Next

Next morning - Weds, 30th May - I rang the local hospital to find out if they had a scan time first thing for me, which they didn't, so I rang the specialist hospital and was told that in order to have an ERPC* at that hospital, my scan had to be there, and that they could fit me in at lunchtime for a scan, and it was likely they could then do the ERPC that night. So I packed my bag (forgetting dressing gown, slippers, and earphones to listen to music on my phone) and we set off, ringing the local hospital as we passed it to tell them we weren't coming.

We needed to go to A&E at the specialist hospital but as it is specialist, and the labour ward is elsewhere, it was relatively quick, and I suspect almost everyone there is in for a similar problem. A quick triage and we were sent downstairs for a scan, where the radiographer did a thoroughly decent job including using visual doppler and narrowing in on the chest area, but couldn't find anything resembling a heartbeat. As I posted previously the foetus was much more as I expected in shape - similar to the previous week - and did not look like it had disintegrated, only like it had not grown further - it still had a distinguishable head and body, and measured 7w6d.

Of course we have since racked our brains for anything that might have happened around 5d after our second scan but that particular Tuesday was quite relaxing so, although we know intellectually that it is unlikely anything I did caused the foetus to stop growing, it is helpful to actually feel blame-free too.

Back up to A&E and a few tears were shed while a junior doctor talked us through the options - well, rushed over medical management, didn't mention expectant management, and talked more about surgical management. I mentioned for the first of about five times that we needed analysis of the foetal material. While we were waiting to be allocated a bed someone in the next cubicle was having a very loud doppler with a pregnancy of uncertain gestation, "about 16 weeks".

I had at this point not had anything to eat since 8.30 and no water since midday, before the scan. They found me a bed and at about 4pm confirmed they'd be able to do the ERPC that day, and that I should be able to go home at 10pm, but I decided I didn't want to arrive home woozy at nearly midnight, so Mr. Spouse went and got me a magazine (forgetting chocolate - he was in trouble later) and went home. More waiting, I went down for the op, and eventually came back to the ward and demanded food. I spent most of the rest of the evening demanding more food, and asking to go to the shop to buy chocolate, and not being allowed to go. I think I finished my magazine, and my first book, and checked various things on t'internet on my phone, and dozed off about 10.30 after the other girls on the ward (unidentified serious gynae op, and huge ovarian abscess) had watched the first Big Brother, and the old lady in the next bed (some type of gynae cancer, removed) had started snoring.

I did have my earplugs, but about 4am was woken by an emergency admission, one of those things that actually makes you feel lucky - early 20s, suspected ectopic, very frightened. I tried really hard not to cry too loudly, and read most of my second book, until drugs came round at 6am and I went back to sleep.

Before Mr. Spouse arrived one of the doctors from the miscarriage clinic came to see me, admired my (Paul Frank) pyjama bottoms, and said how sorry (blah blah) she was to hear this, and then totally blew me out of the water by saying how encouraging it was that we had got this far, we had never got this far before, what they are doing must be working, etc. etc. I have to say that I hadn't thought at all that it was encouraging - more along the lines of, they do everything they can and still it doesn't work - but perhaps she is right. Except she isn't really going to just tell us to go away and give up, is she? Or is she? I have since thought that maybe, if there are two problems (rubbish embryos with genetic abnormalities, and an unsupportive environment), if we can sort out the second, then possibly luck will lead us to have a chance with the first, statistically.

We went back home about midday on the Thursday, after they had finally found me some anti-D (as I'm Rh -ve, and this was my first surgical management). The girl in the next bed still hadn't been scanned, and was getting very fed up of being on a drip. I gave her my magazines and commiserated about waiting for a scan when you are nervous.

I spent the next two or three days in a complete haze, mainly in bed ringing down for things to be brought to me, not even really making it onto the laptop. I think those days were more upsetting for Mr. Spouse, with me being so out of it, and his emotions being very raw, but he was at home with me, and very solicitous too I may say.

It's late, and I'm getting over the (ahem) tiredness from yesterday which followed on from the black tie do of the day before, so I will sign off. Probably only one more update installment - Hospital Visit Mark 2.

