If I knew what was wrong, I'd have some chance of working out who might be able to put it right...
Thursday, November 23, 2006
There’s confidence for you…
At 3 weeks 5 days. 9 DPO. Including her due date – and the fact that she thinks it’s actually 4 days later due to ovulating late.
OK, so I announced my last pregnancy on here at 4w3d. But not on any of the message boards I read. And I didn’t even calculate my due date – and I now deliberately don’t know it. I will allow myself to feel sad on the anniversary of finding out I was pregnant the first time, as I think it’s around then.
In our world, the last cycle is over – phew – a uterine biopsy is, well, OUCH. And DOUBLE OUCH. Followed by lots of spotting and a thankfully early period, which at least put an end to the spotting. I bought a Mooncup. I have been putting this off for ages as I thought you had to buy different ones dependent on whether you’ve had a vaginal delivery or not, but it also depends on age which affects your pelvic floor muscles. I have to say that I probably could have used the girls’ version as I do Pilates and yoga and, erm, lets just say have a busy night-time life, certainly much busier than I did before I was 30. But no matter. It is so far no more uncomfortable than a tampon (I know it’s there but it doesn’t hurt) and it is quite convenient to know it can stay there for a much longer period of time.
We took in our CRB forms this week and as far as we know it all went well, but I may have to have US clearance forms, and I had a panic when someone mentioned references from all the jobs, voluntary or otherwise, that have been with children – that would be starting with volunteering at the university playgroup when I was 19 – does it even still exist? But apparently a selection will do, so I am to make a list of the organisations that I can remember.
Reading continues, for me at least (Mr. Spouse is not such a good reader – and is also feeling a little reluctant at the moment – but I think he’ll manage to process a few selected books in the end). I’ve finished reading (or, at least, skimming) three books by Caroline Archer, which seem OK; one thing that strikes me is that they use behavioural techniques while being rather scathing about them, and trying very hard to come from a hugely psychodynamic perspective. They explain interactions in terms of psychodynamics (the one I’m reading at the moment, by Vera Fahlberg, even goes on about Freud and the Oedipal phase – I didn’t realise anyone even put that in books any more) but then suggest largely behavioural interventions for the difficulties children have – introducing things gradually, in safe and anxiety-free environments, is a staple of e.g. behavioural therapy for phobias. The other thing that slightly bugs me is that none of the interventions have in any way been proven in any kind of research trial. I’ll read on.
I’m off on my exotic trip on Tuesday – not, I have to say, as excited as I could be – the journey there will take 48 hours including a nearly-24h stopover, and Mr. Spouse can’t come. I’ll be back just before Christmas so behave yourselves while I’m gone.
Thursday, November 09, 2006
Sorry to leave you hanging on there!
To continue the story: A lived with me for about six months, during which time he started school and learned a lot of appropriate skills. He started to refer to me as his mother. this is not such a big deal as it may sound – most African children have more than one adult woman they will call or refer to as Mama – it is sometimes necessary to ask people whether the person they are talking about is their birth mother/father and it’s not considered at all an insulting question. He would tell people when we were out that I was his mother – when he was living with me this seemed appropriate – and people would ask us this. This may seem a completely ignorant and mad question, but you have to bear in mind that it is very common in the region to see a white (albino) child both of whose parents are black, and for all they knew there was a similar genetic error which could make it happen the other way round. A became affectionate – but appropriately so – towards me, and seemed to enjoy living with us (my housekeeper and me).
He was also a little terror. It is very likely that he was sexually abused, possibly by the boys who were living across the road. The pattern in the region seems to be for older boys to “educate” younger boys by either forcing them to have sex, or to watch them. Anyway, he had inappropriate knowledge and, according to a colleague, tried to kiss her very forcefully. After I left, there was a rumour he had tried, or even managed, to rape a girl in his school. He could also be violent and oppositional – he was never violent or sexual to me but could be very oppositional, tended to run away (I had to chase him round town in the car a couple of times).
When A was a small child, his mother died, as I have said. His father was a refugee from Mozambique, and had no family locally. He had worked as night watchman for a family who, I believe, were from the UK, and A had lived with them when he was small. He spoke pretty good English for a child from his area (normally it is limited to Howareyouteacher) and gravitated towards wazungu (white people). The British family had wanted to adopt him but his father had understood this would mean not seeing him again and had said no. The only person left to care for him was his alcoholic father. We think he was enrolled in school aged 7 – we are not sure if there are some relatives of his mother locally – and things seem to have gone OK for a little while, until he ran away – aged 10, at most – and his father didn’t look for him.
