Venice

This is a cheat as I was obviously blogged-out yesterday and forgot my final post of the month. Let me off, will you? Anyway this is where we spent our post-wedding honeymoon (we had another holiday later that year, too, because we are a dual income infertile couple and can take lots of holidays) and yes, it is not that sunny, why do you ask? Do you think perhaps I should have known to take a suitcase full of warm sweaters and boots, in May?

I think it will be better perhaps if I get back to my regular intermittent posting as I definitely have fewer comments per post this month, and possibly even fewer comments overall. More posting does not mean more comments, clearly.

Well, it's doing something...

The progesterone suppositories definitely caused a few crampings/stretchings while I was using them, and as instructed I did a pregnancy test on day 28 and then stopped taking them. Following which my period was three, count them, three days late. Or possibly 2 if I ovulated late. Completely unheard of. And now, slightly less crampy but oddly heavier than normal. Heavier I don't mind if it's less crampy.

Turkey

Ok, this is more than a slight cheat, it's a huge cheat, but I couldn't resist this one for today. I have not been to Turkey. My parents went there on their honeymoon, but I wasn't born till 2 years later. So I may have been "thought of" but I didn't exist yet in any physical sense.

My parents didn't just go to Turkey, they drove to Turkey. From England. In a VW beetle (I think - maybe a small Fiat. Something like that). And they didn't just stay in Turkey. They worked in Turkey. On the Catal Hoyuk excavation, which is very famous. They stayed in a tent. In Turkey. In the summer. I'm surprised they stayed married as long as they did.

I think that's what they call Irony

Just went for a blood glucose test this morning, really just as an "in case" which I thought would be fine, but the OB/GYN was humouring me since I was wondering if Metformin might be helpful even though I don't have PCOS, I have had mildly raised blood sugar in the past.

Although it's not in the "definitely elevated" range it's higher than it should be for fasting (117, which is 6.5 in UK units I think).

No pie for me, then.

Paris - the Marais

I stayed in the Marais on my first romantic trip to Paris, with an ex who seemed nice at the time but turned out to be obsessive and a bit of a druggie (in my defense, I had dumped him long before the latter came to light). But it was very much a penniless, walk around Paris because we can't afford to take the Metro or go in any museums, trip.

Mr. Spouse and I went back for New Year a couple of years ago, and it was nice to reclaim the concept of the Marais. I have to say, I didn't really recognise much of it, either because we didn't do as much walking, or because it's changed, or more probably because we went to a completely different part. I just hope I've actually chosen a Marais image!

Bilbao

"Puppy" at the Guggenheim Museum. I have been promising for some time to make my brother a soft sculpture of Puppy.

Another meme

Bold is for done, italics is for “Would like to do.”

