Monthly Archives: July 2012

Grief Bacon

Gentle Readers, my period appears to be turning up a day early (I say ‘appears’. It hasn’t appeared. I have had cramps for 24 hours, I feel sick, my bowel has done its trademark premenstrual panic-and-empty routine, I feel so very grim I’ve called in sick, and yet? Not even spotting. But anyway), so I am in a sort of heap in the living-room with the Olympics on in the background (there appear to be… horses? What happened to the swimming?).

I haven’t been posting very much recently out of a giant, swamping feeling of anxst. And I am very, very bored of telling you all about my anxst. The whole infertility/RPL/borked innards saga has been pretty much nothing but anxst for six years (seven, really, but six blogged), and as well as being bloody unpleasant to live through, it is so fucking boring now. And this is not one of those excellent-reading heart-warming IF/RPL/Borkage stories that canters through high drama diagnoses and treatments and losses and! Finally! The Take-Home Baby! in two or three years, giving everyone a lovely story-arc with weeping-happy-tears resolution, crucially, before everyone gets royally sick of the whole thing and wanders off to find a blog less wall-to-wall tedium and frustration.

*Musical interlude in which we play May a concerto on the world’s tiniest violin*

However, my trousers are getting tight and I daren’t weigh myself, because I have been dealing with the Unspeakable Anxst Du Jour by eating rather more than I think is wise. The Germans, who have a splendid way with a compound noun, call this kind of ensquidgerey Kummerspeck, or grief-bacon, the weight you put on because you are comfort-eating your way through a crisis. (This, and ‘shark week’ for the days taken over by menstruating, are my new favourite terms. Oh, the infinite ways in which the raw, sarcastic, redolent-of-pain-and-blood ‘shark week’ is preferable to the twee, coy, tea-cosiness of ‘Aunt Flo’).

For the sake of my favourite jeans and my dignity in attempting to sit down therein, I shall now vent anxst all over this blog-post. You have been warned.

Your mileage may vary, but for me personally, the best way to be told of a friend/relation’s pregnancy is emphatically not by ultrasound photo on FuckBucket. If the announcer is not particularly close to me and has no clue as to my woes, or, perhaps, not much of a clue and is a clueless clot from the clue-free shopping channel anyway, I’ll let it pass. I might even say ‘congratulations’ (note lack of exclamation mark).

If, however, said person knows me, loves and is loved by me, knows my woes, and still thinks I can learn this alongside every twerp dick and hairball she went to primary school with, well, I get a twitch in my eyelid, is what I get. No, I don’t want a phone-call, either, though I appreciate the personal touch there, and will tough it out. Email me. Or write me a letter. I don’t need eighteen paragraphs of ‘I’m so sorry, I know this is so hard for you, I feel so guilty,’ either, because I don’t like being Bitter McTwisted the Kill-Joy Queen. A simple ‘Dear May, I am pregnant! Just thought I’d let you know before I start babbling about it on FuckBucket. Baby is due on [whenever]. Thinking of you, Much love, Friend-With-A-Clue’. Then I can have my ‘happy for you, sad for me’ moment in dignified privacy before emailing back ‘WHEEEEEEE! CONGRATULATIONS! SO MANY HUGS!’.

The real knife-in-ribs twist is, this friend answered the long, loving, concerned-all-for-her-and-her-toddler letter (with re-cap of our own medical disasters as shortest paragraph in said letter, and done in a ‘just to let you know our news’ way and NOT a ‘where were you, you unsupportive bitch?’ way) I wrote to her to restart our friendship with a brief ‘that was a lovely letter and I was really moved. In touch soon’. And then ignore me for months. While I, you know, had surgery and shit. And then, 24 hours before the Grand FuckBucket Announcement, email me a link to a completely unrelated funny and add ‘we should catch up soon’ at the bottom of that. Oh, hell, no, we should not catch up. She gets three kids (yes, twins. Ultrasound of naturally conceived twins) in the same time I get, what, three? Four? miscarriages. She can’t face me. She offers no support or love or even so much as a ‘how did the surgery go’? I think, right now, we will ‘catch up’ approximately as and when I become the Chief Rabbi of the British Isles.

Meanwhile, because we can’t do naturally conceived twins in a Surprise! ‘oh, goodness, I don’t know how we’ll cope!’ way *hiss*, we have to decide whether we want to blow an entire fucking house-deposit’s worth on, not a baby, but the mere chance of being allowed to buy a metaphorical lottery ticket for a baby.

