I have a cervical smear test booked at my local GPs for tomorrow.
I have a cervical smear test booked at my local GPs for tomorrow.
H and I spent the afternoon discussing what to do, now? Were we both sure we wanted to do IVF? This summer? Starting next cycle, if possible?
May: YES PLEASE RIGHT NOW THANK YOU! NO MORE PERIODS THAN STRICTLY NECESSARY FOR MAY, WHO IS GETTING PTSD ABOUT THEM!
H: Well, yes, of course, let me get my calendar, how will this work with dates, umm, so let me see, we’d be doing egg-retrieval when exactly?
May: WHO THE FUCK CARES YES PLEASE RIGHT NOW THANK YOU!
H: And you need to sort out your smear test (Pap test to you transAtlanteans), and an AMH test – wait, the Riverside will do that… oh, it says here you need a chlamydia test, can you get that at the GP’s? And if there’s a delay in getting results, how will that affect the start of the cycle?
May: WHO THE FUCK CARES IF WE START IN JUNE OR JULY THIS SUMMER PLEASE RIGHT NOW THANK YOU.
H: Well, if egg-collection is too close to the August Bank-Holiday we won’t be able to do CGH as recommended by Dr George as the lab will be shut for a week…
May: WHO THE FUCK CARES no, wait, arse.
May: I’ve been playing telephone tennis with the GP practice nurse about this smear for a week. What if I can’t get it done this week? Then it’s my period and it’ll have to wait for a fortnight and then the results take two weeks, or, in not-NHS-speak, four weeks.
H: So, wait, if we start cycling in July… How long did Dr George say you’d need to be on GnRH agonists?
May: How about we ask Riverside?
H: Let me count on my fingers.
May: HOW ABOUT WE ASK RIVERSIDE?
H: September’s not a good time to cycle for you, is it, what with it being busy at work?
May: WHO THE FUCK CARES HOW ABOUT WE ASK RIVERSIDE?
H: I’m not sure September is good for me, either.
May: WHO THE FUCK CARES WE’LL MAKE IT WORK WILL YOU PLEASE LEAVE THE CALENDAR ALONE WE HAVE NO IDEA HOW I’LL RESPOND TO THE DRUGS ANYWAY IT COULD TAKE SIX WEEKS OR TWELVE OR WHATEVER.
H: October might be better than September, though.
May: I DO NOT WANT TO HAVE ANOTHER PERIOD IF I CAN POSSIBLY HELP IT OH MY GOD H.
And so on.
So, I shall spend every free second tomorrow dialling and re-dialling this practice nurse until she jolly well answers and speaks to me and if I can’t get a smear this week I’ll cry and use emotional blackmail also must ask about Rubella immunity and chlamydia, and meanwhile, H has written Riverside a very coherent and polite email setting out all of the above plus a delicate reminder to Dr George that ‘May’s Quality Of Life’™ is Not Very Good™, so can we not be ridiculous sticklers about things the NHS is responsible for please? Or something. (The phrase ‘ridiculous sticklers’ was not used (I mean, I’ve had a course of the antibiotics used to treat potential chlamydia recently anyway, and H and I are faithful to each other (well, I am (have we all watched House?)) and I had a Rubella vaccination when I was twelve (do they wear off?))).
[Pause, while I recount the parentheses to check they all match up].
As for LIT, which we were planning to do in June, well, Dr Fourth Opinion’s clinic has still, still, not got back to us about when exactly we’ll be doing that, which fact alone is MAJORLY GETTING ON MY TITS.
And, Dr George is not very pro-LIT. He doesn’t think there’s any evidence for it working, and if it did, there should be by now.
I was all, ‘Huh. OK,’ about that, as I wasn’t particularly pro in the first place, but was prepared to do it as side-effects are minimal and H found the hypothesis interesting and possibly even convincing. H, who found the hypothesis interesting and possibly convincing, was a little more, I think, gobsmacked? by this, but I can’t get a clear answer out of him about it. He agrees, however, we needn’t do it this cycle, and revisit it if this cycle tanks abysmally or ends in miscarriage. This decision may well have been brought on by Dr Fourth Opinion’s clinic’s non-communicativeness as much as anything. Dear clinics we are throwing our life-savings at, as a general rule, do not be difficult about communication. Thank you.