1. Started my own blog - Four? Five? Can't remember.
2. Slept under the stars - I'm sure I have but probably when I was about 14 on Guide camp.
3. Played in a band – Does a wind band count?
4. Visited Hawaii - Trying to persuade Mr Spouse to visit for my birthday in February. I have air miles!
5. Watched a meteor shower - In rural Suffolk - magical.
6. Given more than I can afford to charity - I have noticed that as income increases, the proportion of money that I give to income decreases.
7. Been to Disneyland/world - The original, being a California family. My mother thinks Florida and by extension Disneyworld is beyond tacky.
8. Climbed a mountain - By the British definition of mountain, yes.
9. Held a praying mantis - no desire to do this!
10. Sung a solo – Well, probably about 2 notes of 1-in-a-part a capella. I can carry a tune, blend, and both sight read and pick up harmonies by ear very quickly. I can't sing solo, this is not a solo voice.
11. Bungee jumped – why?
12. Visited Paris
13. Watched a lightning storm at sea - I can't remember a specific occasion but when I lived in East Africa I could see the Indian ocean from my balcony and we got a lot of thunderstorms.
14. Taught myself an art from scratch - Does crochet count?
15. Adopted a child - Probably not in 2009 but hopefully we'll be closer.
16. Had food poisoning - One distinct childhood memory is of being given peppermints to suck when my brother and I were really sick.
17. Walked to the top of the Statue of Liberty - What, you say getting the lift doesn't count?
18. Grown my own vegetables - Mainly fruits in the past, but also herbs and some small lettuce leaves at the moment.
19. Seen the Mona Lisa in France - A particular pet peeve of mine is museums where they don't stop people from using flash photography. It was so crowded I couldn't even shout (in French, so might not have helped at all) at all the Japanese and Italian tourists who were doing this.
20. Slept on an overnight train - Mombasa-Nairobi, and Paris-Rome most recently.
21. Had a pillow fight - Again, probably on Guide camp
22. Hitchhiked - I was going to say no, but yes! But only in rural Africa where you wait and see which comes first, the bus or another kind soul.
23. Taken a sick day when you’re not ill - Ahem.
24. Built a snow fort - Probably when we lived in the Rockies when I was 8 as I've not lived anywhere else with enough snow.
25. Held a lamb - I don't think so, but a baby chimpanzee!
26. Gone skinny dipping - Too cold!
27. Run a marathon - I'll aim for a 10k although I am running again.
28. Ridden in a gondola in Venice - Love Venice, no desire to go in a gondola.
29. Seen a total eclipse - Of the moon, but I don't think that's what they mean.
30. Watched a sunrise or sunset - Yesterday - there were a lot of clouds and it was lovely.
31. Hit a home run - No specific desire to do this but would like to be better at ball games (ooh er missus).
32. Been on a cruise - Up the Nile. Or down. Or both.
33. Seen Niagara Falls in person - Yes, but I was quite young. My grandmother's family is from Buffalo.
34. Visited the birthplace of my ancestors - Oh my, which ones? And how close do I have to get? I guess my mother was born in Buffalo (see 33) and my dad in London so that wasn't too hard. Have also been to England, Ireland, Norway, and Germany so that covers all my "ethnicities" and to the UK and US so that covers my parents' nationalities.
35. Seen an Amish community - In two minds on this. I don't really see sightseeing in someone's home as appropriate (I avoid "village tours" when on holiday in developing countries) but am fascinated by the Amish.
36. Taught myself a new language - I don't want to teach myself a language, really, I'd much rather learn it from a teacher and by immersion, though I had an Icelandic penfriend when I was a kid and tried to teach myself Icelandic. As you do.
37. Had enough money to be truly satisfied – I'm not truly satisfied but it's not for lack of money.
38. Seen the Leaning Tower of Pisa in person
39. Gone rock climbing - I think I want to want to, if you see what I mean! But it scares me.
40. Seen Michelangelo’s David - Wouldn't mind going to Florence.
41. Sung karaoke – To great acclaim at an Oxford ball once - well, we were a hired singing group, we couldn't let the side down! Blue Moon, as I recall - though I can't do it solo (see above!)
42. Seen Old Faithful geyser erupt
43. Bought a stranger a meal at a restaurant
44. Visited Africa
45. Walked on a beach by moonlight
46. Been transported in an ambulance - Broke my shoulder in a bike accident - the ambulance arrived with flashing lights but disappointingly drove quite slowly to A&E.
47. Had my portrait painted - One of those things your parents put you through - I could have told them it was going to look awful and not to bother - I think they must have had a no-purchase option because we never got it.
48. Gone deep sea fishing
49. Seen the Sistine Chapel in person - Almost as bad as the Mona Lisa for photography but the monks are fiercer than the Louvre guards.
50. Been to the top of the Eiffel Tower in Paris
51. Gone scuba diving or snorkelling
52. Kissed in the rain - Little option in England
53. Played in the mud
54. Gone to a drive-in theatre - I don't know about elsewhere but there used to be quite a few in southern Africa. I think we saw Three Men and a Baby in Zimbabwe in about 1990.
55. Been in a movie
56. Visited the Great Wall of China
57. Started a business - well, kind of - I have sold a couple of bags I've made.
58. Taken a martial arts class
59. Visited Russia - one of my ambitions is to ride the Trans-Siberian Railway.
60. Served at a soup kitchen - and had tea thrown in my face - not very hot!
61. Sold Girl Scout Cookies – in 3rd grade, my only year of school in the US - I got very worked up about not selling enough and my mother had to talk me down.
62. Gone whale watching
63. Got flowers for no reason - I think I have but I'd like to again!
64. Donated blood, platelets or plasma - but usually I can't because I've been to too many malarial countries and/or been pregnant too frequently.
65. Gone sky diving - no desire!
66. Visited a Nazi Concentration Camp - I know it would be overwhelming but massively important.
67. Bounced a check - No doubt when I was a student!
68. Flown in a helicopter
69. Saved a favorite childhood toy - I dreamed about my Winnie the Pooh, bought when I was 3 months old, the other day.
70. Visited the Lincoln Memorial
71. Eaten caviar
72. Pieced a quilt - several...
73. Stood in Times Square
74. Toured the Everglades - walked along the boardwalks, it's such a weird place with swamp right off the main road.
75. Been fired from a job
76. Seen the Changing of the Guards in London
77. Broken a bone - shoulder, see above
78. Been on a speeding motorcycle - no, just a regular one!
79. Seen the Grand Canyon in person
80. Published a book - well, Mr Spouse thinks my book deal will give us enough to retire on. Had a couple of chapters out.
81. Visited the Vatican - you know you can't visit the Sistine Chapel otherwise, right?
82. Bought a brand new car
83. Walked in Jerusalem - would like to see non-Holy-Land bits but suspect now is not the time.
84. Had my picture in the newspaper
85. Read the entire Bible
86. Visited the White House
87. Killed and prepared an animal for eating - Nope, although they've been delivered live to my house we got the neighbour to to it!
88. Had chickenpox - and missed the first week of junior school! I was devastated!
89. Saved someone’s life
90. Sat on a jury - always get off it but wouldn't mind.
91. Met someone famous - well, semi - various high profile academics, a few MPs.
92. Joined a book club
93. Lost a loved one
94. Had a baby
95. Seen the Alamo in person
96. Swam in the Great Salt Lake - eww, no thanks!
97. Been involved in a law suit – when I was fired.
98. Owned a cell phone
99. Been stung by a bee - or it could have been a wasp.