Incidentally we (as in, our household) don't do Father's Day - something that Mr. Spouse told me when his father was alive, so it's not that he wants to avoid it because of not being a father yet, or because of missing his father who died last year - my own father has never even mentioned it, except possibly to agree with my mother (always wise, at least when she's in the room) when she bemoaned its artificiality when we were children. I don't remember her acknowledging it when her father was alive either - even though she expected something from us on UK Mothering Sunday, and called her own mother on US Mother's Day. So. I haven't commented on it. But Mr. Spouse has been a bit out of sorts today. Though I think it's his Open University assignment, and the same (ahem) tiredness as me, to be honest.

As he's now asleep I'm not going to wake him up and say "oh, were you upset because it's Father's Day and your dad died last year". I'm nice like that.

*Evacuation of Retained Products of Conception. I think in some places they still do D&C as standard, or else a lot of women are told that's what they are getting, as I've seen a lot of people still referring to D&C, even for recent pregnancies. I even saw an online gynae query where the gynae "wasn't familiar with the abbreviation ERPC". But I believe ERPC is best practice now.

In all its gory detail

You realise this is mainly for me, not for you, OK? So feel free to nod off.

Tuesday 29th May, a.m.: After having had a small amount of brown blood (and I mean small - titchy in fact) over the weekend, I rang Liverpool and got Accident & Emergency who said yes, I could come in, they could not promise to scan me that day, but they could check my cervix. I decided to book a G.P. appointment for that day as a quicker way to check if it was closed. My friend J rang, who had the day off and who I'd completely forgotten might come down to see me if she wasn't too tired after being on call. She is a consultant anaesthetist who lives about an hour and a half away from me. This point will become important later. I realised that there was no other day that week for her to come, and at that point was feeling OK, so I asked her to come down that morning and planned to have lunch with her.

After she arrived, I opened my birthday present from her (she is a busy woman!) and that was my last panic-free moment. The paper is, I think, still sitting in the dining room. One part of the present was a blank book and I remember thinking I could put stuff relating to the baby in the book. That is also still sitting there. We decided to walk into town and get lunch, and I nipped to the loo where true panic set in - I found some red blood. I wasn't even sure whether to tell her but decided she'd know what to do. I remember saying "I don't know what to do now". She suggested that I needed to eat (that was a mistake, really as the place we chose to eat took over an hour to serve us some rather mediocre sandwiches - we chose it as it is on the same side of town as the hospital, and there isn't much else out there except my work) and that going to A&E after that would be quicker than waiting for the GP, who probably wouldn't examine my cervix anyway.

So, about 3pm we were in the hospital and after we had refused the medical student trying to put a canula in and the A&E registrar had failed she did it herself. It is very handy having someone bossy and knowledgeable in a hospital, even if she doesn't know as much about fertility/miscarriage as I do - which made me feel slightly better. By 4 we'd been taken up to an examination room in the gynae ward, and finally at about 4.30 I'd been examined, pronounced to be closed, the bleeding had pretty much given up and I and was about to go home feeling much better, with a promise of a scan slot at some time in the morning. J didn't know what they meant by a follicle tracking appointment [which might have been free] nor when I explained I thought it was for the IUI they do at a different local hospital did she know what IUI was. And she didn't know the condoms in the box on the shelf were for TV scans.

We'd been talking about her pregnancy (she didn't find out till she was 19 weeks - she was on the mini-pill and religious about taking it, but had been vomiting - her daughter was just 7 - she is a big lass but although I only saw her after the birth, having not seen her for a few years, I don't think she was that big!) and antenatal testing (she pointed out, quite rightly, that if the baby had a fatal condition I would be wasting six months to a year of my fertility if I didn't terminate early), and everything felt calm.

Then one of the radiographers (I'm assuming - whoever it was, I've never seen him before, and even J who likes her patients unconscious was aghast at his lack of bedside manner) arrived with a portable scanner although I actually felt very calm, and somehow knew it wasn't going to be good, even before he switched much too quickly from an abdominal to a TV scan. The previous scan had been abdominal and very quickly found something - although looking back now I think even if things had been OK he might not have been able to see much since the resolution is very poor on the portable scanner. But I suppose it was probably best for me not to hang on in hope, as in the first pregnancy I had an overnight of hanging on in hope when Mr. Spouse had given up.

