Do you have any children?

I've been asked this twice so far this week. The first time was by one of my Brownies - they seem to have just cottoned on to the fact that I am an adult with an independent life (though she did also ask me if I was a student...) and keep asking me if I'm married, "is that a wedding ring", etc. When I said no, she asked "why not?"

I was a bit flustered, and didn't know what to say - to an adult you can just say "it hasn't happened for us" or even (though it's been three years) "give us a chance, we've only just got married", but neither of those will work for a child. Thankfully the other leader saw I was a bit flustered and told her "She's got lots of students" which then meant I could explain that the students kept me really busy, and then of course explain what students were and what I do, and then have an argument with her about whether I would know her cousin, who probably isn't at my institution (there is another, more vocational, university in town too).

The second time was yesterday when I was attempting to find out if my foot was broken. The shower head fell off the wall onto my left foot on Sunday morning and after the swelling went down a bit yesterday morning, it was still very painful (except if I sit on the sofa and elevate it, which is nice), and had a lump in a place where I don't think there should be a lump, and where there isn't one on the other foot. I can't really walk any distance (especially not in shoes) and I can't drive.

Note that I haven't told my GP practice that I'm pregnant yet - I was planning to book in with them next week, if the scan is OK on Friday. The nurse practicioner at the GP practice said that as A&E have a 48 hour cutoff, I should head over there, where in a miraculous five minutes I was seen by a doctor who said "I haven't got X-ray eyes" and since the foot is a long way from the uterus and the dose is low, I should be OK. The radiographer, however, said that she personally would not have an X-ray in the first trimester, and that there were risks, and I told her I'd had miscarriages before (I didn't mention how many); she asked if I had children. When I said no, she replied "Hang on to this one". Which seemed unnecessarily dramatic.

The upshot was that the doctor refused to do anything, and said he couldn't feel a lump. Now I know he probably sees more broken bones in a week than I have, er, hot dinners, but I couldn't help feeling that someone who is an actual broken bone specialist might have been able to find some way round this. I got the impression that if I had pushed them to treat it as if it was broken, they might have put it in plaster. But I've also been told by friends that when they cracked something in their foot, they were just told to strap it up. Mr. Spouse asked if they could ultrasound my foot, but even in my ignorant state I don't think that would work. I am now paranoid that I'm making my foot worse by walking on it, even if it's just round the house. Anyway, assuming all goes well on Friday, we're going to ask about the risks. Unless of course it is magically better by then.

7w

Not much more to say, really. My boobs still feel sore, though slightly less so, but I feel much, much sicker. I need to eat approximately every two hours, though I haven't thrown up yet. One good thing about pregnancy is you can eat as much dried fruit as you want (if you are like me, and love dried fruit) and you don't get the runs (if you are like me, and dried fruit normally gives you the runs). I seem to feel sicker in the afternoons - in the mornings I'm just starving.

I went to yoga today for the first time in three weeks. I am not sure how good an idea this was, since the time before that was about three months previously. Normally I go to yoga every single week, and have been doing so for about six or seven years, with the occasional gap. I have been feeling a little bloated, and some of the bending over postures were a bit uncomfortable. If I was paranoid (me?) I would have worried it was pressing on my uterus but I know it's still well-protected in there. Happily nothing involved lying on my boobs for long periods of time. But I am wondering about saying something to my teacher. She just does it voluntarily, and is very nice, but I don't really want her altering things in an obvious way ("Dr Spouse, you shouldn't do this one").

I've also booked in to have a reflexology session on Tuesday, on the advice of perceval - thanks - I didn't want to go back to my acupuncturist even though I think she's a good therapist, because she is so bossy about meals. I'm supposed to eat rice for breakfast, according to her. Not going to happen.

I think I feel OK about waiting another week for a scan, though I'm starting to get nervous again, and I'm only sleeping well about half the time. I tried to put a couple of drops of lavender on the pillow, and it ended up smelling like an aromatherapist's boudoir.

Work continues to ignore me, or vice versa, or something. It's exam marking season, which is another good excuse not to go near the office, and to watch back-to-back episodes of trash (yes, it really helps me mark exam scripts accurately. Honest). Currently it's season 1 of The O.C. which I have on DVD. I ordered season 6 of Gilmore Girls ages ago from ebay and it hasn't arrived yet (in fact, the vendor sent me another copy, which also hasn't arrived) and I was originally thinking "don't watch too much of The O.C., you might want it post-miscarriage" but now I'm keping Gilmore Girls for that. But I'm also bidding on things from ebay which I might wear to a black tie do scheduled for when I'm 12 weeks, which, at this rate I won't feel like going to if I miscarry before then. Since it seems unlikely I'll be doing that on my own.

Pants

That's the ones I'm wearing, not a comment on life. They are white. I feel I am becoming more calm...

I had a bit of a panic on Monday and a rather stressful day yesterday - well, a stressful couple of hours in the morning - I felt I should ring Personnel and tell them I needed to have my ante-natal appointments counted as such, not sick leave. They initially wanted me to tell my department but that is not going to happen, so after lunch I rang back and they suggested I ask for annual leave and then they can be recoded later. The only difficulty is going to be getting several days' annual leave during term time, but I think I will be vague and only say that I am actually not just working but away from the office, if pressed. As I've said, I don't want to give my boss the chance to open his mouth just yet.

Continuing to use a visualisation/encouragement technique, this week I am urging Sprout to grow villi and limb buds, and shape its cranium correctly. I've also decided for the sake of my sleep and state of mind I need to do some exercise so I'm going to yoga on Friday and went for a 30 minute walk at lunchtime today.

That article

In case you're interested, it's here. A more recent article from a different clinic gives the predictive power of seeing a heartbeat at slightly lower - 82% - but I'm not clear whether they are all idiopathic recurrent miscarriers, or whether they include some with clotting disorders, and likewise it's not clear from the abstract whether they are using "heartrate over X" or just "presence of heartbeat" as the diagnostic factor. Perhaps someone with a subscription (Thalia?) can enlighten.

