Simi Godagama | Ep #50| Are your Biological Clocks Ticking?

consultations or professional medical advice hey guys i’m tasha hey listeners this is gooney and we’re here to discuss lifestyle medicine i’m not teaching anything new but you know you know i’m gonna be turning 30 this year and i feel i feel a certain type of way and it’s because you know i’m getting a lot of pressure from my family did you find a partner are you going to settle down i have children basically the pressure of like having kids before your time is air quotes up yeah yeah yeah for sure and it’s not only your family you know it’s also when you see some of your peers who are having their kids getting married et cetera and so you’re kind of thinking time is running up it is hard because i started thinking about it before i even received the the backlash from people or like the questions i would say not backlash um when i was about 28 29 and it almost becomes like a existential question because you’re like oh i need to get married so that i can have kids but i haven’t even found a partner um and then if i haven’t met someone how will i start a family and then do i even want a family what do i need to like what do i need to do and then i don’t even know how to answer these questions right are you going to settle down have kids started even before you know turning 30 right for the south asian community 30’s like i’m kind of expired already and uh and so this talk usually happens by the age of like the earlier the better they say right so it’s like 20 21 some some are 18 years old the way it’s talked about it’s more like you want to think about it so you don’t you know become an old mother or you know um but you want to have all these steps ready so that you have this ultimate perfect life that everyone aspired to and to be honest there is a biological clock it is a valid point to bring it up but i think it’s more the way it’s brought up i think instead of putting the pressure on on women to rush into motherhood and to pick motherhood before they are ready to is is a bit of a tricky conversation yeah like instead of like telling us oh you need to conform and meet all these like societal standards of like what’s the right timeline in life uh maybe give us some options and tell us like how do we go about it what’s the mindset around it especially because there’s like real options out there uh on like surrogacy or like ivf right these are the things that exist today a better conversation i think is to address the readiness of what it takes to be a mother and lay down the options and potential risks so that you can you know as you navigate life decide uh what you want for yourself and it’s also tricky because like i don’t see many examples of women in my circle or in my network in my family that i can lean on or to have these like open-hearted conversations about what these options actually mean and how they would look like if you do decide on one direction or decide against another option you know and to be fair to our parents and to these uncles and auntie the tech that is around has only been mainstream in the last decade so they themselves didn’t know you know about it back then plus it was very expensive so now i think it’s the parents that are coming you know the new generation the new cohorts of parents should inform their kids on that that’s my personal view yeah it’s unfair to put that pressure or lay that expectation on them when it’s it’s fairly a new technology right but i guess this ties back to our intention for this conversation and wanting to to have it in the first place right uh which is why we wanted to invite uh simi gurukuma uh to be part of this conversation so that we can openly have this dialogue so simi is an acupuncturist and ayurvedic practitioner board director of the british ayurvedic medical council known as bamc chair of information and communication committee for bamc and the director of the little buckingham clinic in milton keynes in the uk um so welcome sami to data of the podcast hello hello lovely to be here so you know we were speaking about you know the pressure of having kids oh absolutely i think the first and foremost thing is to say that i’m south asian so it’s a absolute given um i think as growing up in the south asian culture it’s a very prominent aspect of being a girl growing up in the world and so the pressures are there subliminally in childhood um and i think that this is not just exclusive to south asian communities i think it’s just generally as being a girl but the pressure is somewhat um more for for girls in this particular diaspora back then sort of ten years ago there was not much information about awareness of couples and conceiving so questions were thrown out and so yeah i’d say from the moment the day we got married it was something that was a definite pressure for me you you get your periods like they already kind of brief you about the fact that you know this will come and then when you’re around you’re 18 uh 21 then you’re like get ready you need to stop preparing yourself that’s that as as as a mage thing and i think that there’s nothing no harm in that because i think actually preparing your mind preparing your body um for the changes that you know as women go through not just to conceive but the journey of pregnancy and then into motherhood is something that we need to be aware of without that element of pressure but more information the mindset is the transition that we need to really focus on right i guess our parents would have thought to educate us and then from education we have to straight go into motherhood right like there was no transition period or to to have that bridge or like something to to prepare you slowly mentally and then physically because