Advance token to the nearest railroad

I am very tired. And I cut my tongue on my brand-new integral tooth razor (fucking pomegranates) while licking peanut-butter off a teaspoon. And my knee hurts. I want a hot-water-bottle. But H says some of you guys have been asking about the Assisted Conception Unit Appointment of Whatever The Heck Do I Do Now, and that I should stop lying in the middle of the living-room floor like a dropped fried-egg and tell you about it. Because it’s good manners, that’s why.

H is very lucky I didn’t get him in a head-lock and make him write this post.

Yesterday was all a little hectic. H and I had been out getting smashed (literally, sodding teeth) the night before. I was going out again that evening, and a friend was staying the night, and the flat looked, as ever, like an explosion in the back room of an Oxfam shop, so I had put on my Big Girl Panties (they have polka-dots on) and scrubbed and tidied and made beds, then rushed out to meet H at the Hospital Out In The Country, and then rushed back to finish cleaning the bathroom and removing at least one of the wobbling turrets of crap, miscellaneous, burying the kitchen table, and then rushed out again, to meet my friend at the theatre, and this involved a delayed train and a twenty-minute shit-shit-shit gallop through a thoroughly scruffy part of town. Oh, it’s OK, I was On Time and had a perfectly nice evening, thank you. Just… flustered.

Anyway. Rewind, to H and I sitting in the waiting room that the Fertility clinic shares with the earwax clinic, worrying that when the nurse came and called for Jane Bloggs and no-one answered, she was actually wildly mispronouncing May Nutsinmay and now we’d missed my appointment. Usual mix of the very elderly and deaf all talking over each other, one beautiful but snot-covered toddler, and quiet sad-eyed couples staring at the floor. I used the 40 minute wait to make copious notes, and underline key words, like ‘scan’ and ‘hormones’ and ‘cyst’, until I was dragged off to be weighed.

Miss Consultant was there in person this time, with a side-order of terribly polite minion who had to sit on a plastic chair behind her and who nodded and went ‘hrrm’ at everything any of us said. Did we mind the minion being present? Not in the least. How are minions to learn to be consultants themselves if they don’t get to watch consultants consulting? And my God, Miss Consultant was on form yesterday. She tore through my notes like the Arrow of Apollo.

  • Haven’t been pregnant since April (probably), but haven’t been trying for several of those months because we were dancing attendance on The Professor at her world-famous recurrent miscarriage clinic. Check.
  • The Professor recommended aspirin therapy, and possible heparin therapy, depending on repeat blood tests when (if. WHEN) I get pregnant again. Check.
  • Last cycle was 74 days long and drove us all nuts. Check.
  • Weird outbreak of pain and bleeding three weeks before ovulation – was it a cyst? I say this firmly. Check.
  • Miss Consultant notes that I have lost weight, and only have a few pounds to go before I reach Official NHS IVF Guidelines weight. I try not to smirk (I am lighter than I have been in years). Check.
  • Miss Consultant announces that I need a scan, just to make sure I’m not growing another teratoma (a dermoid cyst, or teratoma, is exactly what ripped Kumquat the nearly-non-existant left ovary to shreds when I was a teenager, and also screwed with my cycles but completely from the age of 13 through 18). I don’t know why Miss Consultant mentioned teratomas (is it normal to develop two, 18 years apart? Surely you’re born with the fuckers?), and feel panicky-sick on the instant, but at least I am getting a scan at some point, and we can look for piranhas and count Satsuma’s pearls for her. Check, triumphant, because I was prepared to tie myself to her desk with a cable-tie and refuse to go unless I got one.
  • Miss Consultant then also announces that I should really get some day 3 blood-work done, estrogen, prolactin, and FSH. She fills in a form and hands it to me, with instructions to attend the phlebotomy clinic on my next day 3. I am too busy thinking ‘prolactin? What the fuck?’ to remember that day 3 is one of my ‘I am lying on the bathroom floor and no I am not getting up’ days. This should be fun. It is also not quite a monitored cycle, but it’s much more than I was expecting (I was expecting ‘please go away and hump your husband’), so Check.
  • And H hasn’t had a semen analysis since 2007, so he was promptly handed a little pot and a form of his own, to fill and complete and return to the clinic at his convenience. I’m not sure what they’ll look for. I’ve been pregnant quite often, really, so I think we can be sure the quantity and motility are both A-OK. Perhaps they’ll be looking for little Viking helmets worn backwards and tankards of mead.
  • And before we left we had a follow-up appointment made. I have the appointment card in my hot little hand. No stupid letters going astray now hahaha! (Check).

