The plan is...

• Today
• to rest - I was planning to go for a very short run, but energy levels are at zero, since I seem to need 10 hours sleep a night at the moment and only got 9 last night
• This week:
• to rest more, and to go back to work but only going in for the hours I absolutely have to.
• to do a little exercise (yoga, walking)
• to start keeping my food diary again, but only at a keeping-my-weight-the-same level.
• to knit, read trashy novels, and watch trashy TV (Stitch 'n' Bitch is what you want, perceval. If you want to make any of the projects go to a shop and ask them what you could use instead of the yarn in the book. You probably know continental knitting if you have ever learned)
• to order some stuff for the garden

• After that:
• Dunno.

I'm sure this says something about me, or something

I'm typing this while drinking a small sherry. Fino, of course, not sweet.

The hospital visit went OK. I was actually grateful they decided not to scan me - there didn't seem much point, the doctor said (yes, an actual doctor - OK, I saw a doctor last time for the research test but before that it was a nurse). And she really seemed to be taking seriously the fact that we have problems getting pregnant as well as staying pregnant. Previously the gynae at the local hospital seemed to only consider the fertility problems, and the nurse at the RPL clinic seemed to assume we’d get pregnant again quickly. But it was still really, really hard, and not helped by the fact that I didn’t sleep that well last night.

One big question we had was whether there was any way to increase the frequency of getting pregnant; if we have, as I’m assuming, approximately a 50% chance of keeping each pregnancy, which doesn’t really decrease if there’s no known reason for losing them, then two pregnancies in 18 months is desperate (that’s about our average) but two pregnancies in six months would be hard, but at least quicker. No, she said, short of IVF, not really. Clomid is only if you can’t ovulate at all. IUI I know has about a 10% success rate per cycle which is about what we’re on anyway. IVF, as I think I’ve already said, seems like an expensive way to get where we are anyway.

They don't do scans at 5 weeks, as you can't see anything one way or the other. They will see people and do blood tests, but since they couldn't decide to do an ERPC any earlier than I'd be likely to miscarry spontaneously, they can't really do any tissue analysis either. All the blood test would be is watching it happen, as she put it, not preventing it or finding out any extra information.

However she looked at all the results and wasn’t happy with the hormone tests – she asked if I’d had an ovarian scan, which I haven’t. She’s wondering about PCOS. I think she’s wondering in a “well, everything else has been investigated mega thoroughly, but these hormone tests weren’t done by me and there’s been no scan” rather than in a “look at this large hairy woman with 2 periods a year, my word” type way, since although I had mild blood sugar issues when I was 2 ½ stone heavier, I am, as you have worked out, now 2 ½ stone lighter (middle of “overweight” – 5ft 3 and size 12-14), have clockwork periods and am the waxing lady’s dream; she just does waxing Reiki, I think, with me. Though the latter has probably got a lot to do with my Celtic/Germanic/Nordic/splash-of-maybe-Native-American heritage.

So I have an ovarian scan* in 3 weeks’ time which should, based on the last miscarriage, be about the equivalent of CD 27. However, I sneakily did another test (which I promised Mr Spouse I wouldn't) when I got back from the hospital and the hormone levels are still not zero (though the digital bit confirmed what we already knew, the stick had a faint second line again). So it may be another two weeks from now before I ovulate again. But I believe cysts are there a lot of the time, perhaps someone else can help me out here.

She also asked (thank you! Finally!) whether anyone had done any genetic tests on Mr. Spouse. I have asked about this the last two visits, I said. He comes from a family with a lot of only children, I said. Oh, dear, she said. So they poked him about 50 times with a needle and finally got some blood out and after the geneticists have grown it very very slowly in their lab we (probably both of us again; obviously they are doing chromosome tests on me too) will be back in the clinic in early April. Which I guess is about the right length of time for us to get our heads back into decision-making gear, since they are very much not in that gear at the moment.

I am aware this all sounds very rational and together. I don’t feel rational or together but the facts are easier to report than the actual state of my head. I get the feeling work is worried I may go AWOL again on them at short notice; I’m not sure I want to tell anyone other than immediate friends what’s up so they may just have to carry on worrying. Bad luck, work. I did chat on the phone to S who has had the China adoption issues due to the age of her husband; they are thinking about Guatemala instead, and she made me cry by saying “you will have a child, you will be a mother some day, don’t give up hope.”