physically it’s already happening so you’ll just adjust accordingly but the mental part of it is like can be quite torturous i would think absolutely and i think it’s it’s true because i mean the pressures of going through university getting your studies getting your career in line i think that is huge particularly also in the south asian community and then there’s this level of confusion afterwards where it’s like what is my role what is my identity am i career woman am i supposed to be house maker homemaker um and then we get into that dilemma of of an identity crisis essentially of where we lie within that realm and we never quite satisfy either role you know um so the dilemma and the conflict starts right from that point really we don’t even consider like is there going to be a challenge in conception if you just think oh straight we’re going to have a baby and it’s just going to happen right i i actually have fears that i can’t consider and this has been embedded in my mind since since a long time so with a partner or not i’ve been afraid of or what if i can’t conceive and this is like me getting ahead of myself it is something that i am afraid of yeah i think that’s a really valid and honest thing to say because i also had this fear of conceiving and it’s not until time goes by and you start to reflect on your mindset and i look back on sort of my mindset 15 years of class 20 years ago when i was thinking these things and i wonder how much of those thoughts were you worried about conceiving where does it stem from is it a fear of conception is it fear of being a mother is it to do with your past experience is it to do with your relationship with your own mother as well you know that maybe there’s lots of these factors and and we mustn’t forget that you know is it also connected to a trauma that you’ve experienced in childhood and when i am in clinic and i’m treating women or fertility it’s one of the questions that i explore is i look into the historical ideas and what their relationships are with being a mother you know it’s really really important to look at these things but it’s also can be quite difficult as well interesting that you say that also because one of my aunts told me the same thing she’s like if you don’t deal with your issues with your mom they will show up at some point whether or not it’s at preconception or post-conception and you’d have to address it and it might be a rude awakening if it comes in a way that you’re not prepared for right and it’s a lot of pressure i would think for any person let alone like someone who’s expected to like bear a child right it’s an important thing and i think that actually just you know diving into my own personal journey when i first started to understand that there wasn’t conception happening as a practitioner you know you know what you would say to a patient and for me it was a personal challenge that oh here i am as a complimentary healthcare practitioner experiencing infertility and it was primary infertility which was diagnosed after a laparoscopy and it was a real hard hit you know it was a shock to the system you know i’ve lived a healthy life i’ve taken care of my mind my body but what is what is going on here so that’s when i started to see psychotherapy help so i started to look at what would i say to myself if i was a patient of my own and i would look into these historical aspects if there’s anything at play and that revealed a huge body of information for myself to work with so i gave myself that time and i know that when it comes to fertility you feel that every month is a month lost and time seems to speed up for some reason but exploring that and giving myself that space was really really profound i actually started to go on self retreats silent retreats and just really kind of connect with myself in a deeper level do you feel that being labeled as infertile or or having issues conceiving help the healing process it was just a turning point really and sometimes i mean i have patients coming in with all sorts of medical diagnoses and we have these we attach ourselves to labels you know i am infertile or i cannot conceive and in some ways yes that can be useful because it takes you on a journey of exploration it takes on a journey to find the solutions but it’s always important to see how you’re speaking to yourself so i was aware that for me every time i said oh i’m suffering from infertility i was compounding that sense in my body i was basically talking to my ovaries and talking to my uterus and saying you’re not going to conceive a baby so i started to change that and i started to look at how am i going to enhance my wonderful precious body to create life and so i changed that narrative and to this day you know i feel that regardless of a positive pregnancy outcome or not that journey that was instigated by the diagnosis of infertility was absolutely an amazing experience for me on a personal level as a human being it kind of forced me to look a little bit inward and as a practitioner we’re so geared towards looking at taking care of others but this particular experience forced me to to take my own medicine really so as you’re going through this you know process of having a diagnosis around your fertility what are the options you start considering so help from a counselor who helped me to sort of look at these past conversations or the healing that needed to take place from childhood experiences and childhood traumas which were actually at play as i understood as we sort of progressed through the treatments with the psychotherapist so that really was pivotal in me trying to actually understand that what my body is doing now it’s not a permanent situation it’s something that i can start to unravel and that really