So, what Dr George recommended, was Intralipids, progesterone support (this, by the way, is a fucking ranty post for another day, involving The Professor. Remind me to get back to you on that), and steroids (prednisone, I presume), alongside a long down-regulation cycle to suppress the endometriosis a bit, using either Synarel or Buserelin (I can’t remember which) rather than the Pill, because I get migraines.
Huh. I used to get migraines about once every three years when I was on the Pill. And now I get them once every two months or so, on my own natural home-grown hormones. Yo no comprendo.
I must now eat salad and take Metformin (and that’s another post. SORRY).
So we went to the Riverside Clinic, for the Great Big Consultation To End All Consultations (please God).
I am having trouble processing it all.
Obviously, you, my Gentle Readers, would like to know what went down, and all I can say is, I don’t freakin’ know.
Item – Our consultant reminded me insistently of George Clooney at his most winsome. There is a goodly chance this man will have seen my vagina by Rosh Hashanah. Halp.
Item – The friendly chat with Dr George lasted well over an hour. I have never, ever, in my born days, ever had a consultant, NHS or private, who was happy to sit there for over an hour, going over things carefully and thoroughly, making all the ‘yes, I’ve read your notes and remember stuff’ noises. Never. For this alone, even H has a little crush on the man (me, I think he looks like George Clooney, remember? (H disagrees. H thinks he looks like Jon Stewart. Me, I am now having severe hormonal difficulty with the concept of the awesomeness of a Clooney/Stewart mashup. Seeing me naked)).
Item – The Riverside Clinic does this thing where they have you turn up for the initial consultation an hour early, for paperwork, and also so the male partner can retire to a private room and ‘provide a sample’. And then the results of the sample turn up mid-consultation (oh, good Lord, is this what money gets you?) So H was removed by a smiling friendly wee nurse leaving me in charge of the paperwork. I of course dropped the sodding lot all over the floor of the office, and while I was at it I dropped H’s music folder, and the nice lady helping me with it scrambled to pick sheaves of paper up for me. And handed me, poker-faced, the sheet-music for this*.
Item – It took me ten minutes sitting in the waiting-room, shoulders shaking, scarlet face in hands, to recover my composure. I’m quite sure the other couples thought I must have had NEWS OF EXCEEDING DOOM. Oopsie.
Item – H informs me the Riverside Wankatorium is devoid of Worrying Pictures Of My Parental Homes. It is also devoid of select images for the discerning gentleman’s gentleman (boo!) and the images presented for H’s delectation, while, he admits, were acceptable (real boobies!), they weren’t massively inspiring either. And he could hear people tramping up and down the corridor asking each other for files. Poor lamb. Nevertheless, his sample was magnificent, full to bursting with healthy handsome single-headed sperm swimming in nice straight lines. Dr George was pleased. I was pleased. H tried not to look smug.
Item – As for me, my AMH results from three years ago were so bloody spiffing, Dr George is quite sure my ovary is in tip-top condition, and likely to do rather well if encouraged. We’ll be retesting the AMH, but his optimism on the subject was bewilderingly lovely.
Item – The adenomyosis should not be a problem. I am the only person in the world concerned that I might give birth to Flat Stanley. And pregnancy would be good for the adenomyosis. Oh. OK. Oh. I… OK. *weeps with relief*
Item – My weight is not a factor. It’s not an issue. It was not worth even mentioning to me. We could cycle as soon as my period starts if I like. WHAT THE HOLY FUCK?
