Stub

Apologies for the silence, I'll just leave you with this: one of my favourite columnists addressing a topic of great interest to me.

Dear manufacturer,

I wish to complain about your product.

How can a girl be expected to pee in a "cup" (which cup? the one I haven't got from the doctor for the urine test they gave me a cup at the lab for? one of our landlady's Vegas mugs? a spare glass jar? an empty Starbucks vanilla roibos chai latte cup?), dip the stick for 10 seconds, leave it for five minutes ("or possibly 10 to confirm a negative result") and meanwhile run back to the bedroom where her husband is rapidly going off the boil? And if I leave the stick in a handy bathroom drawer, and minister to Mr Spouse's needs, you're going to have to be awfully quick to get back before you are no longer allowed to read the test.

Although I was wondering whether having my insides poked about would make the little girls be a bit reluctant to come out and play, I wasn't prepared for 3 straight days of negative - including the latest day I normally get a positive OPK/fertility meter reading - and not just "well, maybe, let's think about it tomorrow" negative - pretty much blank white negative. Especially since all the other OPK type things I've used before (Persona, an early version of the Clearblue meter, and some digital Clearblue sticks also once I think) have had at least some form of second line from day 13 at the latest.

But as the big girls have done their "ooh, we're sore now" post-ovulation, presumably progesterone-induced end-of-day sigh, I'm assuming the cheap OPKs are a pile of, as my nieces would say, caca.

So I think I'm going to start with the suppositories on day 18 not day 17, just to be on the safe side, but I'm not sure if I'm going to call the doctor about using them in, er, a different area, given just how sore we both were last month.

And then I'm going to ignore the OPKs and use either my Persona, or nothing.

I think I should be done

I said recently that I thought Mr Spouse wanted me to be done with trying to get pregnant but I realised I hadn't discussed it with him.

This came out partly from him being a bit bewildered about what exactly I am aiming for or intending: we do still have a firm commitment to completing the foster care process, and I originally suggested that we give it a maximum of five years from when we started trying (which will be up this September) before definitely pursuing adoption alone, on the one hand, but on the other hand I am pretty sure I want to fully investigate this possible uterine factor/endometrium/septum.

But it also came out from a comment by the lovely Sam, who very kindly came round to tell me how horrible my HSG could have been and take me out for gentle coffee and fun watching her daughter play, fortunately after I'd had the HSG already! We got to telling our long and boring stories (as you do, I'm glad the woman at the next table had her earphones in, I'm guessing she would have moved if she'd been bothered!). Sam said "well, it sounds like you aren't really ready to give upon the idea of having a birth child".

I guess not.

Anyway, I asked Mr Spouse whether he just wanted me to give up on the idea. Actually, he doesn't. He does want me to give up on all these investigations - I think in a way they must be hard on him too, for the same reason they are hard on me. I in particular want, but he wants too, for there to be something easily fixable wrong with us. But I don't think he believes there is. I'm not sure if I do but I'm not sure I don't, either, if you see what I mean.

I wish I was done. I wish we'd been done a couple of years ago, to be honest. I have a little girl in my head from one of the "waiting children" magazines which I saw immediately before miscarriage no 3.

Losing it: Part 2

So: about 18 months ago, I think, I realised that although I was trying pretty hard to "stick to" my calorie plan on WLR, it wasn't working. I could stick to it for a couple of weeks, and sometimes lose, sometimes not, but not really for much longer than that.

Then, one day while lazily reading the Sunday papers with a friend outside a pub, I read an article about Paul McKenna. If you don't know about him, I'm not going to repeat it here, just Google him. He has a book called "I can make you thin" (known to Mr. Spouse as "I can make myself rich") and as it is a very slim volume, the article gave pretty much all the text plus commentary. It is an idea that I had come across before, in various guises, including "Fat is a Feminist Issue" (Susie Orbach), "When you eat at the refrigerator, pull up a chair" (Geneen Roth) and "Beyond Chocolate" (Sophie & Audrey Boss). I had to some extent tried and not really understood the whole concept - which is generally known as "intuitive eating" - but somehow I knew I needed to try it again.