H is still deeply pissed off with his job, by the way, and therefore is rather distant and preoccupied and also rather given to comfort-eating, which is getting a bit mutual-enabling. As have my gluten-free baking experiments – oh dear, if cake is good, we’ll eat it. Who knew?

And then there’s Olympics. You can’t have missed them. The last time they were on was the summer just after my first miscarriage, and I was grieving and angry and wondering if I’d be able to get on with the trying-to-get-pregnant any time soon. As I said then, on the subject of waiting to TTC:

No, the main reason they don’t want you TTC-ing at once is, apparantly, a) so you can take a month to ‘finish grieving’ and therefore not have a full-blown nervous break-down during the first trimester, and b) so they can accurately date your pregnancy from the date of your last period. To which I say a) finish? I was supposed to finish this already? But I’ve got enough left here to keep me going until the London Olympics, and b) how amazingly thick does a doctor or midwife have to be to assume the date of the last menstrual period means jack for a good 20% of the women they are going to see? No, wait, flash-backs to the Early Pregnancy Unit From Hell, don’t answer that.

And here we are at the London Olympics and, oh, God, nobody tell poor May-in-2008 what happened next or she really will have a full-blown nervous break-down.

I don’t think I mentioned it on the blog ever, but I found it in my old-fashioned paper diary (I’ve kept a sporadic diary since I was 8) – When I was first pregnant I had a lovely little fantasy of sitting watching the Beijing Olympics and feeling my baby move for the first time, and being able to tell her in 2012 that we watched (well, were in the room for) the 2008 Olympics together and she did somersaults along with the Olympians. And then I lost her. And all her tiny embryonic siblings since. And it’s finally 2012 and the Olympics are on again and I’m still not pregnant and another dream has died and I keep weeping whenever an athlete wins or loses or just, you know, turns up and represents. We’re all here again and all those embryos aren’t.


Give me a dah dah dah

THOROUGHLY DISTRACTED BY OLYMPICS STOP SEND CAKE STOP NO WAIT I MADE CAKE STOP IT WASN’T BAD STOP SEND GIN STOP


Complaint

I’d got as far as the bus-stop this morning, when my lower bowel decided (unilaterally, I might add. No consultation with the rest of me what so ever) that it didn’t care for, oh, something, and wanted whatever-it-was outside, stat. I sprinted back home in terror, flung the door open, belted past a startled (and half-dressed) H, and locked myself in the lavatory for 20 minutes. Then I came out to bitch about it all, and went back in for another 30 minutes. Came out, phoned work, feeling like a total fucking idiot, went back in. And so on, all morning.

Thank you, Universe. Thank you right in your face.

I was careful, yesterday (if I eat a Bad Thing, it takes between 12 and 24 hours to give me cramps and diarrhoea). I did not eat a single thing that could even possibly contain gluten, or bananas, or wine, or any of the other things that irritate my digestive tract. I have cut out coffee, I have cut out dairy (my eczema was flaring. I am so attractive right now). And I’m not ill. Apart from not daring to be more than a few second’s sprint from a lavatory, I feel fine. My guts should be the happiest guts in the kingdom, ungrateful little weasels that they are.

H is of the opinion that after a migraine, I can suffer several days of ‘postdrome’. He has a point – I was still slurring my words and transposing phonemes (Spoonersims ahoy!) on Sunday night, despite the migraine (The Migraine!) thwopping me one last Tuesday. I also know a lot of people get diarrhoea pre-and-post-migraines. Could it be that? A week later? Do I need to keep a headache-and-the-shits diary (don’t answer that. Of course I do).

AAAAAAAAAUGH.


Answers and the like

Oh! News! We got the results of H’s sperm DNA fragmentation test. And it was….

Drumroll…

Completely normal! DNA Fragmentation index, 15.9% (excellent is under 15%, fair to good is 25% to 15%, fair to poor 25% to 50%, oh crap over 50%). High DNA stainability (ie, sperms with immature chromatins and unusual proteins, leading to poor fertilisation rates (which wasn’t really an issue we ever had) 16.1%. Over 25% is considered a bit troubling.

So there’s that.

I confess to a peculiar and indigestible feeling of ‘oh, so you mean we can’t just give the fuck up and put the cash towards six weeks in New Zealand/Canada/Japan/Rajasthan/Antartica delete-as-applicable?’

I mean, I’m relieved as hell.

I’m sad it’s all me, because I feel like a Weight and an Affliction in this marriage (H begs to assure you all he doesn’t think of me in that way at all, and as far as he’s concerned we’re in this together forever).

