Pain after hysteroscopy

I’m pretty much used to various pains from my irritable bowel syndrome and my painful periods…but since my hysteroscopy I’ve been having really short sharp pains that radiate from uterus for a second, then disappear. It’s been random and a couple of times a day, and so haven’t thought anything more of it. But today at work I’ve doubled over a couple of times, noticeably in front of colleagues, and then been absolutely fine. The pain just disappears. I’m getting closer to the start of my period so I guess that is why it’s getting worse. I’m not very good at knowing whether this is normal or not, so when I speak with the nurse again I’ll ask. I didn’t need any pain killers at all after the procedure last week, so maybe it’s completely unrelated to the hysteroscopy  or maybe this is to be expected ☹

On a slightly related note, I’ve been figuring out when our third IVF will be with the new Lupron down regulation protocol. Depending on when my period starts this week, we could be starting stims the 1/2 April or the week after that! I’ve got the ball rolling with pre-approval from my insurance, I’ve got my birth control pills ready, I’ve stocked up on CoQ10 and new this cycle – melatonin! I’ve checked with my doctor and I can start the birth control pills before my results from the hysteroscopy appointment next week, if all things are good on that front I then start the Lupron for 2 weeks. I’ve also been clearing my work diary too and scheduling in some leave that I postponed from cycle 2. Fingers crossed, things at work will be a little easier going.


The hysteroscopy

I am insanely missing my blog right now!  I have been so busy with work and other things that my blogging has suffered, and I am constantly thinking about things I want to write about and get out of my head, I just haven’t been able to.  There is definitely a truth in writing being a form of therapy…a therapy I’ve come to rely on and when it’s not there I start to get itchy.  Anyway, I am here!  Briefly albeit 😦

Today I woke up at 4AM and could not get back to sleep, I won’t lie, I was a little anxious about the hysteroscopy procedure today.  We got up at 5AM so I could shower before inserting the cytotec pills into my vagina!  Nice.  We arrived at the clinic at 6:30AM and the nurses were great as usual.  I was first on the surgery list, a few other ladies were there for their egg retrievals after me.  I got changed into my beautiful one size fits all, modesty covering gown and climbed into a bed with freshly warmed sheets and a couple of extra because I get so so cold in that prep/recovery room!  I signed my life away and took the obligatory pregnancy test.  It would be miraculous if I was pregnant and we all joked about how we all would be happy if I had to be sent home because it turned out to be positive.  No such luck.

The nurse prepared the back of my right hand for the IV needle.  I have wonderful veins, but the nurse managed to bust it and it started swelling up like a balloon.  I started to feel faint like I was about to pass out.  I’m not a needle fan so watching this made me feel sick.  So she tried again but on the inside of my forearm.  She got the needle in, but it felt really, really weird.  She wasn’t happy with it, so she called another nurse to come take a look and try on my other hand. I was feeling really light headed at this point, so she lay me down almost completely.  The other nurse had done my IVs both times previously, so I started to feel a little better when she attempted to insert the needle in the back of my left hand.  She also used lidocaine to numb the area first so I was instantly less nervous because I couldn’t feel the needle jabbing around inside me!  Finally, the IV was in!


Pre-sedation! The nurses wrapped me up all nice and snuggly

Chris came back to keep me company whilst we waited for my doctor to arrive.  After about 20 minutes she arrived and asked if I had any questions; I may have mentioned this before but she has a real awkward bed side manner, it is actually now growing on me!  Then the anesthesiologist gave me a cocktail of drugs through my IV, and I started to feel like I had 4 or 5 strong margaritas (apparently margaritas was what he was putting through my IV!).  I was wheeled on my bed through to the operating room, and I concentrated really hard on looking around the room to see what it was like.  But that lasted 30 seconds and I was out.  Next thing I knew, I was waking up with Chris next to me, and everyone was laughing and joking at me because I had apparently been dancing to Elton John music in the surgery. Hmmmm.  OK, if that’s what you say!  I think it might actually be credible thing I’d do!