So, brisk as it all was, I think I emerged victorious. The NHS has not washed its hands of me, and my concerns about Satsuma’s recent vagaries were not dismissed. Yay!

And, did you see that? A day 3 FSH test? I have been at this infertility lark for over five years and that will be the first, the very very first FHS test I have ever had done on the correct day. I’m serious. I’ve had two done entirely at random, one in the luteal phase FFS, which told us all precisely nada about anything. (Incidentally, given that my AMH is stellar, or was back in July, does this mean FSH will automatically be cooperative, or can it go doolally-tap without affecting AMH or vice-versa?).

The prolactin I have googled, and comes under ‘wise precaution’. The estrogen will interest me greatly, given the excessive estrogenic activity of my lady-parts when stuck in ovulatory wheel-spin.

Oh, and Miss Consultant suggested, if Satsuma can’t get her act together again, ovarian drilling (60% success rate (did you hear that, you ridiculous gonad? Drilling. You have been told)), and if that doesn’t work, IVF. Oh. So we’re IVF candidates again. I can only assume because Miss Consultant respects The Professor’s opinion as to the cause of my miscarriages, and therefore with that being ‘fixable’, and me being thinner, we’re no longer unacceptable wastes of time and money insofar as that is concerned. I feel rather steam-rollered.

But, some areas of Britain have stopped doing IVF altogether on the NHS, what with funding cuts (what do we want our taxes spent on? Baldness cures or babies?), so by the time we go back for our follow-up appointment with blood-test results and scans and SA results, no doubt the ACU will have been burnt to the ground and its ashes scattered on the Thames. And yet, the National Insititute of Clinical Excellence recommends every couple should have two free IVF cycles. *throws up hands*

And, yes, I did ask what I should do about these day 3 tests if months and months go past without a day 3 (and not for cute reasons neither). Miss Consultant shrugged. ‘Wait,’ she said. As if I’d been doing anything but for the past five arsing bastard years.


17 responses to “Advance token to the nearest railroad

  • twangy

    Mee! I’m first! Unless someone beats me to it. Alacrity! On with it.

    Sorry about the gnasher. Mine did that too, it was upsetting, like one of those dreams where your teeth are loose, only real. Not nice. It should blunten down after a bit. Else, dentist.

    That description of your place is so funneeeeeeee! Ha!

    Do you know I think that appointment was good? Wasn’t it? With the efficiency? And the assertiveness and the way Ms Consultant did her job?

    Yes. Good. Will it be okay to get test with the painkillers in the bloodstream? I suppose so.. I hope the clinic is not too far? Taxi?

    I’m out. Was I first?

  • manapan

    I had the same thing happen to my bottom front tooth a few months ago. It’s just recently gotten to the point where I can run my tongue over it without drawing blood. It will get better over time, or maybe you could see a dentist about having the chip sealed over with filling composite?

    I’m so glad your appointment went well. It is Your Turn, damn it.

  • wombattwo

    Let’s hope the threat of being poked with a dildo-cam, and being skewered with a drill forces Satsuma into submission. She must realise (do ovaries have brains and thought processes??) she won’t enjoy it…
    Glad they didn’t wash their hands of you.

  • Solnushka

    Ah.Good.I was worried that silence meant disaster.

    Good Miss C is taking it seriously and that things are in hand to scare Satsuma silly should she not co-operate and that they aren’t just sitting back and insisting you get on with it. Good also, that some of the admin stupidity should be avoided with actual appointments and such all set up.