supported me and obviously my own medicine as a ayurvedic practitioner and acupuncturist i um i’m very fortunate to have my father so he gave me acupuncture treatments every week and i started taking the ayurvedic herbs i started to really acknowledge my own dosha my ayurvedic energetic constitution and look at my life and what was what was really aligning with me so for me it was about what was not needed anymore what did i need to eliminate from my environment from my physical body to help clear the path for conception right so it’s like having to reset your mind or or turn your mindset around but what about for example adoption or even yeah medical route absolutely so we initially considered fostering and we then considered adoption we actually uh you know then after i had a medical procedure laparoscopy that that kind of confirmed everything i gave myself three months because as soon as you start to think of infertility this small little clock in the corner of the room starts to be this huge clock in front of your face you know and so ticking all the time it’s like tinnitus in your ear and so i gave myself three months and if after this you know confirmation of the primary infertility i don’t conceive in inverted brackets naturally i would start seeking ivf and get myself on that kind of train because it’s it can be a long process so i engaged with a consultant to look at what route we could take as we know your your dad is dr godagama who is known as you know one of the pioneers of ayurvedic medicine in the uk and so you know knowing the background you being also a practitioner in the in the camera industry how did your conversation with him for example go around ivf and was he was he supportive so when i first discussed this with him we sat down we looked at the options available like taking the ayurvedic curbs taking the acupuncture and looking at all the sort of relaxation methods that were needed and exploring your history and then i said i’m about the ivf and he said yes you know this is something that you should really consider and i battle with that idea i mean it’s not that i’ve never taken western medical interventions for things but you generally that’s not your first port of call and ivf in my mind at that time seemed like a sort of unnatural artificial root towards conception and involved a lot of tweaking of my body which i had no control over so it’s also about the control factor handing that over to scientists and doctors which i wasn’t very happy to do and he looked at me and he said why and i said because it’s not natural because you’ve raised me and we’re both in this world of natural medicine and it feels like i’m almost going against that grain and he said to me okay look at it this way if i needed to have an operation and have a stent put in my heart to help my heart and my body to function would you say that that is an unnatural process so you shouldn’t engage with that and i said of course not he said well medicine is there regardless of whether it is a a surgical approach or a medical approach or a chemical approach the medicine is there to enhance your body’s ability to do what it does naturally so once you engage with the ivf if then perhaps it is not giving you the results that you want then perhaps that is nature you know um and that was really profound for me for me to hear him say that almost felt like i had permission to proceed you know i had this blessing to proceed so i i just went for it wholeheartedly just washed away with me from that idea of it not being natural and i talk about this actually with my patients who come in and they don’t want to discuss ivf and they don’t want to go down that route and i try and encourage it as much as i can western medicine has its space along the complementary medicine did you feel that even mentally and physically something happened i felt like actually my my i felt lighter and i then realized that that i was carrying a lot of pressure behind the whole idea of natural conception that idea of being a failure just completely disappeared and that made things a lot easier because when i walked into the consultation for ivf and all the procedures that followed it i actually went into it with a really positive mindset you know um that this is something that’s assisting me as opposed to this is something that’s taking away my control i would have the same thought process because even when my dad had his bypass it was all these questions that we had like is it something we need to do because it’s not natural it’s very intrusive and kind of a similar conversation i had with our cardiothoracic surgeon he’s just like well do you want to live or do you want to die and i think that it’s that black and white because for me it was like well do i want to go down this route that seems a bit endless or do i want to engage in something that might give me some positive results you know and and result in a baby so it’s i think each to their own i have some patients who come in and they really want to just not even consider the ivf and i feel that every journey is individual so if you’re struggling with fertility or conceiving ivf isn’t always something that is going to be important for everybody to consider it’s all down to the individual journey that you’re going through were you afraid of potentially that not working out how much are you guaranteed that this would work uh so i did the usual thing which was to research all the ivf clinics in the whole country i went to i went to harley street i went to the central london class we went to the top clinics i had all consultation i think i must have had about 10 consultations um i was going crazy i even knew which you know clinics had the best paint on their walls okay so wow but it was