And where the hell are my thyroid results? I had them taken WEEKS before H’s second visit to the wankatorium.

Meanwhile, my next period is due in about ten days, so I can finally collect the uterine sample and then we’ll have all the tests and then Dr Expensive Will Pronounce and we can decide whether we can be having with any of it, or not, or what? (The Akond of Swat).

In further news, dinner with Dad and assorted siblings and nieces and nephews went very well and we had a very nice time. I don’t… wut? Seriously? I enjoyed it? The hell? It was as if the universe had benignly given me my real Dad back, the infuriating, talkative, charming, loving, cuddly Dad who raised me, and who I used to worship as a little girl. Foul-mouthed drunk grouchy arsehole Dad was a total no-show. He even found time to ask me, quietly, how my health was, and give me a big hug and tell me he was thinking of us and wishing there was something he could do. I damn’ near cried. Was only rescued by (cute, adorable) Sister-in-Law coming in with fresh cocktails. So I got plastered (H assures me that I nevertheless behaved perfectly throughout).

Yours, thoroughly discombobulated,
May


Irons in the fire

Item – Bullshit week is still bullshit. I woke with a migraine this morning, and just had to go back to bed and put my face in the pillows and wonder who rammed this red-hot skewer up my sinus and why? Why? Why would they do such a thing? What am I, an upside-down Edward II? Skewer has finally cooled down, and I have just found several major errors in the knitting I was (idiotically) attempting in the luke-warm phase.

Item – So, Dr Expensive’s results so far. I feel very much like a woman with a can-opener, a tin labelled ‘best quality fisherman’s bait!’, and a startled expression on discovering that this wasn’t a jokey name for spaghetti hoops. Basically, I probably have an auto-immune problem, I don’t make the right sort of antibodies on encountering H’s DNA, and I may or may not be producing silly levels of NK cells, though as Thalia pointed out, who knows if I’m producing them in my uterus lining? And as Wombattwo pointed out, who knows if this information is even relevant? Has anyone checked if women with ‘normal’ fertility and miscarriage rates get these sorts of results? And to cap it all, the ‘treatments’ on offer are expensive, experimental, under-researched, and in the case of LIT, actually banned in the USA. Oh, thank you Universe, for this clear and simple answer to all my problems.

Item – Anyway, it’s not exactly Decision Time, as we’re still waiting for my thyroid panel results, H’s DNA fragmentation results (I can’t believe that the clinic has two separate, different views of my Dad’s place in its wankatoria. Poor H (Also? The bit about the stuck-together pages in the ‘helpful’ literature? AAIIEEE)), and for my next period to roll around so I can send them a small amount of my uterine lining via FedEx, the very idea of which still strikes me as hilariously inappropriate… “Freshly gathered, carefully mixed with purest saline solution, chilled and couriered expressly across the city, this isn’t just any menstrual blood. This is May’s menstrual blood…”

Item – H, I think, is far more gung-ho than I am about these treatments. As he points out, we do have the money (what the hell else did we save so much for? he points out, gazing pointedly around the hovel we live in), and he is pretty damn keen on the idea of our own biological children (I see his point. We both have beautiful ears. It’d be a criminal waste to let such ears vanish from the human records). Me? I want more science, and I want not to miscarry again, especially not expensively, and I want my uterus to stop hurting me (also, I want an iPad, knee-boots, a kitten and a personal assistant).

Item – I am going to dinner with my brother, and sister-in-law, and my Dad and stepMum this weekend. I am dreading it. I’d love to see my brother and SIL, and stepMum, but Dad is, well, Dad. If he pulls the ‘your mother is a greedy money-grabbing whore’, or the ‘people used to lose babies all the time in the old days and it never bothered them‘ conversation gambits, I will calmly get up, kiss everyone else goodbye, and leave. It is only by holding on to this resolution with iron determination that I can face this visit at all. Yay families!


Tales of woe

We have… well ‘news’ sounds far too exciting… ‘results’ sounds too hopeful… ‘a shit-storm of wtf, I told you sos and up yours NHS’ probably encapsulates it.

