Thalia's fertility journey

Things that don't get better

A good friend has just had total pPROM at 17 weeks. It is her third pregnancy, and the longest one so far. It came out of her fifth IVF cycle. She is 42. She is single and has been using donor sperm, and of course dealing with all the challenges without a partner.

The baby still has a heartbeat but the prognosis is awful as she has no fluid, not even a little tiny bit, so there is no way for the baby's lungs to develop unless the fluid starts pooling again. And it seems the menbranes have just gone - they could not even see them on the scan. And she is leaking fluid. So it's close to over. And she has that nightmare decision of whether to wait it out or agree with the common sense answer that this baby can't survive. The longer she waits, the more likely it is that she'd have to go through labour to deliver the baby if s/he does not survive. And she's not sure if that would be easier - to be able to see the baby and say goodbye - or to have a termination now.

She has chosen to wait and see, barring any infection or fetal demise, for at least a week. Having reviewed a lot of material in the last few 24 hours, and even having had this conversation with Kay of blessed memory when Alexa's waters broke at about 23 weeks, I want to have some hope but I really don't.

All over the world, every minute, this kind of bloody awful situation is happening to someone. The usual litany of 'it's not fair,' 'you can try again,' 'I'm so sorry,' are haunting her ears, as they've haunted the ears of this community.

I am gutted for her and resorting to research as the only help I can provide - she has supportive family around her. I am remembering last weekend when I sent her home with a package of pregnancy books and my favourite matenity clothes, the ones I had hoped to give to my sister in law.

My sister-in-law who is not yet pregnant after a year of trying; and the docs refuse to intervene because her test results, and my brother's, are so good. But she is 37 and has a history of sub-fertility given she tried for 4 years in her previous marriage to get pregnant. I want to shout at them to get into treatment, but they won't. They are confident it will probably happen without treatment based on what the docs said. And it might. But it might not.

Sometimes standing and watching - watching a dreadful loss happen just when you thought things might be ok; watching a potential train wreck without any ability to make it better - is enough to drive me insane.

Bad day

Today I:

• Listened to my baby scream on and off for most of the morning while I tried to get him to nap, gave up but then could not constantly hold him but put him down occasionally to answer the phone/make myself a sandwich/eat the sandwich/brush my teeth etc.
• Dealt with some work crap
• Tried to get a hair appointment booked for the first time in 5 months, involving juggling my temperamental colourist, my hair cutter, my MIL for baby-sitting, and my own timing. Plus the salon reception
• Heard from a nanny agency that they don't have anyone else to send us who is a good fit for our position (short version of long story, the current nanny is not working out)
• Heard that the nanny we were interviewing tonight had accepted another job
• Heard that the nanny we invited back for a second interview isn't interested
• Heard that Pob has been turned down by the nursery school we want her to go to (WHY WHY WHY?? How can anyone turn us down - we are lovely and Pob is remarkable!)
• Got told by inhousepharmacy.co.uk that the domperidone I need to keep my supply going has been impounded by the post office and it's not their problem and they will not resend until the end of the week despite there being a mail strike and despite its essential nature to my life*

It was a bit of a crap day.

* Updated to add, they have now agreed to resend, but said it may take up to a month. I am buggered.

To the asshole in possession of my shopping

Dear Asshole,

I'm impressed. It took you a maximum of 15 minutes after I left the crowded coffee shop to steal the large Hobbs bag sitting behind the leather armchair, pressed against the glass. I know it wasn't more than that because when I called and finally got through to the incredibly unhelpful coffee shop manager, she swore blind it wasn't there, and that was no more than 20 minutes since I'd left the shop, struggling through the crowds with my whiny baby, the changing bag, and my other shopping bag - luckily the one that contained the two essentials of the day, formula and tampons. It's even possible you managed to swipe the bag before I left since I can't remember seeing it when we packed up to leave the shop.

Since the shop manager was so extraordinarily unhelpful I also managed to get a friend's husband to pop down there just in case, and indeed it was gone. I couldn't go back myself, given as how I was halfway home by then, with a whiny, hungry baby, and sadly no husband at home to dispatch myself as he is off having a manly weekend in the wind and rain somewhere.