(Later - I really shouldn't have carried on reading as I just found another article saying the predicitive power is only 71% in over-40s. Excuse me while I go and sit in a hole).

Telling

Traditionally, of course, one does not tell many people in the first trimester that one is pregnant. We have avoided telling people for previous pregnancies - with the first one, I think realising there was a risk of miscarriage, and not wanting people to come back to us at about 20 weeks and ask how it was going. I think we were probably right to do that. With the next two confirmed pregnancies we were obviously more scared of something going wrong, and then it did, so we felt justified.

This time, so many people know that something has been wrong that we are slightly revising our policy. I have told two online communities (including the one that we met through) on the grounds that, I would be telling them if something went wrong, and we would like their thoughts and prayers before that happened. We have also told two of our adoption referees on the grounds that they are probably wondering what's going on with the adoption anyway, and we think we'll tell my mother, and the other two referees, after the 8 week scan, which ever way it goes.

But thinking about the treatment that the clinic is giving me - basically, TLC and ultrasound - and the fact that if recurrent miscarriers aren't getting treatment, it can be the case that no-one except their partner can support them - I wonder if keeping quiet is really the best policy. Perhaps having an aware support system is something that could actually help one's chances?

I'm wondering when is going to be the best time to tell my boss - he only knows I've been ill, not what with, so he doesn't know how scary this pregnancy is. And he can't keep his mouth shut, and I know he'll want to start planning for any potential absence, and I don't want him to do that until I'm 14 weeks (which would coincide with the end of term, which would be bad from his point of view as all helpful parties tend to disperse). But I don't know how much longer I can be regularly irregular in my physical attendance at work, without anyone noticing. And selfishly, if he knew I was pregnant and wanting to nap every afternoon, I might get a lower exam marking load.

Viable

Gestation sac, on abdominal scan, yolk sac and - wait for it - HEARTBEAT - on TV scan.

Okay, that’s the basics, you can skip the rest of the post now. But in detail:

Didn’t sleep much last night, so I got up and read, watched TV, and messed around on my (dying) desktop computer – this is posted from my laptop – Mr. Spouse is coming home with an external hard drive tonight in a rescue attempt. We got the train there and on the way I started drinking my mandated water, after a hot chocolate. Mistake. Hobbling down the road from the train station, and the same problem as about this time last year (post miscarriage no, er, two? three?). Hugely overfull bladder, immense pain in the waiting room, wondering how all these other ladies could actually sit there. I went and emptied a bit out three times and was still told to go and let some more out by the sonographer (aged 12). I think I must have a larger bladder than most people – I could actually hardly tell it was full at the point when it was just right. Note for future occasions.

We could only see the sac on the abdominal, and at first she wasn’t even sure it was that, and I have a hazy pre-bladder-emptying recollection of her saying “do you want a vaginal scan?” but she can’t have given me the choice, can she? Anyway, after asking if I wanted Mr. Spouse to go out (well, he has actually seen it all, you know?) she got to work and saw the gestational sac and yolk sac pretty much immediately and then said “oh, that might be a heartbeat”. I was thinking, oh dear, it won’t be clear, it’s going to be inconclusive. But then she found it, and we saw it for about 30 seconds. She tried to take a few measurements but it was all too small, although she reckoned it was about right for exactly 6 weeks, so I’m not that worried.

She also found what she thought was a small fibroid – hmm, okay, a new problem to worry about. She said it’s tiny and right at the top of the uterus so nothing to worry about but they’ll keep an eye on it. It is clearly not the cause of the previous miscarriages but I’ll make sure they look at it next time (Next time! Yes! Another scan – never thought I’d get to this one, let alone another one).

Anyway, over the hallway to the clinic, where most of my blood test results were back from last week, although the first thing she said was that the clotting screen takes four to five weeks.
Me: Erm, isn’t that a bit late for this pregnancy?
Her: (looking embarrassed) Well, yes, it would only really help us in subsequent pregnancies. But we can give you aspirin now, it won’t do you any harm.
Me: Yes! Please! Give me drugs! Now!

I’m not anaemic (so off the blocking-up iron) and last week’s HcG was appropriate for 5 weeks (they only repeat it if the scan isn’t viable), so no new blood tests.

So, in a stunned haze, I sleep-bought some sandals, a sugar fix to eat on the train, and came home where I slept for an hour and a half.

My breasts are not as painful today and my temperature seems to have come down (but the gynae said my temperature was high enough that I may have had a bit of a virus) – ordinarily this would panic me but all was, apparently, well with Sprout*. I have read that this now gives me an 80% chance of not miscarrying, but I just read a paper from our clinic saying that, although the danger point is about 7 weeks, if you have seen a heartbeat at any point then only about 3% of pregnancies miscarry. And that’s in idiopathic recurrent miscarriers. So adjusting for age, I am starting to feel a little confident. Just a little, you realise.

My skivy-itis seems to be working so I am going to continue my policy of minimal work, much time at home and no vigorous exercise. Even Mr. Spouse (who laughs at my normal working hours) agreed it might be helping.

Now I need to pee again.

*Brussels, geddit?

Anniversary

Our third wedding anniversary was yesterday. It was actually a nice day - I didn't think too much about last year, when I had just miscarried. Maybe this past-blindness is what is enabling me to carry on getting pregnant and not just giving up on the whole thing? Anyway it was sunny and we were both "working" at home so we went out to lunch, and then went and bought me a new printer to fit into my new workstation, and to go with my new monitor. Most of the afternoon was spent setting it up. Very productive, I'm sure.

Officially I need a new workstation in the living room so we can have another spare bed in my ex-study, now just a sewing room. We're doing it now because the window is about to be replaced and the poor joiner needs to be able to get to the window. Unofficially, well, whether our child or children come from the NHS or the Social Services, they need a place to sleep, and if it is Social Services, the social worker needs to see that place.