I vaguely remember them also saying that everything looked good on the camera and they had taken a biopsy to be sure.  I had to ask Chris later if I imagined this conversation because I wasn’t sure if I had dreamed it!

I was really, really sleepy coming out of this cocktail of sedation drugs compared to my egg retrievals. I struggled to wake up and felt very woozy. I asked the nurse if the drugs were different, but she said they were the same, they may have given me a little more this time, or just being tired and stressed can make recovery time longer.  Well, both of those things are true so I guess that explained it.  After an hour of coming out of the operating room, I was ready to be driven home.  We stopped off at Panera bread to buy some breakfast treats.  I also ordered a decaf caramel latte and when I took a sip of it I was convinced it had no coffee in it at all!  It just tasted like steamed milk to me.  Chris tried it and said that it definitely had coffee in it.  I didn’t believe him, miffed,  I didn’t drink anymore of it until I got home, when this time I took a sip it definitely had coffee in it!  So something weird was going on with my taste buds!  I attempted to eat my giant cinnamon roll, but my mouth was sooooooooooo dry I could barely swallow a mouthful.  My throat is sore and my mouth dry now still!  Well at least this time I don’t have a drippy nose!  Ah well, I think I would rather have been sedated than have none, so I can’t complain in the grander scheme of things.

So once again, everything looks normal.  We still have no explanation as to what may be wrong.  I  am pleased that there is nothing obviously wrong with my uterus (well, I am still waiting for the results of the endometrieal biopsy they took whilst they were in there today!).

Tomorrow I will phone and see what the plan is for starting IVF round 3 because my period is due to start 3 days before my results appointment, so I need to see if they will start me on down regulation before the results.  I also don’t really know much about their lupron down regulation protocol and how long they do it for.

For now I have a very busy week ahead of me, but I have a quieter weekend coming, so I hope to catch up with the blogging then and get me some blog therapy in!

The Pre Hysteroscopy Surgery Appointment

The nurse called me back and directed me to the toilet.  I told her I had literally just gone to the toilet 2 minutes before she called me and that I apologised profusely that I did not know I was required to do a pregnancy pee test! Whoops!!!  But the silly thing is that almost two weeks ago we did a blood test after IVF cycle 2 and it was a big fat negative.  I am currently on Cycle Day 11 so it would actually be a miracle if I was pregnant right now!! But hey, I guess stranger things have happened.  The nurse took my blood pressure and temperature as usual, but this time we did something different!  A finger prick to test my hemoglobin levels.  I told her it’s always fun to try something new at the clinic, just to mix it up a bit!  I suggested a fertility test card bingo game, I might be on way my way to winning by now!!  Winning what exactly, I’m not sure…

The nurse explained that she was going to order in to my pharmacy a prescription of two cytotec pills that I need insert vaginally an hour before arriving for my hysteroscopy next week (basically I will need to do that at 0530 on the day of the procedure!!! :-s).  Cytotec is actually primarily used to prevent stomach ulcers when taking Non Sterodial Anti Inflammatory Drugs such as Ibuprofen or aspirin.  But cytotec does have an off label use – to ‘ripen the cervix’ (Haha I love the fact that one ‘ripens the cervix’ like an apple or banana)  Basically it helps dilate the cervix so it is easier for the camera to get into the uterus.  So this adds 4 types of drugs I’ve used during infertility treatment that is off label use – Letrozole, vivelle dot estrogen patches, methotrexate and now the cytotec. Off label use means that the FDA hasn’t approved that drug for the manner in which the doctor has prescribed it.  But all of these drugs are commonly used off label, so I am not worried about it.  But at no point have I ever been told these are drugs are being prescribed off label.  It’s an interesting practice!  I digress….