going too much you know and then it got to a point where i realized that i’m going around in this vicious cycle and it was all stemming from the stress that i was going through to and also this tendency of wanting to control everything so i let it all go i stopped reading statistics i went to my local clinic just down the road and i decided my stress levels were the most important the stress takes a huge role in the outcome of ivf so knowing that i thought well it’s not about going to the best gleaming clinic that has best pain on their walls you know it’s going somewhere that reduces your stress allows your partner to attend because i think that partnership is really really nourishing and milton keynes is where i’m from so we went to a clinic where we could both access and he could be part of all the processes if not most of them even when we spoke to like another chinese medicine fertility specialist she was saying that most often when women come in and they’re having their struggles she tells them to go on a holiday with their partners and then right after the holiday they come back pregnant and it just goes to show like you know you need to cultivate an environment in a space that is relaxing and where you feel like you can connect with your partner right it is all about that connection but also particularly during the ivf process where you’re monitoring your follicles growing every week and you’re seeing them on this on the screen want to be able to connect to what’s happening in your body too and i think that one of the beautiful things actually of going through ivf is that you are able to connect with the process of conception in such a fantastically deep way um if you bring the mindfulness aspect so how how is the ivf uh process like how does that work oh there’s lots of different ways that you can have ivf but for me i could talk about my my process which involved a lot of scans so just to kind of give a brief idea because it’s a huge field so so at the initial stage it was about trying to build up my the follicles so to try and grow the follicles on both sides and so it gets to a point where it is mature the follicles are mature enough for them to then extract those follicles so then that’s called the egg collection process and then they extract the eggs and then for my partner they receive the semen and then it’s put together really essentially in a petri dish and they wait 24 hours to see which eggs have turned into embryos so which which are fertilized and you get a summary the next day of how many eggs have fertilized and they grade them as well which again you’ve got to take with a pinch of salt as well and then they normally back then they would advise you of which ones you would want to be transferred back in and there’s usually a three-day transfer or a five-day transfer into blastocyst so i went for a three-day transfer at that stage they will also be able to tell you if there are any embryos that are worth freezing for future use especially if the current sort of cycle fails then you’ve got to like reserve and you don’t have to go through the whole process of growing those follicles into mature follicles the follicle growing process how like how long does that take so that could take that can it’s actually not that long so it for me it took a roughly about three weeks um of regular scans sometimes twice three times a week they’re scanning and just seeing how long how how mature these follicles are becoming um and they’re they’re many sort of little hurdles that you can go across you know whilst you’re in that process so each each scan felt like a hoop that we had to jump and it’s like felt like an exam really to pass that test you know so when you get those follicles growing it’s that injections you see absolutely so the injections are daily injections and then there’s a trigger injection which is slightly a little bit more i mean they’re not very painful um i actually as an acupuncturist wimped out even though i deal with needles all the time my partner was the one who put the needles in for me so you measured up and everything and that’s also about the connection so i handed him that responsibility of measuring the vials out measuring and taking the right amount and the right concentration and administering that so what’s in those what’s in that injection so it’s the hormones that basically help to balance and the hormones that help to grow the follicles are in those injections and in comparison to the natural way of conceiving right if you were to go the natural route and you speak to your gynecologist what is the time frame like difference between the two the whole process for the whole process so for me when i first discussed about ivf from the first discussion to actually having a pregnancy test positive the process took about four to five months from the initial consultation which is why i often encourage patients who are coming in for natural conception if this is something that they would consider at some point i would often say to them get the ball rolling um now because by the time you’ve decided okay then you’ll have to wait another two three months to then get started in terms of prices like is this a procedure that cost a lot well on the nhs they do allow you to have a primary infertility after a certain number of months so years that you’ve been unable to conceive you will be qualified and that changes from area to area uh for me i went through the private route which meant that i didn’t have to be on a waiting list either so usually back then this is nearly ten years ago there’s about a six month waiting list um and i don’t know i’m in the current sort of environment it would may even be longest your process for ivf was about five months from start to