The main things that make me feel this approach is worth trying are that

1) Diets don't work in the long run. This is partly for physiological reasons - eating too little can make your body go "hey, starvation alert, quick, don't burn any fuel" but properly managed, this shouldn't happen - eating a reasonable amount to offset any exercise should help.
But it is also, probably mainly, for psychological reasons. Denying yourself - being a "restricted eater" - has been shown to make people eat more in the long run, more when they are no longer "denying themselves", and is probably a major cause of yoyo dieting. For the 90%* of women who have dieted and failed, it is not that YOU are a failure. It is not that you don't have the will power. You cannot possibly have that much will power. You are not designed to have that much will power.

2) This approach seems much more sustainable in the long run and also much more amenable to working with kids - especially kids who haven't had a very reliable food supply at points in the past. It's also much more home-life friendly, or at least in some respects it is - I was getting a bit fed up of telling Mr. Spouse I didn't want to eat his favourite dinner because it was too calorific.

However I have kind of half-heartedly tried this approach before and it didn't really work. And you know, I think it may be that I needed to try "proper" dieting first. First of all to appreciate the process:
- no more "I've got to eat this, it's what I planned, I've got to eat all of it too"
- no more "I'm starving but I've got no calories left for today"
- no more "ooh, how many calories in that, ooh I really really want it but I can't have it, oh I'll eat it anyway, I feel so guilty, I'm a real weak-willed ninny"

But also because I learned a lot and also I think because my physiology needed a bit of sorting out:
- I actually have a clue what portion sizes will fill me up, I have tried more recently to eat slowly, and with the WLR emphasis on eating enough fat, I know that reasonable levels of fat are also quite filling
- Losing the first chunk** of weight seems to have sorted out my blood sugar so that I actually feel hungry a lot more often
- I am much more able to exercise now - although I was quite active before, I can do much more now.
- The confidence that Mr Spouse gave me to lose the weight has also helped me think of my body more positively

So, long story a tiny bit shorter, I have lost another stone by dint of:
- Eating when I'm hungry
- Eating what I'm hungry for
- Eating slowly and mindfully
- Stopping when I'm full
- Exercising Moving my body
- Paying some lip service to meditating on body image and listening to relaxation tracks (actually, the former has been of more help - although I thought it wouldn't - I think the confidence being with Mr. Spouse has given me has helped me see something more positive in my body).

All this type of thing is pretty much proven to work - "tapping", hypnosis etc. hasn't. So, on the Beyond Chocolate principle of "be your own guru", I'm taking what works from each of the approaches.

I'm not very good at all of this and I have to remind myself to remember to focus on the positive. I'm getting better at noticing whether I'm really hungry, or thirsty or sometimes just bored. I was never a huge emotional eater - things have to be really really bad for me to need food and it's almost always chocolate on CD1.

Slowly and mindfully is generally OK, and I have a much better place to eat lunch here than back in the UK. My crunch points are 10 minutes before I leave the office for a gym visit/long route home via lots of places, and I realise I'm starving plus I have to do an emergency email; and the more prosaic sitting-on-the-sofa-can't-be-bothered-to-turn-off-the TV. That of course combines with eating only when hungry as it's usually after a meal (though sometimes early evening before we've cooked dinner/if Mr Spouse is still out).

Stopping when I'm full is better at home than when out, but my portion sizes are decreasing, definitely, and I don't always feel the need to eat all of what I bought. This does mean several days a week I really really want dessert but have no room. I should probably persuade Mr. Spouse we need to have a dessert-for-dinner day, but I do have a smoothie-plus-pastry lunch day most weeks, and unless it's a very small pastry again I don't feel the need to finish it if I'm full. So this one kind of combines with "eating what I'm hungry for".

I think, just to go on a bit, that the real confidence booster has been realising that I - and everyone else, yes really, you are NOT a fat pig who will eat chocolate till the world ends - do naturally gravitate towards a somewhat balanced diet.

Generally I want to eat more breakfast than I used to but less lunch and dinner - in particular, I don't feel I have to have sandwich plus fruit plus crisps or biscuits for lunch, I feel satisfied after most of a sandwich plus a drink some days, sandwich plus some fruit others, very much depending. I don't have to eat loads after exercising - I notice I eat a little more but not necessarily proportionately. I also notice that although some "healthy" type foods fill me up quickly (fruit in particular) I get hungry again quickly, but other things that are sometimes termed a bit less "healthy" keep me going a lot longer. I had a chunk of cheese as part of my lunch at about 2pm and it's now 6.30, I've only had a skim-milk*** latte in between and I'm not really ready to think about dinner yet.