On the TV scan the foetus was measuring just 7w - smaller than when we had seen it nearly 2 weeks previously - and he could not see a heartbeat, and the shape was really blobby and not at all foetus-like. I managed to hold it together until J took me home, by which time Mr. Spouse was there, and she went and made a cup of tea while I collapsed, sobbing, into his arms. At this point I was thinking that the foetus had deteriorated into a mass of undifferentiated tissue, and had been partly reabsorbed, and even was wondering if the first miscarriage (empty sac at 10+2) was in fact more advanced than we had previously thought, but had been reabsorbed. I was also feeling even more depressed (personally) than after any previous miscarriage - serious thoughts of self-harm and even suicide), which very much worried Mr. Spouse.

I've known J since we were both 18, but she isn't a very touchy-feely person - I was very touched when she pressed my shoulder before leaving and said "take care of yourself".

We were still promised a full scan the next day, either in an early morning slot or mid-afternoon. I can't really write much more now, but having started the story I think I'm going to have to finish it at some point. Nudge me if you think I have gone off into a deep depression (honestly, I wouldn't be able to write this if I wasn't feeling a whole lot better).

Isn't that what they say about giving birth?

that the only reason people go through it more than once is that you forget how awful it was? I think that must be what has happened to me with each miscarriage. I look at myself from the outside, thinking how other people must see me, and I think that I must seem, to them, who have never experienced it, rather like those who have experienced seven, ten, teens of miscarriages appear to me - slightly crazy and slightly obsessed.

I mean this with no disrespect to those who are in this boat - in some ways I find their stories inspirational - but although I know (either personally or online) several people who have decided that they have had enough of trying to get pregnant, either on their own or with medical help, I am not sure I know of anyone who made that decision after recurrent miscarriage. I have read that once you've done three properly regulated IVF cycles your chances start to drop, but there don't seem to be those statistics for recurrent miscarriages.

But I also feel that, with this 4th or possibly 5th miscarriage, that I have entered the big leagues. I had various blogs on my bloglines list of people who had had 2 or 3 miscarriages, but several of them have recently moved to the "parents" section (one through adoption, but most through carefully monitored pregnancies, just like mine was...). I know there are more people out there, some of them who are being seen at our clinic. I am not sure how much lower our chances are now (I'm guessing about 50% per pregnancy). Like I say, I don't know if our chances are now about the same with each pregnancy, or are exponentially dropping.

I'm just trying to carry on carrying on here, watching TV, avoiding having my mother to stay, eating peanut butter candy (Thalia is fantastic, but thank you to the other people who offered, you are also fantastic), buying shoes, weeping in cafés, arguing with Mr. Spouse and then both of us apologising, avoiding pregnant friends and those with babies (managed two yesterday on the 10 minute walk to and from town). Mr. Spouse says he is trying to be happy for them by thinking that he couldn't possibly wish this on them.

Back home

I was discharged at lunchtime yesterday, and had to take a taxi home (ill-timed out of town meeting for Mr. Spouse - in fact he was slightly grateful they admitted me as he had to leave at an ungodly hour in the morning and was worried about leaving me at home, in pain and bleeding), but actually found that I felt a bit better than even before I started feeling worse, if you get my drift.

However today I had a migraine (haven't had one during any of the pregnancies - I'm guessing it's the hormone crash) and started feeling a lot more emotional. I had a quick trip to the GP - basically for some tea a sick note and sympathy, both of which I got. She even asked how Mr. Spouse was doing, which impressed him. I'm signed off (which here means you are not allowed to go back to work) until the 25th June. There's one more week of term after that (mainly whole-department meetings, which I may cry off and try to catch up with some students) and we are then on holiday for our annual pre-school-holiday-price-hike trip for Mr. Spouse's birthday. I may go back and see her again (instead of my registered, nice-but-male GP). But she'll need to refill her tissue box first. One tissue! How pathetic is that!