Still much the same, otherwise, slightly more progresterone symptoms (very very sore boobs - I swear I've gone up 2 cup sizes - though apparently that could be it for a while, or they could even shrink again, very warm, cramps still there though less sore) though other symptoms are the same or slightly less (sense of smell still heightened, but slightly less nausea), though I did a sneaky test and got a very dark second line, this morning, so that's not worrying me. I'm actually beginning to believe I might get my 6-week scan. Of course, this could be because this pregnancy is going to be like no 1, and I was wrong about having turned into someone who miscarries on their own, but I can't help thinking something might be going on in there and all my exhortations to "fold your neural tube, build a nice sac" might have been listened to.

Still obsessing and worrying and still finding it hard to sleep, because of the obsessing and worrying, but I managed a full day at the office, and have a half day tomorrow. And I got some new knickers (together with my new "secret support" vests) and put on a white pair this evening.

Scared, nervous, petrified, worried...

all of them... All I can believe, really, is that I'm going to miscarry - Mr. Spouse alternates between denial (la, la, la) and saying "When you get big...". I'm still going to the loo 20 times a day, ten of them hormone related (what on earth would it be like if I had anything to put pressure on my bladder??!) and the other ten due to panicky knicker-checking. I still feel slightly nauseous some of the time, seem to have a heightened sense of smell, and have huge, painful boobs and some cramps. I'm terrified of:

exercise (last time I carried on jogging, but I've stopped this time, and I'm not sure about cycling or digging in the garden either, so I'm copping out)
stress at work (I'm sorely tempted to skive Monday and Tuesday, too, although I have meetings on Weds and Thurs)
sex (which hasn't been helped by having fairly low levels of lubrication, for some reason - I thought progesterone was supposed to increase this).
going too far from home (I think I only managed on Friday because I was already out of the house to go to the hospital)
food (I am not very well-informed on what is and isn't safe so spent ages in the supermarket agonising over some non-rinded goats' cheese which I'm pretty sure is OK)
drugs and even vitamins (I thought I should get some Omega-3 but the pregnancy ones came in huge, three-month, vastly expensive packets, so I thought of getting some non-pregnancy fish oils, and then panicked that they would be dangerous, so didn't get anything)
planning anything too far ahead (we are supposed to be booking our summer holidays - but have no idea what we will want to do or where we will want to go)

Basically I'm just terrified. I am assuming that, although I didn't miscarry on my own during the first pregnancy, I have turned into someone who does miscarry on their own. So I am just assuming I'm going to bleed before Friday, rather than have bad news on Friday (of course, I can't imagine I'll have good news on Friday). I'm sure it doesn't feel like this if you are a recurrent miscarrier who doesn't miscarry on their own, but I can't help feeling it would be better if a) I could go to the loo in peace, and less often and b) there was some chance they could do an ERPC and therefore a chromosomal analysis.

No scan

The registrar says they don’t do them at 5 weeks (and I am only 5 weeks today by the calendar, and probably 4w6 by when I ovulated – actually, now I think about it, I think I’ve only ever got pregnant on cycles when I ovulated a day or more late). She asked for blood tests – beta HcG (the nurse asked whether it was to be repeated, so it seems they do sometimes repeat them, but it isn’t – I also know that even some IVF clinics just do one), full blood count (in case the ENT doctor was right about me being anaemic – and if he was wrong, I’m to come off the extra iron), and clotting screen - she didn’t actually say why that one, but I am pretty sure it’s an online clotting test since some people have hyper clotting only during pregnancy. It was a bit strange actually to think that with all these pregnancies, no-one’s ever managed to do any tests during one of them.

She said she’d book me in again in 2 weeks for a scan. I thought about it for about 5 minutes while waiting for my blood tests and when she came back with the appointment request I asked if it could be brought forward, so it is next Friday instead. I have a feeling they don’t like to scan people unless they are then able to get a definitive answer, reasoning that an ambiguous scan may be worse than no scan. But I am not even sure that the pregnancy will last 2 more weeks, let alone my nerves.

Anyway, having arrived ultra-early, I left the hospital 7 minutes after my actual appointment time. Is this a world record? Then I got the train to where Mr. Spouse works, bought Lush products, had lunch with him, bought shoes for us both (our third wedding anniversary present to each other – leather, see?), and had a manicure. I’m so hard-working, me.

Don't tell...

I spent the day mainly sitting on the sofa, reading, watching telly, knitting, with a bit of surfing and also a bit of sewing thrown in. I even did some ironing. However I didn't tell work I was sick - I just checked my email and replied and said I was working from home. I still feel a bit crampy (not as bad as it was, but uncomfortable, and much better when I'm lying down) and stressed and really couldn't face people after the last two, very intense, days.

I'm fairly relaxed about tomorrow's appointment - I actually worked out even if I started bleeding now I couldn't bleed everything away by then (morbid? me?), and given how knackered I'm feeling (and, er, the fact that I did another test this afternoon and it was strongly positive) I doubt that's going to happen anyway. But I'm beginning to really hope they do a scan, even though last time they told me they don't scan at 5 weeks but do repeat blood tests (which would presumably mean going again on Monday... blurgh).

I was putting out some clothes for charity today that had been sitting waiting to be got rid of for several months. In among them were two vests with "secret support" from pregnancy no 1, over 2 years ago. I decided to keep them - I wore them in bed from about week 6 onwards, I seem to remember. Well, I need them now, so even if I just wear them till next week it might make me more comfortable. I don't think I have any lack of progesterone, somehow.

Edited: because I forgot to say that S, the work colleague who is adopting from overseas, was sitting next to me when I dashed out for the clinic phone call, and wanted to know who it was, and I couldn't resist telling her. She clearly hadn't been paying attention (and can you blame her) when I told her all my previous sagas because on hearing I had my first clinic appointment asked if I was 12 weeks. But now I'm wondering whether I should say "I promise not to talk about the pregnancy" to her. She's never managed to get pregnant, and was about to start IVF when they scanned her and found just one antral follicle. I know she finds this painful, but I'm not sure how she feels about another struggling person's pregnancy (as opposed to the irritating other staff we work with, who just have to drop their knickers, apparently).

