Thalia's fertility journey

All's well

Haemoglobin at 12.6, Blood sugar at 6.3 (sorry I didn't get the units). So I'm not anaemic and I don't have gestational diabetes. According to Dr OB, they don't need to test for GD again within this pregnancy, unless the passenger starts to grow too fast in which case they will look again. So I seem to be in good shape.

H was reflecting last night, as he admired my bump (he is very drawn to it but tends to restrict himself to just stroking it a little when we have a hug, I think he's scared it might bite him or something if he left his hands on it for longer), that it's really been quite a trouble-free pregnancy. And although my initial reaction was "are you kidding??? So the bleed at 13 weeks was just another day in our life???", I think he's right really. Yes, that day was terrifying, and yes, I have been tense on many other days, probably most days, but if you look back on it, other than the embryo being small at 6 weeks, and the bleed, everything else has been ok. The embryo/fetus always looked good from the 7 week scan onwards. All our scans have given us good news. The passenger has no obvious defects. I didn't have substantial nausea. I don't have gestational diabetes. I am not huge and uncomfortable (yet). I'm still sleeping well at night. The passenger kicks me on a regular basis.

I hate to type this as it's one of those gremlin-attracting posts, but I think we've been very lucky. Very lucky to conceive spontaneously given my age and my endo. Very lucky to have a healthy passenger (so far) given my age and what we've been through. Lucky I haven't been made ill by the pregnancy. Very lucky indeed. And today I feel lucky. And happy. And excited.

As requested...the squash recipe

Ingredients:

1 tablespoon olive oil
1 1/2 cups chopped onions
I large butternut squash, peeled, seeded, cut into 1/2- to 3/4-inch pieces (if you stab it a few times, then put it in the microwave for a minute, it becomes much easier to peel)
1 cup vegetable stock
1 1/2 tablespoons minced seeded jalapeño chili
About 3-4 cloves of garlic, minced
1 can unsweetened coconut milk
Juice of 1-2 limes (depends on how juicy they are)
2 teaspoons Thai red curry paste
2 shredded lime leaves
12 ounces dried futonaga udon noodles
Additional veggies if you want - e.g., Pak Choi, mange tous etc. Some chicken if you want - I use breasts, cut into 1"-ish pieces 1/2 cup chopped fresh coriander (ciilantro)

The process:

Heat oil in large nonstick skillet over medium-high heat.

Add onions, sauté until golden, about 5 minutes.

Add squash; sauté 2 minutes. Add broth, jalapeño and garlic; bring to boil.

Add the chicken here if you want to (uncooked)

Cover; cook until squash is getting tender, about 4 minutes (it really doesn't take long and you probably do want the liquid to reduce, so I'd minimise time here so that the last step doesn't result in over-cooking)

Stir in coconut milk, lime juice, lime leaves and curry paste. Simmer uncovered until squash is tender and liquid is slightly reduced, about 4 minutes. When liquid has mostly reduced, add whatever additional veggies you want - Pak Choi is my favourite to add at this point

Season to taste with salt and pepper

Meanwhile, cook noodles in large pot of boiling salted water until just tender but still firm to bite. Drain noodles. Return to pot. Add squash mixture and cilantro to noodles; toss to blend. Serve.

Fun and games at the doctor's

Today was scheduled to be just a routine OB visit, except it took place at the doc's new digs in London's fancy medical district. He's doing one clinic a week there, and it was convenient given where I'm working today. The only unpleasantness in advance was needing to drink a can of lucozade in preparation for the gestational diabetes test.

My amusement level was raised by seeing the names on the door, which included Dr Candour. I mentioned this to Dr OB, who said that this was a new venture by Dr Candour and one of his colleagues. Dr OB has been given space one day a week for his clinics. The clinic isn't really open yet, so all the equpment is shiny and new, and everything is very, well, polished. It's all very designer - one of those places where the chic upholstery fabric matches the artwork, if you know the kind of place.

The real fun and games started when the doc asked me to lie down on the (leather although covered with paper, and behind a leather screen) consulting-room bed, so he could listen to the heartbeat. He moved the probe gently around, and found my heartbeat several times, but couldn't, even after 7 minutes (I was counting to save my sanity) find the passenger's heartbeat. And although I'd felt her move not more than an hour before, I of course started to panic. The situation felt particularly ironic (or sucky, if you like), as (i) H had had problems getting there, so I'd told him to go home instead, and (ii) I'd just this morning got an email offering baby clothes on sale, and had been brave enough to purchase my first babygro. Very minimalist, I assure you, white egyptian cotton with two little footprints on the front in grey. Yes, of course this is the day my baby dies, I thought. Then I talked myself down off the metaphorical ledge using the conversation I've had in my head several times over the last few weeks. "No, my baby is not going to die, she's just not. We've got this far, damnit, we're going to have a baby." I know it's not logical, but repeating this in my head has been helpful to get through those moments where I panic because I haven't felt her for a while.

