Sunday, 19 December 2010

A birth, an update and an apology

I gave birth to a perfect baby boy on a misty morning in mid September.

I am so sorry to have been away for so long. I can see from recent comments particularly that my absence has let regular followers down and even caused some upset, and I feel terrible about that. Let me try to explain myself...

My son's birth didn't go exactly as planned. The tale is a post in itself - and one I promise to write - but the long and short of it is that he had to be delivered with forceps, as during the final part of the pushing stage his heart rate started to drop alarmingly with each contraction. That twenty minutes was the most terrified I have ever been, because I thought that after everything I was going to lose him right at the end. I'd had an epidural (in desperation after twenty-six hours of labour!) so he was on the fetal heart monitor, and his gentle, fast thudding was the soundtrack to my labour. The sound of when the thuds started to taper off into the occasional soft thump continues to haunt my nightmares.

A doctor was summoned and the expression on her face made my blood run cold. She told me we had to get him out now, and that forceps would be necessary. The next few minutes were simultaneously a blur of speed and seemed to last a lifetime. I watched with almost detached horror
as I was cut and the forceps inserted, and then I was told to push like there was no tomorrow. This I did, and then the room was filled with the best sound I'd ever heard (only recently superseded when he started laughing for the first time) and my screaming baby boy was delivered onto my stomach, shitting himself effusively in the process and covering us both in black, tarry meconium.

The reason for my long absence from the blog is that the combination of forceps and the speed at which his head was born left me with what the medical profession class a fourth degree tear. This means the cut in the vagina tears through the perineum (which in my notes is described as "completely disrupted", for which read "gone") and anus and into the bowel. I had to be taken immediately to theatre to address the blood loss and also to have a rectal specialist stitch me up, which took nearly two hours.

The upshot of all of this is that only now, with my baby just reaching the three month milestone, am I returning to normal life. The recovery process has been slow and physically gruelling; the pain of sitting in the early weeks was something else. Would you believe that today is the first time I've felt able to sit at the desk chair and spend time on the computer? It's true.

I'm describing all of this in a factual and rather clinical way because the last thing I want is anyone to think I'm eliciting sympathy. I don't even feel sorry for myself, never mind expecting other people to. I have what I've wanted forever, a healthy baby, something I know many people yearn for and can't have. If sustaining a bit of damage to my nether regions in the process is the price to pay, so be it. Flesh heals but I know that the pain of infertility does not. I am so very, very grateful for my beautiful boy.

I always, always intended to blog as soon as my son was safely born. It's just taken me a lot longer than I anticipated to be physically up to it. My reasons for not blogging more during the pregnancy are more complex. I'll do my best to explain...

I'd heard it said before I was pregnant that the first twelve weeks are the worst; that this is the time of fear and uncertainty about whether things will proceed as planned. Not so for me. I developed a wrenching dread of miscarriage and all complications of pregnancy after the first trimester, to the point where at the slightest twinge I was misguidedly consulting Dr Google and self-diagnosing with the worst case scenario every time. I did have quite a few complications as things turned out; nothing life-threatening for either my son or me, but enough to render me a nervous wreck and a frequent flyer at the local maternity assessment unit. The staff there were, for the most part, understanding and sympathetic; many times I was told that such levels of anxiety are common in IVF pregnancies because every step of the way you doubt both that this miracle is actually finally happening, and that your body, for so long your enemy, has the ability to do it.

I also became incredibly superstitious. I'm talking to the point of OCD. I wouldn't have the pram in the house till we were both safely home from hospital. And I developed a totally irrational superstition about my blog. Don't ask me why or how the idea came into my head, but I became fixated that if I continued blogging - and particularly, if I continued in my usual style, with comic griping about the trials and tribulations of stretch marks, having your cervix headbutted, and lakes of curious-looking discharge - that something bad would happen.

I know that's not really an adequate explanation for a nine-month absence, and worst of all for leaving regulars hanging as to my health and that of my baby. I only hope that it explains my action, or lack thereof, at least in part. I never, ever intended to upset or let anyone down.

I have so much to say about pregnancy, childbirth and the early weeks of becoming a mother. I sometimes feel like my brain is teeming with unwritten blog posts; a line will come to me now and then and I want to write it all up so much. I have so much to tell you all! I can only hope that those of you who can forgive my long absence stay with me and have the patience for shorter, less frequent updates snatched when the baby is asleep, as he currently is.

As always, thank you to everyone who has ever read and/or commented on my blog. I now need to catch up with the journey of all those bloggers I came to treasure, whose stories I've also been away from for too long.

I honestly, truly promise to write more soon. My birth story simply has to be committed to the blogosphere - after all my other graphic entries, a tale in which my anal sphincter is torn in two (yes, really, at 10 o' clock and 2 o' clock, according to the diagram in my notes) is too good not to tell! So I mean it when I say I'll be back soon. For now, lots of love.

Wednesday, 10 March 2010

Pregnancy: The end of the first trimester

A fortnight ago I experienced something I never thought I would: a happy scan, in which my husband, mother and I were able to view the movements of a healthy 13-week old foetus.

I was so nervous going in - more nervous than I'd been for the egg collection, more nervous than for the pregnancy test, more nervous even than I was for the seven-week scan which told us whether there was a heartbeat or not. I think my trepidation was fed by the terrified sense that, having come so far, it would all be taken away from me. I was utterly petrified that there'd be a problem with the baby, or that something might have happened to it weeks before without my knowledge.

In reality the scan couldn't have gone better. The sonographer was able to get amazingly clear pictures, and the baby obliged us by swimming about and even sucking its tiny thumb for long enough to pose for a photo. It looked completely healthy - everything that can be right at this stage was right, with particular highlights including a strong heartbeat and evidence that the stomach and digestive system have started to work.