Parenting was hard, and I don’t know how I would have coped with life as a single “parent” if it had not been for my housekeeper. Not only did she do lots of practical things round the house (but teaching A to do the things that were appropriate for his age), but she also babysat when I was away (he bit her), and gave me advice on how she would have expected her brothers and sisters to behave at that age. She was very longsuffering and I was, I hope, appropriately grateful.
The end of this stage of the story comes when I had to move back home and find somewhere else for him to live. His father this time wanted me to adopt him and take him home. I didn’t even know where I was going (as it turned out, I spent the next six months constantly moving) and if I would be allowed to do this, I did do some half-hearted investigating but it was never really going to be an option. I needed to find him a family locally.
Fostering and adoption are just not common at all in the region – people do not care for children that are not kin – so this was hard. He went to stay with a pastor and his family for a weekend and they said they couldn’t cope with him. I was in floods of tears coming home from their house – one of those count-on-the-fingers-of-my-hands floods that only come a few times in your life. Finally a very good woman who worked for the project, who was a friend of mine, said she’d take him in. My job was being taken over by a friend of mine, who continued to employ her, and I knew I could send something for his support through him, so I was very relieved. In fact not everyone on the project liked her (the other colleague I mentioned above, in particular, didn’t) but that didn’t really matter. At least he had somewhere to live.
There is more to come, I just don’t know when!
Monday, November 06, 2006
Instant parent
Stirrup Queens blogged about "finding a baby on the doorstep"; well, this almost happened to me. As in, it wasn't a baby, it was a ten-year-old boy.
When I lived in East Africa, lots of the neighbourhood kids used to come round and play on my sizeable balcony and watch my video and when there was food, they would eat. A group of older teenagers moved into a house opposite and one of the kids that was hanging around at mealtimes was A, who was 10. Turned out he was living with them, doing odd jobs, he had been living on the street, and I found out he wasn't enrolled in school, and asked around - my housekeeper suggested we needed to find out if he had parents before doing anything about this. So we put the word out on the bush telegraph and his dad turned up.
A's father was alcoholic and his mother had died when he was a young child. His father was more than happy for us to feed and clothe him so long as he didn't have to. So he moved in to the spare room. When he came he had only one set of clothes, no underwear, no toothbrush or comb, no school clothes, I think he may have had some flipflops but no proper shoes. Lest you think "well, he's a small African child", most of the children in my town had all those things, and their mothers would have been ashamed to let them out of the house in the state he was in. He didn't know how to wash his own clothes, and the other children laughed at him when they found this out, because they had all been doing theirs since they were small.
There is a lot more to this story, which I may tell you at one point, but at the time I remember thinking "well, I didn't think my first experience of parenting would be a stroppy 10-year-old boy". I was only just old enough to be his mother, realistically, but I was at least an adult. I have also had a lot of people comment "oh, how good of you that was" but really, was I going to chuck him back on the streets? What else could I do?
Saturday, November 04, 2006
Of course when I want cycles like clockwork...
I have two other blogs; one of them is my diary from when I was 11, and is at theyeariturnedeleven.blogspot.com - I have been finding out where all the people I was at primary school with have got to, and it is very good for me - so many of them are not in a relationship, don't have kids, have been divorced... with one happy marriage, I actually feel pretty lucky.
*that little noise you hear is us collectively whimpering.
Monday, October 30, 2006
I think I’m going to have to dripfeed this…
OK, so I never finished the tale of the interview with the agency director, but it’s long enough ago that I will need to check I don’t repeat myself. She sounded pretty positive but trying to be realistic – we would have a good chance of being approved, I think, although obviously they can’t promise anything at this stage, she really endeared herself to Mr. Spouse by refusing to believe he is 51. But if it was between us and a younger couple, then a child’s social workers might well go for the younger couple. However, I believe that in a lot of cases only one couple is considered for a child or children.
One suggestion she made is that we might suit a pair of siblings with a large-ish age gap (e.g. a six year old and a one year old). She was very understanding of the “need to parent”, especially to parent young children and babies, which she says placing social workers often don’t understand, but not to make the mistake of taking an older sibling just so we could have a baby. I have to say I would be up for this if the older sibling was uncomplicated – but that is unlikely – though I heard about a child who had been in a loving foster home for four YEARS before an adoption placement so it is not completely impossible.
