivor, having a body seen on most magazine covers would take extraordinary measures on my part. I would need to tirelessly watch what I eat, obsessively counting calories. I would need to dedicate a good portion of each day to exercising in a methodical and intense way. Trying to mold my body into what I see exalted in the media would have to be my top priority. Even if I did all of these things, there would be no guarantees that I would be happy with the results.
I recently had my annual physical with my GP. Life was incredibly stressful leading up to the physical. We were in the midst of a family crisis that needed some major life changes in order for us to be happy and thriving again.  There was little time to exercise and lots of times to stress eat. I dreaded going to my doctor. The number on the scale rivaled that of my pregnancy weight. I prepared myself for a lecture. Instead I got a, "Hey great job, your cholesterol is down and your blood pressure is good. You are doing great. See you next year." So wait, my GP didn't care that I don't look like a Victoria Secret model? Did she not care about the excess weight I gained? She is happy with how I am doing? Why am I NOT happy with how I am doing? I was counting on her to reprimand me seeing as I had been demeaning and yelling at myself for months. Where was this self-loathing coming from?
I recently went home for my Great Aunt's wake. No one mentioned anything about my Great Aunt's physical appearance at her wake or funeral. No one mentioned how thin she looked at that one wedding in 1985 or that year she gained a lot of weight then lost it. No one remembered and no one cared. Everyone talked about her legacy of selflessness, of thoughtfulness and of service. Her loved ones spoke about her endurance, humor and generosity. It was these qualities that were so greatly missed and will be mourned.
 While at home, I spent a lot of time with my mom, my aunts and my grandma. I was overwhelmed by the negative talk I heard many of them say about their own physical appearance. They said things like, "Oh, I look terrible!" or "My arms are so fat." or "I don't fit into any of my clothes anymore. I hate my stomach." I think if you asked them to rate their physical appearance they would not speak kindly of themselves. I realized that a lot of these attitudes are learned behavior. Who knows how many generations of women this line of thinking has been passed down to? How do I stop the cycle when we as a society thrive on picking apart people's weight and physical appearance?
 It came to me that it is not enough to tell our daughters, nieces, patients, students that they are smart and beautiful, but we need to deeply feel it ourselves.   It is confusing to these young impressionable women to see their role models have self-deprecating views on their body, who often look a lot like their own. We need to love ourselves, even our imperfections because they help make us who we are. We need to love our strengths and accept our challenges. We cannot let anyone else's thoughts or actions stop this from happening. Instead of picking ourselves apart or letting others do it for us, we need to keep ourselves whole by loving and accepting ourselves. 
My mom, my aunts and my grandma will also be remembered by their loved ones for how deep they loved. These women work to help support their families. These women put their families first. These women are incredible and thoughtful friends, neighbors and members of their community. Instead of worrying about our physical appearance and beating ourselves up for it, we need to appreciate who we are and all we do for those around us. We need to look at our priorities and ask ourselves if how we are spending every day is in line with the legacy we want to leave behind.
I do want to make self-care a priority, but I do not want to take extraordinary measures to reach the unreasonable standards society has put on women to "look amazing." I am not buying it!  I.AM.DONE. I want to work instead on BEING amazing.
What does this mean? I am going to keep up the exercise that makes me happy and healthy but not beat myself up over skipping a week of working out if I am overwhelmed. I am going to overall try to eat healthy, BUT take pleasure in eating, drinking wine and enjoying dessert. As hard as it is, I am not going to worry about my dress size or how much I weigh. I will not use the word gross or blech ever when looking in the mirror. I will look in the mirror and try to appreciate myself.
 I am also going to be gentle with my body. My body has been through a lot and the journey is not over. I was lucky to be able to have a daughter and gave birth via C-section to her 6 weeks early. I have had 5 endometriosis related surgeries, the last of which had four specialists scrubbed in. I have had four miscarriages and many failed fertility treatments. My body is worn and weary. It has been traumatized. There are days I am so exhausted that I cannot exercise. There are days I am in pain. There are some days I am so bloated I look pregnant (and have been asked if I am-- for the love of everything holy:  STOP ASKING WOMEN IF THEY ARE PREGNANT. Even if you see the baby coming out of her vagina, politely make other conversation until SHE brings it up. ) I have to remember that my body is my partner and continues to work with me under great duress. My body is doing its' best, as am I.
I am hoping this new freedom of acceptance leaves more mental space and energy to work on my legacy. How do I want to spiritually and mentally nourish myself and those around me? What footprints do I want to leave for those to follow?  How will I bring more love into this world?

