We can now continue with our regularly scheduled programming

Well, I cajoled and pleaded with my uterus to just hurry up and bleed already so that the procedure to remove that polyp would not have to be postponed; and for once, a rant about my disobedient body would be totally unjustified. I'm feeling rather pleased with my uterus for her cooperation, as well as with the overall outcome of yesterday's visit to the hospital.

In brief: I am polyp-free. The procedure itself was slightly more eye wateringly scream worthy unpleasant than I could have imagined - especially since I wasn't advised to take a preemptive pain killer as is usually done with an HSG or whatever - but the pain was short lived. And this whole little debacle can now be relegated to the dustbin of my reproductive organ history (surreal and unfortunate mental image).*

But it gets better. We were actually called into the exam room by the very doctor who I was waiting to be referred to for further investigations on the recurrent pregnancy loss front. (In my experience with such procedures in the UK you don't get anywhere near a doctor, so I was pleasantly surprised off the bat). So far, I have to say I like this doctor very much. He asked us if we wanted to begin with that consultation for RPL as well, since we were already there 'and it saves you a trip'. He then spent the better part of an hour with us, going over our history, the risk factors we might be looking for, what procedures they will undertake to investigate those, and answering all our accumulated neurotic and random questions. He is a high risk OB/GYN, and he thinks our case is best dealt with by their clinic, but he also made a referral to their partners in the sub-fertility clinic 'just to rule everything out and put your mind at ease'. How lovely is that? He had a very calm, clinical approach, but he referred to all my pregnancies as involving babies, and not 'products of conception' or 'tissue'. According to him, since my progesterone levels are consistently strong, there is no reason for worry as yet about my LH levels this past cycle, and said that 38 is still a 'very healthy, perfect age' for having a baby. When our consultation was over and he had removed the polyp, he personally walked us all the way to the phlebotomy lab where we had our blood drawn. This guy gets lots of points for approach and effort and awareness so far. H and I both felt listened to, reassured and genuinely cared for, and that makes all the difference in our feelings of optimism for this road we're walking. 

We both left with a renewed sense of direction and calm, and for however long that lasts (see all the previous posts I've ever written on that likelihood), we'll take it. I said as much to H, that - based on what the doctor had said - I feel renewed in my determination to carry on carrying on for now and try to see no reason why things might not, for once, swing our way after all this time. H pointed out that this had been his message all along and that he was glad I was at least willing to listen to someone. Well yes, while I appreciate - indeed, crave - his optimism and certainty, it is also nice to hear those messages of reassurance from someone with training in something other than, er...political science.  

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And just like that, my birthday is around the corner. Last year, we were still living in Portugal, and we celebrated here, eating freshly caught fish al fresco and swimming outdoors. In March. (I really miss that place).

Of course I had no idea then that a whole year would pass and we'd be...I am tempted to say 'no closer to where we want to get', but when I think about it, there are so many ways in which that's not true. No, we still aren't parents to a living baby. But we're more solid in our determination as a couple to achieve that goal than we have ever been. We both know where we want to go, even if we're not there yet. And maybe, medically speaking, we're even going to get some of the support we need.

So for now at least, my duvet diving days are on hold, not least because we have more than a week of travels and visits and lovely cultural enjoyments to take in. This evening my mother arrives to join us for a celebration of my actual birthday, which will be spent here enjoying four days of long coastal walks, windswept beaches, fresh seafood, exploring castle ruins, and dinner in a real treehouse. After that, we're home for scarcely a day before heading out once again, just the two of us, to partake of some more urbane pleasures, the details of which remain a carefully guarded mystery to me, but which will involve three nights in London, likely visits to galleries, probably (if I have anything to do with it), a stroll through one of my favourite places to hang out in the whole city, and certainly prosecco.

H's penchant for meticulously planned decadent surprises remains unstoppable. When, post-freak out last week, I told him I didn't want to celebrate my birthday this year, as I was starting to see it as nothing more than a cruel reminder of what we haven't managed to achieve, he replied that we don't need to make it about birthdays or the progression of time at all, but that he wants the opportunity to stop the clocks, be in the present, and celebrate me. 

And if I intend to stick with the attitude I embraced post-hospital yesterday, I suppose there is nothing wrong with the enjoyment of some very grown-up pleasures and moments of joy (I have to work harder to stay true to the header of this blog), especially as jungle time will definitely fall in this period, and there's always the hope that such grown-up jaunts may become a thing of the past for us in the not-too-distant future.