positive pregnancy test but if you went the natural route and you were to conceive the natural way some acupuncturists will say a minimum of six months of treatment i am slightly different in my approach because i’ve been through infertility myself i understand that to be rejected by a practitioner because you haven’t come in six months you know and let’s say you’ve got an idea to do ivf at the end of the year and you’ve only got two months to go i would still take that patient on because you could never predict what can happen even after one treatment and i’ve had patients and i’m not going to sort of you know say this is going to happen to everyone but i’ve had i’ve had quite a number of patients who after like a couple of sessions of acupuncture have had positive pregnancy tests naturally you know and um others who have taken longer minimum i would say is three months really uh three menstrual cycles is the given for whether it’s to conceive or whether it’s to improve your ibs or whatever the system you’re needing to change uh the body takes three months to really acquire that change and manifest it and how did your like knowledge and experience as a complementary medicine practitioner and also just growing up with ayurveda and being an ayurvedic practitioner did that knowledge help you in the process of conceiving absolutely i cannot stress how much of that not just the medicines or the ayurvedic herbs that i took or the acupuncture that i received but the wisdom behind it and the philosophy behind it and the mindfulness aspect behind it which really helped me to understand where i was missing you know in those departments so it’s quite a humbling experience as a practitioner to have to face those parts that you’ve been reaching to others but have kind of ignored for yourself so it may had a huge huge role to play absolutely i mean again it goes to show that everything goes hand in hand be it the western medical system or the traditional uh medical system they have a place especially when there’s a point where your body might not be functioning as it’s supposed to and and it can go hand in hand and help you in that process for people who are out there who are trying to to conceive and considering this doesn’t necessarily mean if you really want a child on your own there are there are options out there there are absolutely options and it’s about yes that integrative approach you know and not just through to you know to conception but even after throughout the pregnancy i was carrying twins at the time so it was a huge stress on my body and i’m quite a small framed person so i really believe that the acupuncture i had throughout the whole pregnancy and postpartum had a huge role to you know people sometimes ask me what how did you get over this and i said well i had the herbs i had the acupuncture um and i had the osteopath make sure that my back was being able to be strong and support the twin pregnancy and the extra weight gain so there’s so many different tools that you can use yeah it’s very holistic i think you’re you’re pointing out that we can’t just look at things in isolation um and i think that’s should be a practice in everything we do but you know it becomes very apparent when it’s a health condition i think it’s given us enough information for us to kind of reflect and decide how to navigate potentially wanting to conceive or have a child or what to do it’s a it’s a natural concern you know and the major thing that i find not just my personal experience but also in patients i see is the stress you know it is that pressure going back to your first question is where is the pressure how is that pressure being engendered how can you alleviate that pressure and whether you know you you do that through a natural route or you do that using ivf it’s still just as important if not more with the ivf you know and so i would advise anybody who is going through any fertility issues really look at alternative routes but also if you need to go through the western ivf route too the two can come together very very beautifully when you think about it like kind of tying back to the initial conversation with tasha to speak about ivf it’s really about knowing what are our options turning 30s and having all these different pressures and also the rethinking also the route before you even get to even conceive like did you deal with your traumas did you address your your stresses are you in a space where even motherhood is something you you want for yourself and it’s not coming from you know societal pressures so i think that it gives us a lot to think of yeah and i guess goody from what you’re saying this whole conversation it’s essentially a gateway for an invitation for parents to have an open dialogue with their kids and even just friends having that open dialogue about options that are existing out there so that we can actually remove the stigma and taboo around the alternate ways of concealing if you choose to go the natural way and it’s possible for you then that’s great but if you can’t do that for whatever reason these are like actual alternatives available and accessible to you absolutely i think that’s a really really important thing and it comes back to also that conversation i had with my father when when we did uh conceive and then we had the girls um he he said something was really profound he said oh you’re the first in our generation to have ivf children and he said it with a pride that you know that as human race we’ve excelled and we’ve advanced to such wonderful stages that we can bestow upon people this ability to procreate and become parents and it’s a it’s a wonderful wonderful thing to be proud of you know and and i think that’s a conversation that needs to be had that either way