After being prodded and poked by the nurse I saw my doctor who went over the procedure with me and updated my medical history.  The procedure is relatively simple.  I arrive at 0630 AM at the surgery operating room, they get me prepped and ready in a fabulous gown.  No eating or drinking after midnight until after the procedure.  No make up, jewellery etc.  Similar to the egg retrieval.  The anesthetist will give me a cocktail of sedation drugs, probably similar to ones to the egg retrieval.  Once I am knocked out, they insert a camera through my cervix into my uterus – there are no cuts required.  Then they take a look around.  If there is anything there that shouldn’t be there, they will remove it there and then.  They will probably also take a biopsy of my uterus.  The whole procedure typically lasts 15 minutes.  Then I am back out of surgery into recovery for about an hour for the sedation to wear off, then I am driven home by my lovely, patient, husband.  So it really is a quick and simple procedure.  I might be in a bit of pain afterwards, but there is no requirement for me to rest afterwards, however, I won’t return to work until the next day because of the anesthesia drugs.


Finally after my doctor gave me the low down and I signed my life away for all potential risks, I moved to the business admin office to pay my dues.  Here is the complicated bit.

My insurance provider is United Healthcare.  Well kind of.  My actual insurance company is Allianz.  I work for an international organisation where the majority of its employees work in Europe, but there are a small number of us here living in the US, so although Allianz provides us with worldwide coverage, it doesn’t have a primary market in the US.  So, Allianz pays United Healthcare to be the ‘front man’ for all of us employees who live in the US.  This means that Allianz gets access to all the in-network negotiated benefits and doesn’t have to worry about administration costs of billing etc in the US.  So all my healthcare providers bill to United, United then bill Allianz.

Have I lost you yet???!!

For anything dental or vision I have to pay for it upfront then claim it back from Allianz, then they re-imburse me 90%.  But I also have the choice of paying for any other healthcare service upfront and then claiming it back directly from Allianz,  I don’t have to go through United.  Most of the time this isn’t beneficial because of the in-network negotiated costs can sometimes be ridiculously discounted so it is better to go through United.  Except in the case of my hysteroscopy….

United demand that the hysteroscopy procedure is performed at a hospital and not the clinic.  If it is not performed at a hospital they won’t pay up.  If I went to the hospital, there is a longer wait time, particularly co-ordinating it so my doctor from the clinic can go to the hospital to do the procedure.  Then there is the high cost of doing it in a hospital – approximately $20 000!  Now, there would be in-network discounts on that, but still that is a lot of money when you compare it to what my clinic charges – just $1300 if you self pay.  Also, it is also far more convenient to have the procedure done at the clinic, especially as I know their surgery room well now!  So it doesn’t take a rocket scientist to work out what needed to be done.  Today I payed the $1300 ($400 of it in cash for the anesthetist, sounds dodgy right??!) , and then I will claim that back from Allianz directly in a couple of weeks time when I get the itemised bill.   Allianz don’t care where I have it done as long as it doesn’t cost more than the limit.  This made me think may be I could pay for all my IVF treatment upfront and claim it back – I reckon I could save about $500 if I did that.  But then I remember how many bills I got through and realised that there is no way I could easily track all of that and then track all those claims to Allianz in addition to also handle the pre-approval process.  I did that for my IUIs and it was a headache.  It’s not worth the stress.  Even if it were to give me a crap load of credit card points!!!!

Insurance in the US – what an absolute nightmare.  But I think I probably have it easy despite the unusual arrangement we have with United & Allianz.  I have it easy because I have amazing infertility coverage, and for that I am truly grateful.

Anyway, here I am, ready to go now for my hysteroscopy procedure next Tuesday!!! Who’d have thought I’d be excited for a diagnostic procedure that requires anesthesia!  This is what infertility does to a woman, it turns you into a masochist-craaaazy!

Good plan batman

First of all, let me say a big thank you to everyone who showed us support by commenting on my last update.  It has been a really difficult weekend.  Full of emotional roller coasters.  Chris and I have been brought to the edge with our sadness and confusion about our second failed IVF cycle.  I couldn’t reply to your comments without crying.  I am sure some of you who have been there have felt that overwhelmingness.  I read each and everyone one and they mean a lot, so thank you for your support.