I'm not quite sure what you're going to do with the stuff. It represents my entire winter working wardrobe and cost rather a lot of money. My credit card company says it can't repay me since stealing doesn't fall under their protection plan. This seems a bit unfair, but I know better than to argue with people who don't care in a call centre- that way madness lies. I've done my best to get some recompense, and have left a fairly vitriolic message for the unhelpful lady's managing director, but that's apparently it. No new work clothes for me. Good luck with the houndstooth suit, grey trousers, silk shirt and cream cardigan. I'm fairly sure you're not going to wear them and I'm very sure you're not going to get back what I paid for them. So I guess you had a good day. And I, along with the whiny baby with a runny nose, did not.

Yours

Truly pissed off Thalia

The banality of suffering

I've always enjoyed the poem: "La Musee des Beaux Arts" by WH Auden. I generally like Auden's poetry, but there was something special about this one. Or perhaps it's because I had to do a lit crit on some poem sometime when I was about 14 and my father suggested this one so I learnt if off by heart and my father said lots of interesting things about it. Anyway, it's come to mind a lot over the last few days. Go and have a quick look before you go on. I think typepad will open a new page so you won't even navigate away from here.

Walking out of the clinic on Tuesday was a weird experience (I've realised after all that stuff about how I care about spelling and punctuation that there are some words I habitually spell wrong. Wierd/weird is one of them. I have to correct it every time). It's been a week of beautiful weather in the UK. So the front of the hospital was full of people having a nice day. Sunning themselves on benches, chatting with their friends, having a quiet sandwich break. As H and I clung together, he reluctant to get in the taxi that would carry him back to his training course, I reluctant to dive into the hospital to get my repeat prescription for progesterone and heparin, we both remarked that it felt all wrong. I suddenly understood why films do things the symbolic way. I always laugh when it happens, but it's so necessary, so right. That when the tragedy is occurring, that the external world recognises it and responds accordingly. An eclipse, thunder and lightening, pouring, torrential rain. That's what we felt and that's how the world should have responded to us. But instead, like the scene as Icarus crashes into the ocean, everyone gets on with their lives. They don't notice the pain, because it's not visible enough, we're trained to keep it in.

Monday night was even worse on that basis, the dinner with my entire family to celebrate my mother's 70th birthday. I had booked the restaurant, organised the cake, bought the present, made the card. Everyone knew about our situation. I knew that we would get bad news the following morning. I know you were still hoping for us at that point, and I know my family was, but I knew after that first ultrasound that things weren't going to go our way. So I barely held it together through dinner, as my brothers and SILs talked about their beautiful sons and the lovely things they've done recently. My father gave my mother a picture of her taken exactly 40 years ago at the Grand Canyon, when she would have been about 2 weeks pregnant with me. My mother talked about how much happier she was at this birthday than she was at her 60th. And I continued to barely hold it together - and smile - while my extraordinarily beautiful SIL got the waiter to take our picture around the table.

Once the meal was over I made sure that H and I paid first. As we got up to leave the others to finish their coffee, my SIL asked for another picture outside, as it would look better than one around the table. No, I said. No. I don't want there to be another picture taken of this evening. And then I lost it, and I left. I feel bad as my SIL is a lovely woman and she didn't mean to upset me. But I'm dreading anyone even showing us that first picture. And when I got home I broke down again and cried to H, shouldn't our pain infect the people around us? Shouldn't they feel it too? How can people who love us go on being so happy when our lives are falling apart? It doesn't feel right.

And then I feel horrible for wanting other people to feel miserable. I honestly don't want them to suffer, but I do want some acknowledgement that our lives suck right now. Just like I want the weather to reflect our pain. Our families all know, and told H when he called them how sorry they were. But no one has done anything other than send an email (my mother). No calls, no other emails, not even a text message. One of my college friends called Tuesday night, and another has texted me. One has emailed. Why doesn't my family get it? I don't really want to talk about it but I do want to know that they are thinking of us, however impotent they are to help.

But I guess the answer is that this doesn't really affect their lives. Of course they are sad for us, but then they have to get up to feed their baby in the middle of the night, or go to that important meeting, and that's their life and it takes over. And that's all fine and normal. But it's hard to take when it feels right now as if this sadness that I feel is never going to go away. Maybe that's right, maybe that's true. I know the sadness will get easier (much easier) to deal with and I know we will agitate for our next cycle and in time we will either have another baby or we will move on in other ways. But I think I know that there will always be a part of me that will mourn this loss. Our 22 January 2007 baby. The baby that never really existed. Certainly I will never look at a positive peestick with the same joy again.