Friday

My first appointment at the hospital. I told the nurse I'd only be 5 weeks and she said that was OK. Not sure if it was just a random timing, or last time there were none available in my 5th week, or if this was actually a systematic choice based on the timing of my previous losses.

Also not sure if they will scan me, or just do a blood test. Or what they'd see, if they did a scan.

Feast or famine

That's what it's like on this blog. I feel like I should post often as I might not get many opportunities to post-while-pregnant, just to annoy people.

Cramps: there are three kinds in my world.

Period pains: continual, more or less, and only start after the bleeding. Dull, achey, require painkillers.
Period-related-cramps: similar to period pains, but not continuous. Also dull, achey, and require painkillers. Occur before or during a period. Don't usually occur more than 2 or 3 days before a period.
Pregnancy-related-cramps: sharper, less painful, more like having a stitch in your side. Can also be felt in groin area. Can occur before a pregnancy but can also occur up to 7 days before a period. I don't think I've ever had them in a cycle when I couldn't have possibly been pregnant, and I also never got them before I was pregnant the first time, so I've put them down to either a) unsuccessful implantation or b) a now-slightly-stretched uterus reacting to progesterone.

I've been having type 2 (dull, achey) since about Thursday, but now type 3 (sharper, less painful) have kicked in too, and the proportion is increasing. So I'm in less pain and slightly less anxious that this is ending right now. The last couple of times I had no cramps in warning, only after bleeding, anyway.

Rang nurse. No-one there. Does this sound familiar? If I don't get an answer by about 4 p.m. I'll check with their admin office that she's actually in this week. I would quite like to know if they have any cramp-related advice. Or work-related advice. Or anything really. Interim compromise on the work trip is that I go, but drive myself so I can come home if I need to (I was planning on sharing a lift). Mr. Spouse suggested giving work the heads-up today but I'm not sure if I should tell them "not very well, waiting to hear back from hospital about whether they want to see me/me to go to bed" or wait till I do hear. Writing it down, I think possibly the former.

Nervous

Another positive test, stronger this time (First Response), at 4 a.m. I wasn't going to tell Mr. Spouse till normal getting-up time but I woke him getting back into bed so I blurted it out. He has forbidden me to do any more tests - and he doesn't know about the Friday one.

I would prefer just to curl up in bed and hide for the next week, but I'm not sure this is a good idea, and Mr. Spouse has forbidden it anyway. Unfortunately we have the most boring - but potentially argumentative - planning session ever with our department, lasting two days and taking place at a hotel about an hour from here. All the (numerous) men will get very drunk and ask why I'm not drinking. The women will congregate in the spa (which was my idea, originally) and ask why I'm not in the steam room. And it's kind of been suggested that it would be antisocial for me to book a massage. I am really not keen - I wasn't before, but now I'm afraid I'll start bleeding, and crying, while I'm there.

Still a little crampy, which I don't like. At all. But no bleeding or spotting. I'll ring the nurse tomorrow and ask about that (perhaps she'll tell me to go to bed? you think? no?) and also about doing a couple of blood tests, which they said they do sometimes do at 5 weeks.

Cupcakes

Both the ones we bought from the stall in the market today (mmm... Rocky Road, which was a kind of very thick dark chocolate with the walnuts and marshmallows, and Citrus, which had lemon curd inside it and lemon icing) and the one in the book I'm reading, A Piece of Cake, by Cupcake Brown. I have no idea why I feel the need to read this kind of book as they aren't even particularly representative of children who go through the care system/suffer abuse.

The cramps are slightly better (I didn't need any paracetemol today) and no bleeding as yet, so perhaps there is something in there. It doesn't seem very happy though. I have been trying to distract myself, so I've also been doing a bit of gardening type DIY, putting together a mini-greenhouse, with the help, and criticism (That's not straight! Here, hold this and let me do it.) of Mr. Spouse. He's the handyperson and I'm the gardener around here. But no heavy lifting, don't worry.

Oh look

Christmas uni holiday. Lots of R&R. Positive test last day of vacation. Stressful start of term. Miscarriage beginning of week 2.

Easter uni holiday. Lots of R&R. Positive test last day of vacation (i.e. today). You do the maths. But as it's only CD28 today and I actually think my period is due on CD29 by when I ovulated, and I have mega I'm-having-my-period-right-now cramps, I think this one is going to be a chemical pregnancy.

Still, at least I got to see where the second line should be on the cheapo dipstick tests. My only question is, do I still need to use pads if it's a chem as with a regular miscarriage, or can I go with tampons/mooncup?

Wrong, wrong, wrong

I found out on Easter Day that my friend, who is just a few days older than me, died last Wednesday. I have talked about her in the present tense several times and corrected myself, and likewise forgotten to correct myself, so I’m leaving that first sentence. She and her husband have two under-fives. She had stomach cancer, picked up when the younger one was 6 months old – she thought the exhaustion was just from being a new mother again. The older one started school in September. This is just wrong, beyond wrong.

There is a wake tonight and I am nearby, but not sure whether to go – the funeral is tomorrow, we had a long journey today and have a long one late tomorrow after what will no doubt be an emotionally harrowing afternoon. She is a friend from my old church, and was a large part of making me feel extremely welcome and making the place into a very tightly-knit community. There were only a few people that I got very close to, though, and she was one of them. She had a fairly late miscarriage before the first of their children, and was very comforting to me after my first miscarriage. And she was generally lovely, artistic, warm, welcoming, just a wonderful person. Even if she hadn’t been wonderful, this is just wrong, I tell you. Wrong, wrong, wrong.

How the other half lives

I think this is probably my first foray into private medicine, at least in the UK – in the US I had the sort of insurance that didn’t guarantee you a waiting room full of well-dressed City types, and on the NHS, especially where the RPL clinic is, you get a high proportion of scallies, and a low teeth-to-tattoo ratio. Think people who shouldn’t be wearing leggings, wearing them, and sitting outside the hospital smoking next to a) their baby and b) the No Smoking notice. Yes, I’m a snob.