    I’m sorry it’s still not a quick fix though. As for the day three tests, well, that’s where the threat of drilling comes into it, I’d hope. Drilling, Satsuma, drilling.

  • a

    Wow. That sounds like an actual reasonable appointment. With plans and follow-ups. Maybe there is some merit to socialized medicine after all. 🙂

    Sorry about the sharp tooth attack…

  • katie

    If the prolactin comes back high, don’t fret, just have it re-done (it doesn’t need to be day 3) – mine was high because of needle stress, which is very common.

  • Womb For Improvement

    Am I right in thinking you have a tame GP who will give you provera if required? So hopefully not too much waiting (except for cute reasons) for tests.

    Good luck.

  • thalia

    Yes if AMH is ok FSH should also be. More likely scenario is when only FSH has been measured and it’s ok, AMH may well not be. So I would not worry about that.

    It does sound like the appt went well. Well done. The only thing that bugged me was that last bit. Why can’t she give you some prophylactic provera in case you get stuck in another 74 day cycle? why should you just wait, as you say?

  • g

    Dude, I totally know you don’t want unsolicited traineee OB foreign assvice but for the love of all that is holy do NOT drill a single ovary.

    1. variable and temporary sucess.
    2. you destroy ovarian tissue and you only have one ovary to begin with.
    3. risk of adhesions.
    4. there’s this drug called FSH that would be better. Drilling is outdated.

    The NHS drive me a bit bonkers sometimes.

    Love and continued cheering for camp May acreoss the big pond,


  • g

    As usual, typing before proofreading, feel free to correct the order of vowels in ‘foriegn’ and all my other stuff ups,


    PS. You AMH is cycle day independant and a more reliable number than FSH w regards to ovarian reserve. Also if your oestrogen is high that messes with your FSH anyway. Prolactin, thyroid function and a bunch of other boring stuff is pretty standard ruling-out type stuff.

  • g

    double addit. There was nothing wrong with the ‘foreign’., was there? 🙂

    Never have been that good at knowing the iandeandc stuff and where it doesn’t apply.


  • Melissia

    I have to second g’s advice about avoiding the drilling. You will lose tissue and thus eggs, which you cannot afford to do, having only one ovary. 0varian drilling is rarely done in the US for treatment of PCOS as other treatments preserve ovarian function better without damaging the ovary or the potential of the any future eggs.

  • Betty M

    No idea of merits or otherwise of drilling except that a) it sounds scary and painful and b) I can’t think of anyone who has had it. Glad appt went well though.

  • L.

    Totally not qualified to put in an opinion on any of the details, but it does sound like you had quite a reasonable appointment and I’m really looking forward to hearing what your testing shows. Hoping very much you get some answers and guidance. As for IVF, what a shame–but that’s down the road, so on the other hand I suppose there’s no use worrying about it until you’re there–easy to say, I know. I’m hoping citizen backlash will convince the NHS to reduce restrictions on IF and other maternity services, like the NICU cuts HFF has blogged about–being American I don’t know how realistic those hopes are…

  • Bumbling

    So glad they are taking you seriously.

    Particularly glad they are going to check out possibility of another teratoma – just in case. It’s not common. But it does happen.

    I had one at the age of 8 that ripped away one ovary. And other at 25, which would have done the same if I didn’t pester my GP that something, *something* wasn’t quite right. They were able to save the other ovary with minimal impact, as you will have noticed from Moo’s chuckles the other week. So please make sure that scan happens!!

  • There’s a point to all this, right? « Nuts in May

    […] Perhaps you’ll remember that the purpose of the scan was to look for piranhas (or cysts, or te…. Naturally I asked her if she could see any. She smiled sweetly and said she’d put it all in her report for Miss Consultant (I am seeing Miss Consultant again at the beginning of February). […]

  • Driven to my knees « Nuts in May

    […] as it was day 4, but the clinic’s shut at weekends) bloodwork (estrogen, FSH, prolactin). Miss Consultant had ordered this all back in November, and I never got it done because I became pregnant that very cycle (I ovulated about a week after […]

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