I'm not fully there in what I do nor in what I want to look like/weigh. I'm not sure I ever will be - but I'm at a holding level and a much more healthy weight (BMI about 27-28 at the moment - I think I've gained about 3lb in 5 months in a pretty overweight culture).

Diets beckon - they are very well marketed - lose some weight quickly and go back on a healthy eating plan - but I get a reality check pretty often from some of the ladies on my favourite message boards - how many times have they yo-yoed, there are some much more long term dieters than I am, and so many women who are much thinner and have horrendous body image issues.

This has got SO long but I just wanted to get it all off my chest. If you want some real inspiration, check out everdecreasinggirdle.


*figure plucked out of hat
**term used advisedly
***I have noticed I go for skim milk when I don't want to be filled up for long or am not at all hungry, and sometimes I deliberately go for full fat when I know it's a long time till dinner.

Losing it: Part 1

Or, So Far, So Diet.

In the autumn of 2003 I was pretty sure Mr Spouse and I were getting married (we hadn't yet set a date) and I had just been offered a new job. I was getting my winter clothes out of storage and bemoaning that, as usual, the moths had got into them. However, I found that I couldn't. I remember a long and tearful phone call with me lying on my bed and him calming me down (we were in a LDR at this point). I had also recently been to the doctor who told me the cysts I kept getting were a sign of high blood sugar (which I turned out to have - only marginally - it was 7 fasting and 7 after a GTT and the normal UK range is 4-7 - the cysts were as we now know Bartholin cysts and/or abscesses).

Mr Spouse has, as you may recall, insulin-dependent diabetes. He knows all about sugar metabolism. He'd already noticed how much sugar I put on my cereal and how many sweet things I ate (probably more than him, and he needs the occasional blood-sugar rectifier). I despaired of doing anything about my weight and despaired of changing my eating. But I finally knew it was time to do something. I had never really dieted before apart from a few grapefruit efforts when at school - my mother is a chronic dieter, all food is "bad", and I had resisted getting into this when I left home.

I'd actually tried an online food diary system which I'm not afraid to publicise, Weight Loss Resources. The system emphasises calorie counting, but does all the calculating for you, including saving recipes, and calculating in meticulous detail calories expended during exercise; it encourages you to eat all your exercise calories, which for a bouncy and hungry girl like me seemed good. Plus there is pretty good evidence that just keeping a food diary makes you eat less - I like evidence.

I had done a trial for a few days at a 2lb/week rate of loss and immediately panicked as there was no way I could adjust my eating to that level. However, I decided to give it a go at a much lower rate of loss - 1/2lb per week. Between Oct 2003 and May 2004 I lost 1 1/2 stone (21lb) and my blood sugar was back to normal. Over the following 9 months or so I lost another stone and I was running, cycling, swimming and doing yoga; I cut down on sugary things, mainly through substituting fruit. I didn't feel deprived, though after I'd been using the system for about a year I started yo-yoing a bit.

My weight remained stable, or rather up and down within the same one-stone range, for about the next 2 years, 2 pregnancies. I was very unsure about keeping my eating at a reasonable level "on my own", and I even used the same system but at a no-weight-loss level, during my first pregnancy. I also begain increasingly to stick at a plateau, to yo-yo somewhat (though mainly within the same 10-15lb) and to feel a little deprived when strictly sticking to my calorie limits.

I think it was after my 2nd pregnancy that I decided to try out WW, and I'm sorry if you are a fan, but can you say "patronising"? It may seem niggly, but they have a "system" and if you appear to be ignoring the system, bad luck - not just bad luck, time to get told off. I assume it's the same at meetings, but I was doing this online. Basically they give you "points" to eat (which add up to way fewer calories than WLR suggest, but no matter, I was seduced by the "free" vegetables - and I did also try "Core", where you eat as much as you want of a limited set of foods), and you can "earn" points through exercise. Again, you don't "earn" as much to eat as you would if you calculated them using actual calories, although of course you can lie about how much exercise you do.

You are supposed to eat up to, I think, 12 points per week of your exercise calories, and then you can do 12 more and you aren't supposed to eat those (or at least, you aren't supposed to do more than 12 that you don't eat). At the time I was training for a 40 mile bike ride and regularly racking up 30+ exercise points per week.