It was, in short, an amazing experience, and one I thought I'd never have. I couldn't believe how formed, developed and active the baby was even at this early stage. I'm utterly convinced I can feel movements now at neatly 15 weeks, although all the books say this is impossible until at least 20 weeks for first-time mums.

Bah to the books, say I. They are wrong on more than one thing, let me tell you. In fact, I'm here to bust some pregnancy book myths and blatant understatements, in my usual frank and abrupt style.

1. Slight constipation is common in early pregnancy

Try: you will be unable to defecate for days, occasionally creeping into a whole week, at a time. You will be so bunged up with crap that it occasionally hurts to walk. When you go to the toilet to pee, but in the throes of a bad spell of constipation, it will hurt to even twist the amount you need to in order to pull up your pants. You will be perpetually starving and will eat constantly even as you quake with fear that you are adding to the shit storm. Eating brown bread, fibre and lots of fruit doesn't help, as the lying books claim. Fibre and fruit are ALL I eat. Oh, and every time you do manage to go to the toilet, any minor amount of straining will leave you bug-eyed with terror that you have somehow dislodged the baby.

2. There will be some minor aches and pains as your body stretches

Every day will be an adventure of twinges, cramps, weird stabby sensations and bubbling. You will not be able to work out whether these are due to the excessive amount of wind and crap you are storing, or to normal pregnancy pains, or to a problem you should speak to the midwife about. You will quickly establish yourself with said midwife as a nutcase paranoid nuisance who phones up at every ache. Every time you do this you will feel obliged to say "It's an IVF pregnancy" in an effort to justify why you are so obsessive and terrified. The pains you will experience are not just in your abdomen. The best ones are the ones that feel like someone is stabbing a red-hot poker up your vagina and anus simultaneously. This is especially fun when it happens in a meeting at work.

3. Your vaginal discharge may increase

You may need to insert a pillow into your underwear and would be at risk of drowning if you spent long enough in a sealed room. This too will terrify you every time it happens because a) it's completely alien to all previous experience (for me anyway) and b) every time a splat descends you will assume you are bleeding and therefore miscarrying. Sometimes the discharge will be scary-looking and mucousy, prompting you to demand the midwife do a vaginal swab at your booking visit, which her expression indicates she was not expecting. The results will be normal, making you look like a fool. Other times the splat will be so watery that you will first wonder if you wet yourself. When you establish you did not, you will immediately decide your waters must have broken, which will prompt you to drop everything and leap in a taxi to the hospital to demand another scan, for which you will have to wait three hours in a state of pacing horror. I wish I was exaggerating but this happened last Friday.

4. You may feel emotional

You will burst into inconsolable tears when a knitted duck character on the comedy TV programme Harry Hill's TV Burp doesn't get picked because it doesn't have wings. You may also get so upset when your furniture plans for the spare room are out by a couple of millimeters that you give yourself a nosebleed. Again, I wish I was lying.

5. Nausea may be worse in the mornings

You will develop a new morning routine: get out of bed, retch extensively into toilet without bringing anything up. Climb into shower to be immediately struck by urge to retch further, which you do directly into the shower plughole to save you clambering out again. Dry yourself. Retch more. Attempt to brush teeth and discover this worsens the retching desire tenfold. Repeat, daily, for six to eight weeks. (And I'm lucky that my morning sickness stopped at 13 weeks - I know lots of people for whom this wasn't the case!)

That's my top five myths busted, and I'm only up to 15 weeks! However, make no mistake: I'm not complaining. I'm merely shattering myths and illusions in my normal way. But however much it may sound like I'm whining, I love every second of this. It really is the definition of a dream come true, and I think that's why most of my moans relate to being uncertain about symptoms to worry about and those which are normal. Having never been pregnant before, I just don't know what to expect and when something aches, or twinges, or leaks, I immediately assume something has gone wrong.

This is something I need to get over and I plan to ask my (beleaguered) midwife for advice on how, because I can't spend the next 25 weeks panicking about every bubble of wind. I imagine twinges and pains will get a lot worse before the end - I should think my first Braxton Hicks contraction will see me summoning the National Guard - and all the worrying, ironically, isn't good for the baby, despite me wanting to dedicate every second and fibre of my being to doing things that are good for him or her.

It is amazing what the body can do. I cannot believe I have already created and grown this tiny, 9-centimetre long perfect person. There isn't a second of a minute of a waking hour when I don't think about my baby, wonder how and what it's doing and pray it is OK. Neither is there an instant when I'm not overwhelmed with gratitude that we have got this far.

I feel, for the first time in nearly half a decade, that my body is doing what it is designed to do. It really is an awfully big, exciting adventure and I can't wait to see what happens next.

Thursday, 11 February 2010

The long-awaited update (it's good news)

Yesterday I had my booking appointment with the midwife who will hopefully see me through this pregnancy and beyond.

I'm so sorry I haven't updated the blog with my news. The excuses I cite are a combination of taking time out from writing to focus on being well and getting used to the amazing change of being pregnant after four years of infertility heartache, and also a fair dollop of sheer superstition.

I honestly felt if I shared my news, I would jinx it. It's totally irrational and very unfair on those of you who've been commenting and asking for updates, but it was how I felt and it was very strong.

Only now as I approach the 11-week mark am I starting to feel more confident about actually taking home a baby at the end of this. I have gone through the past two and a half months battling a daily, sometimes hourly, terror of miscarriage. I don't think it will ever fully abate until I give birth, but it is starting to lessen as the weeks progress and my body changes.

