So what the futility happened?

The WTF appointment with Dr George was over three weeks ago now, since when I have been Refusing To Think About It. You’ll have to excuse me. I had a lot of ‘Holy fuck I nearly died’ to process, which created massive interference with the ‘Shit shit shit shit SHIT I miscarried 6AA’ data stream. Basically, my hard-drive needed serious de-fragging. I think I cobbled together a parallel-processor out of tinfoil and spit – it may burst into flames mid-post – so onwards! Let me see what I can dredge out of the dark backward and abysm of time.

(From semi-educated computer jokes to Shakespeare in one sentence. I rule).

We had emailed Dr George pre-visit, so as not to waste the entire appointment in a ‘previously, on House‘ montage. The first thing he said was ‘I see you’ve been in the wars!’ with a welcoming grin, which instantly dissolved into gloom and he added, solemnly, that actually what we’d been through was horrific, and he was truly sorry. He’s normally a cheerful upbeat sort of chap. I see I defeated him. I felt a complicated cross between vindicated and miserable about that. It’s nice to be taken seriously but not very reassuring to be The One That Makes Doctors Gloomy.

To address the DVT and dramatic pulmonary embolism problem, Dr George agreed that whatever my test results up until now showed (i.e. absolutely bloody nothing that could predispose one to thrombophilia) (apart from a tendency to sodding well clot anyway, so bloody there), I clearly had a severe, pregnancy-related thrombophilia problem. He wanted to wait and see what the Haematologist had to say about it before we did anything else, in case I needed more aggressive treatment than prophylactic doses of Clexane, for my own safety. And in any case, I needed time to recover and make sure there was no lasting heart or lung damage (jolly conversation, this). On the other hand, the Clexane should have been enough to protect 6AA, especially as my troubles began when I stopped taking the Clexane. Which, incidentally, will never ever never happen again – me suddenly stopping anti-coagulants after the end of a pregnancy. Hell no. Dr George was quite firm about that. The thing is, the lack of diagnosed serious causes of thrombophilia had lead everyone, everyone, to believe the clotting was only a threat to my teeny-tiny embryos, and not in the least to me. Hahahahahahah.

And then we turned to the sad demise of 6AA. Who had a perfect set of matched chromosomes, and no business failing to develop at all. Dr George declared that waiting to day 5 and having CGH performed on the survivors had been the right thing to do. To recap, back in July:

• Thirteen eggs were retrieved during, uh, retrieval. Dr George was pleased about this. It promises well for future IVF, apparently.
• Nine of those eggs fertilised on being placed in the company of H’s sperm – this is also good, given my age.
• On day three, we had six embryos that looked worth culturing to day five. So we cultured them to day five.
• On day five, we had four embryos left to biopsy, one excellent-looking, one reasonable, one a little slow, and one shabby little creature they could only get one cell from to test.
• Twenty-four hours later, we had the results. Normal 46-chromosomes-in-pairs 6AA and 6BA, one wildly abnormal one (still alive, still growing strongly) which had three trisomies and a monosomy, and the shabby little creature couldn’t yield a result and anyway had conked out overnight. So we transferred 6AA and froze 6BA.
• Consider, if we’d done a day three transfer as per standard, we’d’ve had a one in three chance of transferring a normal embryo, a one in two chance of transferring a non-implanting dud (and a possible chemical pregnancy, if it’s true embryos do slightly better inside one, as shabby little creature was hatching and looking to implant), and a one in six chance of transferring a badly damaged future miscarriage (best scenario) or stillbirth (horrific worst scenario).
• Nevertheless, 6AA died anyway.

So why did I miscarry, given the Clexane for clotting and inflammation, the Metformin for wonky blood-sugar, the Prednisolone for my psycho immune system, the Intralipids ditto, the Progesterone pessaries to keep my uterus from shedding? What had prevented a normal embryo from developing normally?

It is possible the clotting issue was the problem, and prevented 6AA from creating a decent placenta. A human embryo spends its first week or so, once it has implanted, house-building rather than developing itself, so the gestational sac and yolk sac grow first, to nourish the embryo while it works on tapping maternal resources via a tiny little proto-placenta, and then and only then gets to work on itself. If placental development had been botched by micro-clots in my uterine capillaries, 6AA would’ve stalled. And in fact, we had a lovely gestational sac and yolk sac and no bloody visible foetal pole.

It is possible my psycho immune system was not sufficiently suppressed after all (I seem to be Queen of borderline or inconclusive test-results and nevertheless violent symptoms) and there were enough NK cells roaming my uterus to attack 6AA’s placental intrusions, with results as above. There’s a further test (expensive, natch) they can do, testing my NK cells against various combinations of Prednisolone, Intralipids and IVIG, to see which mix suppresses the NK cells best, and then use that. We are thinking about that.

A very very unlikely possibility (and Dr George was adamant this was unlikely) was that I simply wasn’t absorbing the progesterone from the pessaries very well. You apparently can’t really test for this as blood levels of progesterone don’t match the uterine levels of progesterone, as the stuff in the pessaries is absorbed by the uterine area primarily. Or should be. My uterus is abnormal, however, what with the adenomyosis. ‘Next time,’ said Dr George, ‘we could use progesterone-in-oil injections instead, just to be sure. They’re a bit of a pain, though.’