Friday, September 25, 2015

Honoring an Incredible Woman

Forgive me as a take a break from posting about endometriosis and infertility to share the eulogy that I wrote for my Aunt Dot. My Aunt Dot was an incredible woman. Thank you for reading.
On November 4th, 1933, Aunt Dot was born to Kathleen and Robert Phair, joining older sisters Evelyn and Sis, and eventually becoming and older sister herself to Grace.
As her sisters went on to marry and have children, Aunt Dot forged her own path, shining as an athlete and starting what would become a life of service with at risk girls with the Good Shepherds. This work built the start of a foundation of faith that would carry her throughout her life.
Aunt Dot was completely devoted to her family and friends. Many of Aunt Dot's friends became her family. I was told last night at the wake that for many sitting her today, years passed before they realize that "Aunt Dot" was not actually a blood relative. Her nieces and nephews and the generations that followed brought her such joy and laughter. She had this way of making every single one of us feel special with her love and her thoughtful questions about our lives. You truly felt how appreciative she was just to be in your company. When you tried to ask how she was doing, she always answered, "I'm great." and quickly turned the conversation back to you.
Aunt Dot endured many hardships in her life and often lived in pain. Her faith told her that there was a reason for everything. After losing her leg, the Good Shepherd Volunteers from years ago reunited and started gathering again. Aunt Dot told me that losing her leg was the best thing that ever happened to her; that is saved her life because it reconnected her to friends and faith experiences that would go on to be an integral part of her life.
That was Aunt Dot. Perpetual hope. Not only was the half glass full, but ain't we lucky to have a glass? It is hard to explain Aunt Dot to those who didn't know her. I am comforted that all of you understand when I say that she was extraordinary, rare and special. She never complained. She exuded love and faith with every ounce of her soul. Aunt Dot was full of joy. Every day, despite her suffering, she woke up and make a choice time and time again to be happy.
In her last 24 hours, Aunt Dot managed to still give to those around her. She shared laughter, love and her knowledge of life after death. During her anointing, she asked the priest not to pray for her, but for her family. She professed her love for each and every one of us. Hours before her death she exclaimed, "This is the best day of my life." She was fearless in life and death.
In closing, I wrote the following prayer to try and inspire me to be extraordinary.
Aunt Dot’s Prayer
When the world around me is crashing down, when nothing seems as it should,
May I have faith that God is here and find a greater good.
When I’m in despair and one more step I cannot complete.
May I have the grace to just be grateful that I still have feet (or one foot).
May I find hope in the sadness, laughter in the tears.
Generosity of spirit, to pass along the years.
May I see God in all I meet, have faith and pray.
Listen, be thoughtful and grateful for each and every day.
And in my last remaining days, when the temptation’s to be sad,
May I thank God for all the love and joy that I’ve ever had.



Thursday, April 23, 2015

You Are Not Alone NIAW 2015

Every month, a group of women from all over Westchester County gather together and talk about infertility in a safe space. During this monthly RESOLVE support group meeting, women show up and talk about the challenges, heartbreaks and devastations that infertility inflicts. If the group is going as it should, as the leader, I usually sit back and let the women talk amongst themselves and take ownership of the group, taking it where it needs to be for that evening. By the end of the meeting, group members who initially felt all alone before coming to the group are now exchanging phone numbers with veteran group members. A supportive safety net develops.
I always bring my group members chocolate and potato chips.

As a mental health provider to infertility patients, I am often the first person that a patient will talk to, outside of her partner or doctor, about her struggle with infertility. I also am often the only other person she has ever spoken to that has also struggled with recurrent pregnancy loss, infertility or endometriosis. Usually, before the patient and I even start to address the anxiety or depression that often accompanies infertility, I initially spend time with my patient validating her experiences and feelings. I assure her she is not “crazy” and that she is truly in crisis and that this is a traumatic time for her.