Today we had our follow up appointment.  Chris and I prepared for the meeting the only way we know best….by making a list.  We wrote a list of all possible scenarios for ways ahead on this pudding club hunt.  And then we individually wrote down what we felt about each scenario and exchanged our thoughts.  We discussed where there were differences.  It was difficult and emotional to do as we realised that we agree in some situations, but not in others.  It’s OK at this stage that we don’t agree or have the same point of view, but it was bloody hard and we had some very raw and honest conversations.  We used up a few boxes of tissues 🙂  But what was good about this exercise is that we were ready to come to this follow up appointment prepared for whatever the doctor was going to suggest doing next.

When my doctor spoke to me on the phone to tell me the bad news that our IVF cycle had failed she mentioned poor egg quality, I took away bad things from this when I needn’t have.  This was just my doctor’s first impressions report, she hadn’t really looked into my case in detail or reviewed my history.  But this is what she did at today’s appointment.

Our doctor was very positive and believes that our best chance is to try again.  We expected that, but she ruled out egg or embryo donation for us or the necessity for genetic testing.  Our chances are still high more than 50% success.  We will make a couple of minor adaptations to our next cycle with my medication protocol by switching from antagonist protocol to Lupron (Down regulation) protocol.  I am a good responder to stimulation so she believes this may help improve the egg quality.  We will also carefully review our Day 3 v Day 5 transfer options at the time.  I had some excellent Day 3 embryos this time around, similar to my first cycle when I got my positive.  May be my embryos don’t do as well in the culture afterwards.

But before we go into another round of IVF, I need to have a hysteroscopy.  This is a small surgical procedure where the doctor inserts a camera through my cervix to look at my uterus and fallopian tube opening closely to check for any potential damage from my suspected ectopic pregnancy, scarring or inflammation as well as checking for endometriosis and taking a small biopsy for further testing.  So I am scheduled for my procedure in two weeks time!

We have a plan we are both happy with.  I felt a huge relief off my shoulders because our doctor was genuinely positive for our next round of IVF – and we pushed her about it too (well Chris did!!) – there was no BS-ing!   So all things going well after the hysteroscopy, we are looking at an April IVF/ICSI Cycle:-)

Thank you all for sticking with us through this, it has been hard, but you make it all the better!!  XXX


I’m not going to leave you

Yes, it’s true, I have said to Chris on several occasions in the past that I worry that he might leave me if I can’t provide us with a baby.  It’s quite a ridiculous thing to think about, I know.  I haven’t felt like this though for a long time, but I have felt in the past.  Perhaps when I was lot less insecure with myself and our relationship.  I can genuinely say now that I am not worried that he would leave me because we can’t have a child.

After everything we have been through together, I doubt he wants to run off with someone else to give it a go 🙂 I  am just kidding.  But what I really mean, is that I have seen with my own eyes and felt in my own heart how far and how much Chris is willing to put into this baby to make it happen – it has strengthened our relationship in ways I can not explain how.

Naturally, Chris gets offended by the very thought that I would believe he might leave me if I couldn’t bear a child.  He tell’s me:

“I’m not going to leave you, silly”

And I don’t blame him that he might be quietly offended.  I think in some ways it is like I just questioned his love for me.  I never meant for it to be interpreted like that, I just never understood why he would want to stay with me when he could find happiness elsewhere.  I can see now how much it must have hurt for me to utter these words to him “I’m afraid you might leave me”.

I truly do not feel like that today.  I have come a long way since I first worried about this.  I know Chris will be there with me, no matter what.  I am lucky to have discovered this now, I don’t need to worry.  But the funny thing is Chris worries that I still worry.  It’s worrying, all this unnecessary worrying.