And it is possible, if apparently also very unlikely (H and I have both been karyotyped and genetic issues do not seem to run in our typically-non-miscarrying families) 6AA, despite the 46 chromosomes and healthy go-getting attitude, was genetically non-viable on a more subtle level. I don’t know. Nobody knows. There was nothing to test.

We then discussed trying again. Should we ‘bank’ 6BA, our frosticle, and do another fresh cycle to gather up a couple more healthy embryos before I get all perimenopausal? Or transfer the frosticle first and bother with more IVF only if ‘necessary’? H has been rather pro the first option, not least because he always wanted two children, and therefore having a few spare healthy embryos in store and ‘only’ 38 years old, for when I am, oh, 41 say and ‘ready for seconds’, would be sensible. I had been all ‘two kids would be splendid’ up until a couple of years ago, whereupon a combination of ‘I’m too old for this shit’ and ‘I’m too ill for this shit’ and ‘I can’t go through all this that many more times’ put me squarely in ‘one. One would be perfect. One would be a fucking miracle‘ camp. With the proviso that Lord knows how I’d feel about it once I had the Precious One, because I am not stupid.

Dr George was of the opinion that given my clotting issues, we’d want to avoid the oestrogen stimulation of fresh IVF cycles if it wasn’t necessary. He would transfer 6BA first, and then rethink if that ‘doesn’t work out’. This does rather mean H too would have to become more reconciled with the idea of an only child, because if the FET did work, it’d be maybe two years before we’d be up for another IVF, and I’d be 41 and mouldier. Even though the women in my family have late late menopauses and both grandmothers had naturally conceived healthy children in their forties. And would I want to take Cute Ute the Despoiler back into cycling? With a very small child to care for? Remember I call her The Despoiler for more reasons than the recurrent miscarriages.

Anyway, if I am behind any plan, I am behind the FET plan, and see how I feel about a fresh IVF after that. But I am very skeeved about trying again.

Plan, such as it is: Wait and see what Haematologist says. Contingent on her opinion, consider further NK cell testing. Do a FET using recommended anti-coagulants, immuno-suppressants as revealed by test, and progesterone-in-oil rather than pessaries. And see what happens.

To which plans I would only say, why the fuck is everyone being so gung-ho about this? What about me? What about all those miscarriages, including one of a sodding perfect embryo? Why are you all so keen to do this to me again? The hell is wrong with you all, you heartless arseholes?

I’m going back to my bat-cave, and walling myself in.

Over

And it was gone. The sweet, kindly new-to-us sonographer, who had bothered to read my notes before she came and fetched us, and who said she was so sorry for our loss, looked and looked, from many many angles, some very nearly anatomically impossible, but, there lay Cute Ute, empty, with a thin lining, shut tight, deserted.

Our perfect embryo had folded its tent and stolen away.

I thought back to the enormous clot I had passed in the Riverside Clinic toilets last Thursday, that I hastily poked through and saw nothing gestational in. I thought back to the several smaller clots I passed later that day when we had got home again. I thought how surprised I’d been that none of them had been accompanied by more than a mild cramp and a slight stabbing sensation in my cervix, and how therefore I’d assumed I couldn’t possibly have passed the embryo. I have, in the past, suffered a great deal more for a far smaller… object. I thought about how I simply hadn’t felt pregnant since Thursday. I thought about how badly I wanted a coffee, and later tonight, a large alcoholic drink. I gripped H’s hand very tight.

The sonographer found a nurse to talk to us about next steps. We all agreed it was a complete miscarriage, and while I may well carry on spotting and having light bleeds for another few weeks, there should be no more severe pain or heavy bleeding. I felt, guiltily, huge relief that the ‘worst’ was over, had intact slunk past us without our really noticing. I can stop all medication. We can schedule our What The Fuck appointment with Dr George. I came away with a prescription for smaller and smaller doses of Prednisolone, so I can spend the next fortnight or so weaning myself off it.

Gentle Readers, thank you. Thank you all for being there, for reading, for commenting, for popping out of the woodwork to comment for this special and horrible occasion. You mean a lot to me.

Beloved 6AA, beloved proto-child, what the hell did we do wrong?

The bad thing that happened

Me, lying on the table with my knees up and the dildocam stuck up my precious. H sitting by my head, his hand on my shoulder. We are both looking at the screen of the ultrasound machine, and ÜberScanningLady is adjusting the focus. There! There! See it? A gestational sac! It looks exactly like a gestational sac! ÜberScanningLady wiggles the dildocam about and scrolls slowly past the sac. And back again. And refocuses, and bashes me about the cervix again. There’s an appalling silence. I clutch H’s fingers. Why can’t we see a foetal pole and a heartbeat? There’s just a sort of… blob.

‘I can’t get a good view,’ says ÜberScanningLady eventually. ‘The texture of your uterus makes it difficult. I can see a yolk sac, here, but I can’t see a foetal pole. There might be one, here, but the view is really not clear.’

