Monday, 15 December 2008

One step up and two steps back

It's been a long time. And I have a lot to tell you. I'm sorry I've been away so long - I have not been able to deal with writing about any of this, for many reasons that are too complicated and dull to go into here.

My health is really suffering from all this now. I've lost over a stone since this time last year, and I just feel really rundown and old a lot of the time. I suspect I'm now caught in a vicious circle where my low body mass index, and general drawn and pinched demeanour, are actually contributing to my fucked up menstrual cycle. How in the name of all that's holy does one break such a circle?

Anyway. The update. Firstly, the appointment at the clinic. It went better than I expected, in that it was much better to go with my mum than with hubby - on whom, more later - but it happened on a day when I was really poorly with a horrid gastric 'flu that had me chucking up in the ladies' outside the clinic reception before I ventured in. I thought I may have to excuse myself to be sick halfway through my consultation, but managed to last until we were on our way out.

We saw the same consultant I saw in January - the one who told me I had PCOS, which was then discounted by the professor we saw in May. And herein lies the first confusion: she reiterated my PCOS. I said I'd been told I didn't have PCOS. She looked perplexed and thumbed through my notes, then said my symptoms in fact WERE consistent with PCOS, and that the ovarian scan she'd conducted herself - an aside which gave me a pleasant reminder that she has stared at the inside of my reproductive system - showed an ovary that was, in layman's terms, screwed up. (She didn't say that. She said it looked polycystic.)

I asked why I didn't have any of the other symptoms of the condition. She said it varied. I asked why my periods had been normal for years and then gone daft at the age of 27. She said these things happen. I started to feel the angry worm crawling up my spine. My mum intervened.

After we'd agreed to disagree, I summarised my reason for requesting a new appointment ahead of the one-year sentence imposed on me by Professor Fuckwit - namely, that I had not had a period since July, and it was now November. Annoyingly, some of the wind was removed from my sails of self-righteous indignation by the fact that I was in fact menstruating as I sat there - and I had to admit as much, but I concluded by saying my period had "done this on purpose because it knew I had the appointment coming up". (She looked worried. Note to self: try to appear more sane in future.)

We went over the dates of the paltry few periods I have had in 2008, and I reiterated my concern that of the five or so there have been, only one - the one I had in Florida, weirdly - has been what I'd consider "normal" based on my previous, pre-Pill history. She made a lot of notes. She then weighed me and had a massive go at me for being underweight, which - quite rightly - she said wouldn't be doing my cycle any favours. I countered by observing that weight GAIN and difficulty losing weight were typical symptoms of PCOS. She looked somewhat abashed and moved on.

I then asked what we do next and said I was not prepared to hang about in limbo until next summer. I pointed out that my 30th - and with it, fertility that will dwindle at an alarming rate - was impending. And then she said the magic words: that I don't have enough periods to give me a decent chance of conceiving naturally, and that she was prepared to prescribe clomiphene.

In order to progress this, I now have to present myself back at the clinic on day two of my next period. They'll give me the drug, which I take for five days, and then I go back for regular blood tests and scans to determine my ovulation pattern, if any. If any because they start you on a low dose and up it depending on how you respond.

She then listed the side effects. Mother of God. In no particular order: depression, irritability (ha! got you beat on that one), spots, nausea, migraines, hot flushes, night sweats, vaginal dryness (and let's face it, after nearly three years of TTC it's hardly Angel Falls in there already), dizziness. Slightly more serious side effects include a 25% chance of twins and a 10% chance of triplets per cycle on the drug. Oh and if you believe the papers, an increased risk of womb, ovarian, breast and stomach cancer. Let's be clear: this drug is no fucking walk in the park.

Because it's not a cakewalk, she then asked about my support network. She explained Professor Prat had last time noted that I "seemed unduly anxious" (let's pause for OUTRAGE at the use of that particular adverb) and was concerned at my ability to cope, although my "record showed I'd dealt well with the HSG".

My mum - sensing, I think, apoplexy on my part - stepped in and smoothly explained that I had a devoted support network in herself, my dad, my stepdad, my grandparents and friends, all of whom know about my plight. She glossed over hubby but that's because my mum is pissed off with him at present - again, of which more later.

Here's the thing. It's currently, as I type, day two of my next period. And I haven't been to the clinic to get my clomiphene.

Partly it's that I'm scared. I'm just a great, big wimp. The side effects are not to be sniffed at - and as much as I want a family, twins are in the "oh my god that would be amazing" camp but triplets are very firmly in the "now, hang on a second" one.

Partly it's timing. It's nearly Christmas; I'm really busy at work, which is good as it gives me a lot to focus on to distract me from babies, but also means I'd struggle with daily migraines and/or any one of the other side effects you care to mention. So part of me thinks, what's one or two more months in the grand scheme of the 30 we've been trying?

But mostly it's because I actually do doubt my support network - and not my family or friends, but hubby. As this has gone on, he has grown more and more distant from me. He refuses - point blank refuses - to discuss his feelings. He wants nothing to do with this blog, which in some respects is a good thing as it's personal and I'm not always complimentary towards him (though I'd argue that when I'm not, it's warranted). But he has equally pooh-poohed the concept of couples' infertility counselling, which I'm keen on, and even of just discussing it between the two of us.

And we're fighting a lot. They're nastier and nastier each time. We had a humdinger a couple of weekends ago which culminated in me throwing him out of the bedroom for saying to me that I would "die alone and childless". Yes, he really did say that.

And we're not having sex. An increasingly insistent voice in my head keeps saying that if we were dutifully doing the bad thing three times a week, I'd be pregnant by now. Once or twice a month does not constitute dedicated TTC, and I actually have started to feel that by implying we ARE having regular sex - or at the very least, by not admitting we're not - is tantamount to lying to the clinic.

And another thing. His sister's pregnant. With her second. This news was hurled rather spitefully at me during the aforementioned fucker of a fight. He's known for a while but apparently there was "never a right time" to tell me. (To which, I am ashamed to say, I responded: "Oh, grow a pair!")

We're meant to be going to see her for a pre-Christmas visit very shortly, and as much of an arse as I know this makes me, I really don't want to go. She's far enough along that she will be starting to show and I just don't want to deal with that, not a few days before my third Christmas of this.

So there you have it. My big update. I've got the prescription I wanted, but am too scared to take it. I don't know whether infertility has damaged my marriage beyond repair. I don't know if there genuinely is something wrong with me or whether our dwindling sex life is to blame.

In short, I'm the very definition of the Bruce Springsteen song 'One Step Up', which I quote here (slightly paraphased in order to assign myself the correct gender) to end this post:

"Woke up this morning, the house was cold,
Checked the furnace, she wasn't burning.
Went out and hopped in my old Ford,
Checked the engine but she ain't turning.
Given each other some hard lessons lately,
But we ain't learning.
Same sad story, that's a fact,
We're one step up and two steps back.

It's the same thing night on night,
Who's wrong, baby who's right?
Another fight and I slam the door on
Another battle in our dirty little war.
When I look at myself I don't see
The girl I wanted to be.
Somewhere along the line I stepped off track,
Going one step up and two steps back."