Monday 23 March 2009

Clomid and criminal incompetence

What has happened to me today beggars belief.

My period came, as you know, on Saturday. I attended the fertility clinic this morning and explained I was on day three and had come for my first course of Clomid. The nurse took blood, because it'd be rude not to; after all, I donate several vials of the stuff every time I cross the threshold - it's almost like visiting a vampire.

She said she'd call later with the results but that they were basically checking my FSH levels (again) and I should be fine to start my Clomid tonight. She then gave me the prescription and told me I had to go to the hospital pharmacy to collect the drug, as the fertility clinic don't (for reasons that baffle me) keep it on the premises.

The hospital is a good long walk from where I work and it was already gone nine, so I called my mum and she offered to pop by my office, collect the prescription, fill it at the pharmacy and drop the pills off at my house ready for me to take the first one on arriving home from work.

This afternoon at work, I missed a call from the clinic when I was in a meeting with my boss. The nurse who'd foraged for my blood (in both arms, it's worth saying, as she couldn't find a vein - just another fun fact that contributes to the nightmarish whole of this day) said to call her but that it was nothing to worry about.

I rang the clinic but they'd closed for the day. After much soul-searching I decided she'd have said so or tried again to call me if something about my bloodwork indicated that I shouldn't proceed with the drug, so I planned on taking the first pill on getting home. After all, I didn't (and don't) want to have to wait another cycle.

I had it all ready with my glass of water but decided to read through the leaflet first to get a feel for the side effects, as well as any info on activities I should avoid, like alcohol.

Thank fuck I did that. For I hadn't been given the clomiphene I was prescribed by the hospital pharmacy. Oh no. I had been given a drug called clomipramene instead. It is an anti-psychotic, anti-depressant used to treat severe phobias, narcolepsy and obsessive conditions.

As soon as I saw the name I thought something was wrong, but when I read on and it listed the conditions the drug was used to treat, I knew for sure. Hubby was infuriating during this, piping up with fatuous little comments like "Maybe it's got a dual purpose" - the stupidity of which defies belief; I mean we all know infertility can induce psychotic episodes but let's be realistic here - and "The pharmacy knows what it's doing".

Oh no it doesn't. Right now there is probably some psychotic dude somewhere in the city, crouching in the corner eating his own faeces and wondering why he is ovulating.

I rang my mum and together we rang the pharmacy and the on-call doctor at the clinic, and raised a level of hell previously unseen outside the scarier parts of the Bible. I mean, I know I am reporting this in a slightly wry and facetious way but this could actually have been very serious had I taken the drug. I could have had any manner of adverse reaction. And worst of all, I might have persisted with it, believing any ill feeling simply to be a side effect.

Anyway, the upshot is the pharmacy - fearing, I think, being sued - were extremely horrifed and apologetic, and offered to exchange clomi-psych for the correct drug this evening. Cue a trip for my mum and I to the hospital where we exchanged white paper bags with a very sheepish gentleman in the foyer in a scene reminiscent of a film - except for the fact that the plot would be too preposterous to believe.

It being dark in the car, it was only when I got home just now that I realised there were no instructions in the box and that clomiphene was spelled clomifene. With absolutely no faith whatsoever that the drug was correct, I was forced to put in another call to the on-call doctor, who just so happened to be my favourite dice-rolling professor.

She was actually very nice - again probably due to her horror at what had, and could have, happened - and she assured me that the 'f' spelling was just the US name for the drug. She talked me through the dosage instructions and the side effects, and advised me that since this was day three, I should go for it.

I have just taken the pill. It felt somewhat momentous, a bit like the red pill/blue pill scene in The Matrix. I am now going to run a bath and contemplate the prospect of my ovaries rupturing, which my old friend the internet tells me can be a very rare reaction.

I have said it before, and I will say it again: you couldn't make this up.