This post hasn't really ended up where I thought it was going. It was going to be a musing on how suffering is so hard to understand, from an intellectual perspective. But I see that it's too raw, too present for me right now for me to be able to take that intellectual position.

I remain awed and cared for by all your comments over the last three days. Words can't thank you enough.

Bringing the end a bit closer

It pays to say (or type) what you think to your doctor. In writing to Dr Candour yesterday to let him know that I didn't want to take him up on his offer of a consultation, I explained that I wanted to go for the ERPC as soon as they could confirm that things were over. He has just written back to say that he can fit me in next Monday, so he suggests I book my scan for first thing that morning, then come straight over for surgery later that day. Sounds like a deal to me. I need to check with him if being on heparin changes anything, but other than that, consider me booked in.

Just FYI, he said that the reason for their conservatism is that about six years ago in Bristol, a woman was told she had had a miscarriage. A week later things were found to be ok. The same thing then happened again with the same woman two years later. Since then "all units scanning this early have diagnosed a miscarriage over two separate scans." Seems to me I've already had the two scans, but I think because the first one did show (perhaps) a fetal pole, that it doesn't count. At least I understand the protocol now. That poor woman.

Thanks for all your comments. I actually found it harder to wake up this morning than I did to get through yesterday. It's the waking up and realising that things are just going to go on being really bad that hurt the most. I don't have the words to type about it right now, no doubt I will in due course. This is why we blog, right? Anyway, thanks again. 

The beginning of the end

The sonographer looked for ages. I can't fault her for thoroughness. My bowel was in the way so she massaged my abdomen to try and move it. The picture still wasn't great. But it didn't look good. There was a gestational sac. There was a yolk sac. There was no clear evidence of a fetal pole, let alone a heart beat.

She went to get a doctor, who has to view the scan in all cases of a miscarriage. I asked for Dr Casual as opposed to Dr ICU. As the sonographer left the room, H started to sob. I have never seen him sob before. Tears have come to his eyes as I have wept over our misfortunes, but today he sobbed. We sat there, me awkwardly holding the paper sheet over my nether regions, and waited. And waited. And waited. After 10 minutes Dr ICU popped in, noticed there was no sonographer, then left again. I cried some more, thinking that Dr ICU (who I'm sure is a lovely person, but I just don't like him) would be the one to confirm my miscarriage.

Eventually Dr Casual appeared with the sonographer. He'd been doing the transfers upstairs. In the meantime Dr Candour had called down to speak to the sonographer to hear our results, she told us, and had asked them to get a blood test as well. So Dr Casual did a further scan. Lots more pushing and prodding to try and get a good picture, with the same outcome. There was a gestational sac. There was a yolk sac. But there was nothing that could be described as a fetal pole.

The sonographer and Dr Casual agreed that this was not good. Then they told us we needed to come back in a week for another scan. "You're joking!" was my reaction. No, apparently they are not. Because they couldn't get a good picture, they don't want to initiate a surgical 'completion' of the pregnancy, nor do they want to stop the progesterone support and see what happens (I don't want that one either, thank you). So we have to continue with progesterone, and heparin, etc etc etc, for another week.

It's a different week than last week though. There is no hope. They agreed that although there was some minuscule, microscopic, vanishingly unlikely chance that this would work out, none of us really believe in that chance. 7w1d with no fetal pole doesn't really bode well. "If you start to bleed," said Dr Casual, "you must come straight into the hospital." But I'm not actually likely to bleed because the progesterone is keeping everything going. So next week we will return, they will confirm that everything looks shit, and then, hopefully, they will let us have a surgical procedure, which they didn't call a D&C but I didn't catch what they did call it, to 'complete' this pregnancy. Dr Candour has sent me an email saying that he is available this afternoon if I want to see him. Other than showing up and weeping, thus making him feel awkward, I'm not quite sure what this would accomplish, so I think I'm going to say no.

On the way to the hospital the one thing I was hoping for was no more ambiguity. It's not really ambiguity, but the doctors are treating it as if it is. What, precisely, did I do to deserve this?