Item – Apparently, we have a pretty decent chance of getting a take-home baby with IVF. That’s hope right there, that is. I don’t do hope. I have not done hope for so long that it feels very much like it does when you’ve been kneeling awkwardly for hours and your foot has gone completely to sleep. You stand up and said numb foot is suddenly an agonising mass of tingles and throbs, and you can’t put any weight on it because it is not accepting neural feedback and feels like it’s made of jelly and wet sponges. Hope is decidedly unpleasant. Ow. Ow ow ow *hop hop* owie I think I might sit down again.
Item – And then we walked half-way across town in the rain. Because sometimes you just need to walk in the rain for a while.
Item – I’m having Drambuie on the rocks now. You?
*Providing link rather than naming the song, because not many choirs are singing it this summer, and we don’t want a massive H-TMI-reveal to his adoring fans, now, do we? No, we don’t. But the story was too good not to share. Shhh.
Item – We, H and I, have our initial, Be Poked For All The Blood Tests, Endure All the Probes, Produce All The Samples consultation at the Riverside Clinic in a week’s time. This will take a good couple of hours. And then we will, possibly that very day, know if we are doing IVF in June, or if we are hopeless cases who will never have a biological child grown in this ‘ere Uterus Of Despair. So H and I are TOTAL SHUDDERING NERVOUS WRECKS OF HORRIFIC HORROR.
Item – Riverside Clinic are prepared, if we are suitable candidates, to do a cycle with us the very month we have LIT, so no worries there. *Waits for other shoe to drop with a resounding clang*
Item – I need to have a smear test. H needs to have an HIV test. I shall be going to the GP this week to organise the Pokening. I don’t know how H is organising the HIV test, or if it is being done by the LIT people, or by the Riverside Clinic, or what. I’m sure H has told me, but my brain is startlingly non-retentive at the moment. H? Did you tell me? What am I doing? Who am I and why am holding a rubber chicken?
Item – The stress of this, and the constant rows with H, and the general run-down-ness, and I am as brittle as spun glass and as irritable as a sackful of wet cats being bounced along a holly-hedge. I think, this week, I have managed to piss off every single person I know. Go me.
So H finally spoke to the Ditzy Secretary. And she said, ‘oh, we can only do two or three LIT treatments a month, because of the lab bookings, so we can’t fit you in until June.’
And H said: ‘June? JUNE?’
And the DS said: ‘Well, we’ll fit you in sooner if there’s a cancellation.’
And H put the phone down and texted me, and I called him back, and then I went and stood in the middle of a garden square and banged my head repeatedly on a tree.
And then I went to my favourite coffee shop, where my favourite barista was so pleased to see me he gave me a free coffee, and I cheered up a bit.
What the hell are we going to do with ourselves until JUNE?
Having arranged the appointment with Shiny Private Clinic for me, the nurse said she’d send me all the details of ‘the procedure’ in an email. Duly, a few hours later, an email arrived. I printed out the consent form, checked the address in the email, made sure I’d remembered the ibuprofen and sanitary towels, drew myself a little map, and this morning plodded off to work in perfect serenity.
I lie. I was nervous as hell. Just, not about the location.
At the appointed time, therefore, I was in the wrong clinic, explaining myself to a bewildered receptionist who couldn’t find my name on the schedule. But wait! I was on the other clinic’s schedule! The other clinic? Yes! Just around the corner! So I sprinted back out into the drizzle, cussing these fancy-pants multi-location private fertility services and their expensive cupboards dotted all over the city centre like £1000-confetti.
It was fine. Bewildered Receptionist had called Correct Receptionist to let her know I was belting down the road, scarf flying out behind me like a banner, leaving a filthy blue contrail. Apart from the bit where she had to shout ‘push the door now. No, now! Now! Push!’ through the intercom at me while I pulled frantically. My nerves let me down.
Anyway, it being a tiny private clinic concentrating on egg retrieval and imaging, I was being handed my surgical gown and fluffy slippers within minutes of my solving the door riddle. And then a very sweet young nurse introduced me to a very sweet middle-aged doctor, and between them they introduced me to the first comfortable pair of stirrups I have ever wrestled with, and then I lay back and stared at the ceiling of the tiny room while they hoisted me five feet in the air and winched my delicates open with a speculum (I hate specula. Hate hate hate. Hate).
