Old Mother Hubbard

went to the cupboard

and discovered she owned dessicated gonads.

My antenna waved Danger! as soon as I heard the tone of the nurse’s voice down the phone: even over the bustle of the RSC foyer and Harry’s grief-stricken howls (we had just discovered you need to book a timed ticket to go up the tower, and he had been Promised An Immediate Ascent) I could clearly hear that she was projecting enough Cheerful for two; I swiftly deduced that she anticipated I was about to be in deficit. 

(AMH testing is Clever-Shiny-New fertility science, and they’ve recently changed methodology to a 2nd generation assay giving values 40% higher than previously. Keep Calm and multiply by 1.4 if your previous happy AMH level suddenly looks wide of the goal posts.)

Ovarian Fertility Potential                pmol/L  (Not ng/ml, which’d be helluva lot lower.)
High Level                                            > 67.9 
Optimal Fertility                                    40.04 – 67.9       
Satisfactory Fertility                             21.98 – 40.03              
Low Fertility                                          3.08 – 21.97          
Very Low / Undetectable                    0.0 – 3.07       

I scraped a 20. Distinctly and saddeningly sub-optimal, but not quite fully disintegrated into oocytical dust in the coffins of my ovaries, either.

I… wasn’t expecting bad news. Alive to the possibility, yes, but my Autumn 2009 FSH & E2 were – I quote my Consultant – ‘beautiful’, and I felt reassured. Once I’d got my head around the difference between US & UK lab units of measurement, that is. John had been blithely complacent (the man is a congenital optimist, even appertaining to my haphazard reproductive abilities) that I had the ovaries of a nubile teenager, and has had to mentally regroup accordingly.

Ah, well. It’s been a while since I felt really slugged in the stomach. They do say a change is as good as a rest.

Of course, my previous poor response to gonadotrophins now looks completely divorced from the possibility of a still-stunned pituitary after a shitty downreg, and simply looks like common-or-garden Rapidly Emptying Ovaries instead. And the shortened cycle I was crowing over last night might credibly be the dark horseman of the Menopause galloping towards me, waving his scythe, with hot flushes spilling from his saddlebags.

Damn it.

My Consultant has altered my protocol still further on receipt of this glad news and has now prescribed me Gonal F instead of Menopur: I’m not sure why & absolutely can’t be arsed to Google it; the woman knows her business. 300iu for 10 days pro tem, and we’ll see what we get. Another day older and deeper in debt. Sources of Gonal F are, naturellement, more circumscribed than Menopur, although I have managed, after a few phone calls involving Far Too Many Fucking Zeros to get a quote that just squeaks in at under £700, so the cost differential isn’t as Implicationy as I first thought it might be.

If nothing else, this news has made me feel a little more exculpated for already having chosen IVF over IUI – and exonerated altogether for wanting medical reproductive input this time around. 

I know it only takes one egg, but we’ve got to find the bugger first.

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

Admonished

Whenever the red mist descends upon me, I remember an article that Stephen Fry – a talented lad – once wrote for The Listener about losing his sock. I haven’t lost my sock – on this occasion, at least – but my personal DEFCON is fast approaching pushtheredfuckingbuttonandtohellwith’emall.

‘I am angry. I am really angry. I am so angry I can barely go to the lavatory. I am fuming. I don’t think I’ve ever been crosser. If you poured boiling jam down the back of my neck, set fire to my trousers, defecated on the back seat of my car and forced me to stare without blinking at the cartoon of myself that accompanies this article I couldn’t be more furious. Hopping mad about sums it up.’

I’ve managed to empty my bladder, but it was touch and go for a bit.

I fought my way into Coventry during the rush hour this morning for an appointment with my consultant. She gravely thanked me for sending her my back-to-front heart report, and told me that I definitely do need a laparoscopic exploration. I nodded expectantly, waiting for her to announce why she had summoned me back to her clinic instead of simply noting the whole peculiar heart-thing and rescheduling my (postponed-because-of-said cardiac-weirdness) operation.