I’ve finished the sherry now and am just trying to work out if some Green and Black’s will make me feel sick, or cheer me up, and what to veg out in front of on the telly tonight while I try and finish Mr. Spouse’s cuddly, but subtly male charcoal coloured, jumper. One advantage of miscarriages – lots of time to knit.

*Yes, I've had a lap and dye which revealed no problems with my uterus, plus I've had a couple of regular scans - just no ovarian scan - apparently you can't see much of the ovaries, especially if you aren't really looking, during the lap and dye.

Sofa bound

30 hours of heavy bleeding and about 12 of lighter bleeding later, 5 episodes of Gilmore Girls and 4 of Judging Amy, I still feel tired (though heavy bleeding will do that to you), but there are no more cramps and the boobs are significantly less sore. I am slightly wondering if there is a little "tissue" left but I am pretty sure the hormone levels are back to zero.

I've told work I'll probably work from home on Thursday but be off till then. I feel like a bit of a fraud as physically I am not too bad - the bleeding was a bit less protracted this time - but there is no way I can stand up in front of a lecture theatre full of students without breaking down, especially if I do the planned class on prenatal brain development. This year's cohort are just going to have to remain ignorant on that count.

PS to Thalia: yes, I am under the care of the RPL clinic, but as they can't find anything wrong with me this care is repeated scans starting at 6 weeks - which is too late if you miscarry at 5+2. Don't know if this will change in any subsequent pregnancy, or if they have any other answers - we at least have a few questions - and the appointment on Friday is at the consultant's clinic, which means we'll see him, or one of his entourage, and get to ask those questions.

No change

Still bleeding, still red and clotty but also very mucous, still crampy. Basically very similar to the last one, apart from the mucus (I have now, I think, got the adjective and the noun right).

In answer to the comment that said I sound very calm - well, I suppose the panic has given way to the sadness already. I've alerted work, and just feel like I've bedded myself in for a few days of couch-dwelling, the old routine has kicked in. I have no idea where we go from here. I think it's too early to say. I don't know if we will feel up to the prep course - I thought we might, but now neither I nor Mr. Spouse are sure. I thought having another miscarriage would strengthen my resolve to adopt, but we were more optimistic about this one, and perhaps that's why I feel more cheated out of a biological child, or perhaps it's just the immediacy of it. Likewise I thought going through the hell again would make me think "give me contraceptives and give me them NOW" but I'm not sure of that either.

I do know that it makes me more convinced there is something actually wrong, not just bad luck, the pattern is too similar for each of them. And it also makes me less hopeful that they can do anything for us - if the only treatment is TLC and multiple scans, and we can't even make it to the hospital, and the only way to test for chromosomal abnormalities is to test the tissue in the lab, and we can't get that there either, then there's not much to be done.

You will forgive me for being a little despondent at this point, I know.

Prescient?

I woke at 6 a.m. to red blood and cramps. The blood, up to now (6 hours later) has continued but not been very heavy, mainly mucous-y and without clots (this confuses me, as if the mucous is from my cervix, then presumably my cervix is open, in which case why not more blood, and clots?), and the cramps, which intensified over a couple of hours to the point where I wished for ibuprofen (and took paracetemol) have also eased off, and although they did, it now just feels a little sore, and only a little like a period. So far neither the total blood nor the rate of flow are enough to be sure this is the end, so unless it gets heavier I'm in for a couple of days on the sofa counting total number of towels used, I suppose. If I was clever I could check my cervix but I'm not, and it's awkward to find anyway.

Will ring the hospital (but not the agency, I don't think) in the morning. Not sure if they'll want us to go in earlier or just wait till Friday. I don't think I'll be going into work for another couple of days. Fortunately I put a damage-limitation approach to work in operation for the first few weeks of term, as they are, as it turns out, the busiest of the year for me, so I've been refusing everything extraneous anyway.

Slight decrease in panic

Mr. Spouse talked me down somewhat (and I think also now understands more than he did, or wants to, about pee sticks). And having a lie down because I felt completely wiped helped, too, I think. As did (sorry) examining the colour, or lack thereof, of said pee. I'll do another test on Monday morning before ringing the agency, but I do feel a bit better and we did go out for the curry.