I got the news on December 29 following a blood test at the fertility clinic. But if I'm totally honest, I already knew the IVF had worked. I took a pregnancy test on Christmas Day - stupid, foolish and potentially distressing, I know, but I couldn't resist it. I figured starting my fourth Christmas Day with a negative test surely couldn't be any more heartbreaking than the previous three had been.

It was a very, very faint positive. But it's the first time in my life I've had any sort of line in the right box, so it was momentous. Hubby was downstairs when I did it and my voice cracked into a barely audible rasp as I croaked for him to come and look.

I then did what I always do: started obsessively reading about pregnancy testing after IVF online, and convinced myself that it was a false positive caused by leftover HCG hormone in my system from the trigger injection I'd administered some 12 days previously. The general consensus seemed to be to wait until 14 days had elapsed and test again. This I duly did on the morning of December 27, and the positive line was darker. And I really started to hope.

It was still with a thudding heart and knocking knees that I answered my mobile on the afternoon of the 29th, knowing the person calling was a nurse from the clinic and that she had my results. I was stood at work in a glorified stationery cupboard, hiding away as I knew I'd cry either way. To hear the nurse say that not only was it a positive, but a strong one, was just indescribable.

Relief, joy, gratitude - it was a far cry from how I'd felt the night after the embryo was transferred back into my womb. That evening found me crying hysterically because I was sure I'd ejected said embryo during a particularly strenuous visit to the toilet (what can I say, the IVF drugs had bunged me up).

No, my embryo didn't fall out my bum but dug itself in and managed to find a snug home inside me, where I have for so many years longed for a baby to be. I had another moment of drama when I had a very light bleed on New Year's Eve. At that point I was just over four weeks pregnant and became convinced I was going to miscarry on just about the worst night of the year for such a thing to happen. But I was lucky, the bleeding stopped and the clinic, during my weepy phone call to them, said such things are common at around the four and eight-week mark, when periods would have been expected.

I started to feel a lot better, and properly pregnant, when my seven-week scan showed a strong heartbeat and a growing embryo, in the right place (as ectopic pregnancy had been a big fear). And while I am far from reassured, after everything we've been through, that things will be all right (I don't think I'll feel 100% content until I'm holding my baby in my arms), the changes in my body and the symptoms I've experienced have grown my confidence little by little.

I want to - and will, if you want me to - write more about how I am feeling and what it's like being pregnant after all this time and all those tears. But I'm going to leave this entry here for two reasons, the first being because I just wanted to give regular readers a long-awaited and much-deserved update.

The second reason is more complicated. This blog has been about my infertility struggles, and I'm unsure of the protocol of how to proceed. I'd like to keep writing about my experiences through pregnancy and beyond, but I am very aware that my outcome will be bittersweet for people who have not been so lucky.

I have suffered myself - many times over - that heady mix of elation for someone you genuinely like and feel a connection with finally having the success she has yearned for, combined with the inevitable and unavoidable feelings of desperation about your own situation. And to be honest, sometimes I have chosen not to read on.

What I don't want to do is inflict a pregnancy blog on a community of readers who don't want it. I couldn't bear it if I thought I was causing anyone struggling with a similar situation to my own pain. I know how badly it can hurt. So I would really appreciate comments on whether you think I should continue with the blog or leave it here, with a happy ending infertility-wise, but without an ongoing commentary on pregnancy, that longed-for condition which has, at times over the past four years, seemed almost mythical to me in terms of how hard it was for me to achieve.

Finally, for now - thank you from the bottom of my heart to everyone who has asked how I am doing, wondered about my outcome or spared a fleeting thought to wish me well. I appreciate every comment and every thought more than you can know.

Saturday, 19 December 2009

The tale of the egg collection

Thanks for all the good wishes ahead of Tuesday's egg collection - every one was much appreciated and brought me support. Here's the story of how the day went.

I was nil by mouth from midnight the night before, and had assumed I'd be too anxious to sleep, but in fact I was exhausted by 9pm and retired early to a surprisingly decent night's shuteye. I woke at 6, lay for an hour contemplating what was ahead, then rose.

I'd bought special organic unscented shower gel and deodorant for the day of the egg collection and embryo transfer as we'd been advised both by the clinic and by friends who've been through IVF that strong perfumes should be avoided.

I showered, stared for a while at my hideous, gnarly unpainted toenails and then got dressed in the exact same outfit, down to the socks, that I wore for my HSG so very long ago. My logic was that a) the garments in question rank among the most comfy, cosy clothes I possess and b) I survived that so, in the same way that I always tie the exact same red ribbon on my suitcase handle when I fly because so far every plane has landed safely, I'd survive this.

My mum arrived to collect me absurdly early - I inherited this trait from her - and we arrived at the clinic well in advance of my 9am slot. I had started to sense a flutter of panicky nerves during the car journey, but sitting in the waiting room I could feel my body determinedly relaxing in the way it does immediately before trauma. My most pressing concern was the amount of pain I was by now in from the bloating caused by so many follicles. My stomach was hugely distended and uncomfortable, and I felt like I needed the toilet all the time. I could not wait to get those eggs out of me and into petri dishes.

Hubby and I were both summoned into a consulting room by a nurse I hadn't met before. I didn't really warm to her: she tried to make jokes, and I suffer from sense of humour bypass on aeroplanes and in distressing clinical situations. When her cheerful remark that the drug they'd give me was so nice she'd "like to get some for the weekend" was met with a blank stare, she shut up and gave us the facts: they were running a little behind, so we'd need to wait in reception some more before going through to prep me for theatre.

This we duly did. I wasn't irritated that they were behind schedule - these things happen in hospitals - but I do remember glancing at the clock when it reached 9.45 with something like despair, as I'd assumed I'd be nearly done by then. Fool that I am.