Sunday 22 March 2009

Managing Mother's Day

When I awoke yesterday morning and my period still hadn't come after 42 days, I decided to get the weekend pregnancy test over with as I figured starting Mothering Sunday by failing another one would not be enjoyable.

It was inevitably negative. My period then descended at about 6pm yesterday evening, while I was at my mum's helping to create a series of curries for a dinner party we were having. It came in a big, unannounced-by-symptoms gush as I was halfway up the stairs, ruining a pair of pants and meaning I had to borrow some of my mum's.

My periods, when they do come, are so much worse now than when I was a young teenager. It's so odd because I'll go through four or five months of having a regular cycle of about 30 days, and I'll think things are getting back on track, and then I'll just randomly miss one or even two. And then when it does eventually descend, it's like it is wreaking revenge for the hiatus by being super-heavy and super-painful.

The cramps actually woke me up at 5am this morning. I grabbed a hot water bottle and chomped a couple of painkillers, but in the hour or so before heat and analgesic took effect, I was reduced to lying in the foetal position - pause for irony - and whimpering to myself.

It was never, ever that bad when I was a young teenager and twentysomething. I don't understand what is happening to my body. I've said this before but I do often feel I am at war with myself.

Anyway, the upshot is that I intend to present myself at the clinic tomorrow morning when its doors open at 8am with a view to starting my first course of Clomid tomorrow. They told me to come on day two of my next cycle; I have no idea what to expect but feel better for there being at least some course of action to take.

I do know from a colleague at work who has just started Clomid in her quest for a second child that the side effects are unpleasant. She's suffered with headaches and has been sick several times. Her top tip was to take the pill in the evening as she said the worst of the nausea hits quite quickly, so it's better to be dealing with that at home than at work.

I also know that I'll be reunited with my old friend the Renault Espace scan-doppler thing mid-cycle to see if the Clomid has worked and I've ovulated.

My biggest fear is that hubby gets stage fright again due to what he will perceive as the pressure of having to perform at a certain time if the medication succeeds and I do ovulate. I can't voice my fear to him as I don't want to put the idea in his head. If it does happen, I can't imagine finding it easy to be sympathetic. Given that I will be pumping myself full of chemicals and having regular probing visits from the Renault, I feel the least hubby can do is muster an erection.

It's Mother's Day today. My third one since this nightmare began. I haven't found it too hard, mainly because I still think of the day as being about my mum and nana, as I always have done. What's weird is when I hear of the Mother's Day plans and celebrations held by my peers in recognition of them as mothers. Then I feel sad and like a failure, as if I've not properly grown up by being unable to achieve that status myself - always a daughter but never a mum, just like the old mantra 'always a bridesmaid, never a bride'.

I did have one of my typical dark and bitter inner rants while browsing the Mother's Day cards and gifts at the supermarket yesterday, laden with an armful of yellow roses for my mum and tulips for my nana. There were loads of cards with sentiments along the lines of "For my wife on Mother's Day, well done, aren't you BLOODY clever for bearing my children".

Strangely, though, there wasn't a single card that read: "For my wife on Mother's Day, I'm really sorry you're barren".

Monday 16 March 2009

More crazy behaviour

I'm not, as my nana would say, in the best of fettles at the moment.

A colleague and my best friend from university have just announced pregnancies - in my mate's case, it's her second.

I have done the gracious congratulations and I am happy for her, inasmuch as you can apply the word "happy" to a situation that makes you feel like you are being stabbed repeatedly in the throat with an ice pick.

I don't mean to sound like a bad friend - and in fact, it is worth saying that she is an exceptionally good one to me, because she broke the news as she knew I'd prefer her to, in an email which ended with her saying that I wasn't to feel pressured to send my congrats and that she'd understand if I needed some time before getting in touch.

Unfortunately, I read the email shortly after arriving at work one morning, and had to repair to the toilets to cry for twenty minutes before being able to control myself, but she wasn't to know that. The thoughtfulness of allowing me the privacy and reflection time afforded by an email was an extremely graceful gesture on her part. After all, she has nothing to be sorry for. This literally is just the way the cookie crumbles.