She waggles the dildocam about inside me, and scrolls the focus back and forth along the gestational sac a few more times. ‘This is where you were bleeding from,’ she adds, pointing out a small black lacuna in my uterus, just below the gestational sac. ‘It looks like a bit of the lining disintegrated. It’s not necessarily a problem, I’ve seen it in lots of successful pregnancies. I’m just worried that I can’t see a foetal pole… I’ll print some pictures out and get a doctor to come and talk with you, OK?’

At this point I gasp ‘I’m wet! I feel wet!’ She lifts the paper sheet up and peeks at my crotch ‘Oh my dear, you’re bleeding!’

Idiotically, the first thing that pops into my head is ‘Thank Christ for that, I thought I’d pissed myself.’ I barely manage to not say it aloud, and hours later remember it’s a quote from TV comedy Rab C. Nesbitt, when Mary Nesbitt bursts her stitches after surgery.

ÜberScanningLady helps me mop up. Cussed paranoia made me put several pads in my bag that morning, and H fishes out the fattest of them for me. ÜberScanningLady takes us to a tiny consultation room, one I’ve had several blood tests in, and rushes off to find a doctor for us. Dr George is not available, but after only a few minutes a woman I’d not met before knocks on the door and comes in to talk to us, with that rather tight, serious, professionally sympathetic smile that bodes no good to man or beast.

I find I’ve almost completely lost my voice, and can only talk in a tiny little murmur. H has to repeat practically everything I say for me. I don’t say much.

The upshot is, it really does not look good. We hadn’t thought it did. But because Cute Ute is such a bloated monstrosity, and therefore hard to scan through, there’s a chance, a very small chance, the doctor does not want us to get our hopes up, that ‘things might have developed’ by next week. I feel very sceptical. And very, very tired. And I hate my uterus more than I thought it possible to hate one’s own organs. We are booked in for another scan on Wednesday, to make sure. Meanwhile, we go home, and, get this carry on taking the Prednisolone, the Metformin, the Clexane, and the progesterone. Just in case. Though she repeats, solemnly, that we shouldn’t get our hopes up. We decide not to do the Intralipid infusion booked for this afternoon. There’ll be time enough to do it next week, if ‘things have developed’, and the doctor tells us, tactfully, it’s best not to waste money just now. She reminds us not to get our hopes up for the fifth or sixth time.

All this time, I’ve been carrying a cold cup of peppermint tea about with me, because we were early and I thought I’d have time to finish it before the scan.

As we’re on our way out, I go to the loo. This next bit is disgusting. As I sit there, I feel something slithering out of me, and, in a sudden panic, I catch it in my bare hand. The idea of my embryo falling into the toilet seems unbearable. I am holding a blood clot about the size of my palm. I stare at it in horror, thinking ‘but, it didn’t hurt!’. After what feels like an age, I wrap it in paper towels, wash my hands, and stick my head round the door to let H know what has happened and perhaps if the doctor is still about… He rushes off and finds her. I speak to her briefly through the half-open toilet door, and she thinks this changes nothing, in fact could mean nothing, and we should stick to the original plan. She seems embarrassed and flustered, which irritates me beyond measure. It’s not as if I’ve tried to show her the blood clot.

I examine it myself, and can’t find anything that looks like a gestational sac. That and the lack of pain leads me to conclude, eventually, that it is just blood, but I am very concerned at how much it clotted in the half hour between my suddenly gushing blood during the ultrasound and my visit to the loo. I put it in the sanitary bin and wash my hands again, very thoroughly.

We go home.

*Gloom that no quantity of ornamental fans can bat away*

Since then, the bleeding slowed over the course of Thursday, became a thin dark steady drip on Friday, and is as I write, heavy brown spotting. I have had very little cramping, most of which seems to be related to a full bladder or bowel rather than genuine uterine or cervical distress. On the other hand, I don’t feel particularly pregnant anymore.

I do, however, feel like a total delusional idiot, shoving progesterone pessaries up my arse while blood trickles out of my vagina. And I resent the Clexane jabs with the power of a thousand burning suns. But the doctor said to, so on we go.

I emailed my boss, and I am off work for at least a couple of weeks, while this idiotic drama resolves itself.

I called my mother, who said mostly the right things, though I wish she’d shut up about homeopathy and acupuncture and herbs and special diets and craniosacral realignments and gestational surrogates. She insisted on being hopeful in an ‘at least you got pregnant!’ way until I reminded her I’m really quite good at getting pregnant. Heigh ho. She also said she was sorry and acknowledged this was very hard on me. She concluded by remembering H would be horribly sad too, and sending him all her love, which restored my faith in mothers somewhat. H still hasn’t told his own parents, and is dreading it, poor sod.

I don’t feel hopeful, and don’t know how to deal with people being hopeful at me. It’s as much as I can do to keep taking the sodding medications. Gentle Readers, it did not look good. I’ve googled enough 6-7 week embryo ultrasound images to know that that did not look good. Fuck Cute Ute anyway, for making everything as drawn-out, complicated, messy and difficult as possible.

Scared? How about reasons to be scared? (Limbo. Limbo is happening)

Do you know what seeing blood in your underwear is like when you’re pregnant? It’s like being hit between the eyes with half a brick.