After 7 minutes, Dr OB went to get his "old-fashioned trumpet" to see if that would work better, but it didn't. So he escorted me downstairs to meet the very lovely sonographer in her very well-equipped sonography room. It even has an LCD screen set up, high on the wall opposite the bed, so that she doesn't have to turn the screen round to show you what's happening (although I don't quite understand why more clinics don't just turn the ultrasound machine around so that the sonographer has their back to you but the screen is facing towards you). The machine needed to boot up so there was a bit of downtime where Dr OB, the sonographer and I made polite, rather strained conversation. Then she apologised that her gel warmer wasn't on, squirted the cold gel on my stomach, and started the scan. She immediately showed us the heartbeat, at which point I nearly fainted with relief, and Dr OB disappeared to let her do a full growth check etc. Everything looked just fine, all measuring on track, and the passsenger is now head down. The sonographer carefully measured all the fibroids and said it looked ok for natural delivery to her, although the OB would have to decide in the end. The placenta still looks healthy, the passenger was bopping around with one arm up around her head, one leg tucked under her bum, and another stretched out along my side - "using all the available space," said the sonographer. So that was all ok.

The rest of the visit was rather uneventful. We discussed labour again, and Dr OB recommended I go check out this guidance on caesarians, to make sure I'm fully informed about what I want to do. So I'm off to read that shortly. He pointed out again that the stats are dramatically in our favour at this point, and that they will not take any chances with me at all, none at all. Which I do find reassuring (the second part rather than the first as we all know stats lie).

So I'm fine and the passenger is fine and it was just one of those afternoons. GD results will be in on Friday, fingers crossed those will be fine, too.

Retail therapy gone mad

Well, as you can tell by the presence of this post, I bought the Mac. H will be delighted so I don't feel too awful about spending that much money. He can't access many websites from his work laptop so he regularly borrows mine to find what he's looking for, which irritates both of us. And a Mac with all the lovely imovie-type software is just the ticket for that increase in photo taking and home film-making that we hope will start sometime in September. It's really silly to buy one here when I could have bought one in the US for half the price. But I'm not doing any more long haul travel until the baby can come with me, as a separate person, so if we want a Mac any time soon we have to pay UK retail prices. Ouch.

It's been 8 years since I've regularly used a Mac, but my love for them has in no way diminished. They've only grown more beautiful, not to mention faster and with better software. Just touching this MacBookPro is making me happy. The brush against the metal, the resolution of the screen, it's all, just so yummy.

Sorry, lost myself there for a minute.

I now need a bunch of technical help. I managed to download Firefox but it doesn't seem to have loaded properly - it's sitting on the desktop as if it's a separate disk. I downloaded Acrobat but Firefox doesn't recognise that it's there. Any ideas? I also can't turn off the underlined links thing in Firefox - I think it makes things look very messy so I always turn it off in IE.

Although I haven't had the relaxing day I had planned, I did go and spend an entertaining couple of hours (I had no idea how long I'd spent til I got home) in West London's new foodie mecca. It's a very seductive place. I don't usually get to do the food shopping as H has us set up with a weekly delivery of an organic veggie box, and he picks up the other stuff we need himself at our local providers. I'm a very bad food shopper. I buy what looks good with only a small care for what we might actually cook with it. So I've come home with very exotic items, like soft tortillas and salsa, some oven roasted tomatoes and some fresh heirloom tomatoes the like of which I've never seen in this country before; and some simply extra delicious items, like British organic strawberries. I do have a plan. I'm going to roast some corn-fed organic chicken thighs with lemon and basil for dinner, and eat them with some new potatoes and asparagus. I've already snacked on some edamame. For dessert I'll have some of those strawberries with cream. Then for H tomorrow night, not that he deserves it, I'll make a butternut squash curry with chicken, ginger, chard, and thai red curry paste, and we'll have roasted peaches for dessert.

I'm feeling a bit crampy now but I'm hoping it's the passenger settling down after a busy day. More water is on the horizon, and I need to start cooking. Tomorrow I'll get on with relaxing.

Just because I'm pregnant doesn't mean I can't have a bad week

I'm having to type this from my blackberry as to cap off a very long week at work, my computer has decided to croak. This rather puts paid to my plans of a leisurely cruise through your blogs, a couple of long posts, and a bit of research on line, not to mention the work I am supposed to do.