Doctor: Oh, is your period is just finishing, then?
Me: Well, it’s day 12 of this cycle, but I usually spot for about a week at the end of my period because I have adenomyosis.
*Pause, while they insert the catheter, inflate the little balloon that holds it in place (this does not hurt at all. I am astonished), and then remove the speculum and replace it with the dildo-cam (this is less comfortable). The doctor then turns the ultrasound screen so I can see it too. Imagine! Being allowed to behold my own innards!*
Doctor: And there’s your ovary…
Me: *silently, so as not to startle man who has three kinds of hardware up my personals* HOLY FUCK IT LOOKS LIKE A NORMAL OVARY! Ooh, look, you can see the lead follicle and everything. I give it a week to pop. Bets, anyone?
*Nurse presses plunger on syringe full of saline attached to catheter above-mentioned. Absolutely nothing happens*
Doctor: Hmm, I can’t get a clear image of the inside of your uterus. Do you have fibroids?
Me: *pointedly, see above* I have adenomyosis.
Doctor: Oh, yes. Well, I’m going to need to adjust all this to get a better view.
*Out comes the blood-streaked dildo-cam (ew), and the catheter, and rather a lot of fluid (nothing says ‘dignity’ like something dripping down the cheeks of your arse while medical professionals hunt out the wipes and the lube bottle). In goes the speculum again. Fiddle fiddle. Out with speculum, back in with dildo-cam, at a somewhat more uncomfortable angle. And another syringe-full of saline is squeezed up there. Again, nothing happens, though at least they can see where my uterine cavity should be, if I had one. They crack open a new bottle of saline and top up the syringe. For fuck’s sake*
Doctor: Oh, no, look, there it goes! I think the adenomyosis has made your uterus rather stiff. I can’t get the cavity to stretch open fully, but there’s no sign of adhesions or polyps. Are you alright?
Me: *surprisingly* yes!
Doctor: To check your fallopian tube is open, we use a foam, so it shows up on ultrasound.
*The foam is so white and high-contrast it practically sparkles on the ultrasound screen. It wooshes straight through my uterus and blossoms out the end of my fallopian tube in short order. We all stare at it.*
Doctor: Your tube looks perfect.
Me: Thank you.
And throughout, the Doctor and the Nurse kept telling me I was being very brave, and I felt like a total fraud because it really did not hurt. It was uncomfortable, and the speculum pinched, but pain? Nope. There was gore, though, me being me. I needed a fresh surgical gown to shuffle back to the changing rooms in.
And that was it. I paid them, they gave me a single hefty dose of Azithromycin (in case of chlamydia! which you don’t want forced up your passages!) and warned me not to have any alcohol after taking it (boo!), and then the Nurse sat me down in a corridor and carefully made sure I was feeling fine, not in pain, not feeling faint or sick or anything, before releasing me.
So I went and had lunch, took my Azithromycin, and went back to work for the rest of the afternoon. And that was that.
So, step two. We go back to Doctor Fourth Opinion, to do LIT. And then cry havoc and let slip the bunnies of fornication. And see where we’ve got to by the time I’m 38.
So H called any number of private clinics until he found one that would do a ‘hycosy’, as they cutely refer to it, without me needing to be their IVF patient or having an NHS doctor’s referral. It’s a well-known clinic, and conveniently near to work, and doesn’t cost a terrifying amount of money, and they share their results with you immediately (which makes a lovely change from the NHS).
And I am going there tomorrow. By tomorrow evening, I will know. We will know. Hurrah.
I am going by myself, as H has a very, very important meeting he can’t get out of. I’ve had HSGs before, and not suffered vastly, so I am electing to be optimistic, take an ibuprofen, and carry cheerfully on. If this backfires, I will thoroughly and happily enjoy the resultant melodrama. Especially if it gets me off work for a few days.