But there was nothing of the sort forthcoming. She merely started to write out another surgery form, identical in every way to the one she wrote out last September… when she cheerfully bunged me on her laparoscopy waiting list.

I furrowed my brow. She’d forgotten – evidently – that we’ve already driven round this particular roundabout.

I had been scheduled for the knife on the 1st of February – and made that fact clear in every piece of correspondence. I had only agreed with her secretary to postpone the surgery (this was during Consultant’s extended holiday: I was the first case upon her return) because – and feel free to call me cautious – I had thought Consultant might like to be aware that my abdominal arteries and veins are probably somewhere fairly unusual. Her secretary had assured me that she had spoken to her, and simply re-scheduling the Lap was not an option: she wanted to see me in clinic. Furthermore, it has only been by utilising a judicious mixture of furious complaint and wheedling charm that I am not waiting until the end of April for today’s appointment.

I toyed with the idea of remonstrating loudly about the pitiful miscommunication, the complete waste of her time, my time, my diesel, a morning’s childcare costs, and five months of my dwindling amount of child-bearing life, but I couldn’t see much actual benefit in it. I’ve always been a firm believer in making the person cutting your belly open (whilst driving a camera up your fanny) like you as much as humanly possible.

So I sat schtum, and grimly waited to be handed another form. ‘Her list’s only a couple of months,’ I thought. ‘You can cope with that. Cool blue oceans!’ or some such shit.

She stopped scribbling away and looked up.

‘Last time you were here we spoke about your weight. (We did. She told me it would be good to lose some. I agreed. I know an anaesthetist well. I know how tricky it can be to knock out fat people safely. I am totally on board with the losing-weight-is-good concept. But I… didn’t. She hadn’t seemed quite rabid enough about it, I suppose.) Now, before I put you on my waiting list, I think we need to get your BMI down.’

‘Wh… what?’

‘Just hop on these scales, please. I’ll take a kilo off for your boots.’

They were kind scales. Even in my boots, I weighed 4lbs less than I did 3 days ago standing stark naked, having squeezed out every drop of pee I could.

She stabbed around on a BMI chart and merrily announced that I would only have to lose a stone before she would accept me for surgery. Or, to put it another way, I’d only have to lose a stone in order to return to exactly where I was last September, when I weighed exactly the same as I do now.

I’m never wearing this skirt again. It obviously does nothing for me.

‘It’s only a stone!’ she said, evidently noting that my features had clouded over. ‘But you need to get down to at least 88kg please.’

She tucked my surgery form firmly back into my folder, ignoring my outstretched paw.

‘Give (secretary) a call as soon as you lose the weight; she’ll find this form in your notes and put you on the waiting list straight away!’

I thanked her through gritted teeth, and marched out of clinic.

And came home.

And examined a BMI chart.

Her chart must have been as kind as her scales, because 88kg is still a BMI of 32 and unless I insist on using her set of scales again, I have to lose two stone, not one.

I am now a sobbing, angry, frustrated, premenstrual fat woman with a growling empty stomach.

Do Not Approach.

Lord Lucan

The cervical screening agency have, presumably, been firing out my reminder letters to… someone. Judging by the plaintive tone of the letter I eventually received from my practice nurse, they must have been sending me exploding-speculum howlers.

I dutifully made an immediate appointment and bowled up on time, feeling virtuous. Our practice nurse is an old acquaintance and we were chatting merrily right up until she cranked open the speculum and went in search of my cervixes. Cervi. Cervices. Whatever.

There are a handful of medicos – lucky people! – that have had the opportunity of becoming reasonably au fait with my cleverly different

uterine didelphys construction: practice nursey is one of them.  A seasoned professional in any case, and veteran of several Voyages with Bow, Rod, Staff and Speculum along the Wifey reproductive bits, she had the forethought to prepare two vials, and two scrapy-things. And that’s where her carefully-laid plans went agley, because it seems that things downstairs have… really changed.