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Friends, thank you for all your kind words and thoughts through this tough past week. Your lovely, warm messages of camaraderie and understanding allowed me to feel very much buoyed, and a little bit less crazy in my moments of melodrama. I hope that whatever you have planned this weekend, it includes brief moments of joy, opportunities to stop the clock and celebrate you. Because I think you're pretty awesome.

* I am sure you'll think I'm ridiculously melodramatic for spending as much time in print as I have on this topic. You'd be right, but in the absence of anything resembling even the hint of the promise of a future baby on what might otherwise be considered a ttc blog, perhaps I felt obliged to discuss lady parts. I know that a lot of you lament the lack of education we otherwise highly educated women have about our own bodies, but I for one really really wish I wasn't this interested in my own cervix. Just saying.

On Second Thought

Remember how I counted this cycle as done and dusted earlier this week? Well now I'm not even sure if it's ended, and I have to say I am totally confused. I posted that update on Thursday because I had all the usual PMS-ish symptoms - bloatiness and cramping and general blech feelings, sore boobs, fatigue, 30 second emotional meltdowns of the I-will-never-parent-a-living-child variety - that always indicate Day One is on its merry way. By Wednesday evening I had already begun the mild spotting that has become pretty typical since my third loss.

And so I sat, wallowing under the duvet, and I waited. And waited. And nothing really happened.

And before we get unreasonably enthusiastic about the possibilities herein, let me rule out the prospects for anything approximating a pregnancy in the works. Zero. A gazillion negative pregnancy tests concur on that. Well, ok, it was five; but all different brands and all at different times of day - for the sake of triangulation - with the last this morning, just to rule out the possibility (and potential new source of worry) of a late implanter.

I actually had a very faint line on the first test I did on Monday afternoon, but it didn't appear until a good thirty minutes after use*, so in light of that and the subsequent mounting evidence, I'm guessing it was an evil evaporation line. 

At first I worried that the late arrival of my period would clash with the long awaited and finally nearly here procedure to remove my cervical polyp. But, then.

By Friday evening all those predictable symptoms seemed to have dissipated, and now I'm just....sitting here, confused. Not bleeding.

Now I'm sure for many of you who have experienced irregular or anovulatory cycles this might all sound like nothing. (Obviously, it's nothing. Literally). And maybe you can add your two cents and provide some insight as I await the call to my doctor tomorrow morning. However I have always been a pretty standard and predictable 28 day kind of girl.

Fourteen hours of spotting, bloating and sore boobs. I probably even thought that coming here and recording all this on the interweb would help me get things in order and find some clarification. But no, I'm still confused. Was that a period?

Aaaahhhgg! How does all this work if I can't count a Cycle Day? Does not compute!

Source.

* I always think this gives a special insight into the insanity that is my hoping-to-be-pregnant brain. Is there any other item on which you have recently urinated that you would want to save for future reference?

Well, I'm glad I asked then!

In all the recent excitement about presents and awards and wondrous surprises, both random and rather more expected, I have completely overlooked the report on my last doctor's appointment. (Because the internet provides me nothing if not the folly that other peoples' thoughts besides my own spin around the state of my cervix). But well, really, that's also because there's not much to tell. Nonetheless, read and rage with me a moment, won't you?

So I made it to my GP's office (because in this land of NHS referrals you don't get the opportunity to speak directly to a specialist and just ask the straightforward question pertaining to the procedure you're due to have in a mere five - ok, three now - weeks) to discuss the relationship of the surprise discovery during my recent cervical exam to this current cycle.

We're at a new(ish) practice, and you get seen by whoever's on that day, and our conversation with that day's whoever (because honestly, I had trouble believing that her medical qualifications were earned anyplace but the DeVry Institute of Technology*) can be summarized as follows:

Any number of questions I had...

Could this polyp, and not, as I had been told, my miscarriage last August, account for my wonky cycles the last several months?

Do they often materialize that quickly? (Remembering my HSG and uncountable pelvic exams in the last six months)

Will this jeapordize our ttc attempts for the coming cycle?

If we were to become pregnant, could it put the pregnancy at risk?

...were met with a stock answer:

'Again, I really don't know. That's something you'll have to ask the specialist'. In a mere five three weeks. After this cycle has come and gone. Seriously, I've never heard such a continous string of 'I don't knows'.

So yeah, that happened. Thanks for comin' out folks.