We are both in a bit of shell-shock I think. May doesn’t want to get angry again, so has asked me to step up to the mark and write a post although she has given me some of her draft rantings to draw on. Let me start by describing the context of our lives this stuff has landed… May reports:

“Work is stupid and full of stupid people and I don’t like it. I actually reported a colleague to their line-manager the other day, for being an incompetent fuck-wit whose work I was just about that sick of redoing for them (this is, of course, a situation that has been going on for over a year. Rage). I then spent hours sorting out a hideous mess of misfiling and laziness, and had to file another complaint about protocols being ignored. Then I found out I am The Subject Of Gossip in the tea-room, with camps dividing into those who are convinced I’m pregnant, and those who think I have cancer. Then a superior entity told me off for not doing something, and when I said plaintively that no one had told me about it, she pointed out she’d announced it at the meeting. The meeting I was off sick for, did she mean? Yes! Well, I was off sick, and she hadn’t circulated the minutes yet (two weeks later. Hmph). Nevertheless, I should have known, and I needed to go and do it, and bugger everything else in my in-tray, because I should have scheduled the time to do this thing I had no way of knowing I was supposed to be doing. Worst of all, I defended a colleague’s decision to a student, even though I was a bit uneasy about this at the time as I thought she was being ridiculously draconian. I double-checked today, and I realised she was not merely being a jobsworth but had actively screwed up and then not been honest with me in order to elicit my support. I so very much wish now I’d gone with my first instinct of cheerfully telling her not to be such a whistle-dick and to do as the student asked.”

While May is in a “work-induced state of advanced temper”, I, H the implacable, have also been pissed on from on high at work. The Big Project I have spent months working on, has been summarily shelved, and I have been presented with a whole new Big Project with entirely different software and parameters and skill-sets and told, basically, to lump it. Not only that, but show leadership for my team and be enthusiastic for this new Big Project and take charge (even though it’s being run outside of my control) and make sure it succeeds… It’s been a couple of weeks of mayhem and personal anguish as I started to see the project crumble around the edges as if on a cliff overhang, but powerless to stop it then plunge into the ravine.

Meanwhile, my counsellor has gone on holiday for a few weeks, just as I thought I was getting somewhere. May and I have therefore been needling and sulking and bitching and snapping and getting on each other’s tits in a rather distressing manner.

May puts it better than I ever could:

This is H and May, people! Star couple and all-around loved-up snuggle-bunnies of the decade! And I’m all ‘Take your Goddamn issues to the counsellor, because I am stressed to death here and I have no patience with you or anyone or anything!’ and H is all ‘You’re stressed? What am I, chopped liver? And, you may remember, the counsellor is on sodding holiday,’ and I’m all ‘cry me a river’ and he’s all ‘eat my shorts.’ Our sex-life is parlous. Funny that.

In which mood, I had to slink back to the wankatorium, so they could do DNA fragmentation test, with May in the back-ground wailing:

‘but we haven’t had sex for days! And now we can’t for days! I’m going to ovulate to spite you, so there’. Which helped. Even more so as we weren’t going to worry about conceiving until we’d got all our test results back and spoken to Dr Expensive again, so I am being so exceedingly rational and not in the least bit deranged-harpy-on-hormones.

I was shown to a different room this time and dared to hope that my in-laws wouldn’t be looking over my shoulder this time. Alas, while the picture was different it was definitely of the same area – I had the wherewithal to take a picture on my phone this time to show May – I think she was shocked how like their landscape of abode it was, but still laughed [Because I am a cow - May]. A new set of magazines to peruse – and with May not sitting in the waiting room upstairs I felt slightly more relaxed about having a look. It was going fine until I encountered two pages stuck together, which made me rapidly cast it all aside and go and wash my hands again and start from scratch.

I also managed to get an envelope of results so far from Dr Expensive’s clinic when I picked up my referral form… our blood was actually shipped off to Chicago for the testing (not sure what to put on the entry form for the ‘have you been to any part of the USA previously’ type question… ‘part of me has’ may get an interesting response), to whit (for reminders what these are see May’s details wot she wrote):

Item: No STDs (yay/*yawn*)

Item: TH1:TH2 intracellular cytokine ratios TNF-a 26.6 (good range 13.2 – 30.6) IFN-g 16.8 (good range 5.8 – 20.5) big tick next to the figures, so assume that’s OK. However, it’s at the high end and they have a tendency to increase, so would need to be monitored (expensive).

Item: DQ Alpha Genotype – May: 0201,0301; H: 0102,0201 – so we have a 25% chance of embryo looking like May’s DNA to her antibodies and therefore being confused for a possible unwanted cancer or something and attacked. This is probably quite common and shouldn’t be a problem in its own right, but this could also be a factor in other test results and also, as May said, causing increasing sensitivity issues.