I am still in rather a state of angry grief about the way the last cycle ended, you see.
No, I’m not dead, nor on holiday, nor did the infrastructure of the known world collapse, taking the internets down with it. I was just… sulking.
Shark week, it has been, and a good brutal one too. It’s day seven now, and I’m still bleeding like a stuck pig, which you’ll agree is not optimal. Cute Ute the Despoiler has decided she rather likes the trick of easing up on the bleeding, waiting until I am lulled into a false sense of security also mere ‘super’ tampons (as opposed to double-plus super extra ultra tampons, which can double as marital aids, frankly), and then yanking out the bathplug and laughing hysterically (ho ho ho) as I leap to my feet with a tiny shriek and flee to the bathroom, blood running briskly down my leg. I am very tired.
On Sunday night, a week ago now, as full of cramps and anxst as can be, I decided to check my medication supply to see if I needed to renew any prescriptions any time soon. There was no urgency. There was a whole box of diclofenac suppositories right there, see? I don’t remember leaving a half-empty box back on the shelf, so it must be a full box… you see where this is headed, right? Because you don’t have the IQ of a house-plant, unlike me. So on Monday morning, in quite heady amounts of pain and starting to spot, I took my slightly-out-of-date repeat prescription form to the GP, to see if they’d renew it urgently, as, obviously, to my mind at least, anyone on this kind of painkiller really rather means it when they say they need it urgently, nu?
I am, personally, absolutely freaked out and humiliated by what happened next.
The receptionist was adamant that they did not renew prescriptions the same day, it would take 48 hours. That there new policy was that GPs were not to be disturbed for anything short of an emergency. That renewing a prescription was NOT an emergency. That they couldn’t renew it anyway, as it was out of date. That I’d need to make an appointment to see a GP. That there were no GP appointments left for that day. That coming in that evening for the emergency appointments first-come-first-served slots was not an option because they were for emergencies, which this was not. At this point, in tears, I asked if it would be considered an emergency if I threw up or fainted while waiting, and the receptionist told me that wasn’t very nice. She actually thought I meant it as some kind of passive-aggressive twatweaselry. I actually meant the question seriously, because I was in pain and freaking out and what the hell else was I supposed to do?
I was crying too hard to speak at this point, and I was in a waiting room full of people, and so I fled home again. H, thank fuck, was still at home himself, and promptly grabbed his coat in one hand, me in the other, and dragged both back to the surgery, where he, very calmly but sternly explained to the receptionist that this was not about some idiot trying to game the system, this was about a person in serious pain, and that he’d seen how the pain affected me, and that I did, actually, need this drug with some urgency, thank you, and after a few minutes bluster she caved completely and arranged for my prescription to be renewed and waiting for me by lunch-time. So in the end all was well.
And I cried all morning, because I had been so very scared I’d have to do Shark Week with inadequate pain-relief, and because the whole thing was so humiliating. I’m thirty-seven. I’m a nice respectable middle-class over-educated lady with a cut-glass accent. I can, if necessary, out-posh the Queen. How was I reduced to weeping hysteria in a GP waiting-room, being treated like a moronic teenager having a tantrum by a GP’s receptionist?
I don’t think I can do this for very much longer – menstruate, that is. It’s giving me shell-shock. Every cycle, also, is doing more damage to my uterus. When I lie on my back and rest my hand on my belly, now, I can feel it even through my ample padding, a great heavy bruised fist buried in my guts, an obscene parody of early pregnancy.
So, my thyroid. Back at the end of last summer, among the bazillion tests Dr Expensive was gleefully ordering, my GP and I decided to recheck my thyroid, as the last test was taken in 2007.
So I got needled, as per, and then played telephone tennis with the nurse at the practice for a few weeks ending in a no-score draw, and then I forgot about it because Life. And then I saw my mother at New Year and the subject of her thyroiditis came up, and I thought oh! My thyroid! And I needed to refill my Metformin prescription anyway, so I asked the GP to just ‘fess up.
My thyroid, it is normal.