Bless the woman: she was down there an age. A 2010 age is about 15 minutes, I think.

Unflustered yet struggling, she gave me a running commentary of her difficulties with my recalcitrant cervi, during which time her complexion moved several shades towards Hard Labour and her neatly wound bun came several straggles nearer to Through A Hedge Backwards.   

She said it’s a good job she absolutely knew there were definitely two to begin with.

Apparently, one of them has fucked off.

Instead of a neatly-presented duo, I now have an enormous cyclops-like cervix (“It’s definitely had a baby, that one.”) that pops cheerily into view whenever the speculum is opened – and point-blank refuses to move outta the damn way and let its smaller sister have her share of glory daylight. The sadly concertinaed state of my innards following Harry’s bazooka-like launch to Infinity and Beyond, plus internal scar tissue that no longer sits pertly in its proper place, contributed to make my left-hand cervix a far more accomplished hider than the average great train robber.

I DID wonder why locum GP had seemed so nonplussed last Spring. Philogynae didn’t seem to have a problem during his delve about, but he was packing more sets of stirrups than an OCD hoarding John Wayne AND he had a natty array of pube-scorching floodlights AND a handy foot-rest half-way up the wall AND a stout-hearted assistant.

‘But they used to be together!‘ she cried mournfully, after yet another failed rummage. ‘I could see them so clearly! They were unmistakable!’

Poor woman. I did my best to be helpful and encouraging, particularly mid-smear when she was utterly flummoxed as to which side Cyclops actually resided.

‘Give it a prod!’ I urged her.

*prod*

‘Right hand one!’ I announced.

It gave her a frame of reference, at least, but no glimpse of my lesser-spotted cervix was to be had what.so.evah. 

She gave up in the end, on the premise that she felt she had prodded me about more than enough, and both her scrapy-things (which have become extra scrapy of late, I noted) were covered in blood.

‘I never thought I’d not be able to find your cervix!’ she said, shaking her head over the paperwork. I resisted the urge to pat her shoulder.

‘Never mind,’ I said, as I opened the door to the backlogged waiting room. ‘I’ve lost worse things.’

************

Following a Comedy of Unfunny Stuff, I now have an appointment on the 25th with my Consultant – who has seen my exceedingly peculiar (ME? Quelle surprise!) cardiac report and, by the sound of it, has officially Had Kittens. She wants to See Me In Clinic.

Way to reassure a girl.

So, I expect there will be No Surgery For Wifey until Consultant has hurled me through a CT scanner – which is a pricey piece of kit and awfully popular with the cerebrally Catastrophically Unfortunate at all hours of the night and day. Hence, I am not expecting any exciting imaging action anytime soon and I’ll then have to wait for surgery all over again.

Did I mention I was 35?

Baaaaaaa

The delightful Liz at Womb for Improvement has posted today about her appointment to discuss the possible move to IVF, her IUIs having sadly not been successful.

Her post is here.

When I first read it I shook my head in sympathy, because I’ve totally had that appointment. And then I got really bloody annoyed, because no-one should have that appointment.

I found out early and the hard way that I had lost a tight rein on my fertility treatment. An acute piece of miscommunication between my consultant (an excellent one, despite being a 20-minute egg) and the nursing staff during my first IUI procedure led to him replacing the sperm into the wrong uterus.

I knew I only had an egg on my right side… the nursing staff knew I only ovulated from my right ovary… and I thought I could feel him turning left… but I was too intimidated to speak up mid-procedure and ask him if he was heading through the correct cervix. If he had been about to perform an invasive procedure on any other part of my body… I feel I would probably have spoken out. I’m not altogether certain, but I think it was my own feelings of inadequacy associated with my failure to reproduce unassisted, that ultimately rendered me silent.