The Small But Perfectly Formed Clinic is in the bowels of a London teaching hospital, in a mainly 19th century building, so there’s a limit to how posh it can be. But the open evening attendees were, as I say, not your usual gynae clientele.

Most of the talk was about IVF, with little acknowledgement that people might be there for other things, even though a couple of bright-eyed young things at the front asked about IUI during the questions section. The doctor giving the talk did acknowledge to us, though, that she should have talked about people with other needs, as they mentioned, though glossed over, what I think we might be most interested in – an ovarian reserve assessment. She also mentioned, as if it was the answer to ageing eggs, PGS, but she was honest enough to admit that our consultant was probably right, and it probably wouldn’t help us much.

Mr. Spouse says he doesn’t feel nearly as enthusiastic about adoption as he did before the last pregnancy, and I suspect his enthusiasm level isn’t high enough to start the process again at the moment – mine isn’t really, either, though I think it’s a little higher than his. It has also occurred to me that the next preparation course for our agency is probably in the summer, and they wouldn’t want us to do too many home study sessions before it, nor to leave too long a gap before starting again. So we will ring them when we get home and enquire, but not make definite moves to starting again. And I think we might book in for the ovarian reserve test.

I think I might need to compare how I’m feeling now to how I was feeling a year ago – because I suspect it’s the same. Feeling that I have no time, that the next month/six months are THE crucial months for both adoption and pregnancy, that if I put either one off even a little bit I will have missed the window, the perfect cycle, the perfect waiting child. I’m glad the consultant said what he said about my next year – I think I might need to learn to wait a bit more patiently, and to trust that a small amount of time is not going to make that much difference.

Today in the church year is Maundy Thursday – Jesus is all alone in the Garden of Gethsemane, and is very much about suffering, but I think also about trust – that not everything can happen immediately, or the way I want it to.

Apparently Normal

Well, you could have fooled me, but anyway Mr. Spouse was chuffed that his genetic analysis said that. So did mine. The consultant went through all the other results again - a couple of things are slightly quirky (apparently the mini-sacs on one ovary are not follicles, but something they can't quite explain found in 25% of healthy women, but if I had PCOS my hormone levels would be skewiff, and both ovaries would be about 3 times the size, and there is one blood test that is high and is found to be high in about 15% of RPL women as opposed to 5% of other women, but it doesn't make a difference to the outcome, and is usually linked to lupus or another immune problem, but I don't have any of the markers for those).

He reckons our chances with the next pregnancy are about 60%, which is good, as I was reckoning on 40-50%, and he says that given the signs, the next year should be fine for my fertility, and there isn't much difference between 41 and 40. Which is quite good, really, if I actually think about it, as so many other people seem to be saying "ooh, doom and gloom, pregnant past 40, forget it, it's the point of no return". He didn't think much to our suggestions of male factor and/or stress - there is an effect of both of these, but it's small compared to the effect of previous losses and of my age.

It's hard, though, to actually think about it. He did say that with no explanation for the miscarriages, I am in the best outcome group, and although we want to go along and be told a reason and that they can fix it, in fact we have a much better prognosis. But of course that's not what people (i.e. us) want. We want the magic wand and the crystal ball. Apparently about 25% of couples with RPL who come to the clinic don't try to get pregnant again. Since, by definition, you have to have got pregnant 3 times, it suggests you must have been keen to have children in the first place - so it says something that these couples don't try any more.

As for us? Well, I don't know. I don't think we'll be going for IVF. PGS is, as I suspected, a pointless exercise. He thinks it's a combination of the sample size and the willingness to get paid for treatments - not falsification of results, but the file drawer problem. If you'll get paid for doing a treatment, you don't publish the study that says there's no point in doing the treatment. He said there's a study soon to come out from Belgium or Holland saying that in a large population, prospective design there's no point in PGD for translocations, either. IVF with multiple embryos has no evidence to support it - and, given I'm relatively fertile and we would never countenance triplets, not much to recommend it for us, either.

This leaves trying again, and adoption. Try again now and put adoption on hold? Carry on trying vaguely while pursuing adoption? Have a break from trying and carry on with adoption? Just have a break? No idea. I feel like I should want to get on with something, but I'm not sure I really do - I thought I might be all gung-ho for one or the other, and maybe even wanting to ring the social worker before we go away, but I'm not sure I want to. But we are going to London on Weds and the land of Beer and Chocolate next week, so we will have a break from, well, from not doing very much work and feeling guilty about it.

Hospital yesterday, hospital tomorrow...

Went to have my ears looked at yesterday - because of ongoing dizziness - there is nothing wrong with them, apparently I am anaemic. I doubt it, but will ask the clinic tomorrow if this is a possibility.
Clinic tomorrow - have just been printing off abstracts to take with me and say "does this mean..." - I also found an article that said PGS does help with unexplained RPL. I find all this research published by people who might get paid for doing the therapies, on a piecework basis, against my deep-seated research-is-neutral biases. No-one pays me if they use the results of my findings, but those apocryphal "desperate couples" (i.e. us) are very likely to pay to go to a clinic that has published that therapy X may help someone in their situation. Fishy, I sometimes feel. Anyway I have two European articles and two US articles and both the US articles say PGD/S helps and one European article says it doesn't (and the other one is on risk factors).
I've been worrying more and more recently about my brother and the way he is (not) raising his daughters - posted for some advice on a forum I frequent - had some helpful and some not so helpful replies. Two people suggested my brother needs to "get some help", one of whom private-messaged me to ask if he was abusing my sister-in-law. I'm torn between "how dare she" and "yes, if she thought it might be happening, she should say something, even if she is way off and might well be projecting her own experiences". I replied with something slightly politer than the second.

Writer's block

I have been suffering from an extreme case of writer's paralysis at work, which has made me reluctant to try and write anything else - plus the usual technical difficulties meaning I can only really write on Blogger from one computer, and I haven't been at that one very much. Anyway I'm here. We went to see one of our favourite singer-songwriters on Friday and he talked about "writing the cr*p out". So I felt the urge to write something, but then had my usual post-stress (end of term) migraine yesterday. But today we went for a country walk along some extremely flat lanes in the sunshine. So that was good.