I was at work. I’d just finished a desk-shift, and beyond feeling a bit heart-burny and sick, also very tired (i.e. exactly as usual), nothing was bothering me. I went to the loo, as you do. I looked down at the crotch of my bright pink knickers. What was that mark? What was that mark? I wiped myself, and the paper came away smeared bright red. I stood up and looked in the bowl, and the water was stained with red swirls.

I sat down again, and briefly considered blacking out. But this was a cubicle in a public toilet regularly patronised by the sort of student who pees on the seat, and, well, no. No.

I sat there for minutes, trying desperately to work out what to do, while my heart rate very unhelpfully accelerated from ‘sitting on the loo’ to ‘run from tigers run run run run TIGERS‘. Eventually I managed to wrench my fevered brain into some sort of order and decided to go back to my desk, email my boss to let her know what was going on, and walk slowly and calmly up the road to the very-near-by enormous hospital, where I knew they had an EPU, on account of having checked all these things weeks ago in Paranoid All-Contingency Planning Mode. Paranoia doesn’t mean They aren’t out to get you, haha.

And that is what I did. With a wad of toilet-paper in my knickers. For the dignity.

To my almighty fucking rage, my mobile phone had absolutely no signal in the area (how does a network that boasts of being the biggest in Britain not have coverage at the centre of the major city? And it’s been like this for weeks. I am so annoyed, and now it’s personal). And H, poor lamb, had gone off at dawn for a day of meetings at the regional office a good couple of hours away. Ach, I thought, even if I do get hold of him, he won’t be able to hold my hand. I’ll go to the hospital, and keep trying H, and if it’s serious I’m sure I can get them to call him.

The EPU (Early Pregnancy Unit, that is) at Enormous Hospital doesn’t take self-referrals, so I knew I had to go to A&E (ER to you) first and get them to refer me (see? See? I’d checked everything). A&E were in the middle of having half the walls knocked down, of course, and being very busy, but the receptionists were calm and kind. I had a 30 minute wait for triage, surrounded by little old ladies who had fallen over, two other bleeding-in-early-pregnancy cases (we resolutely avoided each-others’ eyes), the standard local eccentric covered in blood and bruises, a toddler with concussion, people in slings, people having picnics, people having bitter spousal arguments in whispers, and one chap who fell theatrically to the ground while shrieking ‘I’m dying!’ down the phone to his mother (turned out to actually be called ‘I skipped breakfast and felt faint’).

I tried slow, deep breathing, but it did not work. The triage nurse was all ready to send me over to the EPU for a scan, but of course he had to check my blood-pressure and pulse. And my blood-pressure and pulse were still both at ‘run from the motherfucking tigers!’ levels. That’s just how I react to a threatened miscarriage. When I was losing Pikaia the triage nurse actually hauled me off for an ECG, my heart was hammering so. I told the nurse I usually had perfectly normal blood pressure and heart-rate, and this was just how I panic, but he shook his head and said the EPU wouldn’t take patients who weren’t ‘stable’ in the cardiovascular sense. And a resting pulse of 122 was not ‘stable’. So he was going to take me through to A&E and get a doctor to have a look at me.

Did I mention they were in the middle of renovations? There were no available cubicles at all. I and some few fellow patients were all popped on a row of chairs in a corridor right next to three men smashing a new doorway into the next corridor. This was not relaxing.

I don’t object to the long waits. It was a busy urban A&E, and there were people having heart attacks and car accidents and head injuries and seizures to deal with. The staff I did see were kind, and did take a mo to let me know they hadn’t forgotten me every now and then. The noise was appalling. The having to talk to nurses about urine samples (mine was full of blood, because I was actually still bleeding vaginally) and, err, vaginal bleeding, in a noisy corridor, next to a grumpy man in a hoodie with filthy feet and fingernails was not ideal, but hey, the cubicles were full of power-drills and boxes of saline, and/or people with limbs hanging off, so we all just lumped it and pretended not to be listening to each other. They checked my blood pressure and pulse a couple more times, in which I calmed down to almost normal pressure but my silly heart kept thundering away at over 100 bpm no matter how carefully and slowly I breathed. The nurse who checked my urine agreed that I was a) pregnant and b) bleeding, patted my hand, and told me a doctor would talk to me soon. Soon meant after an hour and a half, which actually is not too bad for a busy A&E, but said wait entirely failed to bore my heart into submission.

The doctor, who had a charming Germanic accent and a cheerful manner, eventually examined me in a store-cupboard in which a bed and a screen had been hastily jammed. He took a history, blenched slightly at all the miscarriages, was mildly confused by the variety of drugs I am on, but acknowledged he knew nothing about IVF, was alarmed by the history of endometriosis and adenomyosis (‘that is not so fun, nicht wahr?’), and even more alarmed when he felt my belly and found that idiotic monstrous bloater Cute Ute was the size of a fifteen to twenty week pregnancy already oh for the love of Christ. ‘Adenomyosis,’ I said.

‘You,’ he answered, ‘have been attacked by all the devils at once.’ And he patted my hand quite thoroughly.

