Daily Archives: June 25, 2010

On guilt

We had our great big, do-or-die, holy crap how much money? private appointment with The Professor of the World Renowned Recurrent Miscarriage Clinic on Wednesday. And look! I’ve said utterly buggerall about it since.

I don’t know how to talk about it.

Because we’ve been benched.

Gah.

And with the benching, a metric ton of guilt, shame and self-loathing.

I don’t really want to talk about any of it, either. But then, sitting about in a puddle of un-aired misery leads to mould on the lower extremities and an eventual spiral down the Depression Drain. And, as we all know, Talking About It leads to Sense of Proportion and eventually to Pulling Socks Up and/or Putting Big-Girl Panties On. So. Onwards. Show no fear, the Internets can smell fear.

[Insert standard ‘long, rambling, less-than-usually coherent, may contain bad language and references to blood, needles, and fucking idiots’ disclaimer here].

On visiting the World RMC as private patients, rather than an NHS one, we do not go directly to the clinic. First, we stop off at the reception in the private wing of the otherwise good-and-proper socialist hospital to hand over your credit-card details. And the private wing reception area has actual upholstered arm-chairs to sit in, and copies of The Field to read (I’m used to hard plastic and Chat). And the most random assortment of patients imaginable. Normally, when you go to a clinic, everyone in it has what you have – the Infertility Clinic I have been patronising for the past four (four? Farkin’ ‘ell) years is usually held in the same suite as the Ear Nose and Throat lot, so the waiting room is always one-third elderly deaf, one-third depressed-looking couples in their mid-to-late thirties, two snot-covered children with chronic adenoids and bickering parents, and a puzzling man with tattoos. At the private clinics’ reception and billing centre (oh yes), we had a young fit man in sports-wear, three Saudi women in full and total burqas with a translator in a camisole (WTF?), a woman with a toddler (advice to young mothers – don’t wear a dress that short if you have a child to bend over. Or, perhaps, wear less tatty knickers. Thank you), an old man in a wheelchair holding hands with an old woman in a wheelchair, a teenager with a PEG tube. All we had in common was the ability to throw money at our problems. So, Champagne Socialist guilt right there. (I’m stalling. Can you tell?).

Then, having established our financial bona fides, we proceeded out of that building and into the one next door, where the actual clinic was, and my, was it smart. It had a sofa. It had a telly. It had a chunky leaflet with a pretty pastel cover. It also had another couple already waiting, and good Lord but didn’t they glare at us when we were called through before them despite arriving afterwards (queue-barger’s guilt, because I’m British).

The Professor herself looks exactly and disconcertingly like a certain famous and much-loved actress, by the way.

She called us through into her surprisingly small office (into which colleagues apparently feel free to barge mid-consultation to ask for details-we-almost-certainly-should-not-have-been-hearing of the previous consultation, which seems… so very NHS, really), shook hands, and got out a fountain pen (ooh! Private clinic! Do you think she takes the NHS notes in biro?) and our folder. She went through the history we’d sent her again, double-checking some details, ignoring others. She went through what tests we’d already had done, and the results thereof. She totally accepted the two possible chemicals as real, and proceeded to talk about my five (five. Shittity shit shit) miscarriages. She was utterly uninterested in my charts beyond the fact they clearly indicated ovulation and a progesterone surge thereafter. She did not think my bizarrely low basal body temperature was any kind of issue at all. I asked her if the adenomyosis was a problem. She explained that extensive adenomyosis with scarring that circles the entire uterus is sometimes associated with very late miscarriages or premature labour because the scarring won’t stretch to accomodate the foetus, but an isolated patch of it is not a problem and does not interfere with implantation. So, you know, good. And she ordered a double-handful of blood-tests for me.

She also asked me about my weight. I’d checked that morning, so I said eleventy-million pounds (I may be exaggerating out of sheer embarrassment here, and no, I’m not in the mood to tell you how much I really weigh right now), and she did me the unexpected courtesy of taking my word for it rather than sending me off to be weighed again by a nurse (which always makes me feel like I’m being made to stand in front of the class for fibbing, and invariably pisses me the hell off).

And then, kindly, in a very British ‘let’s be sensible’ way (resemblance to Famous Actress if possible even more marked), pointed out to me that the weight and the insulin resistance needed to be dealt with before I tried to get pregnant again. I think she mentioned joining Weight Watchers or Slim Fasters or some-such and went on a little pep-talk digression about the useful psychology of joining such groups, while I stared at her in a manner that can only be described as wooden. All I could think was, ‘lady, I went to an all-girl’s boarding school. For me, the psychology of all-or-mostly female weight-obsessing groups is one of shame and humiliation. So no, not joining Weight-Fasters. So shut up about it. Shut up. Shut up. Shut up.’ And also, I thought ‘May, do not freak out now please. Hold it together, please’.

I tuned back in in time for the upshot. The Professor would like me to lose about 50 lbs altogether before trying again, but immediately said that probably wasn’t feasible, while I went fuchsia with humiliation and rage – what the hell did she mean, not feasible?

The thing is, I’d understood, or carelessly led myself to understand, or deluded myself into believing, (or, fuck it, been lied to by other medical professionals) that the hormonal imbalance caused by/causing (vicious circle) the weight problem was pretty much the hormonal imbalance that stopped me ovulating. So I’d assumed/been misled into thinking that if I was ovulating all on my own, unmedicated, fairly regularly, then my hormonal imbalance wasn’t severe enough to cause miscarriages. Possible Gestational Diabetes and a baby the size of a Blue Whale calf, yes, but recurrent miscarriage?

I had no time to really think about this, as we were now being handed all our paperwork for the various blood-tests to take to the nurse. On autopilot, I discussed a follow-up appointment – did I want to wait until I’d lost some weight (fuck, no) or come back in a month when all the test results would be back (hell, yeah)? We shook hands again, and she said something kind about us ‘getting there’ as we left.