Item: NK Assay (% Killed) Panel
These should be below 15%:
50:1:  14.6% – this is borderline, but it does come down with IVIG and ILs (see NK assay with Intralipid, below).
25:1:  8.8%
12.5:1:  4.5%
IgG conc 12.5 50:1:  8.1%
IgG conc 12.5 25:1:  8.0%
IgG conc 6.25 50:1:  11.3%
IgG conc 6.25 25:1:  8.1%

% CD3:  83.9% (should be between 60% and 85%)
% CD19:  7.1% (should be between 2% and 12%)
% CD56:  8.6% (ditto)
% of CD19+cells, CD5+:  14.1% * – this should be below 10%, so is starting to point to auto-immune issues *eye-rolls all round* May’s family is rife with auto-immune issues, so not surprising.

NK assay w/Intralipid:
50:1 w/Intralipid 1.5 mg/ml:  10.3% – someone drew a large arrow pointing at this number on the print-out. As you can see, intralipid treatment lowers the NK kill rate, which I think is a Good Thing?.
25:1: w/Intralipid 1.5 mg/ml:  5.4%

Item: Leukocyte Antibody Detection
Flowcytometry:  Negative
[T-cells] IgM+:  1.0%
[T-cells] IgG+:  17.2%
[B-cells] IgM+:  53.8%
[B-cells] IgG+:  19.0%

Here is the kicker – these should be above 30%, preferably above 50%. With so many low figures (although the first two are less important the most important is the last) it looks like the Leukocyte Immunization Therapy (LIT) will be order of the day, controversial and expensive we are.

So, in summary it looks like May and H are a little too familiar and friendly, our embryos are so loved and familiar they’re squished out of existence [We shall have to call the next embryo 'George' - May] and May’s system is getting more and more sensitive to the ‘tricksy’ little things. So I said:”Your immune system is just like you, argumentative and hot tempered.” To which May retorted: “Well, even your sperm are fucking passive aggressive!”

Conclusion: a microcosm of our relationship plays out in May’s uterus every month.

And then we laughed like drains, and I made cocktails.

Where does this leave us? Adrift at the moment, not really sure what to make of it all. My instinct, of course, is to run away. We’re still waiting for thyroid and DNA fragmentation before going back to see Dr Expensive. If you see two dazed people looking marooned, crestfallen, slightly bitter then approach carefully, they have been known to snarl.


Another reason

I was sorting out the paperwork, and I realised/remembered/slapped my forehead that Dr Expensive is also doing a thyroid panel on me. A proper one, TSH, T4, Free T4, Free T3, antibodies.

I’ve had my thyroid tested before, by my GP, and each time, despite my fussing, and my pointing out that my mother’s TSH levels kept coming back as normal right up until she grew a bloody goitre so perhaps TSH alone wasn’t reliable, all they’ve done on me is TSH. And I don’t know the exact results for that, either. I call the office to ask, they reassure me it’s ‘normal’. I ask for the exact levels, the nurse says she’ll get the doctor to send them, I get a letter reassuring me they are ‘normal’.

Dr Expensive asked me what my thyroid levels had been and I explained about the ‘normal’. He pointed out that ‘normal’ TSH can be anything under 4 mIU/L, because the NHS don’t tend to treat anything under 4 mIU/L as it’s not cost-effective, but bad pregnancy outcomes are correlated to TSH levels over 2 mIU/L, so it’s important to know the exact level. I said, I was aware of that, and that that was in fact one of the reasons why I’d come to see him. Because getting actual answers, as opposed to vague, unhelpful, ‘normal parameters’ out of my NHS doctors was impossible. He nodded and moved on.

And then, when we arrived home that afternoon, there was a letter for me from Miss Consultant, my NHS infertility doctor. I had been haranguing her secretary for the results of the FSH cycle day 3 test I had back in March (MARCH, people! For the sake of fuck). I’d given up on the bloody results every being found and all. But here was a letter from Miss Consultant about them. She said, and I quote: ‘I am pleased to let you know that the FSH blood test taken back in March was normal. I hope you are progressing with your weight loss…’

As I was saying, *HULK SMASH*.


Testing times

To resume – we left us in the street, H describing his tribulations in the lab’s ‘special’ collection chamber, and me, his loving supportive wife, shrieking with laughter. Oh, and Ossa on Pelion, once H had mastered the difficulties of Unhelpful Naked Ladies and The Looming In-Laws, there were people trotting noisily about in the corridor, leading to good old ‘if I can hear them, can they hear me?’ moment. Nevertheless, H rose manfully to the occasion, and his sheepishness on rejoining me was entirely due to the fact the entire staff of the lab obviously knew where his hands had just been, and he also knew very well indeed that I would inquisitive also mirthful, because I am puerile.