 Most patients who come to me feel completely isolated from their family, friends, co-workers and really from society at large. Infertility is not yet understood or recognized as the devastating mental and physical health crisis that it truly is. The fertile world has yet to learn how to respond compassionately to the 1 in 8 struggling with infertility, either ignoring patient’s realities or saying hurtful and ignorant things to those already struggling. Patients are left to suffer in silence, alone, which only deepens the sense of loss that a patient is already feeling.  

I always make sure to send patients resources to get them connected and invested in the infertility community. I encourage patients to follow me on twitter and I introduce them around to the infertility community there. I tell them to look at the RESOLVE website and find a support group in their area. I encourage patients to participate in RESOLVE Advocacy Day and meet other patients from across the country who have been deeply impacted by infertility.  If she is an endometriosis patient as well as an infertility patient, I send her other helpful resources to find support and understanding. Connecting to others and reaching out during this time of crisis has a positive impact on mental health. It is much harder to feel alone when you are connected to others that get it and empowered.

As a health care provider in the infertility world, my job essentially is to try and be a net that holds patients in a protective space while they are struggling. My job is to connect patients with resources that will help lift their spirits during this difficult time. I cannot make patients feel less scared or more certain about their future, because I have learned that infertility is unpredictable to its’ very core. I cannot control the outcomes of patients’ family building journeys, although I wish with all my might  that I could. But, what I can do is help patients feel less alone by not only my individual work with them, but more importantly, by connecting them with others who are in the trenches struggling with infertility on a daily basis.

Proud to be blogging as a part of RESOLVE's Bloggers Unite during National Infertility Awareness Week. For more information about infertility please check out:
  •  (Basic understanding of the disease of infertility.)
  • (About NIAW)
  •  Also if you are an infertility and/or endo patient please check out my documentary which I hope will make you feel less alone.

    Thursday, April 16, 2015

    EndoTruths: Infertility and Mental Health

    Endometriosis and Infertility each can be devastating in their own right. But, experiencing both at once,  often leaves patients to suffer for years through misdiagnosis and mistreatment from the medical community. By the time patients get the help they need, often their fertility has been compromised and their feelings of anxiety and depression are overwhelming.

    I reached out to the endometriosis community and asked patients to come and meet up to speak about their experiences with the disease. What came from this was 8 hours of footage of patients bravely talking about their unbelievable journeys with endometriosis and infertility. Their stories were heartbreaking, yet their spirits unbreakable. They spoke from their hearts and from their souls. They talked about how devastating the disease has been and the impact it has had on their mental health. They talked about what gets them through the day and what gives them hope, despite their pain.

    I am incredibly grateful to these brave souls who came and testified. I know their stories will help others. Many MANY thanks to Dr. Sallie Sarrel , Jen Rutner , April  , Amanda , Marin , Lauren Tait, Lauren, Colleen, Chelsea Kern and Joe Faller, our needed male perspective, for your time and for sharing your story.

    I have never been more proud of a project. I feel this represents so much of what I cover in my daily work counseling patients worldwide and through my group work through RESOLVE and EndoWarriors. The more we talk about these issues, the less patients will feel all alone.
    You are not alone. We are all in this together.

    Sunday, April 12, 2015

    EFA Patient Awareness Day

    It was such an honor to talk to endometriosis patients about the affects of endo and infertility at the Endometriosis Foundation of America Patient Awareness Day. For those of you that couldn't be there here is my talk!

    Endometriosis and Infertility

    Intro: Hi there, my name is Casey Berna. I am an endometriosis patient myself; I have had two excision surgeries with Dr. Seckin and four endo related surgeries before I found him.  I am also an infertility and recurrent pregnancy loss survivor.  I am a social worker and I do therapy with endometriosis and infertility patients and I also run monthly support groups through Endowarriors and resolve.


    Important Things to know about Endometriosis and Infertility

    1)      This is hard and you are all superwoman. Having endometriosis, a chronic, painful disease is INCREDIBLY difficult. Navigating infertility is a devastating struggle. When you put these two things together, it creates a physical and emotional crisis that is not really recognized by most doctors, co-workers, family, friends and society in general. Handling one of these things is exhausting and all consuming, handling both at once takes superhuman powers, which in my professional experience, most endometriosis patients seem to possess.