I also mentioned the possibility of mixed-race children. I’m not sure she really thinks that dark-skinned bi-racial children would be possible (we, on the other hand, don’t particularly see a problem – especially if they have heritage in a country we could take them to) but she said there are sometimes children who are mixed-race but appear fairly white, or sibling pairs with different fathers where one is mixed-race, and adopters who are dark in appearance won’t take such children, but again placing social workers tend to be rather unrealistic about such children. So that is another option.
So, we have found our referees (three friends – not family – plus one of the vicars at our rather over-staffed church) – they don’t show what the referees write to us, but the referees themselves are free to show us, which we have told them, and they have all said they’ll show us what we wrote. I’ve also been getting books out of the library, and vetting them for Mr. Spouse, who prefers to read newspapers. I have a feeling I might have to bite my tongue when the social workers recommend some of them, as there’s a lot of pseudoscience, poorly explained ideas, and unfounded therapies.
Friday, October 20, 2006
Chances are...
We were discussing this today after our adoption meeting where the SW was probing about how far we felt we’d gone with having a biological child, what we felt about using contraception, etc. I said I felt that we were being told we had a really low chance, and there was no treatment they could give, by the gynaes, and also (if she was any good at reading between the lines) that once we were matched, or had a newly placed child, that like with a birth child we would use contraception as we would want a gap between the arrival of children as any parents would. I do not honestly feel I could say we’d use contraception now (though Mr. Spouse and I are not quite on the same page on this one, as he is now very keen to Get On With It and afraid another miscarriage would set us back for too long, I am a glutton for punishment and feel I could cope with maybe one more…)
Of course the whole interview this morning was not about this. There was a lot more (including, inevitably, Madonna, but I brought my own twist onto this, I thought, with my observation – a major problem I have about overseas adoptions – that they would not be able to have any kind of developmental assessment to get an idea of any difficulties little David might have). Still processing. Output from program may or may not appear here in the next few days.
I think the order of the process is rather different between different agencies, but they sounded like they would be happy to find us a social worker for January, and a place on their February preparation course which, miracle of miracles, does not clash with any of my work commitments. We now have to forewarn our referees…
Thursday, October 19, 2006
Metablog
I very rudely wrote far too much identifying information about one of the very nice women I spoke to on the phone about their adoptions, and as you may have seen I edited that post. People do not like to be identifiable, but adoptive parents especially do not like that, for extremely good reasons. When I started this blog I really wanted it to be a diary, somewhere to spill my thoughts. I don't have huge numbers of readers like Julie or even Thalia, and I don't mind - the occasional bit of feedback is good.
I do post as I say on a couple of forums that have adoption-related discussion and I had put my link on one of them (this one also has fertility stuff, so it seemed particularly relevant) in my profile, but I've decided to take that down. I'm not sure if this is sufficient to return this to the "personal diary, shared with a few" mode - I know I'm on a few blogrolls, but usually they are miles long so it's not like I get a lot of hits from those.
Anyway although this has not been of the scale that others' "outings" have been, the current hoo-ha with Thalia, together with a separate incident in which another adoption blog talked about something I'd been chatting in a PM with another board user about, which made me link them up as the same person, has given me a wake-up call. If you have any suggestions or other warnings, now is the time to make them. I don't want to stop writing, and I want to be informative, but I don't want to be indiscreet or give away too much information about myself, anyone else, or the UK adoption process. I'm going to find and delete the only information (a comment made by me, I think) that enables people to identify me by name, too.
Sunday, October 15, 2006
Some good, some not so good
I heard from a very dear friend who lives in the US and has one son through IVF that she is a) almost certainly coming back to live in the UK and b) expecting FET twins. She was very sweet and said if I didn’t want to mention it she’d understand totally.
We have told quite a few friends about our plans to adopt and they have invariably been very positive - in fact, it has given us some ideas about who might make a good referee (we have to have three each, I believe) based on their comments (although some of them seem to be a little unrealistic about us!) So we thought we should probably tell my mum in case someone else told her, as we were visiting over the weekend. The good news is she says she isn’t going to tell anyone else – though she wasn’t supposed to tell anyone about my first pregnancy, and did…
She was incredibly negative about the whole idea. First of all, she thinks that no children who are not genetically related to us will be any good, to be honest. I have to say this is something I’ve struggled with but we are going to have to get over it. There are nice, pleasant, even bright people in this world who aren’t related to us. Such as my husband, for example. And being highly intellectual is not a guarantee of being pleasant or happy.