As the online system won't "let" you eat more points, I didn't see why I should keep paying for something I wasn't using. The point of this is not that I am petty, but that evidence shows that you lose weight faster if you exercise and eat to balance it, than if you cut down on your intake severely and either don't exercise or exercise a lot. Plus I was hungry!

Anyway, sorry for the moan and I'm sure WW suits some people but really not me.

So after that exercise I was a bit despondent and then got pregnant again and then tried WLR again (not sure in what order) but eventually had to accept that I wasn't going anywhere, though I was still a lot lighter than when I started the whole thing.

Another bandwagon

Is it really good news?

No news, that is.

So my HSG was not too painful, and I am lounging around doing a little light reading and feeling relatively cramp-free (no worse than a normal period, anyway). Apparently they were looking for adenomyosis, too, which I wasn't really aware of. This may be my unrelieved optimism but I had thought that the doctor had decided this was rather unlikely.

Fortunately the HSG showed no evidence of adenomyosis and, not surprisingly, nice clear tubes, but disappointingly no nice explanatory septum either. Annoyingly I wasn't shown the x-ray and I was too keen to get dressed and leave to think of asking to see it.

So I have a feeling that where we go from here is I ask the doctor about a hysteroscopy. I'm not overly keen on having anything involving lengthy recovery time while I am over here, even if having it done in the UK would also mean going private, as we only have a couple of months left, but we should be able to squeeze this in.

I wasn't quite sure I got my point over to her about the possibility of additional suppositories (the blue triangular pills associated with male problems) so will try and remember to print off the article I found, as well maybe as what I've found on hysteroscopy versus HSG. I tend to come over all pathetic when speaking to doctors and forget everything I meant to say, or not explain myself properly, so must remember to take aide memoires with me.

What is slightly depressing about this is that I feel that Mr Spouse has more or less given up hope and is really just humouring me, and I'm not far off that myself.

Something to chew on

Mr Spouse was, as some of you may know, made redundant just over a year ago. This was a cause of much rejoicing as it was the third round of redundancies with the company, and he'd been there umpty-ump years so was in for a very large Go Away Now Please payment. We spent some of it on making our windows wind-proof (a good thing in windows) and some more on getting him teeth that you can chew on (he was previously a product of 1960s school whip-it-out dentistry). People would ask us how we were doing and I would tell them we were fine, both financially and emotionally, and would elaborate on what some of the money was going on. But he asked me not to tell people, saying it was his personal business, though myself I didn't think teeth were that personal, he thought so and I felt a bit mean.

He would never tell other people about our fertility bits unless I gave him the nod, but there are a lot of nosy people in the world, in particular, well, My Mother. She's staying at the moment but is off to see her old high school friends in Washington State on Monday (it's very sweet, they have their 50th reunion later in the year but she and her pals are having a maverick get-together now instead for those who couldn't care less what the prom queen is doing - assuming they had them in the Dark Ages). I have to have a quick pointless pregnancy test on Monday and although I will be able to conceal the HSG as it's on Tuesday I need to think up a reason to stop at the doctor's on Monday.

I can't decide whether to say "I need to run an errand" or "I need to get a test at the doctor's" (what test? what for? a blood test? ooh, do they think your blood sugar is high again? ooh, you shouldn't have made all those cookies*" or "I need to pick up a prescription" (in fact, I need the preventitive antibiotics but am picking them up elsewhere) (ooh, what for, ooh, are you sick, ooh, you'll still be on them when I come back won't you?).

Am I weird that, unless I'm actually going for an operation I will not be sharing any of what's going on with my mother?

The problem is if I do share, she expects things to happen Right Now, both treatment/investigation and, of course, pregnancy; and if I don't share, she seems to assume we've given up. I particularly don't want to share adoption/fostering-related things partly because of her negative reaction to the whole issue, to anything hinting at non-genetically-related (i.e. not "real") grandchildren, and in particular to anything relating to disability, which of course is a risk with birth children as well (though she wouldn't see it - termination can solve anything I think would be her stance) - witness two references to "half-wits" in the last three days alone. Although she did mention David Miliband** to me recently, so perhaps she is softening, but I doubt a previously-fostered four-year-old would meet her criteria.

*Sam, you don't escape so easily - I'll be packing some up for you for later in the week.

**There are many misinformed articles going around about the Miliband family adoption, incidentally, so perhaps I will try and correct them at some point.