H is away this weekend, which I'm a bit sad about but it had its upsides. Until the computer croaked and H forgot his promise to fill the fridge for me so I returned late last night to find just the elderly broccoli and courgettes which have been there for over a week, some apples I put in there a couple of weeks ago with the aim of making stewed apples from them as they were somewhat past their best, and the usual assortment of condiments etc. He also left the sink full of washing-up, and the washing machine loaded with sweaty gym kit. Can you tell I'm a bit irritated?

So instead of my original plans I'm about to go and drop my computer off at work, and then find somewhere exciting to buy something enticing for lunches and dinners this weekend. If you have a blogger blog please forgive me for lack of comments recently, I can't comment on blogger or wordpress from the blackberry and that's currently my only way to read blogs as I'm travelling so much. The doctor is going to ground me from mid-july, so hopefully things will get a bit easier then. I've started to get swollen ankles even on short plane journeys, so it's really time to slow down.

I'm tempted to really indulge and go and buy the mac H and I have both been hankering after for some time, in which case you might get more this weekend. We'll see.

The alien inside me

The movements have been so strong that I thought it must be possible to see them. Sure enough, while she was having a real go at me on Saturday night I lifted up my t-shirt, and whomp there she was, my stomach moved. I couldn't help keeping on looking whenever the kicks or punches felt particularly strong. So far pretty much every quadrant of my bump has been observed to move. Very odd but very wonderful.

She's not always that cooperative. Sometimes she doesn't move in a way I can feel for hours and I really really freak out. I've even poked her to try and get her moving. Doesn't work. I've eaten sweets to try and get her to move. Also doesn't work that well. If she isn't in the moving mindset she doesn't move. Or, more likely, she gets herself in a position where I can't feel it. But it's scary nonetheless. I do know that I feel her more at weekends, so either she moves more when I'm more relaxed, or I am just more conscious of the movements when I'm relaxed. I've also been massively stressed at work, so that probably doesn't help. It certainly helps me freak out that I've killed the baby because I'm too stressed. Melodramatic, much?

It's started to feel really really real. That we might have a baby. I know I keep saying that, perhaps at each stage it just becomes a bit more real. Well, right now it feels real enough to talk about names, and maternity leave, and how to clean out the room that will be the passenger's when she arrives, without me freaking out every 10 minutes. Please let it be when, and not if.

The boards! The boards!

I should have given up the boards long ago, when I first found blogworld. Those awful blinkies and the babydust and the incredible ignorance of most of the people there. But somehow, I got drawn back in. I can help, I thought, I have knowledge! But the board I post on apparently doesn't want that. Either people are posting things like:

No heartbeat, beta of 150 at 6 weeks, now I'm bleeding is there any hope

And people are saying "*hugs*" (only more annoyingly with little people that expand and contract), "hang in there, you never know, this other woman on here had no heartbeat and at 8 weeks they found out she had twins!!"

Or people post some factual enquiry, usually

when can I test?

and lots of people are telling them that it's 17 days post egg collection or 21 days past trigger, or whatever.

On the first set, I have occasionally posted a very carefully worded note to say that things don't look good. A couple of times people have got in touch to say thanks, they appreciated the straight talk, but mostly I get shouted down by a bunch of women who think I am destroying their "PMA" and I should shut up.

On the second set, I sometimes post the facts. Implantation happens between days 6 and 10 in a pregnancy with a good chance of success, so if you are not getting a positive peestick (having tested more than one brand) at 14dpo then the fat lady hasn't sung, exactly, but she's certainly on her warm up. Then I don't just get shouted down, but told that every clinic is different, that there are different ways to calculate the age of a pregnancy, yadda yadda yadda.

In particular, one of the experts on this board seems to find me each time I post advice, and contradict me. She knows a lot, mostly from her own long and painful history, and is tremendously invested in the board, she posts there on almost every thread, but she is just wrong on a couple of topics. The problem I have with her is not that we disagree, neither of us is posting as a doctor after all, but that almost every time I post something she takes issue with it. It's quite irritating to type out a long post, with the sole aim of helping someone at an earlier stage in the journey, and then get attacked, or my advice contradicted, seemingly just for the sake of it. I think the attack is because she enjoys being the most knowledgeable person there, and I clearly know quite a bit, but it still hurts.

I know the answer is to give up the board. I don't have a community there, anyone I care about knows I'm here instead and checks in. I do like to look in on the board for my clinic to see how things are going, but they wouldn't miss me as I don't really post, I just check in. My advice could probably be duplicated by the expert above on most topics, and by others when she has a blind spot. My 'let me tell it like it might be' posts I'm sure everyone could live without. So why am I finding it so hard to just give up?

I guess I like being able to help, I like knowing stuff. That's why I came back to this blog, I wanted to continue to share the benefits of what I know, what I had to struggle to learn, with others. That board community is full of people who know very little, but I think some of them prefer it that way, it's more for support than for knowledge. I'm better off in blogworld where we fib to each other a bit less. Heaven knows I would not miss the blinkies.