We do, however, need to ask to be moved to the next course. If I miscarry after the next few days, but before the course (which starts the 2nd), I will not feel up to it in time. If we went when I was still pregnant, but we did then go ahead with adoption a) I would feel bad not telling them and b) they would, not unnaturally, feel cautious about trusting us when they found out. Which they would. What with medicals. And it is pretty important for your social worker to trust you. And they run at least 3 courses a year, and we should be able to start the home study before the course if the course isn't for a while. And even if they said we could do it anyway, then two days of the course clash with potential 7 or 8 week scans. And the only reason I won't have one of those scans is if I spontaneously miscarry before then, and am feeling awful and lying on the sofa. After which I will want to feel sorry for myself for a while, and not bare my soul to a social worker.

So as you can see we need to postpone the course... But thank you so much for your comments - that is what is so nice about blogging.

Panic panic

For some reason - and I really cannot put my finger on it - I am feeling less pregnant. My breasts still hurt, I still want to pee a lot, I am still getting the occasional, non-painful cramp, and I am still tired. Perhaps I'm just a bit less tired or the cramps are a bit less frequent but I did have some fairly stewed tea this afternoon and the cramps had already been easing off for a few days.

So, stupidly, I came home this afternoon after 2 pots of tea and only 1 visit to the loo and did another digital test. Not pregnant. The stick itself still has a second line which is only slightly more faint than the one from last weekend but not surprisingly, I am panicking. If I am going to bleed, I want to do it before Monday as we said we'd call the agency and cancel the preparation course then if I was still pregnant.

We were going to go out for a curry with friends tonight and Mr. Spouse is trying to persuade me to go but I'm not sure; however I am doing as instructed and having a lie down (which I do need) and reading a book and seeing how I feel. Currently that alternates between resigned and panicky.

To answer a few questions...

No news, as they say... I'm now further along than no. 2 and the state of the boobage as well as my furnace- like nighttime temperature suggest the end, at least, is not about to come due to plummeting progesterone. I'm currently sitting on the bus on my way home to lie under the duvet - didn't sleep well last night, and one of the secretaries told me I was looking really unwell this morning.

When I had an empty sac on a 10 week ultrasound with no 1, they offered to whip it out straight away - which I guess is why I think the same could happen this time. If they saw no sac, probably they would, but I don't know - I'd rather take the bag and be prepared, I think.

Still not meaning to get at perceval, but although I do know the management of RPL is very different to regular, even post-infertility, pregnancy, I really don't want to think or talk about anything after 6 weeks right now. Even that feels presumptuous.

Hollow laugh...

Sorry, perceval, nothing personal but that was the sound of me responding to the idea that I'd be able to wait until 9 weeks for a scan. Fortunately the nice nurse and, I think, NHS guidelines for RPL (or at least the clinic's best practice) agree with me and I'm booked in for next Friday morning. Mr. Spouse can thankfully take the morning off to come in with me and I asked about bringing an overnight bag in case of surgery and she said, somewhat mysteriously, "we'll come to some arrangement". Since it's an hour and a half away, I think I'll take a bag just in case, as if they are sure it's ended at that point (it will be 6 weeks) I'd rather have an ERPC there than have it at the hospital here a few days later, where I wouldn't be sure they'd collect any tissue properly.

No other news, the nurse said to give her a call if I start bleeding, but still nothing, though knicker-watch of course continues unabated, and I am intermittently scared by cramps, though they are small. I actually feel a little nauseous already when I’m hungry, and tired (though that could be caffeine withdrawal – having had 2 cycles off I had overdosed a bit, especially over Christmas. Oops.) and I think that so far at least it’s not going to be immediately falling HcG levels that signal the end of this pregnancy. I will probably do a reassurance test at the weekend if I make it that far, though I don’t know if I could see if the lines were stronger than the Sunday night one as the lines on the actual stick were pretty dark.

AAAAAARRRGGHHH!

That was Mr. Spouse's response when I showed him the (digital, done in the evening, no doubt there whatsoever, definitely positive) test just now. He agreed that if it ends within a week, like last time, we will probably be OK to go to the adoption course, and I also suggested I might consider using contraception if we do that and are in the middle of the adoption approval process - as it will take about 6 months, and we do now have more confidence in the getting pregnant process. I am not sure this will be what happens, though, as I am fairly sure my hormone levels are higher than they were this time in the last one, in which I had a negative test and full-on bleeding at 5w. I will ring the nurse at the RPL clinic in the morning. I'm not sure if they'll do blood tests this week, or wait till next to do a scan.