It was gone 10 when we were eventually escorted to the ward and introduced to the ward sister, who I immediately liked for her warm but no-nonsense manner. There are four beds in the ward - amazingly, the clinic perform five egg collections each weekday - and I was the fifth and last patient of the morning. That meant I didn't get a bed to prep in, because there were two beds in use by recovering women, one awaiting the imminent return of the current operatee, and one with the girl before me in it. We were therefore shown to hardback chairs immediately adjacent to the curtain around my predecessor's bed.

It was fine at first but my abdominal discomfort started to increase - I guess the timing of the hCG injection means your eggs start to mature right before the collection - and sitting on an unyielding chair was no fun. Hubby was doing what he does in airports (I'm terrified of flying): reading a book and studiously ignoring me. The girl in the bed next to me started to complain about her own abdominal pain, which irritated me because at least she was lying down.

The sister then returned and went through the paperwork. She gave hubby a pot with his name on it, and me a credit card thing with mine. We then had to go over to the computer and scan both - they each had a barcode - to "lock us in" to the system and make sure everything that either squirted out of him or was gouged out of me was assigned to us.

After that the sister explained that the doctor - head honcho consultant, I was pleased to learn - would come and put a portacath in my arm ready for the administration of the drugs once I got to theatre. She asked if I had a problem with needles and was rewarded with a hollow laugh.

Hubby was then dispatched to produce his sample. I sat chewing my nails, fully expecting his sheepish head to emerge from the wank room and announce he couldn't get hard. I had a variety of waspish responses ready should that eventuality occur. My favourite was "You need to get a grip - literally".

He was back surprisingly quickly and sufficiently flushed and furtive to suggest that his endeavours had been successful. I asked as much and he announced that they had.

"Where the fuck's the sperm, then?" said I. He explained that there's a little window in the room - sort of like a dumb waiter - where the man puts the pot and then presses a buzzer when he's done, presumably to spare him the mortal embarrassment of walking out into the ward clutching his juice. How very thoughtful of the clinic. Shame stirrups don't come in embarrassment-free models.

Hubby returned to his book looking decidedly pleased with himself. The sister returned, congratulated him - yes, really; blokes need so much bloody encouragement - and then told me to get changed into a theatre gown, over which I was allowed to put the dressing gown and slippers I'd brought along.

I ducked into a tiny changing room furnished with lockers and a load of theatre clogs, presumably for girls who forget their slippers. Luckily I'd brought with me what I lovingly refer to as my "fluffy feet" - a pair of whimperingly soft and furry bedsocks which I wear nightly on my return from work until they get up and walk to the washing machine themselves.

The theatre gown was similar to the one I'd worn for the HSG: press studs in the back of the neck, then loose ties at the shoulders and waist, and otherwise open to the four winds. I was very glad of my dressing gown as I trudged back to our seats.

At this point, the girl in the next bed really started to get on my tits. The doctor was with her when I returned, putting in her portacath. I have sympathy for people who are afraid of needles, I really do, but for fuck's sake. I have no idea how she coped with the daily injections. Anyway, she was squealing and weeping and just generally overreacting in a highly vexing fashion. Hubby saw the expression on my face and his lips curved with amusement. After it was in, she immediately - immediately, mark you - started giggling and claiming to be hysterical, until the doctor pointed out wearily that she hadn't actually administered any drugs yet. At that moment my - and I like to think, the doctor's - mind was made up: drama queen. And she didn't even appreciate that she had a bed.

A few minutes later a new nurse came to collect her. I couldn't see through the curtain but I soon heard the nurse say, "No, sorry, you can't wear that - we need to be able to talk to you. Didn't you bring a CD?" and I knew that she must have not read the admission notes, which expressly forbid iPods, properly. "Nooooo," wailed Norma Desmond. "I need my music!" I mean, I ask you. The nurse sighed and said, "What were you planning to listen to? We have a few spare CDs if you'd like to choose one." The response, uttered whiningly: "Some chuuuuuurch muuuuuusiiiiic.".

After she departed I knew I had probably about half an hour still to wait. I was hoping they'd transfer me into Norma's bed, but they didn't. By this point my stomach was really hurting - it was like having horrendous wind - and the only way I could get comfy was to slouch back in the seat and prop my feet on the low magazine table in front of us. This was fine until a man arrived, presumably to produce a sample, and elected to sit in the chair DIRECTLY opposite my naked vagina. I was less than thrilled.

By this time it was nearing 11am - a lot longer than I'd thought the whole process of checking in would take. I started to worry that I'd ovulate the eggs and ruin everything, but hubby assured me that they wouldn't allow this to happen. Finally, Norma was wheeled back into her cubicle, blessedly quiet now, and the doctor came to say good morning and insert my portacath.

It went into the vein in the crook of my elbow fine, no worse than a blood test really despite what I've heard, and was taped securely in place. The doctor flushed some saline through it to make sure the liquid was going into me and then said it'd be just a few minutes more.

Shortly after that, a new nurse appeared and introduced herself as the theatre nurse. She took my CD - Sarah McLachlan, about the most soothing artist I own, with the particular album chosen for the presence of a song with the line "it'll all be worth it, worth it in the end" - and, after a quick peck on the lips from hubby (for me, not the nurse) led me down the corridor to the theatre.

At first glance it looked like a torture room from one of Eli Roth's less palatable films. There was a low sideboard spread with heinous implements, including pliers (what the FUCK could they possibly need those for? screeched my brain) and an ominous bed upholstered in black leather on a sort of raised dais in the middle. I had to walk to the end of the room, with another nurse beckoning me like a floor manager in a TV studio, and was instructed to insert my barcoded credit card into a reader. A voice then spoke to me from the wall. If I was a religious woman, I might have thought it was God, except it said "Hi, I'm Emma, the embryologist, can you confirm your name and date of birth please?" which doesn't seem like the sort of thing God would say.