I'm not really sure what she thinks our options are - whether she thinks we are doing this instead of getting pregnant. I am not sure I really want to ask, but I know she is not in favour of IVF, so I don’t know quite what she thinks we should do. Wait another two years and hope we actually manage to keep a pregnancy, and if we don’t, then what? Does she think we’re refusing treatment for miscarriage, or that we’ve decided not to get pregnant because we don’t want to have any more miscarriages? I have a feeling even if "old-fashioned" adoptions where young, bright girls gave up their babies voluntarily at birth were still possible she'd probably be against the idea.
But she also seems very set on the idea that adopted children are bound to be extremely disturbed, no matter how good their foster homes, or how little they remember of their birth parents, or how young they are. I have tried to explain that we are consulted at every stage about what types of difficulties we would be able to cope with. We are, I hope, going into this with our eyes open. I also pointed out to her that if you have birth children you have no guarantees - I used the example of autism - she says there's no way we’d have autistic children because we are both normal and outgoing – of course my godmother's family who have a grandchild with Asperger's because they are weird.
As you can imagine I’m not very happy about this! - it's all very well to say "oh, she'll love them when they come along" because I'm not entirely sure she will. As far as I can work out, her opinion is that no-one in her family should have a child with a difficulty or disability, and if you do, you've brought it on yourself - she is really, really negative about the distant family member (my age) with Down Syndrome, despite the fact that she's a happy and loved individual - she says "oh, they didn't have the choice in those days".
I think I’ve been thrown by this partly because of the positive reaction of most of our friends – I assumed she’d be the same – she loves our nieces and can’t wait to see them (although she also can’t wait to say goodbye sometimes!)…
Edited: after Thalia's comment - I don't know which book you've read, but as part of my research is in this area, and there's a lot of recent data suggesting input/environment is MUCH more important than previously thought, and I keep telling my mother this (and have always done so) I can't help feeling like banging her head against the wall and saying "Have I taught you NOTHING?". But strict nativism makes much more sexy copy.
Tuesday, October 10, 2006
A tale of two phone calls (plus a third to come, and several
Last week -phone call to a friend of a friend who lives in the next (vast, rural) county north of us, who has a little boy, aged four, been with them a year, adopted through their Local Authority. As only two women who have never met but have an important subject in common can, we talked for an hour and still had a lot to say. Their adoption procedure sounded boring and long-winded (it might be slightly better with non-LA agency because of how most of the voluntary agencies structure theirs) but ultimately well-run and they are very happy with their little boy. They both work in health/social care fields and had been through fertility treatments and said "no more". Their little boy sounds intelligent, sensitive, and advanced ("Mummy, do octopuses have teeth? How do they clean them under the ocean?"). I asked if they felt the social workers had matched them well to him and they said they felt it had been taken into account that they would be the kind of family to suit a bright and articulate child.
Yesterday - after a bit of trouble arranging it (her husband thinks everyone on the Internet is weird - well, can you blame him) - phone call to a nice woman who posts on two internet fora I frequent (one full of babydust I'm afraid, but very UK-oriented, one full of scary people with children with severe mental health problems, but also helpful in a practical sense). She lives about the same distance from us but slightly nearer Big City. Again, as only two women ..... we talked for an hour and still had a lot to say. They had been through a voluntary agency quite some time ago and their older child was placed with them, and then they had done concurrent placement and had a baby placed with them. Although far more children placed though concurrent placement stay with their adoptive parents, I get the impression from a few different people that social workers minimise this risk, and in their case the child was returned to the birth parents. Another poster on one of these boards whose child stayed with them, I think, said they felt torn between wanting the birth parents to set themselves straight, and wanting them not to, so the baby could stay with them. I'm also not sure whether concurrent placements that result in the child returning to their birth parents will include ongoing involvement in the child's life - most regular foster carers can do this, unless there's something specifically to prevent it. They then adopted their little girl through a LA they don't live in, but who was also quite young (about 12 or 18 months I think). Both children again sound delightful, allowing for the fact that the boy is a teenager! I also asked if the social workers had matched them well to their children, in her opinion - yes, they are always being told the kids look like them.