Despite my own past insecurities, there is something that never goes away on this infertility journey; it’s those very tough days when your relationship with your partner is pushed to the extreme limits.  Just when you thought it was safe, the cork pops.  The feelings explode. You don’t know where they came from. Our resiliency is tested to the max.  That happened this weekend.

I know we will bounce back stronger, with a better understanding of each other’s buttons and mind matter.  It’s just hard to pull myself back up sometimes and Chris is no different.  We normally use each other’s strength to help one or the other back up, but what happens when you both fall down?  I don’t want to wait for help from someone else, we need some self rescue.

….do you have any ideas?  How can we get ourselves out of this funk?  How do you get yourselves out of the blues and into the sunshine, together again?

Happiness Lies in the Present Moment

Nearly three years ago I went to my very first yoga class.  I actually went to an Adult Learning College and took a ten week class for beginners.   As I had just arrived in the USA I thought it would be a great way to meet new people and make new friends.  I was the youngest in the class by about 30 years, so I didn’t make many new friends, but I did meet some wonderful people.  I was excited to be trying a new fitness ‘thing’.  What I didn’t expect from this course was what I would learn about myself.

I arrived 2 minutes late for the very first class (whoops!!!) and everyone was lying down…was I in the right class?  So I lay down my mat and followed along.  The teacher was trying to explain to us the importance of breathing in yoga.  As we followed along with inhales and exhales, I began to laugh at myself, this was way too hippy for my liking.  I felt uncomfortable just closing my eyes and following my breath.  The teacher asked as to think about each breath as we inhaled and exhaled, not about what we were going to have for dinner, or that work project, or that friend you need to call back.  Just to focus our attention on the air flowing in the mouth, down the throat, expanding the lungs and back out again.  Suddenly, I was lost in the present moment.  My mind was quiet.  I don’t remember the last time my mind had truly stopped racing….even when I sleep I dream a lot.  Little did I know this was my first step towards a love of yoga and a new skill of meditation.

After several terms at the Adult Learning College I decided I was no longer a beginner and so joined a nearby yoga studio.  The classes were small, often there were just a couple of us so there was a lot of teacher attention, it was great!!! One of our teachers liked to share with us some of her favourite motivational readings, and from this I discovered even more about myself as I took the time to listen and contemplated the reading after the class in the car on the way home.  It was so peaceful.

The one thing that I have learned from yoga is that happiness is now.  It lies in the present moment.  It can be found quite easily when I allow my mind to rest and take the focus of my attention of my concerns and problems, and allow my mind o relax and remain in the moment.  I find breathing techniques help me do this quite well.

I learned that happiness cannot occur when we attach conditions to meet it.  As this is an infertility blog, a good example is….. “I will be happy once I finally have a child in my arms”.  It is too easy to fail to recognise the feeling of happiness for what it is and inadvertently let it drift away with our thoughts of the future, looking for happiness somewhere else.

I discovered that after my yoga classes I felt a wave of warmth and happiness within myself.

I need to find this feeling again…My yoga studio went bust last year and there isn’t another one that is as close, so I have found excuses.  I could do it myself, use online videos, but I enjoy being lead to that feeling and some times I find it difficult to motivate myself on to the mat.  But excuses no more!  Inner happiness in the present I shall find!!!


Two week wait fun times planning

After two years of trying to conceive unsuccessfully I reckon I am getting quite good at this two week wait malarky.  Admittedly, I’m a bit rusty at it.  So in light of my previous post where I declared my new year’s resolution: I will embrace time, I decided to start thinking about my next two week wait for IVF cycle 2.  Now, I know that I will not be doing anything ‘extreme’ or ‘partying like it’s 1999’….but that doesn’t mean I can’t plan for some fun! right??!

Evening Fun Activities (i.e. post work)

Self-Pampering – Mud mask, jacuzzi bubbles bath, trashy magazine, a bar of chocolate (something fancy like) cosy pyjamas and early to bed.