Having duly confirmed my vital statistics, the nurse took my dressing gown and slippers and I was asked to clamber on to the bed and lie down. I was wearing my glasses, having sensibly left my contacts at home in case the drugs made me fall asleep, and the nurse said I could keep them on if I wanted to. This relieved me as things are always scarier when you can't see properly. I had to confirm I didn't have any allergies and wasn't wearing any nail polish (which, surely, they could have seen for themselves.

Once I was in position, though not yet in the stirrups, my blood pressure was taken. Next, a clip was placed on my left forefinger and an oxygen mask over my face. The doctor was bustling around with who-knows-what at the business end, and the theatre nurse told me she was going to administer the pain killer now, and then once it had taken effect, the sedative.

I didn't feel anything for about a minute but then suddenly it was like this warm, woozy sensation flooded me, starting in my legs and soon taking me over completely. The best way I can describe it is like being very, very drunk, but without the queasiness and room spin that often entails. I'd be lying if I said it wasn't quite pleasant. But one thing about it was that I knew I was no longer in control of my faculties; that I probably couldn't leap off this bed and run away if I wanted to, and that was a bit freaky.

Happy it had taken effect, the nurse started pumping in the sedative. And then it seemed things started immediately, although time sort of took on a fluid quality so perhaps there was a delay. The doctor said she was going to examine me, and I felt an icy cold speculum being cranked open inside me. It twinged a bit more than a speculum usually does, which made the words "Oh, fuck" scoot across my mind. Then that was removed and the scanner put in its place, which wasn't so bad.

"We'll do the right side first," the doctor said, and then there was a terrible pain. It was brief - it lasted maybe 15 seconds - but it was bad. It would have been the needle penetrating my vaginal wall and going into my right ovary. I must have gasped, because they all told me it was OK and how well I was doing.

I don't really remember much about the eggs on the right side coming out, just a feeling of intense pressure, slight crampiness and the sense that a lot of implements were rummaging around very deep inside me. Then I heard the dreaded words, "And now the left side" and braced myself for that stabbing pain again.

I remember nothing after feeling that. They said I might not remember any of the procedure - I like how I remember the pain of my wall being perforated but not something boring like being put on a trolley - and I certainly don't recall it ending, the scaffolding being dismantled and me being put back on the ward.

I woke up after what I assumed was only about ten minutes. I was in bed, in a curtained cubicle, in the recovery position, no longer wearing my glasses. I stared for a while at the curtain until I could focus and noticed that it was printed with images of bridges and famous buildings from the city where I live. I then became conscious of awful cramping pains in my lower tummy, and flipped on my back to ease them. A nurse checked on me just as I was doing this and told me I needed to lie on my side in case I was sick. She helped me roll over and then told me to sleep. I lasted about a minute on my side and then flipped back again. I'm nothing if not disobedient.

I dozed for a while but it was noisy on the ward - I had the sense there were throngs of people milling about - and I wanted my mum. I must have been woozier than I thought and whimpering as much because after what seemed like only a few minutes, the nurse was back asking if I wanted anything. "My mum," I said, so she went to get her. The sound of my mum's voice asking, "Is she OK?" as she was led down the corridor was music to my ears.

It turned out I had slept for nearly an hour and a quarter. Mum got a bit freaked when the first thing I said was that the bridge was on my curtain, until she looked and saw that it was true. She was with hubby, and they each took one of my hands, my mum chafing the one she held between her own as if I'd just come in from the cold. She put my glasses on me and the nurse propped up my bed so I was sitting. The cramps were still bad but subsiding and I started to feel better quickly.

I was given toast with strawberry jam, orange juice and coffee. I hadn't imagined I'd be hungry in a million years, but having not eaten since dinner the previous night I found I was ravenous. My mum read out a checklist of the things I needed to demonstrate before being discharged: namely, sitting up, eating, drinking, walking, and urinating. Anxious to be home, I did all of them.

The embryologist came to see me and told me they had got ten eggs, which she said was really good. I was told to phone at 10.30 the following morning to check fertilisation, and with that was sent on my relieved, if not merry, way.

The only issue on the way home were speedbumps, which jarred my tummy something rotten. But once back in my house I spent the afternoon snoozing in bed and on the sofa, and by evening felt as right as rain, if still a little bloated and sore.

I'm still tired and feel like I've written my fill today, but I'll be back tomorrow to tell you about embryo transfer - all ten eggs fertilised, and we ended up with three good embryos, one of which is now (hopefully) nestled inside me. All in all, it's been a dramatic week.

Monday, 14 December 2009

IVF, weeks 4-6

My egg collection is tomorrow morning at 9am.

How do I feel? There's a scene in the film Armageddon where one of the astronauts about to take off answers that same question. His verdict is: "98% excited, 2% scared. Or maybe it's more like 98% scared, 2% excited - it's hard to tell but that's what makes it so intense." That sums up my mindset this rainy, chilly evening.

I managed fine with the injections in the end. I got to be quite the dab hand with the old liquid siphoning by the finish. Inevitably on my last day I performed the maneouvre perfectly. Had my last morning injection been a gymnastic routine, I finished on the equivalent of a perfect en pointe dismount.

I managed to escape with only a little bit of thigh bruising and several sliced fingers, and the side effects haven't been as bad as I feared. I've suffered with migraines in the past so I was pretty well resigned to having one of those once the hormone cocktail kicked in, but I've avoided them so far. There was a thudding headache every day between day two and six, but a headache is very different to a migraine and I was able to cope.

The nerves I felt going for my first scan were about as jittery as anything I've experienced throughout this process. Because of my high FSH level I'd convinced myself there was a chance I might not respond at all. My big dread was the monitor revealing two stubbornly small and flaccid ovaries which had refused to produce so much as a pimple.