I just about made it to the market and managed to buy a few small things and make it home again before my tears won out over my clenched teeth. Mr. Spouse kindly rang work and told them how long I will, provisionally, be away for, I think also leaving the message that I'd been admitted again, to emphasise that I Am Poorly. Very Poorly. I also seem to have failed to set up my email out-of-office message correctly, so I updated that today, and my irate students will at least have some idea when I am coming back.

I may, as I said, write more about all this when I feel up to it, but I just thought I'd reassure you that I am at least alive, and at home. The pain and bleeding are almost gone, though I am rattling with the antibiotics and as zonked as I wish to be on the good painkillers, there was a little fluid on the scan, so no repeat ERPC, and the swab for infection wasn't back yet when I left, but I think they wanted to be on the safe side and dose me up with killer antibiotics.

Oh how nice

I'm in hospital. Again. A lot more bleeding, clots, and some very severe pain led to a trip to the out-of-hours GP service (a lot quicker than A&E), followed by transfer to the gynae ward, where I am currently languishing, waiting for the good painkillers and some antibiotics.

Trivia

There is a young man I know, through message board/blog route (so when I say "know", you realise I haven't met this person) and he, though only in his 20s, has recently lost his wife. There is more to the story, but this is a tragedy of such huge proportions that you don't really need to know more, though I may post a bit at some point. When this happened, I noticed that fairly quickly he started posting about things other than this huge tragedy on his blog, and on the message board.

I thought this was a bit weird, but I think I understand a bit more. I don't feel ready to process or write much about Sprout and how we lost him (for some reason, we have been referring to the baby as "him"), but I need distraction, more than TV/knitting/reading/napping can provide, so I have also been reading, and occasionally posting, about things that I then think "this does not MATTER. Why do I care about this? Why do I care about anything?".

I'm still in a bit of pain, though not unmanageable, hardly any bleeding, though my whole pelvis seems to be objecting in unison, as I've been having a bit of pain on urinating. No heavy bleeding, clots, or fever though so I'm pretty sure I haven't got an infection, still taking the codeine/gin in alternation. My mother sent home-made brownies (and roses, in the same jiffy bag, rose-scented brownies are surprisingly nice), and Mr. Spouse found peanut butter chunky Kit-Kats which aren't quite Reeses, but are still pretty good.

No-one is at home. Please leave a message after the beep.

The anaesthetic has left me tired and groggy, and the painkillers ditto - just one codeine makes me dizzy and sick, though it works, so I have been taking it at night, plus you can alternate it with NSAIDs, and I'm still quite crampy. I think it's been Mr. Spouse who has been feeling more emotional today than me, as apart from an hour or so in the middle of the night in the hospital, I haven't really been seriously crying. I think I need to be able to feel something to be able to feel sad. It is very different to the previous "natural" miscarriages (the first one was medically managed but apart from timing it was similar to a spontaneous loss).

I'm trying to make sure I have what I need for the next week or so at home but I'm also afraid I'm going to go into recovery autopilot, and just do things that pass the time without helping me feel better - I don't know if the things that made me feel better in the past will be the same ones.

Don't know if I'll describe the whole process, just salient bits, or none of it, but not just yet.

Later: Sent Mr. Spouse out for coffee, lemons to put in the G&Ts (don't worry, I won't mix them with codeine), peanut butter, and Reese's peanut butter cups. They don't have peanut butter cups in our Sainsbury's. Do they have them anywhere in the UK? I think this is a mother's-milk craving - before you could get peanut butter over here, my mother used to bring it back when we visited her parents.

In hospital

You won't be too surprised to hear that. We went to the specialist hospital this morning, the scan showed the same, though clearer and easier to say goodbye, somehow, I've had the ERPC, and multiple assurances that there would be analyses. I'm staying in overnight and Mr. Spouse is coming back for me in the morning.

Not good

Although there wasn't much more blood, and the cervix was closed, the portable scanner showed a poorly shaped embryo and they couldn't find a heartbeat. Another scan on the good machine tomorrow but basically, we are battening down the hatches and thinking about our options.

Red

More blood, different colour. My nice doctor friend is over for lunch so after we eat she is taking me to A&E. Just don't want this to happen in public.