We are feeling quite down however as the news from my friend who is going to be 40 four days before me, has 2 under-5s, and stomach cancer, is not good. What do you write in someone's card if you are not sure they'll even get to their birthday, let alone see another one?

Nothing to see...

No bleeding, just a little, not too scary, cramping, but I'm still only a day late. Haven't plucked up courage to tell Mr. Spouse. If I bleed before Monday I'm not sure if I will, or maybe tell him it was late and I thought the test was positive, and that I'm sad but not too sad, which I think I will be. If I don't but the Monday test is negative I think I'll tell him anyway, plus ring the hospital to see what they say. I am of course on full-on knicker watch but managed to sleep quite well last night.

This morning our information pack from Adoption UK arrived, with our first official (not cast-off, out of date) copy of Children Who Wait, arrived. It did make me feel positive about adopting - there were a few children in there I could see parenting, though they wouldn't be for us I don't think, as either they are too old (as in, I could see us parenting children like that who'd been with us for a while) or we wouldn't get chosen for them because of their ethnicity. I always particularly look for children who are half British and half some-East-African-origin, obviously, and there was one in here, but the social worker blurb asked for a family who could "reflect" rather than "reflect or promote" their ethnic origins. Which is fair enough, but some of the cases just show how unrealistic some placing social workers can be; either really complex ethnicities where they will be lucky to find even one family in the UK with that mix, or children who have fathers of different ethnicities and they think they'll find a mixed race family to adopt white children, or children who are mixed race but don't look it, and ditto. Obviously it is not good to pretend that mixed-race children are white, but people tend to assume children have the ethnicity that they appear to have.

I have been bad, but I will be confessing

I hope you think my badness is justified. I have had a sore shoulder for a few days now and, although I broke the shoulder about 10 years ago so it is occasionally sore, I had a nagging “ectopic” going round in the back of my mind as it wasn’t quite my regular pain. My period is probably due this evening, maybe tomorrow, so this morning I sneaked a Clearblue test and got a faint positive. Not light-of-a-thousand-suns faint, but fainter than the control line. I was actually thinking of heading straight for A&E but as I had to go to the GP anyway I looked pathetic at the nurse and she squeezed me in with a different GP to my regular one (who, er, said we should wait this month after a booster jab on CD2. I ask you – CD2?? With something that isn’t actually contraindicated in pregnancy?).

I’m trying really, really hard to steel myself for this being a chemical (and I will try my damndest to count it chemical if it’s less than about 4w4d). So please, no congratulations. I didn’t want to test this early, and I actually didn’t think I had any regular Clearblue left – I thought I’d stocked up on digital for that exact reason. If I have a late period and don’t know I’m pregnant, I needn’t tell Mr. Spouse I am (I’ll tell him it’s late, but I don’t need to tell him any symptoms). And if I only have digital tests in the house there’s no point in doing one early as they are pretty insensitive. Similarly if I just have a late period I don’t need to tell the adoption agency.

Anyway the plan is to panic a lot over the weekend, possibly presenting this episode to Mr. Spouse as another “trying to be positive” test (that’s what no. 2 was like and we were a little sad but coped fine when I bled at 4w5d) or possibly not telling him at all till Monday if I haven’t bled before then. Then (not sure I can look beyond 4w3d at this point, let alone to the adoption preparation course early next month) I’d have to ring the hospital and get booked in for a scan. If I haven’t bled before the scan, I think that would be the time to ring the agency. It’s a bit of an emotional risk, I think, rather than a medical one – could I cope with going to the preparation course if I’m only 2 weeks past a miscarriage? Judging by my last one, I’ll be really keen to move on, and I probably will be able to.

And the GP? Apparently I’d be in full-on cramping agony if I’d been having shoulder pain for a few days as my abdomen would be full of blood. So at least, so far, I can rule that out.

Adoption reading, books aimed at parents, relatives and childcare workers - first installment

I'm not sure how frequent these will be but there is far too much so far to put in one post so I may do a few over the next few days or weeks. Apologies for the totally idiosyncratic writing style and theoretical stance - these are notes for me, which I guess I'll share verbally with the social worker, but I thought some people might be interested. At least I'm trying to use APA format!