And by the time all this had happened, it was too late to refer me to the EPU, which closed mid-afternoon, regardless of the stability of my sodding heart. And that, Gentle Readers, really did piss me off. I am still pissed off. I didn’t act pissed off, because the doctor was clearly doing his best and thought the EPU were being dicks, both about their opening hours and their arse-covering policies, and because after all I was not lying on the floor weeping in a pool of blood, so I clearly was not an emergency. The doctor wrote me a referral for a scan tomorrow morning, either at Enormous Hospital, or at my Local Hospital of PTSD, and told me to go home and put my feet up, unless the bleeding got worse or I developed bad cramps, or felt faint or dizzy or got a fever.

He then asked if I – he paused, looking at my nerdy teeshirt and loose jeans and bright red sneakers – if I had a partner. I said yes, and he said, carefully, ‘And your partner wants the baby too?’.

‘Very much. We’ve been trying since we got married.’

‘Good, good. Get her err them, your partner, to look after you. You need lots of rest.’

Bless the man. Bless him to bits. I smiled and said I would. I quite like being politely taken for a lesbian, you know (that’s why I dress like I dress, I guess) (but if H were a girl, like hell I’d be doing the Being Pregnant part of the relationship, as I am clearly utterly shit at it. Oh, for a spare and healthy uterus in this marriage!).

And then I and my unstable cardiovascular system and leaky toilet-paper-wadded reproductive equipment waddled off to find a pay-phone and ask H to come home and look after me.

By the time I got home, the bleeding had stopped, and I am now doing brown spotting. I have not had any bad cramps (slight constant cramps being my modus operandi since I discovered I was pregnant) or any other alarming symptoms. But I spent the evening with my feet up anyway, and we got pizza.

Poor H. When he got home he was paper-white, cold to the touch all over, and absolutely clammy with sweat. I don’t suppose his cardiovascular system was entirely stable either.

I am going to call Riverside in a minute and ask their advice. Given that Scary Symptoms have stopped, I’d rather avoid PTSD Hospital and just go for my planned scan tomorrow, if everyone agrees it is safe and reasonable to do so. But I am not going to work today. Bother work.

Because I am tired (NBHHY)

Item – H and I spent Sunday on an outing with my dear Mama, eating an enormous lunch and having a charming walk and visiting an exhibition and filling head with Art. I also took the occasion (‘Darling, why didn’t you come abroad with us last month? We had a lovely time! H would have adored it!’ … ‘Well, errm, since you ask….’) to inform dear Mama of the fact her eldest daughter (c’est moi) was In An Interesting Condition, thanks to the Wonders of Science.

Item – Mum was marvellous about it. She was so pleased, but instantly made a massive effort to control herself and stated that she would try not to think about it all, because it was all so new and tenuous, and then stroked my hand, and asked a few questions about the IVF process and the chromosomal testing, swore herself promptly to secrecy until we give her the go-ahead to Spread Glad Tidings, and then we had a brief discussion about Morning Sickness We Have Known and how very much she hated certain vegetables during her last pregnancy, and then we went off and looked at the Art. And that was that.

Item – I was so tired when we got home I went to bed at 9:30pm.

Item – And then I got up for a wee at 3:30am and couldn’t get back to sleep. It’s one thing having 1st Trimester knackerment. It does not combine well with insomnia and my sodding bladder. I was a yawning dribbling pointless distracted lump at work today. My boss is being nice to me about it. Oh God.

Item – In today’s post, a bundle of letters and leaflets from the local maternity services, full of ante-natal appointments and screening dates and advice on giving up smoking. I promptly sat down on the stairs and cried. It’s all getting so very very unavoidably real even if something does go wrong. I am completely overwhelmed.

Item – Remind me to tell you about the local maternity services soon. They’re run from the same hospital that treated me (so very shabbily) when I lost Pikaia, and where I refused to go back to for any subsequent miscarriages. I am having anxiety dreams about going back there. Gah. Must stop talking about it now or I will never sleep again.

Item – My main issues with having put on nearly half-a-stone already less to do with ‘looking fat’ (I am fat), and more to do with a) being judged and scolded for gaining too much weight by medical practitioners, and b) looking obviously pregnant to people I have no intention or desire to discuss my gestational status with, now or indeed ever. And some of the people I am thinking of are extremely rude nosy and boundary-impaired twatweasels, and others are misogynistic creeps. So. Oh the joy of the large workplace, that has such a mix of people in it.

Item – Bed!

And now kindly wash your hands (NBHHY)

I am having not such a good day today. Yesterday was excellent, in that I felt quite quite hormonal, and found the commute home to be very much a trial to my overkeen sense of smell and evening nausea (that’s me. Not morning sickness, evening sickness). People of Britain! Washing is neither expensive nor bad for you! Kindly do it daily!

And then I slept badly and woke up slightly feverish, with a sore throat and tummy cramps. Oh, fucking hurrah. And not feeling pregnant at all.

So I went back to bed and pretended to be in a coma for a while.

The cramps were actually being caused by a slight gastro-intestinal disturbance – my bowel is not perfectly happy and is alternating between mild constipation followed by Day of Reckoning Also Several Visits To Privy, and then back to nada for a couple of days. Today was a Day of Reckoning, and I think Cute Ute was not enjoying the pressure, as it were. She is being quite domineering in there. Satsuma is also still achy and twingey and at great pains to let me know she took a giant needle for me. Over a dozen times. After having been inflated to a, oh, I don’t know, she says cantaloupe, but I think she’s milking it.