No scan today

I just rang the hospital and the nurse said that given how little blood, and that it's brown, it's extremely likely my cervix is closed, though I can come in, or go to my local A&E, to have it checked, but they won't scan me today since I have one booked for Friday. I don't think they are that full up but it actually saves me a decision - I was wimping out of going to potentially bad news on my own, and now I'll still be going with my mum holding my hand.

It is 90 minutes either to drive (and it's not a very straightforward journey) or on two trains and a bus so given the choice between sitting with my feet up mocking my students' exam answers/watching trashy TV, and taking a long and stressful journey, I am fairly happy to have the decision made for me, and to do the latter. Hopefully Sprout will thank me for it.

Where would I be without something to panic about?

I dashed to the loo before an out of town meeting on Friday morning when I discovered the tiniest bit, ever, of light beige mucus in my knickers. This was after a tiring day and a fairly sleepless night, and at the start of a long journey via the city where Mr. Spouse works to my mother's for the weekend. We had promised ourselves a weekend of R&R but I think there was too much of the second R and not enough of the first as I had a larger, but very light beige, bit each morning, once after, erm, straining, and again this morning when it was gloopier and a bit browner. Apart from the first bit whatever there is seems to be mixed with, erm, how to say this, externally introduced mucus. Logically I know that

a) it is brown, in fact most of it is beige, so there is not a lot of blood and whatever is producing it has stopped bleeding

b) apart from the first day, it was all post-activity and perhaps now is the time to lay off

c) it is very very common to have even some red blood and for it not to be a bad sign

d) it could actually be something external to my cervix

e) all the other symptoms are the same, including the nausea (which, though not worse, seems to be more frequent), and although I have a few cramps if I look at each one objectively it is no worse than any I've had so far this pregnancy. I am also a little confused about the cramping as I've had a couple of wicked bouts of indigestion (sorry, mother, it's not your cooking, I just don't seem to be able to do meat at the moment), and bowel cramps can be easy to confuse with other pelvic cramps.

I'm 9w3d today. You will understand where I'm coming from when I tell you that at exactly 10w in my first pregnancy I had something similar (though quite a bit heavier) and although they pronounced my cervix closed, a scan showed only an empty sac. I know it won't be exactly that way this time, but I've always thought that was actually the first warning of a full bleed, and that it was just taking my body some time (in that case, about 4 weeks) to decide to bleed properly.

I tried to ring the Early Pregnancy Unit at the women's hospital as soon as we got home from my mum's this afternoon but, being a bank holiday today, they were closed and I got the emergency number. I imagine that about 25% of their emergencies, statistically, are miscarriages or threatened miscarriages, though, so they should know what they are talking about. She repeated point a) above, told me to take it easy - "no heavy shopping or hoovering" were her words. I'm taking that to mean I shouldn't have gone to the outlet village yesterday, and that confining myself to home for the next 24h, at least, would not be a bad idea. If I have any red blood, I am to go to A&E locally, but like the other hospital, I can't see them being able to scan me before tomorrow, and in fact, probably not even then given their usual timetable. I have my next scan on Friday, but I will also ring the EPU tomorrow and see whether they think an earlier scan would be possible.

Eating for 1.01

Having noticed my trousers get a little tighter, and being unable to escape the fact that I had been, basically, sitting on the sofa and eating for the past couple of weeks, I promised myself that if I made it past the 8w scan I'd weigh myself. I have put on half a stone (3kg for the imperially challenged) - about 3lb of which I reckon is evenly distributed between my boobs.

Now, I am trying really, really hard not to beat myself up about that - I know that much of it is fluid and blood - but I also know that not exercising, and eating too much sweet stuff, is not good for me or the embryo. So, despite being told not to obsess, I have decided to fill in my online food diary for a week or two. It is not good news. I am eating far more than I need to maintain my weight and I am eating too much sugar, not enough protein, and I'm barely making my 5-a-day some days. I know I should not worry about this, and I also realise I am struggling with nausea, but it is hard not to. I'm trying to concentrate on increasing the amount of protein, and eating slightly less sweet stuff to ward off the nausea.