No, one of the things that makes me sad is that these circumstances have inevitably meant we've grown apart a bit. I still love her dearly and deeply, but we don't see enough of each other and try as we both might to empathise with the other, there's a slight lack of understanding between us now that can't be helped by either of us.

I can't really fathom her frustrations with the tiredness and difficulty of motherhood any more than she can imagine what it's like to yearn for pregnancy so badly that it physically hurts.

Before all this we always shared everything and went through lots of life-changing experiences together, not least preparing for our weddings, which were less than a year apart. I remember us traipsing round what felt like every wedding dress shop in Scotland and northern England, having an unseemly amount of fun. We both assumed that sharing baby stuff and all that went with it would naturally follow. But it feels like things have worked out very differently for me than they have for her.

Anyway, there was that, and then a day or two later a colleague made her announcement. She's not a colleague I know well enough that she knows about my situation, so she broke the news with chipper joy and I didn't know how to make my face make the right shapes and my mouth form the right words.

I think she was puzzled by my frosty reaction and I've agonised over whether to email her and explain myself, but have decided against it in the end. I'm sick and tired of feeling like I have to make excuses, as if I'm some irksome toddler, for a situation beyond my control that I hate, hate, hate and never wished for.

But the thing that has vexed me more than anything else of late was the remarks made by a TV presenter last Friday night, which saw the screening of the UK's biennial charity telethon Comic Relief.

The woman in question - the culprit - was Davina McCall, a woman who found fame presenting the braindead shitfest that is Big Brother. She has three children, or twelve, or eighty-seven - I can never remember as she appears to be pregnant every time she graces the screen. I'm amazed they haven't televised her squirting one out during the annual Big Brother bonanza. After all, it must be like shelling peas by now.

Anyway. Davina was presenting a link about children - babies, mostly - in Africa dying of diseases like malaria and AIDS. It was deeply, deeply upsetting television. After the film ended, up pops fucking Davina with: "This call goes out to all the mothers out there. It takes a mother to understand the suffering of these children. Come on, mums, we're all in the same boat..."

It went on and on, and I started to feel like something was crawling up my spine and setting each vertebrae on fire as it went. Because what the fuck? So because I'm barren I'm not entitled or expected to feel any sympathy at the sight of a baby dying in agony? How DARE she?

This sort of idiocy is voiced quite often, though. It's amazing, the stupidity of people. It always happens when some sort of dreadful crime is reported - a child's murder or sexual assault, say - you get these muppets showing up in TV news footage uttering ridiculous statements like "Speaking as a parent..." as if to imply that everyone without children must be sat at home silently applauding the criminal. It's sheer nonsense. It's insensitive and just basically ignorant.

I ought to pause for breath. I'm hammering the shit out of this keyboard.

My period appears to be on its way. I'm on day 37 and actually got a bit hopeful last week that our Parisian love-in might have borne fruit. I bought a two-pack of pregnancy tests in Boots after a lunchtime "craving" sent me in search of a vanilla bean smoothie, and did one of them that night, which allowed me to retain some hope by attributing the negative result to the weak evening wee brew.

By yesterday morning, still with no symptoms when really I should have sore boobs and brown drizzle by now, I did another one and got into a complete fury when it was negative. I actually managed to snap it into three pieces, sustaining minor cuts to my hand in the process.

It's coming to something when you think that a single pink line in a plastic window looks smug.

My plan is to give Clomid a whirl when my period eventually does descend. It can't hurt, and I clearly haven't ovulated since this cycle has grown to epic lengths and those tend to be anovulatory.

I just hope they don't grill me too much about my emotional wellbeing when I present myself at the clinic. I'm too near tears on this most of the time to be able to lie convincingly. And while I very much think I should explore the avenue of infertility counselling, I don't particularly want to stall the process any further by making the clinic think I need to be psychoanalysed before commencing medication.