So I'd like to tag Bernardeena, Country Chick, geepeemum, May, Thalia, and the Hairy Farmer Family. What these people have in common is they are my UK British IF/miscarriage/adoption posse. Apologies if I've missed anyone out or misclassified anyone - and I know a couple of those blogs are not only or even mainly or even at all, now, about IF/miscarriage/adoption, but are partly, or have been.

(I have just realised that I also tagged Almamay, whose blog I had not been following as it doesn't show up on Google Reader, which is why I didn't classify her in my previous post about US bloggers in the UK, and only after tagging her this time did I remember she's also from the US).

Joga

Or maybe that should be "lloga".

My yoga class today was taken by a stand-in teacher who had a fairly strong Spanish accent.

"And breed..."

(which seemed not so much an instruction to frighten the horses, as a general instruction for life. Either way, not happening).

Meme

Courtesy of Everyday Stranger.

I actually had to go to the 6th/6th/6th/6th to get this photo as they are somewhat oddly arranged on the Mac but this is our house in SoCal (of course it isn't our house in the rainy North of England!)

Linkfest, Or, We Are Legion

There are, as we all know, huge numbers of infertility blogs. However, there aren't very many UK fertility-related blogs; there are scads of US-based blogs, but hardly any based in the UK. I have a few that I read regularly, and I have noticed something.

A large number of these lovely people are themselves from the US. Forgive me if I've got it wrong, but in the adoption crowd, we have Drawing Baskets from the Nile (who has another blog, but whose adoption journey is on this one), and we have 3rd Culture Mum. In the IVF crowd (tried or was successful with), we have Barren Mare, BarrenAlbion, and Everyday Stranger. And in the let's-have-another-miscarriage category we have Blogapotamus Rex. Of course, some of these categories overlap; and I may have missed someone who knows I read them but who I've forgotten is in one of these categories, or American. Sorry.

I count about 6 regular reads from UK infertility/miscarriage/adoption bloggers in the UK (and one German, hello perceval!). When I find a UK blog dealing with these issues I tend to bookmark it - though I've not counted a few that are dormant, that have moved lock, stock, and nappy pail to a parenting blog, and I've left out the Irish in my total (sorry!). So it seems to be approximately equal numbers, despite the small proportion of Americans in the UK.