So. I have here the receipts, and TheSheila’s helpful link to Explanations Of Everything Immunology in the comments of my last post, and let us see what all this expense and pother is for. (The expense! AIIIEEE!).

Item one – The consultation fee. Well, that is self-evident. Onwards.

Item two – FGA 4+6. What in the name of wonder is this? Comparing the price list with the FAQ with my own memories of Dr Expensive’s explanations, I conclude this is the Natural killer cells panel TH1/TH2 intracellular cytokine ratios. Basically, has my psychotic immune system filled my blood-stream (and hence my uterus) with Cells of Rage, dedicated to hunting down and destroying every possible trace of DNA it can’t be having with, starting with cold viruses and the like, passing into panicked reactions to random proteins in pollen and, say, kiwis, and ended up going on rampages against embryos trying to get a grip in the old ute. The science gives me brain-ache. The treatments are usually things like steroids and intralipids, or even IViG, heparin, progesterone. Anyway, it’s treatable.

Item three – LAD. Oh, this is Leukocyte antibody detection. A sample of my blood is mixed with a sample of H’s, and then they look to see if my leukocytes have gone into rabid attack mode and if so, how rabid, and why. Basically, my leukocytes are supposed to attack ‘foreign’ DNA (virus, bacteria, fungus), and ‘self-but-altered’ DNA (ie tumour cells, cancer). If my immune system can’t ‘recognise’ H’s DNA as foreign, it then assumes the embryo is ‘self-but-altered’, and kills it. The treatment is controversial and complicated, and involves inoculating me with H’s lymphocytes, in an attempt to get my body to recognise his DNA as foreign-but-benign and leave the embryo alone. If H is ‘too similar’ to me, they even use donor lymphocytes. It is thought that the first pregnancy ‘sensitizes’ the woman’s immune system, and screws up subsequent pregnancies. My first was a missed miscarriage that had to be scraped out of me, and all the rest have been early losses and ‘chemicals’, which seems to hint that my immune system has learnt since the first miscarriage to kill embryos on touch-down. But the treatment! Expensive and experimental and controversial and involving blood-products from donors! Fucking fucky fuck fuck!

Item four – DQα Genotype. Both H and are tested for this. All our cells have two ‘markers’ on their surface, which our immune systems recognise or fail to recognise, one inherited from each parent. If our embryo inherits a combination of alleles that make its markers too similar to mine, my body thinks it’s a tumour and kills it (basically, a similar result to the above via a different genetic mechanism). Treatments, again, are steroids and intralipids or IViG, Humira, or even the above LIT treatment with lymphocyte inoculation. Again, it is possible for the woman’s body to become more sensitized on subsequent pregnancies (causing earlier and earlier miscarriages, implantation failures, etc.). Or there’s always donor eggs or sperm. And the donors would also have to be tested, to make sure we aren’t wasting our time. *tears hair*.

Item five – HVS. HVS? What? Ohhh, High Vaginal Swab. Yes, I remember that. I wince every time I think of it. We’re testing for chlamydia, gonorrhea, bacterial vaginosis, and other similar STDs and infections that can create an inflamed, hostile uterine environment and damage the growing embryo. Treatment, month-long course of four different brutal antibiotics. Yay!

Item six – Semen C+S – Same test as above, only on H, and for which he battled the combined forces of bad porn, in-laws, and a possible audience. Apart from the risk of passing the infection to me (we’ve been banging sans condoms for about 15 years now. Horse has bolted), an infection could damage the quality of the sperm, anything from killing them outright to stealthily warping the DNA inside them, so they produce crappy little embryos that don’t know how to grow organs and conk out instead.

Item seven – Chlamydia, Mycoderma. This is code for more testing of the above. It is theorized that the infection could have migrated to the uterine lining and no longer be present in the vagina, or present in the vagina and uterus. So they give the lady a large padded envelope containing a small padded envelope and a plastic pot, and send her home to await her next period, and on the day of heaviest flow, they want that pot filled and, get this, FED-EXed to the lab. I am to send a pot of blood and gunk across the city by expensive courier. I am floored.

And this is not counting the repeat sample H is to give this week, for sperm-count/DNA fragmentation (which can be caused by many things other than STDs, you know, including shitty-bad luck).