It's just as well they can't see me in my own time, mind you. I do the strangest things. If the destructiveness with the pregnancy test above isn't odd enough, try this for size as a parting shot: I had a bath an hour or so ago. Standing up to dry myself gives me a full frontal view in my bathroom mirror. I stood there and sang the following in a crazy falsetto to my lower abdomen whilst whacking it with the towel: "Look at you, you pathetic piece of shit that doesn't work."

Now that's not right.

Sunday 1 March 2009

A helpful chat with the doctor (no, really)

I visited my GP this week for the first time in a year or so. The reason was a sore and weepy eye which turned out to be a blocked and infected tear duct - I knew all that crying would catch up with me one day - but after he'd diagnosed and prescribed treatment for that, he asked how fertility stuff was going.

"It's an unending nightmare," I said frankly. He said he'd just heard about a couple he'd referred having success on their first IVF cycle ("Oh fucking DID they," thought I, reflexively bitter as per) and had hoped it was us. It made me happy to think that he cares, as the production-line impersonal nature of the clinic has been one of the things bothering me.

I described our diagnostic procedures and consultations to date, and admitted that I wasn't especially happy with the clinic, and particularly with the head professor, who I cannot forgive for her "Don't expect to get a six every time you roll a dice" inanity.

My doctor laughed when I told him what she'd said - not in a nasty way, but in a way that belied incredulity that a fellow medical professional could be so insensitive. "It's OK for her," he said, "she's got four kids!"

"She's in the wrong job, then," I replied, mentally placing another dark mark (indeed, four of them) against her. It's not that I'm opposed to being treated by a woman with children - on the contrary, there's an element of "I'll have what she's having" hope associated with that - but her fecundity certainly explains her inability to empathise with her desperate, infertile patients.

Anyway, I talked through my current concerns - which are that we're being railroaded into Clomid when my periods have actually regulated over the past four or five months. Temperature monitoring and symptom spotting indicate that actually I am ovulating - as did a home ovulation tester kit six weeks or so ago - and I don't believe Clomid is necessarily the answer for us if the issue is not ovulation.

I really want to have the post-coital test to determine whether I'm murdering hubby's swimmers before they even infiltrate my cervix. I have visions of a war movie happening in my vagina every time we have sex, with his sperm gasping their agonised last to the strains of Barber's 'Adagio for Strings'.

(When I say I "really want" to have this test, I obviously don't mean that in the every-girl's-dream sense. Nobody wants to hotfoot it to the clinic with their legs clenched to allow a team of strangers to peer up their hole at the aftermath of what should be a private act of love. I mean that I want the test in the sense that I want to explore every possibility before we identify the most suitable treatment.)

The professor at the clinic had refused me the pleasure, citing the fact that the condition was "very rare" and so their protocol was not to deem it necessary. At the time I argued the toss with her, saying that surely rare meant still a possibility, but she was not for turning. My GP explained things to me in slightly clearer terms. Evidently the test is pretty unreliable - the number of sperm that ooze out or die of natural causes during your post-shag journey to the hospital can skew the result negatively. If only the professor had bothered her arse to explain this to me, I wouldn't have spent the past six months wondering. Ho hum.

My GP also said Clomid was worth a shot. He agreed that my periods regulating was a good sign, but he said I may still be ovulating infrequently and that Clomid may be a chance to right things and conceive naturally - or as near naturally as damn it - with "a minimum" of adverse side effects (those triplets again). He said if I was worried about side effects, I had a lot more to fear from IVF than from a course of Clomid, and that I could try it for a cycle and if I hated it, not do it again.

In short, a twenty-minute chat with a GP who has throughout this ordeal professed that fertility is not his area of specialism has proved more useful to me than countless sessions at that bloody clinic, however many awards it has won.

I discussed the conversation with hubby and we've decided that if we have no success this cycle, we'll give Clomid a bash next. I'm currently just past halfway. Watch this space.