New food (2 nights) – Cook or bake something outrageously random for dinner that requires some new cooking skill!  Like working with pastry or something equally different.  Glug it down with a random new TV programme from Netflix or Amazon Prime. Sadly no alcohol to glug.

Fun with friends – hang out with friends, either invite them over for take-away (take-out) dinner or try somewhere new together.

Fun with family – I can’t really do this well, but I will spend some time writing a couple of letters to my family back in the UK.

Meet some new people – go to one of my local social and sports club nights, make an effort to be sociable!!!

Crafty and creative (2 nights) – do some knitting (including teach myself a new stitch and practice it), start/continue my new painting (it’s a secret what I am planning to paint!!!)

Date night with hubby – Trip to cinema or rent a DVD with lots and lots of popcorn and some BIG SNUGGLES.

Blog focus night – discover some new blogs and write a new blog post (perhaps from my collection of ideas I have left over from NaBloPoMo 15).

Weekend Fun Activities

Well there is potentially only one weekend I will need to keep busy for!

Road trip to Charlotte, North Carolina (to include going to a Basketball game, a walking tour, perhaps a nice meal out and a trip to Lemur Land on way back!!!!).  I am pretty excited about this road trip.  My Birthday present was tickets to see the Charlotte Hornets play the Washington Wanderers.  I don’t support any particular team, I just really wanted to see basketball game!!! It was perfectly planned by Chris.

I looked back at all my previous blog posts that were tagged with the 2 week wait (2WW)…I think the key for me is to keep myself busy, even if it means I am just ‘planning’ to relax and pamper 🙂

Ohhhh I should also mention that I have ZERO home pregnancy tests in the house!  I used them all up last time and did not replace them.  So no sneaky testing will be happening this time around!!!

Do you have any other tips for the 2WW?


Today I am reflecting on time.

time quote.jpg

This week I turned 33 years old, and so I decided to celebrate all the threes, 33!  I had a few friends over for an afternoon tea party and we learned how to knit.  Yup….you may have been mistaken into thinking that I was actually having my 65th Birthday Party.  But haven’t you heard?  Knitting is totally hipster.


This is how I imagined my friends and I to be like at my Birthday party.  Very Cool.

Thinking about turning 33 I realise that I am quickly heading towards 35.  Yeh, yeh, that is two years away.  But 35 is the age that women apparently ‘may find it more difficult to get pregnant’…note – it can be difficult, not impossible.  And that is to be said for a woman who was supposedly more fertile than myself.  So, if the next round of IVF is successful and we do decide to have a second child I would definitely be past 35 if we ever tried to conceive again.  Not exactly what I had in mind!   But time is never going to be on my side and I can’t cheat it!

Today as I did a bit of early spring cleaning, I took down our four photo frames Chris and I put together for our Wedding day.  They were starting to curl and look a bit raggedy.

Dani and Chris-516.jpg

Our photo collage we put together for our wedding day…we look so young!

I peeled the photos off the frame and I noticed the lack of wrinkles on my face in some of the photos.  A couple were from over eight years ago when Chris and I first met.  As I look in the mirror today I see my slightly more pronounced furrow lines and wonder how much my life experience impacts these lines.  Often we associate wrinkles with ‘wisdom in life’, and I sure feel like that.  Since I met Chris we have done incredible things in our lives.  If I were to die today I would think I had led a pretty amazing life and would go with a smile.  But experience and wisdom doesn’t simply come from the good things in life, it’s also the bad things.  I think it’s difficult to truly appreciate the good things without experiencing some pain.  So when I see those furrow lines in the mirror I don’t just see time fading, I see time enriching me.

“The more sand that has escaped from the hourglass of our life, the clearer we should see through it.” – Jean Paul Sartre

With infertility, I want time to pass quickly, I’m always waiting. The dreaded two week wait (How many of those have I written about on this blog now??!), waiting to start treatment or waiting to end treatment!  But I don’t want it to pass so quickly that my furrows grow deeper and I realise too late that infertility made me accidentally press the pause button on gaining that life experience and wisdom – the good, bad and ugly.

