The day comes when they have to declare

I hopped nervously onto the scales this morning, and noted grimly that I had gained Shriek! pounds over Christmas. (There are three Imperial Groans in a Shriek, and roughly two Shrieks to the Ululation. 4 Ululations to the Shitload. I reckon a Groan = 2lbs.)

I’d half expected to gain more: my eating has been pretty profligate since *thinks* well, since Harry became poorly with ‘flu in the middle of December, I suppose. I become, under stress, a person with alarmingly embiggened food entitlement issues. As the ever-inspiring Cecily said recently, it’s easy to slip into “I deserve” behaviour. And it really is soooo, so sweet and easy when there’s festive biscuits, chocolate and cheese under your nose, morning, noon and – literally, because I spent a lot of ’em awake in December – night.

Stepping off the scales, I started furiously planning my assault on Mount Weight. Againagainagain. John has been nagging me to cancel my gym membership, as I’ve not been since I returned to part-time work back at the end of summer, and I was feeling grimly satisfied that I’d continued my haemorrhage of £30 a month for bugger all, after all. I was busily calculating how long it might take me to get back down to 13 stone (an Ululation+a Shriek away and my self-imposed maximum weight for beginning a pregnancy -or I will end up trampling on my own boobs when I walk waddle at the end of it) when it dawned on me that my reptile hindbrain is running (figuratively. Even my inner lizard feels podgy) before my higher thought processes have finished deciding whether to walk or not. Againagainagain. 

 Here’s the thing: Nice Consultant, having had a damn good rummage about in my innards, peered closely at everything, blitzed a wee bit of endometriosis on my left uterus, performed a polypectomy (benign) in my right uterus (that was the ‘synechia’ seen on scan, I expect and hope) and taken two biopsies that came back showing proliferative endometrium with no sign of atypia (the letter said atopia, mind you) has pronounced the Harry-Housed Uterus Of Doom, attached to my one decent-ish ovary, fit for purpose – and would like us ‘to try for a baby now.’

I stared miserably at her, sat in the plush surroundings of the local private hospital (as the NHS kindly gave me a surgery follow-up appointment in late March) and tried my best to explain to her why I have such deep-rooted misgivings. I am darkly convinced that the blood supply to my right uterus is borked. I’ve never, in the 25 years I’ve been suffering this shit, had a proper bleed from that uterus, pregnancy excepted; primordial brown-black gunk is all I ever get. (That thud you just heard was likely my father slamming the laptop lid shut in hasty recoil, btw.) My right-uterus pregnancy with Harry was successful only in that he survived with what appears to be very minimal brain damage. I started spotting at 9 weeks, and had increasingly heavy episodes of bleeding every few days, eventually accompanied by contractions. His heartbeat on the doppler was terrifying to listen to, because, every couple of hours (I spent a lot of time listening. A lot.) it would stutter, hiccup, and decrease from its gallop to a throttled set of slow – very, very slow – thuds. It was a while before Harry obliged me (and vindicated my slew of worried phone calls to my midwife – ‘your own abdominal sounds, I expect, dear’) by performing this particular trick in the presence of medical equipment operated by someone with an MD, but when he finally did, Consultants Were Urgently Summoned. Ultrasounds Were Ordered, Stat.

I had over 20 scans during my 33 week pregnancy with Harry, and was in and out of hospital like a fiddler’s elbow, but at no point was a cord or placental abnormality spotted, and I wish I’d had the presence of mind to ask for my placenta to be properly examined after birth. Harry gradually fell away from the growth charts, and was born with symmetrical IUGR. He became very unstable shortly after birth, required fully ventilating, and had atypical seizures accompanied by massive desaturations in NICU. He did not, evidently, manage to dodge all the bullets. But you know all this.

I blame my right uterus. I blame the crappy endometrium. I blame my faulty housing. It seems so inescapable to me that evidence indicative of a poorly oxygenated child, added to evidence indicative of a poorly oxygenated uterus, should equal CONCLUSION in the eyes of the medical world. How is it just me that thinks this?

And it is just me, you see. Everyone around me thinks I’m wrong about the uterus, and I am marooned by my fears, painted into a corner alone, bleakly conspicuous as the one who is expected to do all the bleeding if I am right and they are wrong, and it all goes totally tits. I am defensive, bewildered and afraid.

John has never shared my view of Right’s poor performance, stoutly citing the tally of my 3 miscarriages in Left. As far as he is concerned: only one uterus has produced a living baby; quod erat demonstrandum.

VIP Consultant was of the opinion, when we last spoke, that Harry’s difficulties are probably co-incidental.

In response to my expressed worries, Nice Consultant reassuringly (in manner. Not, regrettably, in effect) told me that the biopsy on Right is clear, and that it was a ‘lovely looking uterus!’ before she began talking about aspirin and heparin therapy and those bloody awful progesterone lard torpedos. I didn’t have the mental wherewithal to ask her explicitly while I was there, but I suspect that she would not countenance performing an expensive and quite major procedure – IVF – when there is no medical evidence, apart from my dark forebodings and probably-brain-damaged son, that it is required. Ethically grey, I think.