Mercer, J. (2006). Understanding attachment: parenting, child care, and emotional development: Praeger Publishers.
Review [originally written for the discussion forum at Adoption UK website]: This is written by a respected academic and although it is primarily intended, I think, to be of use to parents who are wondering about childcare issues and, especially, divorce, it is really readable, with only a little jargon, and it has a lot of information which will be highly relevant to adoptive parents (I imagine, not being one myself!).

All of the work on attachment that she talks about is very well researched, and has been confirmed in a number of studies. She also talks about some "misuse" of the term "attachment". In particular, she talks about some of the more extreme therapies (I know that some people have come across these, I don't want to tread on anyone's toes by slagging them off, but I do know that some can be actively dangerous), and also tries to disentangle "bonding" (the parent's feeling for the child) from "attachment" (the child's feeling for the caregivers).

I know that reading this will give some people a slightly different picture of attachment than they have read in more popular "therapy" books but I do think that what she writes is based on actual research rather than speculation, and she uses the most accepted definition of attachment.

The other thing that is helpful about the book is it really goes into detail about the different ages and stages of attachment, and how it works for adults. I know that my students, and friends who are parents and ask me for advice, are always keen to know when children go through different stages - it is so easy to think that what will work for a child aged 1 will also work aged 4 - and to expect that a child should be able to do one thing when in fact they have not gone through the previous stage.

Fahlberg, V. (1994). Child's Journey Through Placement: Brit. Agencies for Adoption & Fostering.
Interesting and quite informative – probably really aimed at social workers but in language that can be understood by parents. Gives parents a good idea of the processes children and social workers go through in coming to the decision to place a child for adoption, and some of the things they (should) take into consideration. It appears to be a fairly introductory text for social workers, but some of the things I have read elsewhere suggest that even the basics are sometimes ignored. It also has easy-to-read and fairly accurate sections on child development (strong on social development, not surprisingly, but with some other aspects covered).

Sunderland, M. (2006). Science of parenting: practical guidance on sleep, crying, play, and building emotional well-being for life. New York: Dorling Kindersley.
Very long on speculation and extrapolation and, sadly, short on science. The book tries to give biological explanation for each and every behaviour but unfortunately we do not know that much about how neural activity even correlates with (let alone drives) children’s behaviour. Fails to acknowledge the possibility that children can, for example, learn how to behave themselves in situations when they would naturally find it hard, but instead expects parents to adapt everything to the child’s supposedly “inevitable” stage of development. This means the book is rather disappointing for parents of children with difficulties as the implication is that therapy and behaviour modification can’t work, either. Some of the supposed links between brain and behaviour are rather unfounded (there is no evidence children who are left to cry for moderate lengths of time end up with neurological damage, as she implies) or in fact current evidence actually contradicts them (she labours the point that children’s frontal lobes are underdeveloped – so they can’t be expected to do anything involving higher thought – when in fact we know they can do some things that require frontal lobe functions from at least the age of about 18 months -2 years).

Is it worse...

to flirt with someone when your spouse is there or when their spouse is present? Or both?

This has nothing to do with fertility or adoption but it's not something I want to blog about on my other blog. We went to a great, but quite small, New Year's party, with a fancy dress theme, where we knew four of the people there and there were 6 others we didn't know, three single men (that we already knew one of), one single woman (who we already knew) and the rest couples. Everyone else already knew each other and to some extent it felt like those parties that you go to when you are single and you feel you need to make an effort and schmooze everyone in the room – I haven’t been to one of those in a while.

One guy, however, seemed to want to flirt with all the women. I may be imagining it, but he particularly seemed to want to flirt with me. But his (very attractive and sexily dressed, in a fun kind of way – this was fancy dress remember) wife was also there. As was my (rather under the weather due to a cold and not his usual dryly humorous self) husband. Comments, rather than touching, though he was the only person I’m not married to to try to kiss me at midnight, and he dived in first. I noticed he was doing it to L, our single female friend, to some extent too, but I still felt a bit targeted. Perhaps just because he hadn’t met me before.

In other news, you can catch me in January’s Redbook (US) – a very small, and probably completely misreported (I’ve received it but not read it very closely) segment in the Parenting section.