Seriously. TSH is 1.14 mu/L. Free T4 is 14.1 pmol/L. Given that reference ranges for ‘normal’ are respectively 0.4-5 and 10-23, this is very normal. Hell, the TSH is not only under 5, it’s under the magic 2 recommended for ladies attempting ensprogulation. So, dear internets, given that you’re cleverer than my doctors, is it worth having my thyroid antibodies tested, or is the fact TSH and T4 are perfectly fine finio fine fine?
Anyway, it sort of cheered me up.
And! H has found another doctor specialising in reproductive immunology, and has contacted him, and has made an appointment, and we’re going to see him on Thursday. For a 4th opinion! Which is not in the least bit weirding me out and making me sound neurotic as a bag of wet cats!
If he recommends medicated + Clomid DIY cycles ad infinitum, I will climb his freakin’ curtains and make him eat the pelmet.
Item – You may have noticed H and I have stalled a little on Forward Progress In A Fertile Direction Also Known As Better Reproducing Through Chemistry. We have all our test results, I have a plan and a clear idea of what I will and will not put up with in terms of treatment. But… [awkward pause]… You see, Dr Expensive’s plan is to do LIT, then do several cycles au naturel, while medicated to the freakin’ eyeballs with steroids and anti-coagulants and intralipids and then progesterone too. H is up for it. I am very (very very very irrationally freakoutily) concerned that we’ll get the timing of the sex wrong (this happens, you know, even to H and May the Defiant Sex-Bunnies Of Doom). Or, we’ll get it nearly right, but it would’ve upped our chances to do it one more time which we didn’t. Or something. And the cycle will end in Shark Week and I am – shall we say concerned? Yes, concerned will do – concerned that I will react very poorly to this and put some kind of strain on our marriage. I am inclined to try IVF, frankly. At any rate, I want to put a definite bloody absolute limit on how many cycles we muck about with freestylin’. Say three. H, however, well, apart from my doing the poor man’s head in re: Correct Timing of PiV, he has reservations about IVF. Reservations he is in fact rethinking, admittedly, but he is currently in a Moving Forward In A Non-Committal Way To Preserve Own Sanity Whilst Trying Not To Freak Out The Wife paradigm.
Item – This, I decided, was a propitious moment to do NaNoWriMo.
Item – Basically, for the month of November, May will be closeted in the study/bedroom/kitchen/living-room floor with her lap-top and all the coffee in the Northern Hemisphere. H has nobly agreed to feed May at regular intervals and chuck a duvet over her every midnight. I did NaNoWriMo once before – before this blog, even, and did in fact write over 50’000 words in one month, and I did in fact get a perfectly useful first draft of a possibly quite interesting detective novel out of it, the only drawback with which was that the hero was as interesting as a roofing tile. Since when, eventually, he had gender reassignment surgery and the novel took off – but NaNoWriMo is for first drafts not rewrites, so New Eve is still in a box somewhere awaiting her redraft and I will be doing something quite quite different. However, the first time I NaNoWriMoed I had neither a full-time job nor a bastard set of damaged innards with a thing about chronic pain and fatigue, so I am asking a vast and complicated ask of myself here. This could be messy. Also faily.
Item – But fret not, Gentle Readers! You will not dwell in the suburbs of my good pleasure. H has also nobly agreed to take custody of the blog while Sturm und Drang is in progress. He his very own self even volunteered unprompted to perhaps take this space to explore his ambivalence to IVF and other such related matters (see? All Items Are Linked And Relevant). So feel free to nag him, starting November 1st.
Item – No news of my SiL. My family is remarkably bad at news. People often get married, have babies, get divorced, move house, and even die in total obscurity. Every few years we have meet-ups and the entire room rings to repeated cries of ‘you did what? When? WHY? WITH WHOM oh my God pass the gin.’ I have called my brother and left phone-messages, but I clearly see that ‘updating little sister one sees twice a decade’ is really, really not on the to-do list, and frankly nor should it be. Just… I worry.