Having cheered, marginally, up about that, I then decided to weigh myself, because, Gentle Readers, I feel rather larger than I was. And I indeed am piling on weight at a rate of a couple of pounds a week since they popped the embryo back in dear God. I have not changed my diet. If anything I am snacking less because the metal-mouth makes chocolate very unappetising. Fucking hormones. Not that I mind putting weight on and growing serious tummy as such – I am pregnant, damn it – but it feels a bit weird to be gaining so fast and looking so very… tummy… already. I am six weeks. Surely nothing much should be happening, weight-wise, yet? My little passenger is the size of a raisin. Raisins do not weigh 6lbs. So there was that.

Remind me that I’m on Metformin, which has always made me gain half-a-stone or so because I’m weird, and I’m on progesterone, which makes everyone bloated and constipated, and I’m on steroids, and what did I think would happen on steroids?

Naturally, having crushed my indifferent breasts into my ribs repeatedly and having made myself eat mayonnaise to mere mild pleasure rather than unGodly retching, I peed on the remaining (cheap, insensitive (it told me I looked fat, the bastard)) pregnancy test. The test line came up thick and vivid before my pee had even soaked as far as the control line. Last week, the same brand took two minutes to provide a faint, if clear, line. So I am peeing out rather more HCG than I was last week, for what it’s worth. Which isn’t much, when you’re an Olympic-grade worrier like me.

There’s a whole week to go before the scan. I am going to go quite quite mad.

I have put myself back to bed with the ginger ale and a bucket of herbal tea and Agatha Christie. It seems the only thing to do under the circumstances (crapping hell, my throat is sore. A colleague was off sick yesterday after sneezing and coughing all over the place on Wednesday. Do I think…? Yes I do).

Terror. Terror is a thing (NBHHY)

Yesterday, I was paddling about on Twitter, seeing if anyone had said anything amusing lately, in a fairly serene and optimistic mood (I know. Optimism. Who’d’a thunk it?). And instead I saw the news of an eight-week scan gone tragically wrong – no heartbeat, no baby after all.

Yes. That can happen. It happened to me, once. Seeing that forlorn tweet was like falling through a trap-door. I was overwhelmed with sorrow for the woman who posted it, and empathy, and for a few minutes I could only think of her sadness and remember how bereft I had felt when Pikaia turned out to be blighted after all.

And then, of course, I panicked on my own behalf.

It’s over a week until my scan. I am five weeks and four days pregnant right now (by that slightly daft reckoning that assumes pregnancy a) begins on the first day of your period and b) your cycle is always exactly 28 days. This embryo was actually conceived three weeks and four days ago). If I had a scan now, it’d be inconclusive at best, as my embryo and his/her entire playpen are still too small to visualise as more than a tiny circle, a few millimetres across, the heart, even if it is there, too small to see beating. And I have no worrying symptoms at all. The cramps that bothered me last week have mostly naffed off, unless I walk a lot, and then they go away when I sit down and have a drink. I feel sick in the evenings. My breasts hurt. I get light-headed easily. I am not spotting at all. I, a life-long night-owl and midnight-oil-burner, am ready to clamber into bed at 10pm sharp. Nothing Bad Has Happened Yet.

And I am absolutely paralytic with anxiety.

The baby will not die because I rejoiced in its existence.

The baby will not live because I panicked and fretted and grieved over it.

I must keep telling myself that. And keep taking the medications. And wait.

I ramble (NBHHY)

I am so impressed with all your contributions on my last post, Gentle Readers. You are such lovely wise people, and I Big Puffy Heart you all. And so does H.

The thing about my In-Laws (a thing Robyn was very wise about in her splendid comment), is that they would make absolutely perfect grandparents. They would dote on the child, they would be loving and fun and no doubt would be daftly indulgent at times (which is all the more fun and a great bonding experience). And they are also reasonably sensible about such matters as a bazillion sweeties and being quiet when the grown ups are talking, darling, so I would, I do, feel quite sanguine about their involvement in the putative kid’s life. My own grandparents were either rather distant and preoccupied, or rather stern and uncuddly, or, ah, dead. Nevertheless, the stern grandmama was also the one I loved best, because for all her disciplinary ways, she loved us and invested a great deal of time and trouble in us, and for all she was a little scary, she was also safe as a cathedral. And there. I digress, but it’s important to me that the little sesame seed has other grown ups about who prove to him/her over and over that s/he is family. And loved. And worth time and attention. And H’s parents would give that in spades. So in the end, if I have to suck up a certain amount of non-apology and undealingness, I will suck it. Bitch wildly about it here, no doubt, but otherwise, suck it.

In aid of this mellowness, came a little gift from my MiL, along with a little note to tell me she was thinking of us.

My own beloved-but-impossible Mama, whereas, has earnt a great deal of kudos chez May because, after an appalling start near the beginning of our Great Pregnancy Quest as Sayer of Hurtful Dumbass Things In Chief, she made an effort to listen, understand, and empathise as best she could. And though she can still be tactless, she is trying not to be. The armfuls of cash she keeps trying to force on us for infertility treatment, for example – she cares, she has money, she throws money at problems until they go away. And I think she would relish simply being a loving granny – in my niece Minx’s case she has often had to be Sole Responsible Adult while practically babysitting Trouble as well as Minx, and Trouble’s arsehole ex into the bargain.