And, as John does not forget to point out, I swore I’d never have IVF again, in any case. I responded inversely to downregulatory drugs and gonadotrophins half the time, and it was the hormonal shock of chemical menopause that started my pesky heart palpitations in the first place.

 Take your life in your own hands and what happens? A terrible thing: no one to blame. I am under no obligation to believe either my doctors or my husband – only pressure, of an oblique and partially self-imposed sort. If I let myself, and myself alone, take this risk – because I want another child – in the face of what I believe to be great danger, then how could I avoid great bitterness and blame to myself if my child is born severely brain damaged, or dies?

And then, of course, there is the fact that I appear to have some type of auto-immune or clotting disorder, which has, thus far, declined to be identified by blood test. My first-ever pregnancy went so very, very heart-beatingly well (right up until the point where it abruptly, unfortunately and probably-chromosomally didn’t)… and all my subsequent pregnancies have been distinctly troubled affairs, a fact which I brood upon, darkly.

I am having a lot of dark-brooding type thoughts all round, in fact, because I have a lot of reasons not to have another child. The chances of my carrying a baby to term are, we know, pretty much zero. My terror of prematurity is fairly profound. We’re not rich (and surrogacy, although a logical suggestion, is not the solution for me.) John and I are both sporting a shocking amount of grey hair lately. Harry’s behaviour, although in no way his fault, often puts our relationship under strain. Coping with a newborn as challenging as Harry, as well as looking after Harry himself, would be… an utter impossibility. My forebrain backs wildly away, waving frantic *jazz hands*.

I am firmly of the opinion that when the archaeologists dig me up in a few hundred years’ time, the fancy-pants futuristic bone-mineral-density-type scan they do of my skeleton will reveal a tree-ring of complete devastation caused to my frame by sleep-deprivation, fear and stress during that time of pregnancy and early motherhood. I dread future baby sleep-deprivation to my very marrow, because prem babies generally aren’t restful. With colic, reflux, hole-in-heart, alarming apnoeic-distress episodes at EVERY nappy change due to (what, with hindsight, was fairly sodding pronounced) sensory processing disorder, and it’s unsurprising I was so battered, that, on a couple of occasions I actually hallucinated, which was interesting and un-fun.

And, when Harry was 2 or 3 months old and breastfeeding for England every two hours, my immune system fell through the floor and I came down with the most God-awful illness; flu symptoms, multiple cold sores all over my lips, tongue and up my nose, searing 40 degree temperature… I can remember, for the first and only time in my life, wanting to die. I wasn’t remotely depressed: I just felt so spectacularly wretched in my very febrile state that I thought that I was, in actual fact, really dying, and as the inevitable was happening it might as well get a move on and stop prolonging the agony. And I couldn’t even get anyone else to have Harry, because by that stage, he was disdainfully refusing a bottle. Emptying stomach=hurts=MOAR BOOB, MUMMY! It was quite a low point, and I am pretty sure I said I’d never do it again.

I am so horribly distressed. Harry would, I think, love to have a sibling and I would likely grieve that loss of his in later life as much as my own. Being an only child has its own peculiar set of benefits and penalties. But I just can’t bring myself to step off the edge, and commit. Commit to that Right Uterus of Doom – as opposed to the Left Uterus of Slightly Higher Numerical Doom But Markedly Better Blood Supply. Everytime I try to think about it seriously, I have a nasty mental wobble, feel quite sick, start sweating and hastily push the whole idea right to the back of my brain.

The back of my brain, where the podgy reptile lives. Lizard Hindbrain has, without consultation with higher authority, ordered the repro-friendly vitamins that Nice Consultant demanded, in the loveliest possible way, we both take. (I thoroughly enjoyed John’s expression when she told him she expected him to take Well Man Conception vitamins, but my smile sank out of sight when I discovered these particular vits were £10 a month. Each!)  Plus, Hindbrain also ordered some easy-dosages of the low-dose aspirin that I am supposed to be taking already, and aren’t. Hindbrain has also had a major re-arrange of the bedroom over Christmas to facilitate the path of multiple night-time trips to the ensuite. Hindbrain has even managed – and this was quite clever of it, working unsupported – to book an IUI cycle, commencing February. And today, it seems, Hindbrain is keen for me to quickly lose some weight.

I am still bewildered. I am still afraid. I have experienced 6 months of clomid, 2 IUIs, 2 IVFs, 4 miscarriages, a stressful pregnancy, a premature and dangerous birth and serious worries, first, about Harry’s survival, and later, his health – and withstood it, as people generally do when they have to, because being entirely overwhelmed by events is seldom a valid post-Victorian option. 

I know what lies behind and I know what might lie ahead. And the ground I’m standing on right now looks pretty damn comfy, thanks. But I’m 36 next month, so it’s now, really now, or… not. There’s nothing to gain by waiting. Refusing to choose is also a choice.

For some people the day comes
when they have to declare the great Yes
or the great No. It’s clear at once who has the Yes
ready within him; and saying it,

he goes from honour to honour, strong in his conviction.
He who refuses does not repent. Asked again,
he’d still say no. Yet that no – the right no –
drags him down all his life.
CP Cavafy

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