there is absolute beauty in either process yeah yeah this this whole point actually reminded me of a cousin of mine who actually got ivf and she kept it a secret from the whole family until the babies were delivered and we were all so confused because we’re like this is this is a miracle like this is a great thing that you’ve done and she got twins as well and during this episode i really am realizing and reflecting through your experience simi like kind of the pressures that she probably would have faced and maybe she didn’t have the tools to she probably didn’t and also i think it’s just your your surrounding environment as well because you know going back to being south asian it is a taboo it is something that we feel that is something that’s dysfunctional within either you know one or the other the you know the husband or the wife or the well there’s a dysfunction in the marriage even you know what what’s wrong there and i think that you know trying to dismantle that is really really important so my girls are now nearly nine and they know about ivf they know how they’ve started and this is a conversation i had right from the beginning and i said well when i’m embarking on this i’m going to be open about it i’m going to speak about it because when they are in this world do we hide that where their origins are you know what do we what message do we send then but often in clinic it’s mostly the south asian uh patients that i see that either the female women are coming on their own and their partners are not turning up and this is something that i’m very very strong about convincing and getting the partners to come and seek support um there’s a huge dynamic at play when they’re both coming in and also they’re the ones who are least likely to let their families and in-laws know that they’re going through this so they don’t have the support network if you don’t speak you don’t receive the support network so you’ve got to start by speaking again it’s about the pressures and the stresses you have around conceiving and if you don’t have the you know the support from your partner if you don’t have the blessings from your family if you don’t have in an environment that helps you in the conception it’s it’s hard to it’s a huge yeah it’s a huge load to take so it’s like have create cultivating that space where you also allow people to uh trust you with their story and and then you’re building a community right a support network really that’s where we exchange and that’s how we grow really you know before you go to me we have rapid fires and the first one is what do you notice what are the first signs that shows that you’re out of balance my sleep so as soon as i have a day where i am just wired and i can’t get to sleep i might be excited i might be writing something or maybe even painting something you know and i have to check in with myself saying oh and as a practitioner of chinese medicine as well i’m like oh that’s my liver chi you know that’s my um certain meridians that are at play here so that’s speaking to me so my body speaks to me when i’m my sleep rhythm goes out of sync and then everything else is a cascade of offense after that and i guess the to counter that uh what is the coping mechanism to to get yourself back into balance um to be honest it is to have a pause day so i give myself permission and i think vinnie you’ve known me to have a few poor’s days so i’ve uh um just you know i do not return phone calls i do not reply or respond to emails and i will literally just um sit in the house and almost it’s not a tantrum on my life but it’s really maybe it is but it’s like saying no right i say no to everything and i’m just gonna just sit and listen to the birds i’m gonna use this yeah i’m gonna look at daisy i’m gonna actually admire the weeds that are growing in my garden since i haven’t been on top of it but just to sit and breathe just pressing pause is something that i often end up doing after those kind of mad nights of not being able to sleep and then i suppress a pause and i find that my body and rhythm just starts to sink again and i give myself permission now to do that and as a mother of young children you know i’m running multiple different businesses and it’s very important to give yourself that permission i didn’t know that it was something i could grant myself that you know always think that i needed to ask my husband not ask my husband just tell him oh i need to just not do anything why are you telling me you just do it yourself you know just make that decision you don’t need to yeah it’s so sweet she does have the most awesome husband yeah and i’m not biased here yeah she’s very lucky and our last question is what is the book that impacted the most your view or your approach to well-being well there’s two books one it probably sounds like i’m plugging it but i’m not it’s my father’s book because i was very young i was 16 years old when he was writing it at the time and i was very heavily involved in proofing it for him as a 16 year old who was pretty good at english grammar at the time and still i suppose and um so i i really got to read his words and then see the finished product in the book when it was published and that had a profound effect on me but prior to that i was 14 when i first picked up the dalai lama’s book the tibetan book of living and dying and it really really really had a impact on my life and the art of happiness i’d say i didn’t understand most of it i was 14 a lot of it went over my head but there was something very soothing um to the soul reading those words in that book thank you for sharing thank you so much for having me if you enjoyed this episode go ahead and select the follow or subscribe button for now stay safe and we’ll see you next week