I would just like to say to my compatriots - look at your babies. Then look at me. I have no American accent (except apparently I can "do" a bit of one on the phone, to get myself understood, and I can say my first name in a way that sometimes gets spelled correctly here. No, it's not spelled with a D, but I can gamely say it that way with the best of them). Neither, you would probably think, has my mother any more. Mind you, another American friend was accused of losing her accent entirely due to living with her British husband for about 5 years and really - not so much. She just sounds a bit more East Coast Posh than she did before.

I have, however, grown up with low-key Independence Day and Thanksgiving celebrations; with summers at the beach with my American grandparents; with only a US passport until I was 20 (and France, of all places, started demanding visas for US citizens); with standing in the long line at Heathrow; with being nagged to say You're Welcome; with quite a few things (lunchboxes, peanut butter, Cat in the Hat) that are now commonplace in the UK but then were, frankly, Weird.

I am your babies' future... I hope that doesn't scare you too much.

So THAT'S what an RE is

I had my first ever visit to a real live RE on Thursday. Infertility is not covered under my plan but complications of pregnancy are, and the doctors helpfully seem to be lumping anything that will help me achieve a sustainable pregnancy under this heading. I was very disappointed, though that the office did not say "RE's OFFICE" but, just like the ones at home, said "OB/GYN - Infertility Clinic"*. Ah well.

I have, I am happy to say, been very thoroughly investigated already for absolutely everything that can be a cause of recurrent miscarriage. So no more tests apart from a couple of swabs, another progesterone level, and just to check up on an old health issue, I need to get a fasting glucose and insulin level at some point. I hate it when they insist on 8 hours fasting when I know my glucose levels are through the floor after 5, it's 1 pm and I ate breakfast at 8.

It was about day 23/24/25 yesterday (depending on how you count it and when I ended up ovulating this cycle) and my progesterone turned out to be 11. OK apparently for an unstimulated cycle but not as high as previously. My ovaries looked good, my FSH levels were pronounced "fine", apparently Righty was on this month, and Lefty looked a little small (going out of business, or just not awake this month?). However...

The lining of my uterus was very much not what it should be. Not very thick - only 5mm - and very dense - no 3 layer pattern. In some ways this is disappointing. In others it is kind of a vindication.

It's disappointing because, hello, has no-one thought to look at it before? When I've been in for testing, why has no-one said "come back on day 21 and we'll look at your lining"? But then, I remember I have had an internal scan on about day 26 before and was told it was all thick and nice and, and I quote, "juicy". Plus I had a doppler at day 21 which was pronounced "fine", though it was for an experimental study and I have no idea if that would tell you anything about lining thickness/quality or if it was just a random number.

So maybe it's an intermittent problem, or a new problem - if the latter, new since about 18 months ago. Anyway, it doesn't sound good, and I'm on my first ever course of progesterone suppositories. Lovely. Also daily baby aspirin ("but I was told not to take it as it prevents implantation" "Well, it's all just voodoo medicine". Reassuring!).

I asked a few more questions too: Clomid, no, not helpful if you are ovulating, and if you are old. Also discovered later it doesn't do good things for the endometrium. DHEA, makes you feel more upbeat and gives you higher sex drive. Otherwise, not much proven effect. Metformin, we'll see how the blood sugar and the insulin levels are.

I've been mulling over the whole thing: the RE suggested PGS ("but I've been told it doesn't work"; "oh, yes, that's true, recent studies suggest it isn't any use" - er, so why suggest it). And surrogacy (Great Pumpkins - is she actually suggesting my eggs might be fine? And worth using?). And donor egg ("your FSH is OK but you might have more success with younger eggs"). Personally, she'd go down our own preferred route of adoption, if we have to choose some other route. But she knows other couples will try other things first.

In some ways this diagnosis is very frustrating - it doesn't appear to be easy to treat, and if it is (as it may be, though it seems unlikely) due to adenomyosis (sp?), it's pretty much impossible. If I'd had the diagnosis earlier, perhaps something could have been done. My body may preventing my babies from growing, even though otherwise they would have been fine.

But in other ways it makes me feel a little better. It's not all just because I'm old, and because my eggs are coddled. I had my first miscarriage "quite young" at 37 (thank you, blush blush). I continually feel guilty that I didn't get married younger, that I didn't meet Mr. Spouse when we were younger, that it's all my fault for jaunting off round the world and not knuckling down to finding a spouse before I was 30 (while of course I was completely ignoring every single man I met in every country I lived in, and fighting off marriage proposals left right and centre, and never having failed relationships/crushes on gay/uninterested friends). But perhaps I would have had this problem if we'd got together when I was in my 20s too.