Of course, it wasn’t the only reason. I didn’t need to actively draw on sales training to identify that my flat-on-back-and-angled-10-degrees-head-down-with-legs-splayed-and-strapped-in-with-BIG-FUCKING-STRAPS-to-the-stirrups lowly vantage point was not one in which I was likely to gain mental control of the discussion.

There was, in fact, never much discussion. Chatty exchanges to nurses during the scans, yes; I’m always talkative with my knickers off. Lots of wondering why the hell my cleverly different internal arrangements seemed to be responding so contrarily. But during the actual appointments, my function seemed largely to be that of a listener.

And that’s… fine. As far as it goes. I am not a doctor, still less a fertility expert with years of experience. I was there for advice, for treatment, for the love of God, please give me a baby, because we’ve tried and tried and tried and I’m desperate now. Anything. I’ll do anything you say.

In the aftermath of the IUI-error, my consultant telephoned me to apologise for his mistake. (He did, incidentally, immediately accept complete personal responsibility and never even mentioned the fact that his staff had, without a doubt, propelled him into theatre with his didelphic-uteried patient without mentioning that only one uterus was actually good to go.) He asked me why had I not spoken to him of my worries during the procedure, rather than to the nursing staff afterwards? The medical staff, he stated, were a team – and the patient was a key member of the team.

I couldn’t formulate an answer for him at the time, other than to say that I really wasn’t certain which cervix he’d used, and my doubts had grown afterwards – which was true, as far as it went. I left quiet the fact that I found him silent, scientific, unapproachable, intimidatingly senior, cerebral – and that I always entered his presence in an unhelpful mixture of quiet awe, cognitive lock-up and near-total flustered aphasia. The fact that I had either waited long impatient weeks or paid out huge dollops of cash to gain a seat in his presence did nothing to diminish his aura, either. I would no sooner challenge his opinion than I could picture him on the toilet.

My counsellor (for whom I have an adoration little short of outright worship after her years of kind and clever responses to my dribble) challenged me on this theme, I seem to remember. The reproductive-inadequacy that was a constantly recurring topic, but also, for instance, when I was cheerfully submitting to tests, the purpose of which I was foggy about.

Relating all this to you now makes me wonder quite how I got myself painted into such a mental corner, because my polite exterior is underpinned by such an imperious bossy-boots that you really wouldn’t credit me with such passivity; yet when I am faced by someone with a decent degree, a white coat and a confident manner, I surrender my autonomy like a shot. Weird.

Now, not every fertility patient turns into quite such a bunny-in-the-headlights as I did (and after notching up two more IUIs, two IVFs and three miscarriages, I became noticeably better. I even grew to understand and interact with my 20-minute egg rather more effectively. Now, I am probably even operating at everyone else’s level of Normal, with a leaning toward Pushy.) but it’s a common enough phenomenon in the well-documented maelstrom of psychological stresses, traumas and spiky-dildocam-lined emotional bearpits that are so strongly associated with the journey an infertile couple make. 

It’s difficult enough getting to grips with the astonishing degree of bureaucratic incompetence that exists, despite the extra billions, within our health service, without being let down face to face at the actual sharp end. There’s not a doctor that doesn’t pay lip service to the notion of mutually agreeing the road forward with an informed, empowered patient (particularly given the pronounced deep-axe-wounds-to-psyche nature of the treatment) yet all too often the patient encounters a dismissive, supercilious, terse, chivvying, insensitive scientist. I read post after post about them.

Probably not all those traits in the same doctor, mind. That would make them Assisted Reproduction’s very own Basil Fawlty and their IVF stats would have to be awfully appealing to stay in business.

It’s… not good enough. This isn’t about a GP having an off day and being snippy with the 5th antibiotics-for-a-blatant-virus request he’s had since lunchtime. This is desperate fucking stuff, no pun intended. The course of people’s entire lives gets mapped out in these appointments. Discussing why your body is not doing what is expected of it is acknowledged to be a terribly difficult conversation to have, and yet during it, solutions are still being prescribed, not explored.