So as I move forward into 2016, my new year’s resolution is to embrace time and make every bit of sand in that hourglass of life count for something.

How to make big decisions when dealing with infertility

Throughout infertility we are often faced with the kind of decisions that are life changing.  Life changing decisions for the more fertilely inclined will probably involve: whether or not to get married, which house to buy, where their next holiday destination will be, what career to choose, whether to stay or quit a job, and of course, the classic – whether they should tell their best friend that their partner is cheating on them.

For us infertiles it might also include whether or not to re-mortgage the house to pay for another round of IVF treatment, adoption, surrogacy or a.n.other expensive treatment, whether to undertake genetic testing of embryos, which body part to sell for the exuberantly priced hormonal medications we have to buy or whether to terminate a pregnancy to save our own lives.

Ok so I might have trivialised the decisions fertile people make (Please don’t take offense!), but I think you get my point.  Making decisions throughout the process is tough.  Fortunately for me, this is my line of business…I help the military make tough decisions, whether it is on operations or in peace time, I help them to see the wood for the trees.

So there are a few of the more simple techniques that I can show you that you might be able to use to help you when you get stuck in a rutt.  They are also useful to work through with your partner.  In-fact, it is is even better if you do work them through with your partner (or your BFF, sister or other close relative).  Getting an outsider’s perspective from someone who you trust can be helpful (obviously you don’t have to listen to them :-)).

I’ll order the techniques in difficulty, starting with the easiest first…


  1. Take out a large blank piece of paper and write at the top of your paper the dilemma you are trying to resolve.  For example. Take methotrexate treatment to terminate suspected ectopic pregnancy.
  2. Draw three columns down the page, each with the heading: Plusses, Minuses, Interesting.
  3. Start with the Plusses column.  Think about what the likely positive outcomes would be if you took the action.  Write each point down with a plus sign”+”.
  4. Next think about the likely negative consequences if you took the action. Write each point down with a negative sign “-“.
  5. You may also write down things that are interesting about taking this action – these might be outcomes that you are simply unsure of what the future might hold.  Write each of these down with a question mark “?”.
  6. Simultaneously get your partner to follow the exact same process.  Make sure they write what they feel, not what they think you want them to write!!!  This is a time for honesty.
  7. Now compare your lists and talk about the differences you might have and why.  If you don’t understand something on each other’s list then use the couple’s validation technique (described here) to help you explore each other’s feelings.  It is important to explore your differences and understand why they might exist.
  8. Hopefully a conclusion will fall out of this list writing.  If it doesn’t, then the dilemma you are facing is probably too complex for this technique, you may want to try another approach.


This is one of my favourite techniques!  You can do this on your own or with your partner, or as many other people as you like (ideally no more than 6 people otherwise it gets a bit chaotic!)  This technique makes you think with 6 different perspectives and helps you to organise your thoughts.  Edward De Bono who created this technique says:

“The main difficulty of thinking is confusion”.

He is quite right, and this technique helps to overcome a lot of the confusion in our minds.