On the matter of STDs and other infections, H and I have been both boring and safe in our sex-lives. I have not had sex with many people, and except for with H, I was neurotically scrupulous about condoms. H confesses to one (ONE) silly bout of unprotected sex when he was 17 (which I’ve known about since, I think, the day after it happened (and it was before we started dating)). H and I stopped using condoms when I went on the pill, by which point we were an Established Couple Very Much In Love, also we were 19 or 20. So neither of us had much chance of picking up an STD. But if one of us had, the other had pretty much no chance of not being affected. The thing is, the thorn is, the person H had unprotected sex with at 17 had prior to that had unprotected sex herself, with several people who were not exactly careful or abstemious, so there is a tiny, remote, possibility that she gave H an STD before he even so much as considered me for a kiss, let alone life-long bondage (tee-hee). And, yes, I know this incautious sexual partner of H’s rather well, and thereby know rather a lot about her sexual habits (rather than suspect, or maliciously impute).

If we do turn out to have an STD, I may have to kill her.

There is always the possibility that either H is or I am lying about how cautious and sensible we’ve been since, or how loyal. But I know me and I trust H.

And there is always the possibility that the infection I developed after my first miscarriage (post-D&C) never went away, and that was totally not down to carelessness on my behalf. There are bacteria that live naturally in the vagina that are fine where they are, but a problem if introduced into the uterus.

Which is why we agreed to do all the infection tests. Despite being as faithful and devoted and clean-living as Darby and Joan.

And now we wait for results. Well, H has to go and battle the bad porn and looming in-laws again, bless him, and then we wait.

I am in a bit of a state, mind you. As we were sitting in Dr Expensive’s office, I has being harrassed by the thought that he was taking us seriously, which meant there were serious things to do, which meant treatments and expense and bother, which meant laying my poor heart open like a laboratory specimen to That Bitch Hope, and I don’t want to hope, I don’t, I don’t, it hurts too much, I want my nice safe Bat-Cave.


Tales of the unexpected

I wandered away from the internets for a few days, not for any particular reason as such. I just… wandered off. I was doing things like ‘watching Wimbledon’ and ‘seeing friends’. It was intense, dudes. (No it wasn’t).

So, there was that Important and Scary (hell yes, I was scared) appointment with Highly Recommended Doctor Expensive. I was going to tell you about that. Hello! This is me telling you about that.

I managed to give myself the yips while sorting through and putting-in-date-order all my infertility and RPL paperwork to date. Every few minutes sheets of hospital discharge notes and letters CC’d to my GP would fountain from my lap accompanied by a Swearing Voluntary in F Major. My God, Gentle Readers, it was depressing. All that happened to me? Why? (Answer sadly presents itself as, whyever not?).

But having all the results and letters with me, in date order, was invaluable in Dr Expensive’s office, as he fired questions at me – ‘Have you done this? Why? And this? Why not?’ – and flipping through them so I could hand him pages of results in a matching brisk manner was infinitely preferable to, say, crying. Which I was tempted to do.

(Not that Dr Expensive was unkind. And frankly, briskness and matter-of-factness are very much the best strategy for me, because sympathy and concern, while very welcome, make me wail and then the ‘extracting vital information’ part of an appointment gets derailed and I have a fit of rage in a coffee-shop later. Derailed! And no answers! Aigh!)

In short order, Dr Expensive considered my AMH, FSH and estradiol tests of times gone by, and decided they needn’t be retested as yet; took on board that my uterine cavity, remaining fallopian tube and only ovary were in good nick; discussed my miscarriage history (I may have got miscarriages two and five the wrong way round, but as they were both chemicals, I don’t care); and then drew diagrams all over a prescription pad to try and explain how sometimes the embryo is too similar, genetically, to the mother, whose immune system then attacks it, thinking it’s a tumour, and other times the embryo is too different, because the woman is basically allergic to her partner’s DNA, so the immune system attacks it, and then sometimes there are infections or auto-immune problems that make the uterine lining hostile, and sometimes the man can have a lingering infection that shatters the DNA in his semen, even though he’s producing normal amounts of normal looking sperm, and then there’s the treatments, which involve anything from steroids and IViG or Intralipids, to injecting the woman with donor leucocytes, to donor sperm and/or eggs, and H and I looked at each other in shell-shock also bewilderment, because on top of all this jargon being fired at us, Dr Expensive has a marked accent and I was missing one word in five. And being nervous, I was speaking in my best Well-Brought-Up-Mouse voice, so one word in ten was one or other of us saying ‘pardon?’