The Plan, such as it is, for The Tellening goes now as follows:

• The Scan is on the 15th. Ideally, we tell everyone after the Scan. We tell regardless of whether we get lovely news or tragic news, because everyone knows we are doing IVF this Summer.
• The hitch is that my mother has invited us to spend the day with her the weekend before the Scan. Therefore, we will almost certainly tell her then. And BEG her to keep schtum until after we tell the In-Laws. Tell no one! Not even the Aunts! They talk to In-Laws! However, it’ll only then be a few days until the Scan, and we will explain that a) H wants to tell his parents himself (this is not exactly true – he’s dreading it, but feels it is His Duty, and they will appreciate it) and b) we don’t want to worry them with uncertainty for so much as a second if we can help it after all the stress and bereavement they’ve been through in the past few years. Especially as FiL is a Great Blurter and there is H’s remaining frail champion worrywart grandmother to Not Worry.
• We will then tell my Dad, and let the Bush Telegraph deal with family outliers.
• You guys who read this blog know already.
• Other friends will be told as and when we see them. May be sooner rather than later as that wee fecker Cute Ute is so large thanks to the adenomyosis, I have already ‘popped’.
• I have several infertile friends on FuckBook, and also several acquaintances and distant family whose attitudes to these things I do not care for, therefore we are keeping this off FuckBook for as long as feasible, so as not to turn my newsfeed into a river of bitterness and humiliation. For me or them. Thank you.
• Work? Well. I’ll be completely outed by Tuesday if my boss doesn’t give over the shenanigans. I shall adopt a stoical expression also I shall practice saying ‘it’s not your business, but if it ever does become your business I’ll be sure to let you know.’ And pray I don’t vomit or pass out.

Symptoms!

Normal symptoms: Slight nausea, worse when hungry; sensitivity to smell; metal mouth, constant, irritating; tired, sleepy all the time; breasts becoming increasingly tender and itchy, now with added nipples; very, very, very tragically bloated about the middle, and retaining water like a cactus; speaking of cacti, about as prickly (had ridiculous meltdown this morning and cried because H had slightly misled me about whether he was going to be 30 seconds or 5 minutes fetching his iPhone. In retrospect, most of the meltdown was about people not being honest with me, so I think the telling white fiblets to family about timings etc. to buy ourselves wiggle room was a no-goer. I have issues about honesty. Great big stupid ones. This is what happens when an entire family spends generations lying to each other ‘for your own good’. BUT I DIGRESS).

Weird, or are they? symptoms: Despite sleepiness, insomnia and a tendency to wake at six am in a state of anxious gloom (we’re blaming Prednisolone and PTSD); As I mentioned above, Cute Ute, starting from the size of a ten week pregnancy as she was, has already popped above my pelvic bone and can not only be clearly felt by laying a hand just below my navel, but has already got together with the squishy bloat to make my jeans too tight and my figure look decidedly *pregnant* already; episodes of dizziness (surely five weeks is a bit bloody early for fainting fits?).

Meanwhile, H is having more and worse anxiety dreams than I am.

On further outing (nothing bad has happened yet)

A couple of days ago I was commuting to work, as one does. My route takes me through an extremely large and busy train station, and as I was trotting along the main concourse, I walked smack into my mother.

Which surprised me, as I thought she was still on holiday.

‘Oh, no, we got back last night,’ she said, kissing me. ‘We’re in town to do some shopping and speak to business people. How are you, my darling? You look well. Is there any news?’

With great presence of mind, as I am trained like one of Pavlov’s dogs to never lie to my mother (it’s a bit of an affliction, to be honest), I said: ‘We can have a proper chat later.’

‘Oh, that would be lovely! Lets have tea together! What time do you finish work tonight?’

Christ.

So I spent half the day panicking about How To Tell My Mother. In the event, panic wasted, as her business meetings overran by hours, and we agreed tea was to be postponed to another day. Of course, then H and spent the next few days twitching every time the phone rang, in case it was her. But she is very busy, and so far it hasn’t been. This will not last.

As for my Dad (my parents are divorced, and live at opposite ends of the country), he is currently much preoccupied with his own serious health issues. However, he gets very peeved if he realises he’s the last to find out family news. If I tell Mum, I’ll have to tell him shortly afterwards. And yet, I do not want to enfretulate him. He has a heart condition, after all. God damn it.

And then there’s H’s parents, about whom I am feeling complicated and prickly. I started miscarrying in a slow, dreary, tedious way on their sofa-bed once, Christmas 2009, and their response to that sorry event can be summed up here. I’ve never really quite got over that, and now that I think of it at length (instead of slamming the file shut whenever my mind strays over there), it has all put a bit of a crimp in our relationship. I don’t want to upset them, or be a source of grief to them, and I am very sad they haven’t had the grandchildren of their own that they want so much. But on the other hand, I’m not sure I care for their bland indifference to our, mine and H’s, actual physical and emotional suffering, coupled with tactless trampling on sensitive issues and moments of extreme awkwardness whenever the subject of childlessness comes up. And no, I don’t care for the business of educating them about ART. We’re all discussing the pros and cons of 3-day versus 5-day CGH-array embryo testing, and they’re all ‘have you read this article in the local newspaper about full-fat dairy products improving fertility?’ They mean well, obviously, but they are trailing about five or six years behind us in terms of getting their heads round our journey, and it drives me fucking nuts. This is your son, your family, your loved ones. Sack the fuck up and pay attention, for the love of Christ.