We went silently back to the private clinics’ reception, where they keep the nurses. H was having a blood-test too, as part of a research study into recurrent miscarriage genetics. I’d cheerfully ticked the ‘happy to participate!’ box without checking with him, as I hadn’t realised they’d want his blood too, which made me feel like a prize rotter, but H was perfectly mellow and agreeable about both that and about being punctured, bless him, so the nurse took a little vial from him first, with a dainty little needle the size of a kitten-hair, and still managed to bruise him.

Then I sat in the special chair while she gathered together ten separate vials (H blenched at this point, ha ha) and found a needle the size of a ship’s cannon to stab me with (I didn’t bruise at all. Life is odd like that). I know I was being tested for AMH and for a thrombo-elastogram (the NHS doesn’t do that one), and for Factor V Leiden, (but hadn’t we done that one?), Antiphospholipid antibodies (is that the same as anticardiolipin? Or is there more to it than that?), Protein-C Resistance (I think), Prothrombin Gene Mutation, MTHFR, my own DNA vial to match H’s, is that all of it? Dammit to hell, I was too shell-shocked to make notes, again, and now we’re both annoyed that I didn’t. There were definitely ten vials, and that is not ten tests. And I know there were some she didn’t order because she had the NHS results before her. Curses curses curses. I hate me when I go all limp and biddable like that.

And then we went and tormented the credit card in the billing department, to pay for all these sodding tests I can’t even remember, and walked back out into the London traffic, me considering where, exactly, I might find a nice quiet out-of-the-way cliff to chuck myself off.

Enter Long Dark Night of the Soul, on the subject of my baby-killing lardy arse, and just how much I loathe and despise myself about that now (exceedingly, thank you for guessing).

Before anyone leaps up to trash the good Professor, she never said anything at all about this being my fault, or that I was to blame for my weight, and she absolutely and repeatedly acknowledged that it was very hard for me to lose said weight etc. etc. And she is thoroughly exploring other possibilities, isn’t she? So this isn’t about her being an anti-fatty.

But we are still benched, at least for this month, and then after the follow-up appointment, until she decides I am slim enough, I suppose, unless I wish to rebel madly and risk dumping another few embryos down the crapper.

I tell myself a forcible benching is a good thing. I’d never have the strength of mind to bench myself, and I clearly, clearly, need to back off and concentrate on my health and the inside of my increasingly untidy head for a while. Even if I am 35 and running out of time for all this, especially given how slowly I lose weight. Damn, I’ve just bitten one nail to the bloody quick.

I am scared to face just how freaked out and miserable I am about the whole fat=miscarriage thing. I am, in fact, so scared and freaked out I actually did something productive. I promptly got out a low-carb diet book that my MIL had given to me a couple of years ago (which annoyed me at the time. Actually, it still does annoy me. I do not take advice on this matter. End of. Except, it appears, from stringent diet books that annoy me (whoa, that is fucked up)) and… started to diet. I haven’t even fantasised about cake or ice-cream (beyond a mandatory ‘shut up about the ice-cream’ when H mentioned we had some left. I don’t care. I’m not touching it). As far as I am concerned, food is now the enemy again. I have been fraternising with said enemy, trying to make peace with it and not make myself utterly fucking miserable over it, and it has turned round and shot me in the ever-expanding arse.

By sticking to the book like a religious maniac, hopefully I won’t become bulimic (but see my adolescence, 15 through 19, for the been-there-done-that (yes I was thin, no I wasn’t in the least bit happy) reasons why this is an ugly possibility). Also, hopefully, I am old enough and wise enough not to go into full-on May Must Suffer mode and start behaving like a giant dill around food, driving the entire family nuts in one easy dance-move.

I am in a rather foul mental place right now, so you’ll have to hope for me.

By all means share your own dieting experiences, dear and lovely readers, and what worked or did not work for you, and whether the New Convert Cake Hating actually lasts or not, and so on.

Just, and this is really important for the sake of my mental health (wobbly, brittle, probably out of warranty) don’t tell me what I should be doing or eating. Just, don’t. I have Issues and I will react by Ignoring you for weeks if not months. Just as no one should tell an infertile woman to ‘just relax’! or ‘just adopt!’ or ‘eat pineapple, my cousin did and now she has quads!’, so please could no one tell me to ‘eat [whatever]’ or ‘see a dietician!’ or ‘join a power-yoga class!’ etc.. I decide what I eat. I do not do group exercise. Is final.

To be really ranty-angry for a couple of paragraphs, the thing is, I react badly to advice on this, because the person giving it has always been either some smug cow who’s never had an eating disorder in her smug life, or was projecting her own eating disorders onto me as a form of cheap self-therapy, and both scenarios sucked.

And chiefly, I have just asked people not to give me diet-and-exercise advice, so doing so at this point would be grossly rude, at best, and I don’t like rude people much.

If I sound massively defensive, it is because I am massively defensive. I have masses to defend, after all, not least the whole ‘I was a teenage Binge-Starve 100lb pin-up’ thing. And the fat=miscarriages thing. And the inner voice yelling ‘it’s your own stupid fault, you don’t even deserve a child, you fat bitch’ thing. And the whole talking myself into thinking the weight wasn’t such an issue as long as I was ovulating thing. So, yeah, tell me how to diet, tell me how I killed my babies and what I should’ve been doing instead, tell me to my face I am stupid and how infinitely superior you are in your superior dietary wisdom. Watch me react really maturely to that.

Watch me react really maturely to the whole bloody issue right here right now, in fact.

Did I mention I was in a foul place mentally? Fuck it, pass the celery. I don’t really like it, so it should suit me beautifully right now.

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