    2)      Be gentle with yourself, take care of yourself. Just because you have superhuman powers doesn’t mean you have to use them all the time. Feel free to say no to moving your brother into his new home, skip Cousin Susie’s baby shower or opt out of visiting your friend in the hospital who just had her third baby. I give you permission, no I demand you to protect your heart, body and your spirit during this time of crisis.  When you can remove any toxic people or situations in your life that suck all of your energy and bring you more stress.  I have one patient who calls her mom right before her transfers and tells her she can’t talk to her for a week. During this time, I feel like many of us are just doggie paddling through life, you don’t need someone or something to pull your head below water if you can avoid it.

    3)      Be aware of the emotional impact endo and Infertility. Many patients struggle with anxiety and depression. Endo causes fatigue, pain and the diagnosis and treatment of the disease is not simple. Patients undergoing infertility treatments, seeking out third party reproduction or going through the adoption process, often have hope, but their struggle is real and they often feel a lack of control and uncertainty. There are real stressors, financial emotional and physical often associated.  These experiences can be isolating.  Getting involved in the endo and infertility communities changed my life. Connecting with other women online who are going through similar things or attending a local RESOLVE support group can truly help. Get connected. And parts of endometriosis and infertility are downright traumatic. If you feel like you are drowning, reach out; find a good therapist who understands endo and infertility. It will help so much.

    4)      Be your own advocate. I have worked with so many patients who, even at the top clinics, have had their endometriosis dismissed or ignored when seeking fertility treatments. Listen to that little voice inside of you when it says that something doesn’t seem right or feel right.  Listen to your body. Educate yourself. Go online. That right I am ENCOURAGING YOU TO GOOGLE. Ask questions in the reliable forums. Read the articles posted on the endometriosis specialists sites regarding infertility.  If your dr. dismisses your questions or the information from specialists or dismisses the role endometriosis can play in infertility, find a new doctor. This is your body. Believe in yourself. Remember you are superwoman.  

    5)      Keep faith in yourself. Family building is a stressful and invasive process, it is so intense. Endometriosis can also be an intense, invasive and relentless disease. So many patients come to me saying they feel broken, broken on both a physical and psychological level. There is so much uncertainty, fear and sadness that come with all of this. One of my endo patients, a staple in my RESOLVE group, is an incredible support to others, her warmth and smile light up the room.  She texted me the other day to say her latest IUI failed, and after a very long road, she only has one more left to try. She is losing faith. After cursing the universe for her, I told her that I have no idea how this is all going to come out in the end but that I have faith in her as a person, faith in her beautiful relationship with her partner, and faith that no matter what comes, she will be able to find the strength and tools to figure out her path. This process can make us lose ourselves. But the truth is each one of us is incredible individuals with gifts and strengths. Even though you may not feel it at times, you are more than your endo and you are more than your fertility capabilities.

    Monday, March 23, 2015

    5 More Sleeps Until EndoMarch and EFA on Today!

    Are YOU Excited? Because WE are SUPER Excited!!
    Are you coming to the Today Show Plaza this Saturday March 28th for Endometriosis Awareness?
        Here are some last minute details to keep in mind!
    1)      Have you registered? If not register here. Don’t forget to tell Today that you are here for Endometriosis Awareness. If you or a loved one do not register beforehand, NO WORRIES, you can register that day on the plaza.

    2)      Have you made your poster yet?  My poster is shown above! This is the poster that the wonderful interns at the EFA made. 
    Make your poster catchy and bright! You also will be able to make posters at the PLAZA, they will have paper and markers.  Have your loved ones make posters that say catchy things & tell a story like, “My Aunt Katie rocks Endo.” or “All the way from Canada for Endometriosis Awareness.”  “Jersey Girls Fight Endo.”  “My best friend fights endo.”

    3)      Yellow! Yellow! Yellow! Be fun and creative! Wear a yellow shirt or scarf. Come with a yellow hat or funny yellow glasses. We are looking to grab the attention of the Today Show. They are into fun, passionate and energetic crowds. Dollar stores have great yellow merchandise.