I was thinking the other day about waiting - and about how infertility and miscarriage both involve a lot of waiting, usually for CD1. Although this month's CD1 (Friday, if you care) was something I was slightly waiting for, it isn't as big as these genetic test results, which are still a week away. I can't believe how long it has seemed we've been waiting for them. I also know I've been feeling like they will automatically decide us one way or the other - and I'm trying to prepare myself for still feeling uncertain.

Dream Mommy over at You Could Always Adopt posted about an incredibly rude person asking "which of you can't have children"? Although no-one's asked us that I have a feeling that if one of us turns out to have a translocation, people will if we tell them what is happening. Unfortunately those people may be family, and therefore may have a right to know - I have several cousins without children, and one of Mr. Spouse's cousins has a 20-year-old son, and it would save a lot of heartbreak if they knew miscarriages were likely. When I say "people", I actually mean "my family". They are the nosy ones - and also, given their general irritating fertility, the ones that are less likely to actually have any business asking.

£6K

That's what the dental treatment that Mr. Spouse probably needs will cost. It's also, coincidentally, the cost of one round of IVF+PGD, give or take. Good thing we have plenty of equity in the house - that's what comes of both of you moving into one house, both from more expensive cities.

I was at a small, friendly conference last week and shared with the colleague (from a different institution) who gave me a lift a small taste of our difficulties - while mainly talking about my horror at my brother's childrearing (or lack thereof) principles. One of the main things I'm concerned about is that he smacks his older girl, and I imagine will do so with the younger one when she's a bit older. If we adopt, then I'm not sure I would actually dare leave my children alone with him. Even if we had birth children, I'd be very wary, but for a child who has experienced abuse to be smacked - well, you can imagine.

This is sort of by way of saying that we are starting to think about adoption again. Ironically I think we are more likely to decide in favour if there is nothing wrong with either of our chromosomes - though I'm sure you all understand that, because nothing wrong = no fix. I was thinking about this after my conversation with C on the way to the conference and decided when I got home to have another look at the copy of Children Who Wait* which had arrived a few weeks ago. But there was a new one. One little girl - now aged exactly 12 months - had been in the previous two issues, and is half British, half-country-I-lived-in-for-2-years. There are children of a surprising variety of nationalities - I counted about 5 European ones plus American - usually the SW depts ask for a family that can "reflect and promote" or "reflect or promote" the child's ethnic origin (perceval, I haven't seen any part-German kids but I'm sure they are in the system - neglectful families come in all ethnicities). They were also looking for a family who were practicing Christians, though this particular child was a "reflect AND" not a "reflect OR". The nationality bit made me go "ooh" and the Christian bit made Mr. Spouse go "ooh". So even if this child is not for us, it made us think. I'm trying not to Google the meaning of her first name (it is similar to the name a friend over there's son has)

We are going to our next appointment just before Easter and have a nice break in London (with the clinic open evening) and Belgium (with beer and chocolate. Fruit beer. Mmm... Guess who's given up alcohol for Lent??) and the Isle of Wight (long story). We plan to touch base with our social worker briefly before going away, on the assumption that she won't make an appointment for a few weeks anyway, if that's what we decide to do.

*if you don't know it, it's a publication in which local authority social work departments can advertise children who are looking for adoptive families, who are "hard to place" for one reason or another. They have to pay for this so don't do it if they can avoid it.

Knitting again

The girl in the house down the road/office over the corridor has had her baby - rather late - she was hanging around work two days ago looking very bored. Baby's first name - same as my niece. Baby's second name - same as my mum (whose second name is the same as my other niece). And, in fact, one of my preferred names for girls - though if we adopt obviously we will get no choice in first names, but could use it as a second name.

Time to get knitting again - a very good way of not dwelling on things I find.

Erm... okay

Haven’t been particularly well – I have a recurrent inner ear inflammation (symptoms – dizziness, slight nausea, can’t drive or ride my bike, tired, doctor prescribes something which I think is antihistamine) which I suspect flares up when I’m busiest because it’s stress related; and I’ve been very busy at work; and I can’t really blog at work because a) I don’t have time and b) Blogger and Macs don’t mix; and I don’t really want to blog from the PC at home because I would rather veg on the sofa. Hence no posts.

I read the article on miscarriage that Thalia linked to, and emailed the authors to ask if they had analysed their risk factors separately for recurrent miscarriers. I did phrase it in fairly statistical terms so hopefully it will have made sense to them (though I am not a statistician, medics think that only statisticians know about statistics, but psychologists are supposed to do their own statistics, so I sound a little like I know what I’m talking about, but medics never believe that I do anyway). But they haven’t replied. However apart from some minor things (like multivitamins, which are probably just an indicator of a) caring or b) eating properly in general), the article also had a strong suggestion that stress – either one-off or long term- has a significant impact on miscarriage. And I have only ever got pregnant out of university term times, and two of my miscarriages have been during busy teaching periods. Including this last one. And I am beginning to wonder if I should really be pregnant and working; and of course feeling very guilty and sad that dashing around between 4w and 5w could have been bad for this one, when I ended up off work at 5w anyway. Something else to talk to the consultant about, I think.

Speaking of which, after a bit of phone runaround, the consultant’s secretary thinks my FSH/LH must be fine (or the consultant would have given her some wording to the contrary to send/tell me) but the genetic tests aren’t back yet. I assume that it’s quicker to do PGD than to do this because they know what they are looking for – clearly people can’t wait 10 weeks for genetic testing on an embryo. I’m going to ring again 2 weeks before our early April appointment, anyway, just in case. I’ve booked us in for an open evening at Small But Perfectly Formed Clinic which a) does PGD and b) happens to be right round the corner from our bijoux flat-ette pied-a-terre type thing. If we did IVF there we’d have to consider not just the cost of treatment but the lost income… But as we’ve just watched the Money Programme “The Cost of Kids” (£180K per child, pregnancy-18, apparently) and have decided any children are only having Oxfam or Freecycle clothes and equipment, perhaps we’ll save at that end…

Another weekend, another birthday

I'm getting very blasé about this... we have a big (local) party tonight which is a surprise in that I don't know where it is, and everyone else thinks I don't know about it, but Mr. Spouse had to ask me who to invite. Tomorrow we're going to see Eddie Reader and next week The Producers. It's all go! But one of my best friends can't come as she was up all night as her hospital was supposed to be admitting people from the train crash (Not Many Injured) - although they actually didn't, they had to clear all the beds...