The good news is that the results from the original smear test came back normal, meaning there is almost certainly nothing of concern with regards the polyp itself. That was really scary, so...Phew. I'm still hoping ('cause hope springs eternal) to get some insight into how this may be implicated in (and potentially even resolve) our struggles to conceive over the last months. But - as I've been reminded again and again by my caregivers (let's use the term loosely) - that will have to wait.

So I'm hoping, in the coming days and weeks** for more little surprises, or at least shiny things, to keep me busy.

Feel like I'm hitting one. Source.

* If you actually earned any of your degrees there, and are reading this...Well, sorry.


**Because there's also that other, more familiar kind of waiting just around the corner.

Are you listening NHS? No, I thought not.

I should probably preface this post with the statement that I am, as a proud and grateful Canadian, 200% in favour of totally free, totally accessible universal healthcare. And, with roots as deep in this country as in my country of birth, and having spent many formative and happy years of my adult life here, I can also say that I'm something of an anglophile. Actually, it's for that reason that I feel the need to post an angry missive. (I did warn about my rants on perceived social injustice).

I'm so angry for all of us - in this community in particular - that in a country like the UK, with £1000,000s worth of technology at our disposal and a huge knowledge based economy full of specialists and highly trained individuals, that poor attitudes continue and bad practices can so negatively effect the quality of care. I'm speaking particularly of obstetrical, gynecological and prenatal care here.

When I read reports like that in last weekend's Sunday Times - indicating that many NHS staff don't trust their own facilities - and which, more importantly, told the story of a woman who was informed by hospital staff of the high likelihood that her baby had died in utero, but then that she'd have to come back on the following Monday to confirm it because the ultrasound department only operates weekdays, (I'm not making this up)....Well, what can I say? It makes my heart break, my blood boil and yet it's all too familiar.

When I first realized something was up while carrying S, I called the Early Pregnancy Unit (which is meant to exist precisely for such moments) at my then local hospital, to be told that, at under 18 weeks, 'there would be little we could do, so try and enjoy your evening (!!!) and if the problem persists call us back tomorrow'. Again, not making this up; a prenatal care nurse actually said that to me. It was my first pregnancy, so I didn't quite realize at the time how appalling that truly was (though I've kicked myself so many times since for the fact that I didn't. Oh, the guilt). As true as it might be (though in some cases not), that a pregnancy at just under 18 weeks is far from save-able, do they not understand the notion of person-centred care? Do they not appreciate that we are not merely carriers of life they sometimes hardly seem bothered to acknowledge, but also whole people with concerns and fears and hopes of our own, and that we deserve care and empathy for all of that too?

The hospital in question in the article, in a neighbourhood of south London very near to where I once lived, offered a formal apology after the case was included and published in the wider research report.

And the NHS wonders why the UK has one of the highest stillbirth rates in all of Europe? Pretty scary. Of course the sad truth is that many losses (including, probably, my own), are not preventable, even with the interventions of modern medicine. Some causes (particularly the 'unexplained' variety) of infertility are not easily treatable. But that doesn't mean that when we place ourselves, our hopes and dreams and fears in the hands of those we trust to care for us, that they cannot display a minimum of compassion, even when their hands are tied so far as intervening goes. Sadness and disappointment in such cases are inevitable, but they can be minimized if treated with kindness. Successful medical treatments almost invariably contain an element of psychological and pastoral care as well as biomedical. I'm not just speaking from the experience of a patient; in my profession I know this also to be true.

It makes me so angry on behalf of all those lovely, loving, resilient and brave women and men I know here in the UK, struggling to conceive and then often struggling through scary, difficult pregnancies to bring home healthy babies they desperately want to care for. They deserve so much better. This country deserves so much better.

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In tangentially related news, I received my appointment letter from the GYN clinic with a date of 14 March for my necessary colposcopy. Yeah, they were quite literal about the 'emergency' six week wait, almost to the day. I'll speak to my GP tomorrow about how that might affect our attempts for trying this coming cycle.

The letter itself arrived a mere three days after my initial exam. So I guess they're pretty efficient with correspondence, if not treatment.

Shaking my angry fist. Source.

Panic averted ,and gratitude

Really, thank you all for stopping by to commiserate and becalm my fears yesterday. It was really just what I needed to hear. After taking a while to chill out yesterday afternoon, and heeding the wise and warm advice of Kimberly and JenS (thank you ladies!), and just the right approach from H (more of which in a moment), I was able to calm down and see this diagnosis for what it is. That is to say, really truly, probably nothing. And a little research this time did actually help to assuage my panic.