There was no need to worry. To be fair, the secret voice in my brain which is currently insisting that this whole thing might just work had told me I had nothing to worry about because I'd felt my ovaries kick in round about day five. It was the same feeling I had on Clomid - a sort of low ache, almost like you have wind, worse on the right side.

The head doctor at the clinic did my scan with her trademark - and actually increasingly appealing - no-nonsense style. The hell with KY jelly and easing it between my lips - the Renault was rammed, bammed and thank you mammed into me with very little in the way of opening pleasantries. Which suited me fine as I was burning to know what my pesky ovaries had been up to all that time. Despite the twinges I'd felt, it still seems weird that a little jab in your thigh flab every morning can make eggs grow there.

Immediately the doctor murmured "Oh, this is good," and I craned my neck to look at the screen. Even I could see them - oval, shadowy follicles clustered on my right ovary. She counted five, then twirled the Renault and located seven on the other side. Withdrawing the scanner with similar gusto to that with which she had introduced it, she proclaimed this to be excellent progress and sent me on my merry way with a view to presenting myself for a final scan on Saturday gone.

The jabs got a bit sorer after that, presumably because there wasn't much expanse of thigh flab left that hadn't already been skewered and injecting into a bruise isn't much fun. But I persisted and as I did the windy ovary pain got a bit worse each day, and my stomach started to bloat.

Saturday's scan went like a dream. I now have 14 follicles, seven on each side, all of which the doctor deemed to be the perfect size. I administered my hCG injection last night - it stung like a motherfucker, being cold out of the fridge, and the injection site on my beleaguered thigh flab is puffy and inflamed, but it is done and I now have no more needles to deal with. Hurrah and huzzah. I felt like cracking open the champers but since I've sworn off alcohol for the duration of this - might as well treat my body like a temple being the logic - I had to make do with water with lemon.

I've felt emotional but not as much as I feared. I imagined I'd be breaking down in tears at adverts, or howling in anguish on the train platform when I'd just missed one (both of which are exhibitions of myself I've been driven to previously by fertility woes).

But since the first scan revealed all was well, I've actually felt happier and more positive than I have for a while. It has to be said that this is down to some fairly wonderful caregiving by my legendary best friends, mind you. Friday night saw me not fretting and angsting over the next day's scan, but instead munching pizza, sipping peppermint tea and giggling in my PJs on their sofa. To be distracted, taken care of and amused during this nightmare has been wonderful.

So now. A short description of my physical state.

My stomach is distended like a malnourished orphan and I fancy that I can feel every one of those 14 follicles jostling for position on my ovaries.

I have unpainted toenails, as instructed by my egg collection admission form, which also forbids me from wearing makeup (unthinkable; surely a slick of mascara won't harm my eggs), deodorant (but cunningly, I have bought an odourless organic one - a girl doesn't want to be smelly), perfume or body lotion.

(It is worth pointing out that I have not had unpainted toenails for longer than it takes to remove one coat and apply another for at least 15 years. I always thought I had quite pretty feet but it turns out it was the varnish making them so. They are butt ugly naked. My nails are a sort of pallid yellow colour - as a result, one imagines, of nearly two decades of continuous varnish-wearing - and they look bigger, ganglier and sort of masculine. I hate them. My mother - from whom I inherited my obsession with toenail varnishing - was appalled.)

I now need to pack my bag - I'm instructed to bring a dressing gown, slippers (with which I can hide my unattractive feet, thank fuck), a toilet bag and a favourite CD with me. Then it's early to bed in the hope of some sleep. I'm not allowed to eat or drink after midnight, because of the sedative they'll give me. I'm to be there for 9am.

I'm told I may not remember the procedure - I bloody hope I don't - but I'll do my best, tomorrow or as soon as I feel well enough, to describe what I do recall here.

I very badly wish all this was over. But while I'm anxious, I know this is just another hurdle I need to get over in my quest to get what I want more than anything in the world.

Wish me luck.

Thursday, 3 December 2009

IVF, weeks 1-3

So. I started Synarel nasal spray on Sunday November 8, after a training appointment during which we were taken through the whole process in blow-by-blow detail. I've taken it every day, twice a day, since then.

I thought I'd have blogged more during the first weeks of IVF but it's surprised me how tired I've been and how little I've had to say.

I think one reason I haven't written anything is that there's not an awful lot you can say about taking a nasal spray. The bad things are, in no particular order:

1) remembering to take it at 9am and 9pm every day. This is inconvenient because I leave for work at 8 so most days I need to take it in the office toilet. There are days when I've been busy, distracted or just forgotten and then been stricken with panic at 11ish and forced to hare along the corridor to do my sniffling.

Taking the evening dose isn't much better. So far I have inhaled it during a ghost hunt at a castle in a rainstorm, sitting in the cinema during a film, at a salsa class, and round the side of a theatre ahead of meeting a moderately famous comedian.

2) sometimes when you snort in the wrong way, it goes into your sinuses and stings like when you were a kid at swimming class and inhaled chlorinated water. It also tastes bitter and unpleasant when it trickles down your throat, a bit like chewing aspirin without water.

3) the side effects haven't been too bad for me, limited chiefly to the odd hot flush in bed at night, several medium-strength headaches and one fainting episode (but that was when I was poorly anyway with a virus, and I'd just stepped out of a hot bath). One odd thing is that I seem to have low-level heartburn all the time in that when I eat or drink I feel a slight burning sensation in my throat and chest. But, like I said, no side effect so bad that I can't cope with it.