My period turned up on Thursday, politely avoiding my birthday, and Ash Wednesday (2 years, liturgically, after we saw an empty sac the first time round), when I had a negative (cheapo) test - glad I didn't waste the good ones. Thursday I felt so crampy and sick and tired and just wanted to glaze in front of the telly and Mr. Spouse felt the same (well, not crampy obviously, but he's getting over a nasty cold) and I mentioned an appointment or something and he said "I don't feel like doing either IVF or adoption" and I didn't feel I could say anything because he was clearly just as out of it as me (and he went to bed at 10pm, unheard of). He did clarify yesterday that he meant he didn't feel like doing anything now, and that is exactly how I feel too. But I got rather panicky for a moment.

So far, not bad

Being old, that is. I had a lovely weekend away with 6 friends and us in a historic house (from the Landmark Trust), and then on Sunday large quantities of family came round to visit, see the house, and eat buffet platters ordered from Waitrose. Officially they were not all in the house at the same time (the house people are a bit fussy about that - it is annoying, because if there are 10 of you you can only have 2 extra guests, whereas if there are 2 of you you can still have 2 extra guests). These are the friends I was blogging about a while back - two infertile couples and us, with our RPL friends coming on Sunday.

There was also a new friend from where we live now, and an old friend from the last place I lived but about five, who has since been first my flatmate and then went out with my cousin for over 2 years: he, although not a bad chap really, probably needs to realise that 38 is not too young to settle down. In cousin-versus-friend, she wins.

One couple are my absolute bestest friends (she's a primary school teacher, they have just been referred to a gynae) but the others (she works in children's TV) are more Mr. Spouse's friends, and are slightly more conservative than us, though very sweet, total bricks, and were really great when the house was invaded by the hordes of relatives, including five children. They are the ones who are going for "treatment" (we haven't asked what); when we were choosing food at the restaurant on Saturday night (example of their brickness: she is very unfond of fish, I had chosen a fish restaurant, but checked alternatives were on the menu, without realising she couldn't stand the smell either. In the event the smell wasn't too bad, but it was noticeable. She just kept quiet and slipped away early. Like I say, a brick.) she said "oh, no blue cheese either".

I thought she meant she had an allergy to that too, but no, she's been "eating as if pregnant" for two weeks out of four for the last two years. My mind boggled. But perhaps everyone else does that too? Come on lurkers, I know you're out there. Tell me.

You may have noticed a slight absence of something. That's right, my period. I noticed too. It's only CD30 which would be no big deal after a miscarriage, if it were not for the very early appearance of post-ovulatory symptoms (the can-I-leave-my-bra-on-please syndrome) this month. Either for some bizarre reason I had a progesterone surge before I ovulated, and ovulation was later than I thought (in which case, our timing wasn't as bad as I thought, but I imagine that progesterone would have worked like the mini-pill, so I won't be pregnant), or it's the longest luteal phase in my own personal history (in which case our timing was off, so again I won't be pregnant), or it was just being polite and waiting till my birthday (yesterday, we went to see Casablanca on the big screen) was over.

Anyway, I'm promised pancakes, so will go and remind someone of this.

Briefly, all's well

I had the last appointment of the ultrasound day yesterday - 4pm - as I had a meeting in another city (not the one we live in and not the one the hospital was in) in the morning, and fortunately a nice colleague was getting the train with me back from the meeting and distracted me from worrying, and we were early enough that I could start drinking my large quantities of liquid once I got off the train, and didn't have to walk too far with a full bladder.

They even saw me on time (slightly early, actually) and the radiographer was very pleasant (though she didn't say "oh, I'm sorry" when I told her I didn't know where I was in my cycle because of the miscarriage). But she was able to tell me my uterus looked nice and "juicy" (packing the tampons for the weekend, then), and my ovaries were both the right size (though one was sitting on top of the uterus "like a hat") and then on the condom-covered one (not had that before - the gel wasn't too bad, do they sell it for, er, personal purposes do you think?) she could see that there were lots of little follicles on the right gearing up to argue over whose turn it is, and one big empty one on the left.

All in order, no cysts whatsoever. As everyone goes home about 4.30, the waiting room across the corridor where I normally go was empty but the receptionist suggested I go and see if the nurses (as in, walking down to the nurses' station without an escort) could track down any test results that were ready. The usual nurse was with a patient but I was willing to wait a little while (I'm reading Blood, Sweat and Tea, which is this blog's book), and they were all lovely and polite and left her a message and made sure they came out to the waiting room to reassure me they'd left her a message, and then to tell me she couldn't find any notes so I could ring the consultant's secretary another day. So I will - at my local hospital they aren't allowed to give you results over the phone but can read you the consultant's letter (!) once it's dictated - and the secretary is very nice, so I think I'll try next week for the hormone tests (LH vs FSH - but I doubt it's going to be any big revelation) and in a couple of weeks for the genetic tests. My theory is once I tell them I'm in the RPL clinic they feel sorry for me and let me do things other patients (the heavily pregnant ones that smoke outside the doors next to the sign marked NO SMOKING, or the ones with a newborn ditto) aren't allowed to do.

Now off to a large Landmark Trust property with 6 friends for the weekend; family are joining us for lunch on Sunday, and on Monday I will be Officially Old. No restaurants are open on Monday so we're going to see Casablanca at the local art house cinema and then to a country house restaurant on Tuesday (although I have to be at work early that day as I'm starting running a new study. Syntactic priming, if you're interested. Bad timing), and Mr. Spouse has a not-very-surprising surprise dinner (I had to tell him who to invite) planned locally for the Saturday. Never let it be said I do things by halves.