All this railroading happens to a person who has already lost all control of something so screamingly fundamental as their own body’s ability to naturally procreate.

Your own fertility treatment is a difficult ship to steer.

It’s 1am. I’m still annoyed.

Harry has woken himself coughing; after half a failed hour of rocking-chair cuddles I have decanted him into the parental bed, looking delighted with himself – John, rather less pleased. He is now attempting to re-bottle him, and there is Screaming. My tonsils are still the size of walnuts, my eardrums are bulging and my neck has grown a fine assortment of swellings and lumps. I have a long day tomorrow.

Rahrahrahrahrahraaaaaaaaah. Bloody, bloody everything.

A Little Knowledge is a Dangerous Thing

Apropos of the No Eggs! Cockerel Complex! whimpers that populated my previous post, Thalia comments:

Um. I assume you did either chemistry or biology o-level. And if you remember back to those days you’ll remember that UNITS are very important. And now if I tell you that UK measurements of E2 are made in pmol/litre and US units (and the charts which show normal levels) are shown in pg/ml, you’ll hopefully start to blush a little, then feel relieved. Divide 94 by 3.67 (see here http://www.globalrph.com/conv_si.htm) and you’ll get your actual level according to this chart (http://www.fertilityplus.org/faq/hormonelevels.html#female). 94/3.67=25.6 or NORMAL.

Now stop worrying. hahahahaha

Brains. The lovely lady haz dem in spades! And also, bloody Americans! If you hadn’t gone and DONE stuff back in 1775, and become this whole swanky World Power thing, we’d all be singing together uproariously from the same scientific hymn sheet right now – and I wouldn’t have had a sleepless night.

All this is precisely why Doctors cry and hammer their heads into the desk when their patients confidently pipe up with their self-diagnoses of beri-beri, leprosy or galloping dandruff. Although, they can’t entirely blame the phenomenon of internet…

Jerome K Jerome: Three Men In A Boat. Published 1889.

THERE were four of us – George, and William Samuel Harris, and myself, and Montmorency. We were sitting in my room, smoking, and talking about how bad we were – bad from a medical point of view I mean, of course.

We were all feeling seedy, and we were getting quite nervous about it. Harris said he felt such extraordinary fits of giddiness come over him at times, that he hardly knew what he was doing; and then George said that HE had fits of giddiness too, and hardly knew what HE was doing. With me, it was my liver that was out of order. I knew it was my liver that was out of order, because I had just been reading a patent liver-pill circular, in which were detailed the various symptoms by which a man could tell when his liver was out of order. I had them all.

It is a most extraordinary thing, but I never read a patent medicine advertisement without being impelled to the conclusion that I am suffering from the particular disease therein dealt with in its most virulent form. The diagnosis seems in every case to correspond exactly with all the sensations that I have ever felt.

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch – hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into – some fearful, devastating scourge, I know – and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it.

I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever – read the symptoms – discovered that I had typhoid fever, must have had it for months without knowing it – wondered what else I had got; turned up St. Vitus’s Dance – found, as I expected, that I had that too, – began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically – read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee.

I felt rather hurt about this at first; it seemed somehow to be a sort of slight. Why hadn’t I got housemaid’s knee? Why this invidious reservation? After a while, however, less grasping feelings prevailed. I reflected that I had every other known malady in the pharmacology, and I grew less selfish, and determined to do without housemaid’s knee. Gout, in its most malignant stage, it would appear, had seized me without my being aware of it; and zymosis I had evidently been suffering with from boyhood. There were no more diseases after zymosis, so I concluded there was nothing else the matter with me.

I sat and pondered. I thought what an interesting case I must be from a medical point of view, what an acquisition I should be to a class! Students would have no need to “walk the hospitals,” if they had me. I was a hospital in myself. All they need do would be to walk round me, and, after that, take their diploma. 