I am not quite sure if a) the two women understood my question about matching rather differently or b) they have very different priorities in matching and the social workers took this into account or c) they have very different priorities in matching and by chance the social workers got it right. I do know that of all the children I have seen on social work websites/magazines the pair that has stood out most for me was a pair of African descent who were noted to be advanced for their age. I'm pretty sure Mr Spouse would not be up for this particular pair but I guess what this tells me is I don't mind if people don't tell me the children look like us... I know they think about this when allocating donor sperm or eggs, but at this point I suppose what I'm trying to say is it would be a luxury, rather than a necessity.
So I've now got Wednesday afternoon down as my afternoon to ring the first agency - the one that does concurrent placement. Despite the lengthy contact sessions and the risk of the child going back to birth parents, I feel this is a good way to go. I don't think the risk of placement breakdown is any greater than with a regular adoption - although it might be differently upsetting to have a child returned to their birth parents rather than leave because we could no longer handle them or they put other children at risk. It remains to be seen whether our geographical distance from the contact centre can be put aside since our travelling time is no longer than many other much closer families (it's only 10 minutes longer than the woman I spoke to, for example).
Voicemails - mainly to the miscarriage nurse, again, I'm afraid. I finally got the information sheet from the clinical trial but I still want to find out about what happens if my prolactin levels are still too high, can we be tested for the balanced translocation (very rare I know, and probably only in my mind because of Julia, but also I have these niggling doubts about the very high number of only children in Mr Spouse's family), and my acupuncturist keeps on at me to find out if the progesterone cream is OK to use. She thinks not (it could stop the progesterone receptors working, she thinks, and I never specifically asked the nurse, and feel that (though it would be much easier) I cannot lie to my acupuncturist...
[Edited because I had put up some information I shouldn't have]
Friday, September 29, 2006
I am married to a very lovely man
Now, I did think I was doing OK. I found out about the pregnancy (I think she must be about 5 months, but a clever dresser) during a day-long meeting where she was sitting opposite me, and I was OK - bored, but OK. Then when I got home I fell apart. Why does it still hurt? Why was I OK last time I got my period, but not on hearing that this very nice woman is pregnant? Will it still hurt if we have children but they are adopted?
Anyway unfortunately Mr Spouse had gone to see his mum after work and it's a long journey so by the time he spoke to me and realised how awful I was feeling he couldn't get home for a couple of hours. I moped in front of the telly with some soup and some cake and then had a hug when he got home. Today he left before I got up as usual and I'd said I was going to work from home - or possibly even call in sick, but in fact I had a lie in and felt much better so I went in late. And even managed not to have an extra coffee, which normally I need to perk me up when I'm feeling crap. So I got home and found...
a card saying there were flowers for me next door. He had sent me a bunch fo flowers! Isn't he sweet? He says it's in the appendix to the Husband Contract.
Monday, September 25, 2006
I'll let her off
Anyway all the clotting tests are fine but my prolactin was elevated. Apparently this can be due to stress but she'd like to repeat it. She says it isn't related to the miscarriages but they'd like to repeat it. I don't think they would have taken this one before - a quick Google reveals that elevated prolactin can prevent ovulation, but since we know I'm ovulating nicely (had a decent progesterone level in that round of tests on day 24 or so I think, too), that's not the issue. The RCOG guidelines say that evidence linking hyperprolactinaemia with miscarriage is "equivocal". But if it's elevated again I'll ask if it can be treated, I think.
However they don't think there's a clear reason for the miscarriages so they are going to send me a letter about the NK cell trial - but given how slow the wheels of NHS bureaucracy grind, that is unlikely to be this month - apparently the research registrar is only just back from holiday today anyway.
So, I thought that we'd be taking the month off this month but it seems not... which brings up a whole load of adoption-related stuff.. perhaps for another post.
But I'll leave you with what the nurse at the GPs said to me while I was having my smear (why can't they hold the smear stick in one hand while they do the speculum with the other? why do they have to walk off and leave you in pain?). "So, do you have any children already? (no) Oh, did you just start trying quite late (yes, we only got married two years ago- was she going to tell me off for putting it off?)?"
OK, given that she only has my last 4 years' notes, or less, and I only told her the most recent referral to the gynae was for infertility (that part WAS her business), how does she know I didn't have ovarian cancer in my twenties, say??
Friday, September 22, 2006
*(&)$*£@&$)(*
So still no results. I know she's getting my messages because she called me herself early on Tuesday to say she only had half of them and the rest would be available on Wednesday. But she hasn't called me back since.
