Now We're Getting Somewhere

If you've been following along in the incipient stage of this blog and reading my rants and raves, you'll already know that I attribute all of my misfortunes to the NHS rather than my own dysfunctional lady parts. Well ok, not really. But truth be told, I haven't often felt very cared for, or my medical or emotional concerns very attended to in my recent dealings with them. But today, I am here somewhat sheepishly but delighted to (semi)retract my statements of discontent.

This morning we had to make a visit to our GP office to sign paperwork for the referral to a specialist (other than the one I'll finally see in a few weeks to discuss my polyp). We also had to schedule updated CD3 and CD 21 bloodwork, so that's happening.

The appointment didn't start so well. I have been peeved with this process, with the accumulation of too many months of inaction and too many disinterested medical practitioners, and so I think my default mode has recently been one of snarkiness in these situations. So when we sat down with the nurse practitioner to complete the intake questions, and her first one was 'Do you have any children?', my response in the negative - 'That's why we're here'. (Duh.) - might have been a little too far on the brittle crackly side of dry. H silently implored me from over the unsuspecting nurse's head to behave myself if we want to move forward with what we want to move forward with. (He has this whole crazy philosophy of not pissing people off if you want something from them...I know, right?).

OK, so we went through all the questions, reviewed my paltry history - 3 pregnancies, 0 live births - we scheduled the bloodwork. The nurse practitioner was a bit brusque in her manner, but I'm ok with that as long as we get something done. And then while she was sitting there appraising the situation, things started to shift, almost imperceptibly. She said she wondered why we were actually being referred for infertility rather than recurrent loss, because although there are clearly subfertility issues that are preventing us from moving forward, most of these seem to relate to the viability of our pregnancies and not, well, complete lack of conception. Good god, someone who not only actually took the time to read and think through our entire medical history, but who saw fit to analyse it and prescribe accordingly!*  Bells started going off in my brain. We told her that those were in fact our sentiments exactly, but that in our previous location no specialist support had been offered for RPL, and thus we'd been referred for fertility.

(A little background is probably in order here. On our last and only visit with a fertility specialist last autumn, we were told that our problem was not really one of fertility; that in fact we both looked fine in that department and clearly could conceive, and that our real issue was sustaining a healthy embryo/pregnancy. Then this advice was given: the doctor told us that we should keep trying naturally for 6-8 months and if we conceive in that time we should call right away so that we could be provided extra monitoring and support and that they might be able to get to the bottom of why I keep losing babies. Oh no wait that's my best-case-scenario brain talking! What they actually said was if, after a conception, I end up miscarrying again (reassurance and optimism incarnate, they were), we should 'save the tissue in a pot in the freezer so you can bring it in for testing at your next appointment'. Eight months later. Yep. Also, they said that after those 6-8 months - and remember they had just said conceiving isn't the issue for us - we should consider moving straight on to IVF. Whaa? Huh? Anyway, the overall impression was one of a conveyor belt, one-size-fits-all treatment regime. Not reassuring. And clearly not very compassionate.)  

In contrast, the nurse today said that she wanted to make sure we got the appropriate care, and not send us on a wild goose chase. She said to leave it with her and she'd make the right enquiries about where to start. This is, in a word, huge. At that point, as we were getting up to leave, I could already have hugged her. But as we were tripping over ourselves thanking her - you become so grateful of the simplest human gestures in these moments - she said, almost as an afterthought: 'I've been through IVF myself, so I know how important these things are'. She understands! I love this nurse, brusque manner and all. For this one appointment, the first time anyone has paid us and our concerns and our medical issues enough attention to really get things done, I love her. I would book all my future appointments according to her work schedule if I could.

So now we're awaiting a referral that might actually bring us towards some of the answers we need, and more important, a game plan for the future. I don't kid myself; this is still the NHS and that means a big waiting game for now, but to at least be heading in the right direction feels like a watershed. I'll nag about what's happening with the referral when I go for my CD21 bloodwork on Thursday and then, hope that we're on the road. After all this waiting! After so many months of feeling like we're stuck in a pinball machine, being randomly zinged from pillar to post! This could mean more coordinated care with, for example, the specialist I'll see for my polyp removal/investigation, as they're all located in the same women's hospital and often work together. If we do ultimately need to go down the IVF route - realistically, we may still be looking at this later in the year, considering how ancient we are - again, all the care would be coordinated. And the best thing is, with this arrangement, if we were lucky enough to get pregnant on our own, according to my new favourite person, there would be early and extra monitoring available. (First trimester care generally suuucks here, in my experience). Seriously, this is crucial for my emotional health, if not my physical.

After so long kinda spinning our wheels, I'm a little bit hopeful and so heartened by such a simple exchange. This feels like progress. This feels like a beginning...of something.

Fingers crossed. Source.

* Is it just me, or is it often the less acknowledged, more poorly paid professional who steps up on these occassions?