  1. I like to have 6 separate blank pieces of paper ready. 1 for each of the 6 hats.
  2. Take your first sheet of paper, and write at the top: THE WHITE HAT – FACTS & INFORMATION.  The white hat makes you think about data and information.  It is used to record information that is currently available and to identify information that may be needed to help with your decision.  I.e. questions you may need to ask your medical practitioners.  Now think about all the facts you have about the problem you are facing.  For example, costs $$, available budget $$, dates, times, who is involved, who is not involved – any other facts or information you may have.  Write all these down.  Don’t forget to add any questions you may have that you simply do not know the facts of at that very moment – this is important!  Once you have run out of facts and information…move onto the next step.
  3. Take your second sheet of paper, and write at the top:  THE RED HAT – FEELINGS.  The red hat is associated with feelings, intuition and emotion.  this hat allows people to put forward their gut feelings without justification or prejudice.  Now write down your gut feelings you may have.  For example: “This drug is going to kill my immune system so I know I’m going to be sick for a long time after I take this injection. I don’t want to be sick anymore, I’m sick of being sick”.  Once you captured your feelings move onto the next step.
  4. Take your third sheet of paper, and write at the top: THE YELLOW HAT – BENEFITS.  The yellow hat is for a positive view of things.  It looks for benefits in a situation.  This hat encourages positivity even with people who tend to be more critical.  Now write down all the benefits you can think of.  Try to see the positive light when ‘wearing’ this yellow hat.  Once you have run out of positivity (!!) move onto the next step.
  5. Take your fourth piece of paper, and write at the top: THE BLACK HAT – CAUTIONS.  The black hat relates to caution.  It is used for critical judgement.  Sometimes it is easy to spend a lot of time focusing on this hat.  Now write down all the issues or downsides you can think of.  It is often easy to be the critic.  So for every negative, try to match it with a positive (using the yellow hat list and add to the yellow hat list if you need to).  Once you have finished being negative, move onto the next step.
  6. Take your fifth piece of paper, and write at the top: THE GREEN HAT – CREATIVITY.  The green hat is for creative thinking and generating new ideas.  This is your creative thinking cap.  Review your list so far.  Try to think about how you might want to overcome some of the negatives on your list – think creatively!!  You could try writing something crazy or wacky down to start with, then try to turn that crazy idea to something more realistic.  This can be difficult to do on your own!  Get some thoughts from other people!!  It is important at this stage to not immediately put down any idea your partner may make.  All ideas are good ideas when ‘wearing’ the green hat.  When you are ready move onto the final step.
  7. Take your sixth and final piece of paper, and write at the top: THE BLUE HAT – CONTROL.  The blue hat is the time to think some more about the thinking you have just done!  The blue hat reviews, summarises, concludes and makes decisions.  Now is the time to review your other 5 sheets of paper, add any last final ideas (it is OK to go back and look for any gaps in any of your 5 hats)…and time to discuss with your partner, similarly to the +, -, ? technique resolve differences in opinions and make some decisions.

Hopefully this technique will help you consider all sides of an argument and help you find some alternate points to your specific dilemma you may never have considered before.  The thing I love about this technique is that you can do this with your partner without worrying about ending up arguing.  Only negative things can be said when wearing the black hat…!!!  Use that to help you get things out on the table.  You can download a blank template here: But I would highly recommend doing the YELLOW HAT BEFORE THE BLACK HAT!!! Sometimes you can do the BLACK HAT before the YELLOW HAT, but it really is up to you 🙂

It is simple once you have done it once, and after you remember the 6 hats, you can apply this as a mental model to any decision you want to make.


This isn’t really a formal technique per se, but it is something I came across a while ago when I was making a decision about whether or not to take methotrexate to terminate my suspected ectopic pregnancy.


I used this notepad to help me make a decision whether or not to take methotrexate

I bought a pad of paper that had blank lines to fill in anytime you want to make a decision.

decision blank

It nicely mixes up the two techniques I have already explained, and it is quite funny.  You can buy these ‘Knock Knock’ notepads from amazon here.

OK this post is long enough already….I’ll write about some more decision making techniques another day 🙂

3 months post Methotrexate

Today marks the day that 3 months ago I took the methotrexate shot to terminate my suspected ectopic pregnancy.  Today is an important day for Chris and I because we are officially allowed to try to conceive again!  Woohoo!!!  We were on a ban from conceiving just in case I got pregnant and the methotrexate was still in my system causing damage to the embryo.

Three months has flown by…I have kept myself busy with work travels and finishing off various projects at work before the end of the year.  Also preparing for Christmas has been a nice distraction too.  Now all that is left to do is make some time for a few parties to see in the new year.

You cannot believe how much I am looking forward to 2016 and our next round of IVF treatment 🙂 yup….this craazy lady here is looking forward to being stabbed in the tummy with needles.