And therefore, I do not, absolutely not, no-how, want to tell them I am pregnant, have them all be happy, and then tell them I miscarried and have them all sail straight back onto their river-cruise in Egypt and make like it never happened. That would pretty much ruin our relationship for years to come.

H is in charge of telling his parents about our fertility issues, as I am in charge of telling mine. Both sets of parents are a few miscarriages short of the grand total (discussing the very early ones is just beyond me, to be honest. They are important medical information and cumulatively have done something ghastly to my psyche, but as individual events they’re all a bit ‘oh fuck not again,’ rather than soul-crushing). I think we missed a trick, not telling them the grand total earlier. I wish we’d also spent time telling them what is and isn’t supportive behaviour. But, to be fair, they have had Bad Sad Times of their own recently, and it never seemed the right moment, and now in this corner we are painted.

What to do, Gentle Readers? What to do? Keeping in mind that my Mum the Incurable Excitable Chatterbox talks regularly and gossipily to H’s parents, so if we tell her, we shall have to tell them within days. And I don’t know if I can keep this from Mum all the way until the scan, because she was trained by the KGB and also, they all know we were planning on doing IVF this summer. We communicated that much, at least.

(This is all very silly, isn’t it? What a cheeringly daft thing to have got my knickers in a knot about. TELLING FAMILY).

Outed (nothing bad has happened yet)

On Monday, as planned, H and I went to see the GP, in order to get all my miraculous baby-sparing medications transferred to NHS prescriptions, which would be ever so much cheaper and easier to refill.

Naturally, I became terribly anxious (read: freaked out, snapped at H for no particular reason, had anxiety dreams) about this. I had visions of doctors refusing to do this without a proper letter from Dr George (we’d only managed to crowbar a rather vague email out of him), or refusing to do this on principle because it was a private IVF cycle (you know, like cosmetic dentistry), or refusing to do it because they didn’t understand why we’d want these drugs in the first place (in NHS IVF, they often have you stop progesterone on getting a positive pregnancy test (I know! What the serious fuck? And then they wonder why NHS success rates suck compared to private! How about because they treat it as vanity bollocks and don’t keep up with the research at-fucking-all?)).

Yeah, no. We saw a rather eager young chap who not only cheerfully and instantly sprang to his computer and printed out handfuls and handfuls of prescriptions for me, but also booked me into the NHS antenatal service, tested my urine for sugar and protein as if I were a normal pregnant woman (all fine, BTW), and wrote me out a Maternity Exemption certificate. This piece of NHS starlike wonder and genius guarantees that all pregnant women do not have to pay a penny for any even vaguely pregnancy-related medications for up to a year after the birth of their child. To make up for the being-shit-about-infertility part. This certificate is now stuck to my fridge, so I can stare at it in bewilderment and awe with all the more ease.

And then I went to work, and very discreetly, by email, let my boss (who knew I was doing IVF) and the office manager (who has to sort out which category sick-leave and doctors’ appointments fall under, because pregnancy stuff is tracked separately so as not to affect sick leave entitlement), that I was, in fact, uh, well, oh for God’s sake, pregnant (eeeeeeep I typed it I typed it eeeeeeeeeeep). And could we keep it quiet just for now, please and thank you.

Since when, my boss has given the world’s worst performance ever as discreet secret-keeper. She turned, on the instant, into the Mr Bean of discretion. I’m surprised she doesn’t *wink wink nudge nudge* me every time she speaks to me. For example, this morning I got caught in the rain on my way to work, and feeling chilled and disgruntled, I grabbed a decaf coffee. I have studied the available guidelines from several sources, and it seems that the magic number to stay under is 200mg of caffeine a day, and one frikken’ decaf has between 10 and 50. Also, I usually drink several coffees a day, and colleagues do actually notice and comment when I cut down (May: wild hair, glasses, nerdy teeshirt, coffee cup). So, decoy coffee, if you will. I had not yet sat my damp self down at my desk when Boss popped up and gasped: ‘Oh, May, is that coffee? Should you be drinking that?’ ‘It’s decaf,’ I said. I should’ve said ‘Of course not. It’s methadone,’ but I was tired and undercaffeinated. ‘I should phone your husband and let him know!’ she trilled. I smiled, weakly, incandescing under my various colleagues’ curious glances.

(Phone my husband oh my horsey God).

Later, she freaked out when I went to go pull something out from under my desk, and got a male colleague to come and do it for me. Which he did one-handed, and then gave us both a very curious stare, while I went absolutely puce with mortification.

I may have accidentally murdered her before the end of the 1st trimester. Or, because I simply must not strain myself, got any number of willing colleagues to do it for me.

It dawns on me that I do not have a repeat prescription for the Metformin. So I shall have to go and annoy the GPs again tomorrow. Bother.