In the 'life is shit' category

Zarqa's pregnancy is ending. Her baby, a girl, had Down's syndrome. Zarqa is about to disappear from the bloggy world. Go and tell her you're thinking of her and you'll miss her before she goes.

No where

Diana Wynne Jones's book, Fire and Hemlock, relies for its denouement on two stone pillars which rotate. On each pillar are the letters, N, O, W, H, E, R, E. Between them then they can spell No where, Here now, Where now, Now here. That's what this feels like. Rotating spheres of meaning, coming and going, and in the end signifying not that much. It's hard to make sense of this.

I knew on Monday that it was over. Those pangs I wrote about were clearly period pain. Of course knowing and believing are two different things. Certainly my subconscious knew it. I dreamt all night that I wasn't pregnant. It was one of those dreams where you are completely convinced that it's real. It was horrible. When I woke up at 04:15 it took me a minute to orient myself again. Then I tried to feel relieved that it was just a dream. That I might still be pregnant. Then I felt the pangs again and knew that I wasn't. I slept on and off until about 07:15 when I gave up and went to the loo. And found blood. I wish I could remember the precise words of the ending to The Peacock Spring. Una gets her period and it's the end of her final clinging onto her relationship with Ravi. But my copy is in a box somewhere and I don't want to murder Rumer Godden's words. So let me try. It felt like the end. It felt like a final full stop on a story. A sharp cut to the thread of hope I'd been finding it increasingly hard to sustain for the last 18 hours. "The curse has come upon me." (My mother and her generation called their period "The curse". Do you think they got it from Tennyson or is that something from time immemorial? Do Americans of a certain age ever call it that?).

And while we're on the topic of hope, let me be clear that there is no hope for this cycle. Nothing could survive the total destruction of its habitat like this. I refuse to call a period Aunt Flow, but boy is this flowing. It's dark and red and heavy and hot and angry. Of course I guess I could have an ectopic. But since I have no symptoms, even though I've been told by the clinic to continue the suppositories, I very much doubt that I'm going to be subjected to that particular trauma. Which I suppose is one lucky break I've had. But it is full on. I'm having the worst pain I've had for years, which is leaving me nauseous as well as crampy. Which at least has the bonus that I wasn't tempted to drown my sorrows in food yesterday. I did eat some of the HUGE box of chocolates that H went out of his way to buy from the best chocolate shop in London (I don't think he realised how many chocolates they can pack into a box, or how much it would cost!), but my heart wasn't really in it. Nor did I fancy breaking my wheat-fast and so while H had pizza for dinner, I had a salad. I think I'm too sad even to want to over-eat. That's a rare occurrence for me.

I'm crying at the drop of a hat. It's not easy as, unlike Susan, I can't hide under my desk to do it. Luckily yesterday I was able to turn all my meetings into phone calls. So I did everything from home in my pyjamas. It got the work done. Today I have to be chirpy and present in person again. I reckon I can do it in 30 minute increments. I'll have to find some reason to duck out when I need to.

I still have to go for a blood test, but I got the nurse to let me go in tomorrow instead of Friday. I just want this to be over with. I have an appointment with Dr Candour on the 29th. We have to wait that long because, get this, "It takes two weeks for the clinic doctors to look through the file and return it to Dr Candour." Two weeks. No worries. How about I walk over there and just help them with that little task, huh? Or don't you think they'd apppreciate that? While I'm there tomorrow I have to sign some kind of consent form for them to release our records so I can get a copy for big guns clinic. My intent is still to do another cycle where we are and then see what happens. In the meantime I want to get going with BGC as they have quite the waiting list. Not surprising given their figures.

I'm not ready to start hoping again. I know that this cycle was not the end, but it is so hard to let go of the thought of our perfect eight celled embryos and the perfect boy/girl twins they were supposed to turn into. I had already imagined their summer birthday parties and chosen a few potential names. I know. I'm a sap and an idiot. When I noticed myself doing it I stopped myself, but it's hard to keep control of your brain all the time. I keep telling myself that doing another cycle is a good idea because it gives us the potential of a few more frozen 38-year-old embryos for future reference. Actually, they'll be 39-year-old since my birthday is in January and there's no way they'll let us cycle again before then. I never thought I'd be 39 and not even pregnant. Life wasn't supposed to be this way.