    4)      I am getting to the Plaza around 6am to line up. You can line up at the corner of 48th street and Rockefeller Plaza. I am encouraging all of those who want to be seen to get there early. It is a first come first serve attitude when it comes to getting your spot. They will let the crowd in just before 630.  I am requesting that we leave room for some organizations in the front row so that they have a better chance to be interviewed about their work.

    5)      Logistics: You can bring a knapsack into the plaza, it will just have to be searched by security. Food, drinks and snacks can be brought in. You can bring cameras and cell phones. Dress comfortably AND WARMLY, there is a lot of waiting around and hanging out. If you need to take a break, you can leave and come back.  Next store, 30 Rockefeller Plaza,  has a downstairs public space which has a Starbucks, lots of other dining options and public seating. If you need a break, you can go there and hang out. After the Today Show, I encourage all patients to go there to hang out for a little bit and be together.

    6)      Weather: So far, the weather looks like it is going to be good. But keep checking the weather and get a yellow poncho or umbrella in case of rain. We will be there rain or shine.

    7)      If you have any questions please contact me, . Thank you for participating. Our main goal is to have the word endometriosis said on the Today Show on March 28th.  Obviously, it is a little discouraging that none of the major news networks have done a segment on endometriosis, a disease that effects 1 out of every 10 women and that takes 10 years of suffering on average for a women to get diagnosed. So if they won’t come to us we ARE COMING TO THEM!!!!!!!

    Saturday, February 28, 2015

    Endometriosis and Infertility Awareness Videos 2015

    Hello valued endometriosis community members! I am putting together three separate videos for Endometriosis and Infertility Awareness. Two of the videos will explore the effects that endometriosis and/or infertility have on mental health. One of the videos is entitled “think endometriosis” and will talk about the effects that misdiagnosis and mistreatment have on the patient, the quality of life and their fertility.

    These videos are for education purposes and also to help other patient feel less alone. Infertility and endometriosis have a profound impact on mental health.  Anxiety and depression are a common side effect of struggling with these diseases. Yet, it is not often talked about or it is ignored. Trauma and grief are also a big part of the lives of women suffering from these illnesses, yet women don’t always know they are experiencing these things.  It is time to shed some light on these issues to help patients understand what they are feeling. Mental health care providers need to be sensitive and aware of these patient needs so that they are not dismissive. Doctors need to not only treat the physical needs of each patient but ask the patient how their emotional health is and give them resources for extra support.

    My “Think Endometriosis” video is directly aimed at educating the medical community at large. So often the patient’s journey to seeing an excision specialist is a harrowing one filled with well meaning, but uneducated doctors that do more harm than good. I first started going to a gastroenterologist at the age or 19. Had he diagnosed me, I would have had far less surgeries, far less pain and would have made better choices regarding my fertility. I have talked with women who have gone to the top reproductive endocrinologists that this country has to offer and yet their advanced endometriosis was missed and their treatments unsuccessful and written off as unexplained.

    It’s time to bring these horror stories to the forefront in hopes that doctors educate themselves and change the way they treat endometriosis patients and think about endometriosis. Most often women do not have the energy to confront the doctors that are not giving them the treatment that they need or those who have mistreated them. They simply move on to someone who can help them and not look back.  Hopefully sharing these stories will help patients who suspect endometriosis not have to go through the cycle of trauma that other patients have endured before them. Maybe even well meaning doctors who may see this video will change their ways.

    When: Saturday March 7th from 10am -2 pm . I will have brunch available in the conference room for patients to socialize and will assign half an hour increments where I will take each patient into another room and record them.

    Where: Maria Droste Counseling Services 33rd and Madison

    What: I will ask patients a series of questions regarding their journey to diagnosis. I will ask patients to open up about the emotional toll endometriosis/infertility has taken on their lives, their relationships, the way they view themselves and their overall mental health.

    I am going to post the video on my youtube channel and share over social media. I will also present it at a lecture I am doing at Fairfield University.

    If you are able to attend or have any questions, please send me an email .  I may be able to also do some skype interviews. I am working on that possibility.