Some sites (oh ok, wikipedia) suggest that only 1% of polyps are malignant. Then there is this probably more reliable but slightly less reassuring site, which observes that polyps are 'often benign' (how often we don't know, because like good medical professionals and unlike wikipedia, they don't want to play the numbers game). Thing is, I don't have any of the symptoms they're outlining, which I'm thinking is a good thing.

There are a few particulars about this situation though that probably help to explain my strong reaction. Firstly, my complicated medical history; namely the fact that I am already a cancer survivor, (yes, babyloss mom and 'terminal' cancer survivor...I sure can't complain that life has been boring, however much I wish I sometimes could! But I'm getting off track, and that's a whole different post). The fact is, the statistics for any potential malignancy, for the rest of my days, are slightly skewed, slightly different for me than they would be for someone who had never been previously diagnosed. Not terrible, but slightly higher. In my past GP practices they would have flagged this immediately, but (again, lovely NHS), these new doctors since my return to the UK seem not to be concerned. OK, I guess I'll have to deal. I can do this.

But more to the point, and something to which I am sure readers of this blog can relate, it's the uncertainty of the waiting as it relates to ttc, infertility, and those monthly hopes-too-often-dashed by what can feel like piles of random bad luck. This is something I have a little more trouble dealing with. You see, a little more basic research (touchingly conducted by H) revealed that cervical polyps, even if they cause no real health risk to a woman, can cause problems with fertility because they interfere with movement of sperm through the cervix as well as implantation, and that if you do conceive, you may be at a heightened risk of miscarriage. Suddenly a whole new set of red flags are going off in relation to my more recent history...

Now the thing is, I last underwent one of many pelvic exams back in November of last year, prior to an HSG which showed no abnormalities with either my tubes or uterus (other than a small, apparently inconsequential fibroid). No one mentioned anything about my cervix. So this leads me to a new set of musings, that go something like this: either I've been dealing with medical practitioners so careless as to have thought that for a woman undergoing subfertility testing and experiencing recurrent miscarriage, cervical polyps were not worthy of note (!!), but treatment of which, had care been directed otherwise, could possibly have averted our months upon months of fruitless ttc and at least my most recent early miscarriage last August (I know, I know...all those 'what ifs'...). Or if not, then this sucker just sprung from nowhere and grew quickly. And maybe I'm still overreacting, but neither is an option that really allays my concerns in relation to baby making.

Why does this all have to be so complicated for some of us?

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In any case, H had just the right words to dissipate this feeling of uncertainty and worry last night. I had called him at his office to rant discuss the situation, and when he arrived home, bunch of cheery tulips in arm, he was armed with lots of information on the link with infertility/miscarriage. (Sometimes his slightly obsessive penchant for planning comes in handy). He pointed out that while it's frustrating to think back on time we might have 'wasted' (is there really such a thing?), on the up side this looks like a potentially simple answer for some of the weirdness and disappointment we've experienced in recent months. He may have a point there. It would be great if that annoying little thing provided us with some answers, if for once things really weren't that complicated.

I'll continue waiting for the letter with my appointment to arrive, along with that other wait. Luckily I have a date with my husband tonight, which gives me the excuse to sparkle a bit, and lots of hiking planned for this weekend, if the weather holds. (And if need be, I have this space to pour my fears and worries). So really, things aren't bad at all.

Blooms to bring spring to my worried soul

Oh f%#k

Right about now, I could be writing a witty post about surviving the travails from deep within the two week wait (I'm halfway through). But this is not that post.

This morning I went for a routine smear test, and while down there, the nurse found a polyp on my cervix. She said it was 'probably nothing to worry about', but I could tell by her reaction on finding it that she was a bit freaked out; she admitted never having seen one before. (Perhaps I shouldn't have asked?) I'm being referred for a colposcopy so a specialist can have a better look, and won't know anything more until then, I guess*. I'm resisting the urge to goo.gle the hell outta this thing, I know it'll only make me feel more anxious.

Come on universe, can you not just cut me some slack here? Once upon a time, I used to love and worship my body like it were a goddess temple, but nowadays I'm not so sure it deserves quasi-divine status.

It's probably nothing, they said.

But seriously, what if it's not nothing? All of a sudden, this has turned into an altogether different kind of waiting.


*Thanks to the wonders of the National Health Service here in the UK, according to my GP practice, any colposcopy referral will be treated as an 'emergency' case. Which means I have to wait only...oh, just a maximum of six weeks.



I'd totally do it, if I thought it'd work