PGS versus PGD

These two tend to get confused. PGS is supposed to check for aneuploidies but the latest evidence is that it does not decrease the rate of miscarriage. PGD is for a specific condition (in our case, possibly for balanced translocation) and there is some evidence that it does. I am sorely tempted to push for IVF whatever the outcome of our genetic tests but this little piece of research hopefully will help me keep my head.

Ovarian scan on Thursday. I know so little about this that I wasn't sure if it's vaginal, or not - Google wasn't my friend, so I rang the consultant's secretary, who nicely put me through to the US department, who told me it was "probably both" and I should turn up with a full bladder. Since the hour before will be spent getting there, by train and bus and a little walking, that's going to be fun.

Perhaps the brain is functioning again

Although I'm tired today (partly because of odd dreams), I am actually enjoying a less-than-trashy novel the last couple of days, and felt quite accomplished at work today when I understood what was going on with my complicated spreadsheet (don't leave things for three years, is today's lesson).

I was right, you know - always nice to be vindicated - about the friends who have been trying for just over a year. They finally got the GP to make an appointment (she's sent them away after 6 months - my friend is 37, I wish she'd told me, I would have sent her back to bully the GP). Chatting with her last night and my work friend who is now thinking of Guatemala instead of China (her husband is "too old") felt good. I shared with my friend today how I feel I either shock people ("is it actually possible to have that many miscarriages? weird or what?") or make them think we are mad ("surely they would have stopped trying by now") when I tell people, and how there are some people I probably won't tell, but she doesn't react either way. Both of them asked if we'd get NHS funding for any potential IVF but I strongly suspect it's not available for PGD even if it were available at my age*. And PGD doubles the cost.

Anyway - my dreams - first one, I dreamt I'd gone for my ovarian scan (next week) and had found out I was still pregnant. I woke up feeling happy, and realised it was a dream. Second one, I dreamt I'd gone for the scan and had found out I had an ectopic. I woke up terrified and it took me longer to come down from that. Then I dreamt I had gone back to the town I lived in in East Africa and had left loads of stuff there which they wanted me to sort out, including for some reason some old spectacles someone had given me to take out to give to people, which of course I hadn't been able to do, not having any optometry training (people do have the strangest ideas about what is useable in developing countries - or at least, what is easily distributable and the best ways to distribute it. Oxfam, folks. They know what they're doing). Don't think that one was pregnancy related.

*Just looked up on our NHS trust's website - they have a contract with a hospital to do their IVF, as there's none in the area, but it's one that doesn't do PGD.

Not funny

It is really far too soon for me, but my body has decided this cycle is in its second half and has presented me with all the post-ovulation symptoms – extremely sore boobs, especially when I take my bra off at night, some mild cramps and (sorry) a fair bit of discharge. It does seem as if these have started even earlier than they normally would in a cycle, with a few twinges returning about 10 days after I started bleeding, but I wonder if this is one reason why some people get that post-miscarriage fertility surge – they still have a bit of progesterone hanging around from the pregnancy. No fertility for me, though, as that would require having had that sex thing at the right time that really, if you’ve just miscarried, you don’t feel like.

I had another low day yesterday (unfortunately if I want to sing in the concert, I really do need to go to choir – but yesterday was my last 9am fully animated lecture) so that doesn’t help either. A new choir member turns out to live round the corner from us and have a baby who is the same age the first (first what? baby? pregnancy? dunno) would have been.

So, would anyone who is pregnant and doesn’t feel it like some of these symptoms? I’m happy to offload them.

Incidentally if you are in that group and I’m normally a commenter on your blog (this applies to at least a couple of people – Thalia, Inhospitable) then I am still reading, gingerly, and still cheering you on but not really able to comment at this time. For some reason I don’t seem to find it quite so hard to read baby blogs (though there’s one I’m thinking of deleting from my Bloglines as it’s pretty smug) or even later pregnancy blogs (though in person these people are also hard to cope with), but with someone who’s just ahead of me it’s harder. I guess later pregnancy and birth are just fantasies – late first trimester is somewhere I thought I had reached safely, but really never did.

I'm not dead yet

Another week, another plan. I at least survived this week, with only one major meltdown, which not surprisingly was after my Very Long Day (I'm an academic, bear with me on this one) which started with leaving the house at 8.15 (yes, I know, and Mr. Spouse catches the 7.14 every morning, I don't know I'm born) in order to find a parking space to give a 9.00 lecture (to about 300 students - you try being animated at that time in the morning - and if I'm boring they all snore) followed by a regular day's work and a 2 hour class of 10-ish (depending on how many turn up) from 3-5 (you actually have to be MORE animated in those but you can at least give them things to do while you drink your tea) followed by, some weeks, a couple more hours work, but this week by going home, stupidly doing another test (negative of course - tiredness is now officially not hormone-induced) and then heading back for choir practice till 9.30-ish, then getting home after having to give a friend a lift and therefore hold it together in the car, followed, as I say, by meltdown.

So, we say thankyou for Mr. Spouse, who says he feels guilty that he isn't as sad as me. I told him if he was pleased or relieved I'd thump him, but he is allowed not to feel as sad as me.

Tonight, to take our minds off the fact that we should be at our preparation course, we're having a night away at a "restaurant with rooms". We like that kind of thing.

This week, we are trying to work full time, do a bit more exercise (gentle running, cycling to work) and be more assiduous on the food diary, as well as read up on (and, harder, persuade Mr. Spouse to read up on) PGD. This from the couple that said "no IVF, thanks".

We heard this week from some friends who confessed they were seeking assistance to conceive, and I'm wondering (counting on my fingers) whether another couple we know should be going to the doctor's now, or whether to gently nudge them to do so (and if so, how - last time I talked to her, she was very complacent, and it's been a year since she told me they'd started trying - we're seeing them in a few weeks so perhaps there will be a Happy Announcement).

Gotta dash - should have packed half an hour ago!

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.