Wednesday, September 20, 2006
OK, seriously, what AM I?
So, another cycle, another wasted test. It's now 2 years since we started trying to get pregnant. If I calculate it rationally, that's a maximum of 26 cycles (28 days each) but of those I was pregnant for, say, 3, having a break for 2, on medically enforced abstinence for 1 and out of the country for the crucial week of another one. So that's 19 cycles and probably 3 measurable pregnancies. So I would imagine your average infertile would laugh me court of court if I claimed to be infertile too. Even if there were only 2, that's 1 every 9 months. But I don't feel very fertile.
Again, I don't feel as if I've had so many pregnancies and so many miscarriages - not compared to some people - some of whom seem to get pregnant really easily, perhaps that'[s how they fit in so many miscarriages? Or am I just misperceiving the time because time in my world goes slowly, but only reading their blogs it seems to go quickly in their world.
There does seem to be a dichotomy between difficulty getting pregnant and difficulty staying pregnant - I guess I do have both, but it's hard to tell how severe either one is - which will turn out to be the dominant one - will I never get pregnant again? or will I have more miscarriages? or will I be lucky?
If only I knew...
Tuesday, September 19, 2006
It only goes to show, you never can tell
I recently made the online acquaintance of someone who seemed to be in a somewhat similar position to me - worked in a similar field, was married to someone quite a bit older than her, similar age to me, was unable to get pregnant (in her case because of health issues) so was considering adoption (in her case from China). We had emailed a few times and I was going to call her (I had her mobile number) but was away on holiday so somehow never got to it. She then posted on the forum where I knew her from saying her husband had been in a serious car accident and was in hospital, in intensive care, and texted me asking to post that he was going to need more surgery. Shortly following this she posted that he had died.
This upset me, not surprisingly. However, a few hours after this it was posted that she had in fact been an impostor, and had also had several other (and I have to say, much more extreme) personas in the past, so had been removed from the site with immediate effect. Now I'm not sure what to feel. I know that some of the things she told me and/or posted were very similar to my own situation, and were not written after I had shared my circumstances, so it wasn't particularly a case of her singling me out - but it still feels personal. We've had a death in the family, a friend's father has died, a friend my age has inoperable cancer, and to be told that a husband of a friend who is very, very similar to my husband/marriage in salient ways had died was just TOO close to the bone - I was in bits.
I don't know if this (what appears to be a case of Munchausen by Internet) has ever happened in Infertile World, but it seems as if it could easily happen. And it makes you question your grasp of reality.
I did ask Mr Spouse if he was real, but he declined to answer, on the grounds that he'd have to kill me if he told me. We had been watching Spooks...
Monday, September 04, 2006
When can we...
As Thalia just blogged, if you think there is a possibility you might be pregnant/have just had a scan/be just about to have a scan/have just miscarried/be just about to miscarry, then it is hard to plan ahead, especially for major things.
After the last miscarriage, at 5 weeks, just as we were supposed to be going away for the weekend for our anniverasary, and I was supposed to be giving a talk for work also several hours away (the same place, though), I am really scared of travelling while pregnant. But I also know that, if we did have another very early miscarriage, then I'd probably be fine with travelling after a couple of weeks - after the first miscarriage, I went to East Africa and was glad to get away. But I'm also not going to anywhere disease-ridden (especially malarial) while pregnant - and this is totally contrary to my normal inclinations, which are that lots of people get pregnant and give birth just fine and live in such places, and I have access to better medical care than most of them. I'm not planning a home birth in a developing country, don't panic, but I've always been a bit dismissive of nervous Nellies. Now I am one.
So my mind is full of scenarios like: will I tell the student whose fieldwork I'm going to supervise the real reason if I decide to cancel? Would I only tell her if I'm pregnant, but not if I miscarry close to the trip? Would I go if I was 15 weeks (I think that's just about possible)? She knows I've been sick on and off. So perhaps "I'm sick again" would do. But if I was at work, and cancelled 4 weeks before the trip, would that wash? Would my GP even write me a note for the insurance (probably, as it is a malarial area)?