Farce.

Dr Expensive announced a suite of tests he thought we should do first. We nodded. We has been expecting tests. Blood tests. A few vials each. Right? We were ready for that. But no! First, Dr Expensive wanted me to strip off so he could collect a vaginal smear (wut?) to test it for chlamydia/gonorrhea/mycoderma (i.e. bacterial vaginosis). OK. I pointed out I was still menstruating just a little, and he assured me this was not a problem (is it not? For whom is it not?), so I meekly went behind the screen in the corner and removed my trousers, knickers, and tampon, which I wrapped in about three square feet of paper towel before putting in the bin. So that made me feel Extremely Self-Conscious. and, oh, the table had stirrups! You don’t normally get stirrups on the NHS! Luxury! But of course, because I’ve never used them before, I couldn’t work out how in hey I was supposed to get my feet in them, so that was not comfortable. And then Dr Expensive snapped on his latex gloves and poked at me with an elongated cotton bud. And it hurt. For a few very unpleasant seconds I thought he’d stuck the thing up my urethra, but then it scraped at a slightly different angle and I thought, no, wait, that’s where I thought it ought to go, and then he removed it smudged with blood, so I decided I’d go to the loo as soon as I could, and if I peed red, I’d march into his office and shriek, and if I didn’t, I’d put the whole thing down to the adenomyosis and suck it up.

(Pee was fine. We’re blaming Cute Ute, also possible bad angle of entry, which mystifies me, because surely Dr Expensive has done hundreds of these, and my anatomy is very normal in that regard, or did he mean to collect a sample from there too and I simply didn’t understand what he was saying? Because what just happened?)

Anyway, that was unexpected.

Even more unexpected, Dr Expensive told H to provide a semen sample. H blenched. Dr Expensive explained, to test for chlamydia and/or other infections, and to test for DNA fragmentation (we had the results of previous SAs with us, and H’s count and motility and morphology have always been normal). The DNA test would have to be done between two to five days since last ejaculation…? H delicately made it known that in that case the DNA one could not be done right then, possibly breathing a sigh of relief, but Dr Expensive shrugged and told him to provide a sample just for the infection test and come back later to do the other one, so H blenched again.

Then H and I went back to the waiting room and let the nice lady at the reception desk do something horrendous to our credit card, in exchange for which we were given a form each, a large padded envelope, and instructions to go just down the street to the lab, where we could be relieved of our bodily fluids.

The lab was very smart, with stylish sofas, and fascinatingly mixed clientele. I was called through in minutes, and a nimble-fingered man took seven vials of my blood in very short order, and while he was doing so, my vaginal smear was brought over by the clinic staff, practically lying on a cushion of state, which was unnerving. And then I went back to the waiting room, where H no longer was, and sat knitting and staring into space for a while.

H eventually reappeared, looking faintly sheepish, and we sidled out into the sunlight to hunt for coffee.

‘So, H, tell me about the wankatorium,’ I hissed as soon as we were more than a few yards from any other humans. And bless him, he did.

They took his blood first (five vials (I lose! Five vials and a pot beats seven vials and a poke with a sharp stick!)), which we decided on balance was a good thing, because trying to, err, while knowing They Are Waiting For You With Needles is probably more off-putting than having to, err, in your own time even with a fresh needle-mark (H does not like needles). Then he was handed a pot instructions (instructions? Who doesn’t know how to, err…) and ushered into a small room containing item, a doctor’s couch covered in paper from those giant rolls; item, a sink; and item, a small side-table with a drawer.

‘Ooh! Ooh! Was there porn? What was it like?’ I interjected with unseemly curiosity.

Yes, in the drawer, were two folders. The first folder contained magazines for men! Who! Like! Men! Yes! And were pleased to see them! I have to say, this information delighted me. I like an equal opportunities clinic, so I do. H, however, doesn’t like men in quite that way, so he put that folder back and took out the next one, which did indeed contain Naked Ladies. Unhelpful naked ladies. How where the ladies unhelpful, I asked, boggling. Well, said H, either their breasts looked plastic and fake or their genitals did. It wasn’t particularly inspiring.

By this time I was unhelpfully giggly, of course.

‘And,’ said H, woebegone, ‘There was a huge picture on one wall of a beautiful landscape. Which would have been nice and soothing, only…’

Yes?

‘It was of the area where your Dad lives.’

Boom-tish!

[Discussion of the rest of the tests tomorrow. Because I've just noticed it's past midnight, is why].


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