Then I wondered how long I had to live. I tried to examine myself. I felt my pulse. I could not at first feel any pulse at all. Then, all of a sudden, it seemed to start off. I pulled out my watch and timed it. I made it a hundred and forty-seven to the minute. I tried to feel my heart. I could not feel my heart. It had stopped beating. I have since been induced to come to the opinion that it must have been there all the time, and must have been beating, but I cannot account for it. I patted myself all over my front, from what I call my waist up to my head, and I went a bit round each side, and a little way up the back. But I could not feel or hear anything. I tried to look at my tongue. I stuck it out as far as ever it would go, and I shut one eye, and tried to examine it with the other. I could only see the tip, and the only thing that I could gain from that was to feel more certain than before that I had scarlet fever.

I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck.

I went to my medical man. He is an old chum of mine, and feels my pulse, and looks at my tongue, and talks about the weather, all for nothing, when I fancy I’m ill; so I thought I would do him a good turn by going to him now. “What a doctor wants,” I said, “is practice. He shall have me. He will get more practice out of me than out of seventeen hundred of your ordinary, commonplace patients, with only one or two diseases each.” So I went straight up and saw him, and he said:

“Well, what’s the matter with you?”

I said:

“I will not take up your time, dear boy, with telling you what is the matter with me. Life is brief, and you might pass away before I had finished. But I will tell you what is NOT the matter with me. I have not got housemaid’s knee. Why I have not got housemaid’s knee, I cannot tell you; but the fact remains that I have not got it. Everything else, however, I HAVE got.”

And I told him how I came to discover it all.

Then he opened me and looked down me, and clutched hold of my wrist, and then he hit me over the chest when I wasn’t expecting it – a cowardly thing to do, I call it – and immediately afterwards butted me with the side of his head. After that, he sat down and wrote out a prescription, and folded it up and gave it me, and I put it in my pocket and went out.

I did not open it. I took it to the nearest chemist’s, and handed it in. The man read it, and then handed it back.

He said he didn’t keep it.

I said:

“You are a chemist?”

He said:

“I am a chemist. If I was a co-operative stores and family hotel combined, I might be able to oblige you. Being only a chemist hampers me.”

I read the prescription. It ran:

“1 lb. beefsteak, with
1 pt. bitter beer
every 6 hours.
1 ten-mile walk every morning.
1 bed at 11 sharp every night.
And don’t stuff up your head with things you don’t understand.”

I followed the directions, with the happy result – speaking for myself – that my life was preserved, and is still going on.

Very Nearly An Armful

I both love and hate the internet.

My consultant told me my day 3 blood tests were, and I quote, ‘normal’. I have therefore spent the last couple of days all Tra-la-la!-ish and not giving it another thought, until I have just now sat down to google the actual numbers involved, which I dutifully asked for and scribbled down.

FSH: 6 Good!

LH: 5 Better!

E2: 94 Not good. Not good at all. I’m now worried that the FSH figure is rendered meaningless, and that I am possessed of about as much future egg potential as the average cockerel.

Prolactin: 126do hope I have written this down wrong. I think I meant to write 26, which still seems the higher end of good.

SHBG: 27.1 The internet has no strong opinion on this.

Testosterone: 0.5 This seems awfully and suspiciously low. John has just rolled back from an infrequent trip down the local pub and, when I mournfully broadcasted this figure as being woefully insufficient, he nodded sagely and promptly and plaintively cited his sex life as also being woefully insufficient. Apparently, the two are linked.

Lastly, I have written ‘Thy’ which I suspect means thyroid stimulating hormone. I have 1.607 somethings of it, which is probably about normal.

I’m now attempting desperately to give brain space to the phrase ‘Diminished Ovarian Reserve’ in a way that doesn’t actually involve me chewing on furniture. Most of me is thinking that if my Beautiful Lady Consultant (Stunning. Face, figure, the lot. Obviously possessed of a simply humungous brain. And a kind, courteous person, too. Gah!) isn’t worried, then neither should I be. She impressed John and I once again – very much – and really, I just need to get off google and let her get on with it.