Tell me to go cold turkey please.

Letting go of the crutches

It's a bit like going to the gym, blogging, I've found. You get out of the habit and it becomes hard to see how you ever managed to post every couple of days or so. I have been ill, and I have been travelling, but still, there are the 20 minutes before I go to bed, or the 15 minutes waiting for a meeting, surely I could have filled those with an update. No? Well, here I am. I decided, just like the gym, to type SOMETHING, just to get myself back in the loop again.

The cold was really awful. It was just a cold, I don't think I ever had a temperature (funny how we English say that. I mean, I always have a temperature of some sort, but we describe having a raised temperature as just 'having a temperature.' Doesn't really mean what it says), but I felt absolutely awful for a few days. You can tell it's a bad day for me when I don't want to either watch television or read about how all of you are doing. Despite this I stupidly struggled to work on any day that wasn't an actual holiday. It's been a really busy time and it was hard to justify the time off, despite feeling like death warmed up. It's been nearly 3 weeks since I started feeling bad and I'm just now shedding the final symptom, which is a hacking cough that makes me sound as if I've been smoking for 60 years.

The really bad weekend in terms of how I was feeling was 2 weeks ago now. Last weekend, despite the coughing, I had a fun time in US City, including buying rather a lot of pairs of shoes at an exceptional sale, getting my nails done, going to the theatre with a colleague, and having a relaxed morning in my hotel room with the New York Times, some french toast, and half a season of ANTM. Despite having had a perfectly fine time, this weekend I'm home and it's distinctly preferable.

The passenger is doing very well. We had a scan on Friday to see how she was doing and how blood was flowing through the uterus, to see if I could come off the clexane (LMW heparin, same drug as Lovenox). The answer is she measures bang on track, and already weighs 750g or 1lb9oz. That feels big, although as H pointed out, she's going to hopefully at least triple in size before she makes an appearance. Which makes me a little nervous given how big I feel already. My blood pressure was 85 over 50 (??!), the blood flow through me, the passenger and the placenta all looked fine, the resistance in the arteries was low, which is good apparently, and so the advice of Dr OB was that I stop the clexane.

This made me a little nervous.  If everything looks fine while I'm on the clexane, isn't that a sign that I should stay on it? Apparently not. Given that there are no controlled studies on this situation, they don't really know what good looks like or how to tell what treatment is really needed. So the fact that the blood flow is normal is taken as a sign that the clexane has done its job and I don't need it any more. The hypothesis is that at this stage the placenta has thoroughly invaded the wall of the uterus and there's no more work for the clexane. Given what Julie's placenta looked like when Charlie was delivered this feels a little unconvincing, but then her mutation is Factor V Leiden, not MTHFR so perhaps that explains the difference?

"Of course, if you feel psychologically dependent on it, I'm ok to keep you on it for another six weeks or so," he said, reassuringly. "But leaving you on it til full term increases the (very low) risk that you'll get bone thinning problems, which can be severe, so I don't feel happy about doing that." I don't know if he was TRYING reverse psychology on me or if that sentence just came out that way unknowingly, but either way it was effective. I agreed to leave the surgery without a new prescription. I know that he wouldn't take me off clexane if he didn't think it was the right answer, the best answer for both me and the passenger. I know that he knows more about pregnancy with MTHFR mutations than anyone else in the UK. It is still nerve wracking. However, clearly not that nerve wracking as I still had 2 syringes left, and thought I'd use those to wean myself off, but it's Sunday mid morning now and I haven't used them. My last injection was Friday. My stomach is already thanking me.

I'm still on baby aspirin, "can't hurt, might help" according to Dr OB, and the mega folic acid, so the passenger still has some protection. I will return every 3 weeks from now on to check in on both me and the passenger to make sure we are doing ok ("we would have done this anyway," he said. "But you can come in every week if you want."). Dr OB wasn't completely reassuring however. "You may get complications," he said. "Your age, the genetic profile you have, and the fact that the blood tests that have been done show that you have a high concentration of red blood cells in your blood, all these are risk factors for pre-eclampsia. But if you get complications we won't know if it's due to coming off clexane or not." Cheers, then, I'll just go away and relax now.

No, really, I feel ok. I do trust the doctor, and I do know that the passenger is doing just fine. She's very reassuring. Every time I worry that I haven't heard from her for a while, she'll deliver a beautifully timed poke in my stomach, and I know she's ok. She seems to move around more just after I've eaten, but whether that's physiological and she's reacting to an increase in nutrients, or just psychological on my part and I'm more aware of her just after a meal, I don't know. But I do know that eating a couple of tropical fruit flavour life savers just before a scan makes the sonographer's job a lot harder.

24w3d