*To be strictly accurate, at home it would say "Gynaecology - Infertility Clinic".

I worry

This is slightly edited from a forum post and is, I guess, kind of a thought about nationalised vs. private (patient pays) healthcare. There are other systems, I know, and HMOs could well work in a different (and possibly worse) way.

Someone was complaining that they were jealous of people with private, non-UK doctors who gave their patients more advice than in the UK. I wasn't convinced the advice was better.

"I have to say that my impression of the advice people get when they are dealing with private clinics outside the UK is that advice and protocols are based a lot on personal experience of the doctor, with quite a lot of "let's do this and see if it works for you", which if you are a doctor working with a patient that is paying themselves doesn't lose the doctor anything.

My impression of treatment within the NHS is, apart from IVF, treatment decisions are more evidence-based i.e. only prescribing treatments that are known to work for a lot of women in the same diagnosis category. That's certainly been my experience - when we were in the UK we asked whether it would be helpful for us to pursue a few different options and rather than saying "let's try it and see" we have been actually pointed to the medical evidence.

"I do work in a field where I have the skills to read medical journals, though they sometimes are a bit opaque, but I think if I couldn't read that sort of thing they'd still explain why a certain treatment didn't work.

"IVF in the UK is a bit different because although some areas follow the NICE protocols (3 paid cycles), which are based on how likely it is to succeed after 3 cycles, not really on cost, others go purely on cost, which basically means one cycle for almost no patients.

"Private IVF seems to be similar to private medicine everywhere, though. We went to an information evening at a purely private clinic that has had very good results; they do a specific technique (PGS) which we thought originally might be helpful for us, but as I said the NHS clinic explained why it wouldn't and what the current evidence was. They were still standing up and saying in their presentations that they offer it and that it's helpful for people in our situation. It was only when I spoke to the doctor presenting privately, after the presentation, that she admitted that she too knew about this evidence that it wasn't helpful. I wondered if she'd have recommended it for us if we'd gone along as new patients without the information from our NHS clinic."

Sorry for the recycling - I started writing on the forum and then realised about 3 sentences in it was really a blog post so I had the blog in mind!

Oddly our experiences with our current health provider (an HMO) have been pretty good and they do seem to make sure they are seen to be practicing on evidence. I've been cogitating about what healthcare would work for the US as a whole and although I don't know that much about how much is spent per person under different systems, I know we spend vastly less per person in all of the European nationalised systems. The premiums we're paying just now are very high, but if our current HMO didn't turn a profit, had more advantages of scale, no billing and eligibility staff (how much do they cost, one wonders??!), the cost per year on average would be close to what the average US citizen pays (averaging out the uninsured/can't pay and the wealthy/private medicine people).

Interesting article here. If everyone in the US paid $5000 per annum, we could have a giant nationalised, evidence-based HMO (or, if people prefer, state by state or county by county). If that's too impersonal, people who can afford it would be free (as in all other countries with nationalised health care) to pay for private treatment. If that's too much (and it's less than we are paying, I don't mind saying, but more than some people could afford), then the costs need to be shared round more and/or the price of medical care items and services needs to come down. Does the hospital really need a grand piano in the lobby??

East London

This is the church we got married in. It seats 1000 (we had "only" 180 guests).

Palm Springs

Gorgeous, but pretty weird, and I'm very glad we went in October, not July!

Cornwall

If you haven't been, go now. At once. Well, maybe wait for the summer.

Hollywood

Mr Spouse is quite good at taking arty photos.

Tanzania - Small airplane

After losing my passport I had to get it replaced in Nairobi, which meant we had to leave our safari early and fly back instead of driving. This is the plane. Reassuring, no?

Tanzania - Ngorongoro crater

One of the biggest concentrations of large mammals on the planet.

Tanzania - Coffee growing area

It is truly gorgeous here. I had my passport stolen also but it does serve me right for leaving it lying around in the hotel lounge.

Back in the saddle

We interrupt your photostream to bring you other news.