It is very hard to get to the point of not thinking about my weight, after more than three years of mainly thinking about it. Before I lost weight, I was adamant I was fine - it took a failed glucose tolerance test to wake me up, which is partly why I'm now worried, though at the weight I am now I don't have any problems with glucose, I am very worried about gestational diabetes. But I am also catching myself thinking "I don't want to be a huge fat mother". I actually am not that worried about being a huge fat pregnant woman, partly because I can't quite believe I can get that far.

I had mad ideas of carrying on running while pregnant, and although I am almost certainly not going to go there (boobs hurt too much, and I'm exhausted - took a 2 hour nap today - even leaving my foot aside, so unless they magically stopped hurting in my second trimester, it would be a no go) I still feel idle. I'm not a very sporty person, just fairly active, and I don't like being inactive, but I am still a little scared of being too active.

Big grins all round...

Getting your stuff ready to go for a scan, if it's 90 minutes away, is a fine art. First there are knickers you don't mind losing, then enough books (and lightweight enough) to read when you're both dying to pee, and potentially going mad waiting for a decision to be made. Then there's "do I take overnight stuff". I took my contact lens case and toothbrush, as years of travelling experience leads me to have two sponge bags ready packed at all times - the mini one, with the lens and tooth stuff, and the big one, with the soap/shampoo/hairbrush etc.

But in the event my pessimism was not needed. As you can see, all were happy, including the nice doctor (the one I've seen twice before, and Mr. Spouse once, when we were there in January. She was crying that time, in sympathy with us.
Me: I wish they'd wear name badges, so I'd have better chance of remembering her name.
Him: She was.
Me: So what's her name then?
Him: I forget.
We were too busy looking happy, I think.

Anyway we saw and (pretty much immediately) heard the heartbeat, saw a vague shape of embryo, which measures 7w2d but the doctor says not to worry as there's a large margin of error. It measured 11.1mm and clearly just 0.1mm off would be easy to do, but would make at least a couple of days' difference. I reckon I am 7w5 to 7w6 by when I ovulated so I will try not to fret about that. I did give in to temptation and look up my official due date, which should have been December 29th, so I reckon this would be a January delivery, realistically. And we now have about a 90% chance of having one, by my guesstimation.

The radiographer (50-ish, male - I didn't know they made male radiographers) referred to it as a foetus and we were also later directed to the fetal (sic - despite this being the UK) medicine centre so although I think it is technically still an embryo, that also makes it seem a bit more real. The fetal medicine centre visit was to book in for a nuchal translucency scan and combined blood test thingy. We feel that if there is to be not-so-good news, we would like to know sooner, even if we are pretty sure we won't want to do an invasive test, or terminate except in the case of an abnormality incompatible with life (and we also discussed this case). I had been ruminating on this for a few days and it all came out in an incomprehensible rush (rather like the tax information Mr. Spouse was trying to send me to sleep with last night) but I think we are now on the same page. I think we always were, actually. It is partly personal conviction, partly history - at the moment we feel like we would rather have a baby, and child, with some problems than no baby, or child, at all.

So this afternoon we went to the seaside! In fact, to a gorgeous Victorian town which, local legend has it, was visited briefly by Napoleon, and on which he modelled Paris' main streets. Well, that's what they say. For more information, read the hilarious Lancashire, Where Women Die of Love. We had a slightly substandard pub lunch, and then wandered around the continental market, clearly laid on specifically for us, and enjoyed the fine weather, ditto.

Then home, where I have just come off the phone to my mum - who on being told the news, squealed for about five minutes. She is going to come to my next scan (1st June) as Mr. Spouse is getting to the stage where he will have to take unpaid days off to come with me. She was clearly delighted, not only at the news and the invitation to hold my hand, but also at the chance to get out of something her fellow retirees had signed her up for that she didn't fancy. I swear, she's busier than me. She again bent my ear about my brother's parenting skills (or lack thereof - I better measure up to her idealisation of me, is all I can say!), but seemed a bit more positive about them than recently (long story).

I'm just going to remind Mr. Spouse that he said he'd cook something for me, as I need to eat but can't face the kitchen...

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!