The good things are - well, there aren't any, unless you count the fact that I've responded to it. I had a scan on Tuesday which revealed two very subdued, deflated ovaries - and so they bloody should be, for what they're putting me through - and an empty womb with minimal lining. Everything as it should be after nearly three weeks on the spray. I now need to keep taking it up until the egg collection at which point I can replace this daily activity with the delightful alternative of ramming a pessary up myself.

So I was given the go-ahead to start the injections. I had a training appointment with my favourite nurse after my scan. To say it went badly would be to do injustice to the word 'bad'. I am completely ham-fisted and clumsy at the best of times. Dealing with tiny, fiddly-as-fuck vials and needles while under a reasonable amount of strain and immediately following a vaginal probe did not improve my dexterity.

For my first trick, I shattered the tiny glass vial which contained the dilutant solution. WHY do these need to be so small? I get that there's not a huge volume of liquid and we are living in an age when minimal packaging is considered environmentally sound, but for fuck's sake, I'm not a member of the Sylvanian Family.

And another thing. Why do they have to be glass? It's not like they can be recycled - they get thrown in a sharps box and incinerated as clinical waste, so make them plastic and easier to handle! I cut my hand in four places trying to snap one open in front of my initially amused and then anxious nurse. I left the clinic with four elastoplasts on one hand and another on my arm where I'd had my blood test. I looked like I'd made an extremely bungled suicide attempt.

I'm on four amps of Menopur because of my higher than average FSH levels, so having eventually opened a dilutant vial and sucked its contents into a syringe, I had to be shown how to pierce and dissolve four separate (glass) vials of powder. Each time, you have to squirt the contents of the syringe into the vial, dissolve the powder, and suck everything back up again. Fiddly doesn't begin to cover it.

After that you detach the big fuckoff needle and reattach a smaller injecting needle before easing the plunger up to 1ml, getting rid of the air and then doing the jab. For this you need six hands because you have to pinch your skin, insert the needle, depress the plunger and withdraw it all at virtually the same time. All I can say is thank fuck it's women who do the injections during IVF, as we all know men can't multitask.

At the clinic, I injected myself with a bit of saline solution to prove I could do it, then my first real jab was yesterday morning. I had set everything out the night before, like a cook before a big dinner party, and barely slept because I was so nervous about being able to manage without the nurse. But it went surprisingly smoothly - which, as I discovered this morning, was beginner's luck. It reminded me of the first time I parallel-parked my car after my driving test: it went in first time and I sat stupefied by how this could possibly have occurred. The next time, it took 40 minutes and involved tears, howls and a prang on the bumper.

Perhaps this morning's disaster was because I hadn't slept a wink, having spent the entire night convinced a demon was hiding in the wardrobe after watching Paranormal Activity at the flicks. I knew things weren't going to go well when I immediately sliced my forefinger opening the glass vial. I bleed a lot even from small cuts so was seeping all over the assembled sterile apparatus, but feared I'd be even more bumbling wearing a plaster so I left it.

The next problem was that I couldn't get the frigging syringe to suck up the fluid from the first vial of powder. I kept pulling it up too far and running out of syringe and then leaving a load of liquid in the bottom. If you're not superhumanly quick it seeps out the end of the needle anyway, and for a while I was making absolutely no progress. Time was ticking towards when I needed to leave for work, despite me allowing 20 extra minutes for the injection, and I began to get flustered.

Chanting "fuck, fuck, fuck" in a low but urgent voice, I eventually got all four vials of powder sucked up through a manoeuvre that combined the speed of a panther with the cunning of a fox (essentially, just tilting the vial, ramming the needle in the corner of it and twirling it quickly to attract all the liquid).

However, I had created loads of air with my epic syringe endeavours so the resulting mess looked a bit like a bubble bath by the time I was ready. I started remembering all the films where a murderer injects air into a person and causes a clot that kills them. So I had to tap the syringe for ages to get the bubbles to clear.

After all that, it seemed cruel that I still had to get through the painful bit. I was on my right leg today, which means as a righty that the angle and needle trajectory is more complex, so it hurt more than it did yesterday and I've developed a bruise for my trouble.

All this snorting spray and stabbing needles would be a lot easier if only I were a crack and heroin user. But what am I saying - if I were, I wouldn't need IVF since drug addicts get pregnant at the drop of a hat.

I needed comforting after all that and since hubby had fucked off to work long before I even began my endeavours, I decided waffles, maple syrup and blueberries were the way to go. They were good. But then my car wouldn't start. It has been making a low but insistent beeping noise for a bit now and I've been studiously and foolishly ignoring it. Having consulted the manual and talked to my stepdad, I knew all that was needed was some water in the radiator, but rather than sorting this out at the weekend when I had bags of time, I'd left it till a few minutes before my weekly 50-mile drive to the office I work out of on Thursdays.

I'd never topped up my radiator before but figured if I could inject myself with hormones then surely this couldn't be beyond me. So rather than driving to a garage where I'd be mocked for female incompetence and probably charged for the privilege, I decided, unwisely, to tackle it myself.

Well, I couldn't get the cap off, could I? I tried everything - pulling, twisting, tearing, even prising with my key - but it was all to no avail since my car was manufactured by safety-conscious, obsessive-compulsive Volkswagen. (I believe I howled "Come on, you German bastard" at one point.) Eventually, defeated, hormonal and weeping hysterically, I phoned my mum and yodelled for help which was provided - bless him - within ten minutes by my stepfather.

It remains to be seen what tomorrow will bring. I guess there's a knack to it and that you get better every day. I also think a good night's sleep will help. But the trauma has stayed with me today and I've felt extremely weepy. I suppose it's only natural, given I'm suddenly flooding my system with hormones after suppressing it for nearly a month, that I should feel odd.