At home, I cycle to and from work - about 4 and a bit miles, and quite hilly - a couple of times a week. I'm organised with clothing and cycle in bike clothes, change in the office, put on makeup etc. I got a bike back in September, probably, but then I didn't have a bike rack or a basket and then after that I had pleurisy (which is NOT AS BAD AS IT SOUNDS though still quite painful). I feel fully restored now, touch wood.

So I finally got to ride the bike home from work yesterday. I didn't ride all the way to work as it's 6 miles up a very very steep hill, I rode about a mile and a half and then put the bike on the bus - a very good invention, in the UK you can if you are lucky put your bike inside small trains but not usually trams and definitely not buses - to go up the hill.

I wasn't entirely sure if I was going to ride home though as I had a lot to carry home and it is very very steep (did I say it's steep?) and it's pretty dark on the less busy road, and pretty busy on the less dark road. But I braved it and I was mighty glad I did. , Once I'd ridden home down the hill which is the first couple of miles of the ride home, the downtown part of our little suburb - we live the other side of downtown - was completely solid with traffic as a water main had burst. Oh how smug I felt, asking the nice man in the high-visi vest if I could push my bike round the corner, and walking past the traffic.

Then of course my light failed halfway home as I hadn't charged it enough. Grr. And my legs hurt. But very steep downhill with brakes on all the way, plus more up and down than I thought in downtown, meant a 6.5 mile journey still only took 50 minutes. Not too shabby.

Next up: Dr Spouse starts running again. Watch out, neighbourhood.

Tanzania - Lake Manyara

There is a very small giraffe in the distance, honest.

Tanzania - Coast Region

This is on the beach in the town where I lived for 2 years. You can basically see this view from my old house.

Zanzibar - Sunset from Beit-al-Ajab

Sorry - cannot resist another one. This is from the House of Wonders.

Zanzibar - Indian Ocean

Zanzibar - Stone Town

I could fill an entire year with daily pictures of Zanzibar. I think I've been there 10 times, the first time being in 1990 when it was really non-touristy. It changes every year, sometimes for good (it is a lot safer than it used to be and there are a lot more places to eat where you won't get a stomach bug, and places to stay where the loo isn't a hole in the ground), sometimes not.

Kenya

This is in a small town on the coast of Kenya, where I sometimes work - the monkeys hang around outside the office and play on the cars.

Mombasa

Same work trip as the previous picture.

Lake Victoria

From the Uganda side, I am very sorry it isn't from Kisumu (where Obama's father comes from). I have been to Mwanza, on the Tanzanian side, as well but it was a while ago, and to a couple of other places on the Ugandan side, but not to this part of Kenya. I was in Uganda visiting another student working here. It's very bizarre as it completely looks like the ocean, sandy beaches, blue water - but is fresh water.

Universal Studios

Cheesy, I know. I am sure I've been there at least 3 or 4 times.

Lombok, Indonesia

Visited about 18 months ago to supervise a student's fieldwork. I have prettier pictures but I love this one because it was just taken out of the window of the house I was staying in, but you probably can't see the kite very well.

Gol, also in Norway

Although this doesn't show the scenery - part of the same trip as the previous picture, but taken from the window of our rather cramped cabin where we had an ill-advised ski-ing holiday with my mad family.




(Have just noticed Blogger thinks it's tomorrow already - so that's why the times have been messed up.)

Nablopomo

So I've decided to jump on the bandwagon, but I need to do something really simple. I am on Facebook and I got into a kind of competition with my cousin into who had been to the most cities on the Cities I've Visited widget.

So I've decided I can easily post 29 (now) pictures of places I've been. Some may not be pictures I took myself but I'll try and post ones either Mr Spouse or a friend took. I'm not sure I'll write much in the way of comment on these, sorry!

Today: Oslo.

I'm sure you've all been on tenterhooks...

We ended up both being angels. I had already decided to knit a pair of angel wings for myself and was bowled over when Mr. Spouse said "OK, I'll have wings too". In the event he loved his wig but refused to wear the wings for more than about 5 minutes. Fortunately his only took a couple of days to knit:



while mine were a bit more complex:




You can almost see the full effect of my costume here, but sadly you can't quite see the bright green leggings I scored in a store in Palm Springs which said "everything $16". Except the leggings which were $8!