I told you that ‘it’ would likely take the form of knives or cameras: in fact, it will now involve both. Consultant number 1 will be driving cameras via my cervi (Cervixes? I’m never sure.) into both Cameron and Blair and zapping furiously away at anything adenomyosisy the cameras see, particularly this synechium thing, whilst Consultant number 2 (my previous Awfully Important chap, and apparently a particularly outstanding surgeon) will be slicing into me via the sunroof and having a good rummage about down the back of the sofa uteri for anything interesting. If they find any buried loose change, I must remind them that the landowner gets 50%.

They are, at my particular request, also going to have a look right behind my uteri, and see if I have any endometriosis sticking them to the front wall of my bowel. I’m royally fed up of sinking, cross-eyed in pain, to my knees and gasping like a gaffed fish every time I have concurrent lower-bowel peristalsis and a period. 

Surgery form

My surgery form highlights the fact that my BMI is 33 (I was slightly indignant about the upwards pointing arrow. It is exactly 33, thank you so very much. I feel the different ranks of Obese and Even Obeser need to be preserved here.) and that I will be in theatre for well over an hour. I’ve been knocked out by general anaesthetic a fair few times, but never for more than 30 minutes, so I expect John will be fielding the sick bowl on this occasion.

I was perfectly calm about it all until I spotted the bit about them requiring 2 units of blood. Eeek.

Beautiful Lady Consultant said two things to me that I had some difficulty processing:

Firstly, that ‘you have absolutely no problems with fertility at all.’ I was about to fall about laughing, until I grasped her meaning. I am, thus far, rather good at becoming pregnant, if an egg and a sperm are introduced into a candlelit womb and invited to slurp oysters together. I have never, in fact, failed to become pregnant from any finished course of treatment, and have managed to do so once from an unfinished course. My problem, of course, is that I refuse to either ovulate properly in the first place, or obligingly stay pregnant.

Secondly, she was sorting industriously through the towering piles of paper that constitute my notes, and pulled out a collection of scan photos. ‘Which pregnancy was this?’ she asked me, pointing to the date of January 2006. John and bickered conferred briefly, but could not decide whether it was the first or second IVF. ‘It was a twin pregnancy,’ she said, casting a quick upwards glance at me.

Which… is something I was never quite sure about. I had been told, albeit blurrily, in the midst of grinding pain, that they had seen a second sac, but this was during a scan the day after I had already miscarried, and I saw no further – evidence, shall we say? – over the next few days. So I had almost thought they were mistaken. But the photo BLC showed us was of two unmistakable pregnancy sacs, albeit collapsing, and I’m a bit confused how they missed telling me about this during earlier scans, although the evil was plenty sufficient to the day thereof in any case. I lie awake at night sometimes picturing these children of ours; these extinguished beginnings. Their sleeping faces, their soft limbs, their laughter. I’ve been counting three, and it should have been four.

She told me I had a month or so to get some blubber lost – not precisely her exact words – although I have been trying to get hold of their office all day to delay the scheduling more towards Christmas, as during November I will be flat-out working. Hopefully fat-out, too, but we shall see.

Of course, I’m now wondering whether delaying a whole extra month means wasting one of my puny number of remaining eggs.

*shakes head to dispel image of cavernously empty ovaries with a tiny handful of rice-sized eggs cowering, utterly endocrinally overcome, in the corner*

Lets talk about something else, hmmm?

I had a lovely surprise yesterday morning. Katie has knitted a beautiful, elegant and soft snuggler for me, as part of the Pay It Forward scheme, and my photo by no means does the fabulous knitwork justice. It even suits me! 

snuggler

After admiring the workmanship, it occurred to me that I had actually better pull my finger out and get mine finished underway. So far I have stitched one (1) item of the three required, and not even completed the seams. Roll on the long winter nights, else they haven’t a snowball’s chance in hell.

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