And then, what about the adoption? Mr Spouse has agreed that we will try our luck with the concurrent planning people - no idea if either his or my age, or our distance from their centre, will be an insurmountable obstacle - but they should tell us definitely no, or that we have permission to apply, pretty much immediately. So the plan is to make that initial enquiry towards the end of October, leaving either them or the other agency two months to get the criminal records checks out of the way before starting the proper application early next year. But do we do the traditional "I'm not pregnant AGAIN since I just got my period so I will cut my losses and ring them now" or is that a bit too predicatable? Again, do I wait till my next cycle (not for 3 weeks) to book my Asia flight so I know more clearly the possible options (the 15 weeks pregnant will have been ruled out then, you see).
I really hate this ruling my life by my cycles, and I know I'm doing it to myself. I guess if you have treatment in the equation you just have fewer options for any one date - but you know further in advance which ones might lead to a pregnancy. I know the real answer is "book now, see what happens, don't let anything else be ruled by your cycles", but it's hard.
Thursday, August 31, 2006
I really, really should know better...
I'm also tired and sad - my very sweet but quite elderly and, latterly, fairly sick father-in-law died on Tuesday. I think Mr Spouse saw it coming more than I did, in fact - he's much more of a realist than me.
We spent the Bank Holiday weekend at a festival - we've been going, separately and together, on and off, since 1983 (when I was a little teenager, and he would have been my youth leader!). Being the kind of place where people of like mind and marriagable years get together, there are a lot of couples and babies. I was pretty apprehensive about going - we didn't go last year, as I should have been about 38 weeks pregnant, and we would have stayed away, so didn't want to wander around going "oh, we shouldn't be here". But although there were lots of babies, children, and bumps, I remembered all those years of watching couples, and how happy I am now with Mr Spouse - and tried to trust that we'll be going with our children, one day.
Friday, August 18, 2006
Not too shabby
I asked all my questions apart, I think, from the one about implantation - I am pretty sure I am right about the cramps, since they only started after the first miscarriage (and we were only trying to get pregnant for 3 months before the first pregnancy), and don't happen every month. I don't think our problem is getting the sperm to the egg.
So the story is:
Multiple clotting factor tests, including all the ones that were done before and then some, and lupus etc. - she distracted me while taking the entire arm's worth of blood from my useless vein (I must have been a junkie in a former life) by telling me about the house she is buying where the previous owner was proud of not having hoovered in 17 years. If any are positive they will recommend either aspirin or aspirin plus low molecular weight heparin once I get pregnant. She said she saw where the nice gynae was coming from suggesting I take it anyway, they don't really suggest it but she didn't sound like it could do any harm. They won't do the genetic clotting tests again.
There may be a spina bifida issue. My brother and father have club feet (spina bifida can cause this, or you can have it alone) and there was a question of a cousin with a dimple in her spine. She wants me to take 5mg folate if I get pregnant - she said no need to do it before. I think I may get a prescription just in case, as finding out I was pregnant on holiday, for example, would be needlessly nervewracking. This also counteracts the hyperhomocysteinaemia (MTHFR) so that would be sorted too if I have it.
If all the tests come back negative then they will ask me if I want to be entered into the NKC trial. Since the tests are due back just as my next (but one) period starts (in a month's time) I might be able to get the biopsy done for that in September or October. So it is not all that shabby - she even apologised that they weren't recruiting this month because of too many lab staff being on holiday. So they are only recruiting people who clearly have idiopathic recurrent miscarriage. It being a clinical trial and all. I think they do also recruit from elsewhere in the country, again with a diagnosis of IRM.
I think it is at that stage that they would do a uterine ultrasound too. I'm not entirely clear what they see when they do the laparoscopy, but I would have thought they'd see anything obvious - so I'm not massively worried about that.
They don't do progesterone supplementation - if you have oligomenorrhea they give HcG - but I'm too regular for that.
So, if I see those two blue lines I'm to ring immediately (do not pass go, do not ring Mr Spouse - OK, I think I can ring him!) and they will follow me up. I could, I think, have similar follow up in my local hospital - in fact, it turns out the nice gynae used to work in the Liverpool hospital, as a research registrar - but I think I might use it as an excuse to take more than the odd day off work. I am even thinking of asking if I can go part time for a while (most it can be is 2 months, right?) if (when! when!) I get pregnant again. It does seem as if supportive care is actually the best - and extremly succesfull - intervention for IRM.
I actually feel like there is a way forward - and I have also started to feel more positive about adoption. I don't feel the same urge to get and stay pregnant, though it would be nice. I think that our plan C* (apply officially to adoption agency 6 months after last miscarriage i.e. in November) could still work out, as it is highly likely all my tests will be over by then, and I don't really think IUI is that crucial for us any more.