I think, though, that being reasonably au fait, if a tad incompetent, with the concept of sticking a needle into my thigh after two days is testament to the fact that you can do anything if you put your mind to it, and want it enough. I think I'll leave it on that reasonably positive note.

Wednesday, 28 October 2009

Gaining the IVF drugs and losing my furry friend

Holy sweet smoking shit at sunset.

My mum collected my IVF drugs today. The two SACKS thereof. I came home, saw said sacks sitting on my coffee table, with a note to say there was more in the fridge. I unpacked them and set the assembled goods before me in growing disbelief. It was like Christmas morning in the mad scientist's house. I then hastily repacked the sacks and forced down the ratatouille hubby had whipped up before I lost my appetite.

Hubby and I just spent half an hour in the spare room - the coolest, darkest room in the house, being as it is a forlorn place where a baby should reside - with the drugs and assorted paraphernalia spread before us.

It's just overwhelming. It's overwhelming. There are:

- two boxes of nasal spray
- five boxes of crazy glass vials with some kind of liquid-and-powder combo
- fifteen small needles in orange packets
- fifteen scary ass huge motherfucking needles in green packets
- about 250 (looks like) syringes
- a "sharps box" which looks and sounds like it should feature in Saw VI
- a packet of pessaries made of VEGETABLE FAT
- a partridge in a pear tree

I have so much to say right now and yet the terrifying nature of having these drugs ACTUALLY in front of me has rendered me virtually inarticulate.

The biggest news - and the reason I've been away for awhile even with IVF plans proceeding apace - is that my cat died.

I'm still not ready to talk about it in detail. Regular followers might remember I nursed him through cancer 18 months ago. We knew his time with us was limited as he had been diagnosed with kidney failure, but I was hoping he'd see me through my first cycle of this hell.

However, fate moved against us and he started having daily seizures ten days ago. Hubby had taken me away for the weekend as a sort of last ditch romantic break before IVF, but we had to cut our trip short and rush home so my mum and I could jointly make the decision that it was time to let him go.

The vet came to the house last Monday and my darling furby died in my arms on his favourite chair. It was the worst thing I've gone through to date. We buried him in the garden and since that awful day not a second has passed when I don't miss my best boy. Not having a furry companion has made the loneliness of infertility bite even harder, but any notion of getting another cat makes me feel unfaithful. I guess right now the pain of losing him is still too raw.

That said, I have written all of this so far without crying. It's all about crying less each day and I'm impressed I've managed to tell the story - badly, but I've got the words out - without dissolving. I think the fact I am still bug-eyed with horror about the sacks of drugs lurking next door may have something to do with it, mind you.

So that happened. Then my relative who'd just had two embryos transferred had her pregnancy test, and it came back negative. She started bleeding the next day. I know I said last time that I was jealous - and I was, fuck me, I was green - but I never, ever wanted her cycle to fail. She is hurting so much right now and my challenge is to be there for her as best I can while making my own final preparations.

So on day two, a fortnight ago, I visited the clinic for my bloodwork. Turned out my FSH is 11.7, which is a little higher than they'd like for IVF (though not off the map) but a lot higher than it should be for a 30-year-old. I'm told stress can play a part, and with my cat and various other factors I suspect that's had a significant effect, but the clinic did say it may also mean my ovaries are struggling and that in turn may mean a higher chance of a cancelled IVF cycle or indeed a total failure of my body to respond to the drugs. They've prescribed me a higher dosage of Menopur - four ampoules rather than three. Whatever the fuck an ampoule is. Up until this month I thought it was something to do with plugs. I guess I was off sick the day we covered this shit in school.

So I got my treatment schedule, and they want me to start the nasal spray a week on Sunday. I get to attend the clinic on Friday for a "teaching appointment" to tell me how to take it. I'm not sure exactly what kind of imbecile doesn't know how to take a nasal spray - I mean, what, am I going to stick the bottle in my ear? - but there we go.

I'm not squeamish about needles but some of those motherfuckers are big. My relative tells me the last one - the one with the HcG in it - is the worst, because that's been kept in the fridge and is icy cold right about when you start flooding it into your thigh. If my hormones fuck up we may not even get that far. Right now, this autumn just looks like one long track of increasingly steeper hurdles, each one of which may constitute the end of the road.

I also may jest about being intellectually evolved enough to figure out a nasal spray, but I'm clumsy, bad-tempered, impatient and liable to hurl small, fiddly things that don't comply with my wishes at the wall. How in the world I'm going to manage with the selection of Sylvanian Family-sized glass bottles, dinky vials and stabbing instruments currently shoved hastily in a chemist's carrier bag on my spare bed is anyone's guess.

The side effects freaked me out, too. I mean, obviously chest pain, decrease in breast size, vaginal bleeding, migraine, shortness of breath, vaginal dryness, hot flushes, night sweats, muscular pain and abdominal swelling are every girl's dream, but we've all read about the scary stuff associated with IVF. By which I mean the cancer. That's a c-word that puts all my fears about what's going to happen to and in and around my other c-word into perspective.

I'm particularly looking forward to the pessaries because I've always imagined what it would be like to shove a lozenge of vegetable fat up myself and wait for it to ooze stickily into my pants. Every night for fourteen nights.

My timings are such that the egg collection will happen shortly before Christmas, which works well in terms of holiday from work and rest potential. What potentially sucks is that if things go well and we get eggs, then embryos, my pregnancy test will take place New Year's Eve. Kind of a bum start to 2010 if it fails, no?

I have the word DAUNTED in block red capitals in my head, but it doesn't do justice to how I feel right now. I think a more accurate summary is that I feel a level of terror and anxiety sufficient to almost - but not quite - anaesthetise the pain of losing a 19-year furry friend. I so hoped my little kitty would see me through this.

And here are the tears.