Things that made me well up yesterday: Seeing an undergraduate student come in with her TWO count them TWO little girls who were both accidents and who mean she's taken 4 years so far to do two years of her degree. Seeing the "baby wall" at the RPL clinic and not believing I'm ever going to have a baby picture to put up there. And then hearing that my father-in-law, in his 80s, is in hospital with pneumonia. The vicar decided he needed to go to hospital, having called round to see them. Mr Spouse (who was also tearful, not surprisingly) is worried he won't come home, because he doesn't think he can. We also worry about my mother-in-law, who is a similar age but more hale and hearty, but who does not tend to go out on her own, as she lacks confidence, so is at great risk of getting very isolated.
*A having been "get pregnant quickly" and B being "OK, we forgot to mention the part about staying pregnant, so let's get pregnant again and keep it this time."
Monday, August 14, 2006
A few links...
This is the Royal College of Obsetricians and Gynaecologists review of care for recurrent miscarriage.
This is very depressing for those of us with older husbands. I sent the link to Mr Spouse but he hasn't commented yet.
This is the four-drug combo study. I think I'd be more impressed if I knew what kind of clinical care the untreated women got - as frequent ultrasound and attendance at an early pregnancy clinic also seem to reduce the recurrence of miscarriage.
and finally this (absolutely, positively not work-friendly) has to be my best search term ever (and a mad search engine, too). No idea what page I'm on as I didn't dare go that far.
Friday, August 11, 2006
Note to self part, er, I don't know
Clotting factors: which tests will they do? Check they are doing the MTHFR as they couldn't do that locally.
Chromosomal factors: when will they test Mr Spouse for the balanced translocation? Can he have the blood taken locally?
Elderly reproductive system factors: is it worth me getting my FSH done again (the gynae said not, since it was only taken in January - I imagine she's right - perhaps next year)? What about an antral follicle scan - would this show a decreased ovarian reserve and would that be affecting the miscarriage?
Immune factors: are they still doing this trial of steroids? Does this require a biopsy? On a) day 21? b) a barrier contraception cycle? This will be yes to a) but no to b).
What about this new study of four-drug therapy for recurrent miscarriage? I realise it was a study with no placebo group but would they approve me trying the treatment? If no, would it do any harm to try aspirin (the gynae said it wouldn't)? Progesterone? (I have actually ordered some progesterone cream, partly because - of course - I hope it will help us conceive, but also because I have heard it's good for premenstrual cramps, which continue to plague me some months).
Which aspects of the therapy (steroids, aspirin, folate and progesterone) could I start at day 14 of my cycle, given our difficulties conceiving? If she says "none", would it be worth going onto the higher dose of folate anyway?
If I have another miscarriage, and it's not too fast, is it worth my having and ERPC to try and test any tissue? Would they be able to keep the tissue locally or would I have to go down there?
Oh, and about those cramps - is it possible they are conception cycles, with attempted implantation?
I'm hoping this is going to be an interactive post - if anyone can think of any questions I should ask, I'll add them in.
Notes from the notes:
I have looked into Foresight, but I think we are doing, or have done, everything anyway (vitamins - though there's no evidence anything except folate helps; stopping smoking - neither of us ever did; testing for STDs - got that sorted; heavy metals in hair - erm...)
Agnus castus - I understood that was for short luteal phases, which I don't have. But I'm prepared to be corrected.
The progesterone cream arrived today (about 6 dpo) and is very, er, creamy.
Wednesday, August 02, 2006
On holiday
One comment recently asked me if it was hard for me to work with children, since we haven't yet managed to have any of our own. Mr Spouse was also asking me why I like volunteering with the Brownies (and why I suggested he might do some volunteer work with children, too), wondering whether I don't find it hard to have to give them back.
In other, not great, news, my work colleague who was going to go for her free IVF round on the NHS has had to cancel. I don't quite understand the protocol, but she says she went for an antral follicle scan (is that right?) at the start of her cycle (do they scan before starting? other people tell me they only scan after stimulation) and they found 3 follicles whereas they were hoping for 15? or is it 15 each side? Her FSH was also quite high - they've never found any problems before. She says she was (understandably) very sad at first but now they have resolved to go ahead with adoption from China. We are going to start a two-woman campain for equality of adoption leave with maternity leave (they recently updated the T&C at work and made maternity leave the same across job grades, but didn't update the adoption leave, which was previously inferior anyway).